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Biomedical subjects

C F Mountain

Publications and source records attributed to C F Mountain.

At least 73 records · Page 4Linked to original sources
PubMed1981

Chemoimmunotherapy of small cell bronchogenic carcinoma with VP-16-213, ifosfamide, vincristine, adriamycin, and Corynebacterium parvum.

Thirty-five consecutive patients with small cell bronchogenic carcinoma (SCBC) received chemoimmunotherapy with VP-16-213, Ifosfamide, vincristine, Adriamycin, and Corynebacterium parvum. Of 33 evaluable patients, 26 (79%) responded with complete (55%) or partial (24%) remissions. Complete remissions were more common among patients with limited disease (11/14 patients, 79%) compared with those with extensive disease (7/19 patients, 37%) and among patients (11/14 patients, 79%) compared with those with extensive disease (7/19 patients, 37%) and among patients who were ambulatory prior to therapy (16/25 patients, 64%) compared with those who were nonambulatory (2/8 patients, 25%). Myelosuppression consisted primarily of neutropenia. Eight percent of the treatment courses in 29% of the patients were associated with hematuria and/or documented episodes of infection during neutropenia. There were three deaths possibly related to treatment, in two of which there was no evidence of disease at post-mortem examination. Six patients relapsed in the central nervous system (CNS). In four instances, CNS relapse was the only site of tumor progression. Central nervous system relapse was more common among evaluable patients who did not receive prophylactic brain irradiation (5/17 patients, 29%, vs. 1/15 patients, 7%; P = 0.23). The median survival duration for all patients was 63 weeks, being slightly longer for patients with limited disease than for those with extensive disease (70.9 weeks vs. 56 weeks; P = 0.18). This was also true for patients who achieved complete rather than partial remissions (71 weeks vs. 50 weeks; P = 0.09). Patients receiving prophylactic brain irradiation experienced longer survival (100.8 weeks vs. 48 weeks; P = 0.01).

Adult↗
PubMed1981

Role of intravenous hyperalimentation as an adjunct to intensive chemotherapy for small cell bronchogenic carcinoma.

Forty-nine patients with small cell bronchogenic carcinoma (23 limited and 26 extensive disease) received their first two of three courses of intensive remission induction chemotherapy with (21 patients) or without (28 patients) intravenous hyperalimentation (IVH). The chemotherapy included six remission induction courses with ECHO (epipodophyllotoxin VP-16-213, cyclophosphamide, hydroxydaunorubicin, oncovin), followed by six courses of maintenance with PRIME (procarbazine, ifosfamide, methotrexate). Prophylactic brain irradiation (3000 r/2 weeks) was given to all patients and those with limited disease received chest irradiation (5000 r/5 weeks) at the completion of ECHO. Thus far, all 30 patients who have completed three courses of ECHO have responded with complete (70% CR) or partial (30% PR) remissions. The CR rate was higher for patients receiving IVH (85% vs 59%, P = 0.25). Myelosuppression was pronounced and predominantly in the form of neutropenia. Median lowest neutrophil counts were zero during each of the three courses of ECHO and lasted a median of 5 days at levels less than 500/mm3. Major infections occurred in 21% of courses. The administration of IVH did not ameliorate the hematologic, gastrointestinal, and infectious morbidity of ECHO chemotherapy. However, it resulted in preservation of body weight (P less than 0.01) and improved skin reactivity to a battery of six skin antigens (P = 0.03). The administration of intensive therapy with ECHO +/- IVH was well tolerated and resulted in high CR rates in patients with small cell bronchogenic carcinoma. The administration of IVH was most helpful in preventing severe weight loss and augmenting response to a battery of skin antigens. The long term survival effects of these observations are yet to be determined.

Adult↗
PubMed1980

Chemotherapy of extensive large cell and adenocarcinoma of the lung: a randomized trial in 210 patients.

Two hundred ten patients with advanced adenocarcinoma of the lung were entered into a two-arm randomized trail. Cytoxan + CCNU + methotrexate was compared to Adriamycin and procarbazine. The tumor response to CCM was significantly higher than the tumor response to Adriamycin and procarbazine. No significant difference existed between the two treatments with respect to survival. Initial performance status, weight loss prior to therapy, and response to therapy were all found to be significant prognostic factors. Median survival time relative to responders in both treatment groups was 31.7 weeks and 15.8 weeks for non-responders.

Adenocarcinoma↗
PubMed1980

Predicting loss of pulmonary function after pulmonary resection for bronchogenic carcinoma.

Studies of regional pulmonary function using radioactive 133xenon gas and spirometric tests (forced vital capacity and forced expiratory volume in the first second) were performed before and after unilateral pulmonary resection for cancer of the lung. Ninety-one patients were evaluated; 47 underwent total pneumonectomy, and 44 underwent lobectomy. The postoperative serial evaluations were classified into short-term and long-term studies (less than or more than three months, respectively). The preoperative and postoperative data were utilized to derive formulas for predicting an estimate of the overall functional loss after pulmonary resection based on the number of segments removed. The correlation between the predicted and measured postoperative values was good for resections involving more than three segments (r = 0.83). Prediction for smaller resections was unreliable. While both regional and overall pulmonary functions were relatively stable after pneumonectomy, there was a disproportionate early loss, followed by significant functional improvement with time following lobectomy. The anticipation of and preparation for this early loss of function may be crucial in the treatment of these patients.

Carcinoma, Bronchogenic↗
PubMed1978

The contribution of surgery to the management of carcinomatous pulmonary metastases.

The presence of carcinomatous pulmonary metastases is a common clinical problem viewed by many physicians as beyond the realm of definitive surgical considerations. However, a number of patients dying with pulmonary metastases will have the totality of their disease confined to the lungs. In this select population, there is some potential for long term control or effective palliation through aggressive surgical management. This study quantitatively assesses the value of surgery in this setting and examines the prognostic effect of several important clinical variables. A single set of criteria were adhered to in the selection of patients. Cases were stratified in accordance with the intent of surgery, namely, 1) complete control and ablation of all known disease, or 2) reduction of total tumor burden to examine the possibilities for enhanced control by adjunctive therapeutic modalities.

Adult↗
PubMed1978

Clinical biology of small cell carcinoma: relationship to surgical therapy.

No prognostic factors could be identified that influence survival in patients with small cell carcinoma undergoing traditional therapy. These findings identified small cell carcinoma (1) as a distinct disease entity with reference to non-small cell carcinoma, (2) as a nonsurgical disease, and (3) as a disease demanding systemic treatment.

Adult↗
PubMed1977

Intravenous hyperalimentation as an adjunct to colon interposition for carcinoma of the esophagus.

Ten consecutive malnourished patients with undifferentiated squamous cell carcinoma of the esophagus underwent operation for colon interposition. They received intravenous hyