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Biomedical subjects

B Jereb

Publications and source records attributed to B Jereb.

At least 19 recordsLinked to original sources
PubMed1992

Concurrent vinblastine and radiation therapy in bladder cancer.

BACKGROUND: Since mid-1987, 29 patients with invasive transitional cell carcinoma of the urinary bladder (T1-3 N0-X M0) were treated with concurrent radiation therapy (RT) (target dose [TD], 62-66 Gy) 1.8-2.0 Gy/day for 5 days a week with a break in the middle of treatment of 2-3 weeks and vinblastine weekly 2 mg/5-12 h intravenous infusion. METHODS: Patients were divided into two groups: those had only the initial therapy (Group 1) and those who had both courses of RT combined with vinblastine (Group 2). Patients eligible for cystectomy were selected for full-dose RT, according to the results of treatment with a TD of 36 Gy. RESULTS: Tolerable toxicity rates were noted. No patient was excluded from the study. The authors report a clinical complete remission rate of 71% at early evaluation of treatment and a 3-year local progression-free survival of 66% (for Group 2 patients). These results are comparable to those obtained with more aggressive chemoradiation therapy regimens. The authors also noted improved local disease control in patients who received combination therapy in comparison with the 17 patients treated with RT alone. CONCLUSIONS: The authors suggest that concurrent RT and vinblastine therapy is an attractive alternative to other chemoradiation therapy regimens, and is especially superior to RT therapy alone in caring for old patients or patients in poor general condition.

Adult↗
PubMed1991

Human leukocyte interferon alpha (HLI-alpha) for treatment of pleural effusion caused by non small cell lung cancer. A pilot study.

Fourteen patients with ipsilateral pleural effusion from non small cell cancer of the lung, 10 of them with generalized metastasis, were treated with local application of HLI-alpha in addition to other symptomatic treatment. Cytology of pleural fluid at the beginning of treatment yielded cancer cells in all but one. HLI-alpha, 2 x 10(6) International Units (I.U.) diluted in 20 ml of distilled water was injected intrapleurally each time. The mean survival of the HLI-alpha treated patients, measured from the first treatment of the pleural effusion, was 10.8 months. The performance status improved in 9 patients following HLI-alpha treatment. The pleural effusion eventually ceased accumulating in all patients. To judge from cytology of tapped pleural fluid, the cancer cells disappeared during treatment with HLI-alpha in 11 patients.

Aged↗
PubMed1990

Intracranial germinoma: report of seven cases.

Seven children with histologically verified intracranial germinomas, treated between 1983-1987, are reviewed. The four boys were 12, 14, 15, and 16 years old; two girls were 9, and one girl was 10 years old. Four tumors were suprasellar, and three were in the pineal region. Parinaud's sign was the first symptom in the pineal tumors and diabetes insipidus in the suprasellar ones. The latter four patients also had pituitary deficiencies. The tumors were totally removed in three patients, partially in three, and one patient had biopsy only. Two patients had disseminated tumor. All patients received radiation: four to the tumor bed, one to the whole brain, and two to the whole central nervous axis (CNA). The doses to the tumor were 30 Gy in three, 40 Gy in two (one whole brain), and 45 Gy in two. The dose to the CNA was 24 Gy. Five patients had chemotherapy as well: cyclophosphamid (cytoxan) 80 mg/kg in two doses, three times in 3-week intervals. All patients are alive and well. Total disappearance of tumor followed chemotherapy before radiation in three patients. Lower doses of radiation (30 Gy, 40 Gy) and irradiation of the tumor bed only were sufficient for tumor control in localized germinoma.

Adolescent↗
PubMed1989

Controlled trial of the prophylactic administration of antibiotics in sclerotherapy of esophageal varices.

The aim of this controlled trial was to determine the usefulness of chemoprophylaxis in sclerotherapy of ruptured esophageal varices. Sixty patients bleeding from esophageal varices, without signs of infection at admission, were included in a randomized open trial of one-year duration. Thirty patients received, along with the usual standard therapy (infusions, transfusions) 4x1 g ampicillin intravenously over 3 days, and 30 patients received the standard therapy only. Bleeding varices of the esophagus were sclerosed transendoscopically intravenously using 1% polidocanol solution. Body temperature, general condition, white blood count, differential blood count and sedimentation rate were followed-up over three days. There were no statistically significant differences between the groups in the mean values of the mentioned parameters. There was no correlation between the dose of sclerosant used and body temperature or leukocyte count. Chemoprophylaxis proved to have no effect in this indication.

Adult↗
PubMed1989

Intratumor application of human leukocyte interferon-alpha in patients with malignant brain tumors.

Seventeen patients with malignant brain tumors have been treated by local application of human leukocyte interferon-alpha (HLI-alpha) in addition to radiation; eight of these patients also received chemotherapy. Twelve patients were treated for primary tumor and five for recurrence. After partial removal (or biopsy), an Ommaya reservoir was placed with its catheter in the tumor cavity, and 3 Gy was given to the whole brain in 2 weeks with a local boost of 1.5 Gy in 1 week. During radiation therapy HLI-alpha (2 x 10(6) U) was given through the Ommaya reservoir two or three times per week. Vincristine (2 mg) was given during radiation therapy weekly and in combination with cisplatin (60-80 mg) every other week. Four patients are alive and well 11, 14, 15, and 30 months after treatment and 5 have died without tumor. The fact that the patients did not survive despite the effective local tumor control suggests that, at least in some of them, degenerative changes in the brain tissue as a result of the combined treatment might have been the cause of death.

Adult↗
PubMed1989

[Early detection of colorectal carcinoma using the Hemdetect Test].

Cellular immunity was examined by two methods in vitro: absolute number T and B lymphocytes (E.T. and E.A.C. rosettes) and by the lymphocyte transformation test, in 280 patients with psoriasis (83.5% with psoriasis vulgaris and 16.5% with other forms of psoriasis). No statistically significant changes were found in comparison with the control group.

Adult↗
PubMed1987

Intrapleural application of human leukocyte interferon (HLI) in breast cancer patients with ipsilateral pleural carcinomatosis.

Seven patients with ipsilateral pleural carcinomatosis from breast cancer were treated by intrapleural application of a crude interferon-alpha (IFN-alpha) preparation (HLI). In 4 patients, previous systemic treatment had been without effect, and 3 patients had recurrence after initial remission. Pleural carcinomatosis was confirmed by cytology in 6 patients and by histology in 1 patient. HLI was given in doses of 2.2 X 10(6) IU two to six times. The effect was evaluated by cytological examination of the pleural fluid; malignant cells disappeared in all six patients who were evaluable. Pleural fluid, while not totally resolving, did not accumulate further after HLI. Disseminated tumor was present in all at the time of eventual death. No tumor was found in the pleura at autopsy of 2 patients and the pleural fluid was free of malignant cells at the time of last follow-up examination in the 4 others. These results seem to justify further investigation on larger groups of patients with better technique of application.

Adult↗
PubMed1986

Radiation and chemotherapy of parameningeal rhabdomyosarcoma involving the orbit.

Eighteen patients with parameningeal rhabdomyosarcoma (RMS) involving the orbit were treated at Memorial Sloan-Kettering Cancer Center (MSKCC) between July 1971 and October 1983. Fifteen patients were children with a mean age of 6 years and three patients were adults with a mean age of 21 years. In four patients, the primary tumor originated in the orbit, while the remaining 14 had other parameningeal primary sites. The tumors were in a very progressive local stage, with destruction of facial bones in most patients. Six patients were treated with the T2 chemotherapy protocol and 12 received the T6 protocol. The radiation treatment plan for all patients was designed to deliver between 4500 and 7200 rad delivered to the primary tumor over 4 to 16 weeks. Eleven of the 18 patients (61%) are alive and well with a median follow-up time of six years. Two patients died of therapeutic complications and five died of tumor spread with central nervous system involvement. Ocular complications included acute and chronic conjunctival, corneal, lens, and retinal changes, which were less severe than those reported in previous series.

Cataract↗
PubMed1986

Abdominal recurrences in Wilms' tumours: a report from the SIOP Wilms' tumour trials and studies.

The Wilms' tumour trials and studies conducted from 1971 to 1980 registered 1042 patients. Of these, 82 patients developed an abdominal recurrence. Particulars of these were studied. Half of the recurrences occurred in stage III patients. Often several untoward prognostic factors could be identified, such as large tumour size, difficult operation, incomplete excision, peritoneal adhesions or metastases, tumour extending to renal vein or vena cava. A tumour rupture increases the chance for an abdominal recurrence, especially if appropriate radiotherapy is not given. In many of these cases, postoperative radiotherapy seems to have been insufficiently tailored to the operative findings. For stage III cases, a careful discussion between surgeon, radiotherapist, and pathologist should lead to the optimal radiotherapy field size and dose for each individual patient, so that the risk of abdominal recurrence can be reduced.

Abdominal Neoplasms↗
PubMed1986

Redefined role of radiation in combined treatment of Ewing's sarcoma.

Eighty-six patients with Ewing's sarcoma were analyzed as to the role of radiation therapy. Fifty-eight patients (P group) had removal of the involved part of the bone after preoperative chemotherapy, and 28 (NP group) had local treatment either at the same time or before chemotherapy. Thirty-six of 58 P-group patients (61%) and 13 of the 28 NP-group patients (48%) are alive. Five of 48 patients in P-group, who had postoperative radiation, had local recurrence, as did 6 of 11 without postoperative radiation, a statistically significant difference (p = 0.001).

Adolescent↗
PubMed1985

The incidence of herpes zoster in patients with Hodgkin's disease. An analysis of prognostic factors.

The incidence of zoster in 717 patients with Hodgkin's disease was determined by a retrospective chart review. All patients had been treated and followed in one of six cancer centers. Prognostic factors that might predict the subsequent incidence of zoster were examined by univariate and multivariate analytic techniques. Intensity of treatment was a key factor in the incidence of zoster. Thirty-six months after initiation of treatment, patients receiving chemotherapy-radiation-chemotherapy had twice the attack rate (27.3%) of those receiving radiation alone (11.5%). The pediatric age group had a significantly higher attack rate (26.6%) than did adults (18.7%). Stage, histology, and laparotomy did not influence the incidence of zoster.

Adolescent↗
PubMed1985

Parameningeal rhabdomyosarcoma (including the orbit): results of orbital irradiation.

Twenty-three patients with parameningeal (including orbital rhabdomyosarcoma (RMS)) were treated at Memorial Sloan-Kettering Cancer Center (MSKCC) between July 1971 and January 1983. Twenty were children with a mean age of 6 and 3 were adults. In 6 patients, the primary tumor was from the orbit, whereas the remaining 17 had other parameningeal primary sites. The tumors were in a very progressive local stage, with extensive destruction of the facial bones in 19 patients. Eight patients were treated with T2 chemotherapy protocol and 15 received T6. Seven patients received 5,000 to 7,200 rad delivered to the primary tumor in 11-16 weeks, 15 patients received between 4,500 to 5,000 rad in 4-7 weeks, and 1 patient received 3,000 rad in 3 weeks for residual microscopic disease following surgery. Two patients were treated with radiation to the whole brain; no patients received radiation of the whole central nervous axis (CNA). Fifteen of the 23 patients (65%) are alive and well with a medical follow-up time of 5 years. Two patients died of therapeutic complications and six died of tumor spread. In five patients, involvement of the central nervous system (CNS) was the cause of death. The prognosis of orbital RMS with parameningeal involvement is no better than in other tumors of parameningeal sites. In those patients who had impaired vision because of optic nerve damage prior to treatment, the vision did not improve following treatment. There was no impaired vision seen due to radiation damage of eye structures except in the lens.

Adolescent↗
PubMed1985

Therapy of CNS leukemia with intraventricular chemotherapy and low-dose neuraxis radiotherapy.

Successful treatment of CNS leukemic relapse has been frustrated by frequent local recurrence and eventual marrow relapse. We describe the treatment of meningeal leukemia in 39 children with intrathecal remission induction followed by the placement of an Ommaya reservoir to facilitate the administration and distribution of chemotherapeutic agents into the CSF. Six hundred or 900 rad of craniospinal radiation and maintenance intraventricular and intrathecal chemotherapy was then administered. Systemic reinduction therapy was added in the later cases. Sixteen children (41%) experienced no further events, with 17+ months to 13+ years (median, 25 months) follow-up . Eleven patients (28%) had CNS recurrence, nine (23%) bone marrow (BM) relapse, and two (5%) testicular relapse as the next adverse event. The course of patients with first isolated CNS relapse differed from that of the others. Eleven (69%) of 16 patients treated for first isolated CNS relapse are alive and 9 are event free, while only 35% of patients whose CNS relapse occurred simultaneously or after recurrent disease at other sites are alive (P = .04). Seven of 23 in the later group are event free. The difference is due to the increased incidence of BM relapse in the later group (30% v 6%; P = .04). For patients with first isolated CNS relapse, the life-table median CNS remission duration is 42 months. The projected CNS relapse-free survival and event-free survival 8 to 10 years after CNS relapse are 40% and 32%, respectively. Headache, nausea, and emesis of short duration were frequent during therapy. In three patients, the reservoir had to be removed for infection. No patient suffered neurologic deficit related to the reservoir. The therapy described can reduce the CNS relapse rate with manageable toxicity. Systemic relapse is still a major problem after multiple CNS relapse and in those in whom the CNS relapse follows or is simultaneous with relapse at other sites.

Adolescent↗
PubMed1979

Radiation in multidisciplinary treatment of children with malignant ovarian tumors.

Thirteen girls with malignant ovarian tumors treated at Memorial Hospital from August 1971 through October 1975 with extensive surgery, multi-drug chemotherapy (T-2 protocol) and postoperative radiation were reviewed. The plan of radiation was to deliver 3,000 rads to the whole abdomen and boost the para-aortic and pelvic area with 1,500 rads in five to six weeks. In only two patients was the radiation conducted as planned. In others the treatment was either interrupted or discontinued due to complications. Four of the thirteen patients are dead. The cause of death in two of these patients was distant metastases; the two other patients died without evidence of tumor due to treatment complications. Three of the nine patients who are alive without evidence of disease have late complications. Following radical surgery, lower doses of radiation given concomitantly with T-2 protocol chemotherapy seem to be sufficient for controlling the disease.

Adolescent↗
PubMed1978

Thin needle biopsy of solid tumors in children.

Thin needle biopsy of a suspected tumor will usually yield material amenable to cytologic examination and sufficient for diagnosis. Sixty children with suspected solid malignant tumors were subjected to this procedure. The masses biopsied were in bone, abdomen, mediastinum, tongue, pharynx, soft tissue, and peripheral lymph nodes. The diagnostic yield was 66% on first biopsy and rose to 93% on repeated biopsies. The diagnostic accuracy was 97% in malignant tumors with histologic confirmation. There were no proved false-negative diagnoses, and two (3%) false-positive (for malignancy) diagnoses. All patients were followed up. There were no complications of note.

Adolescent↗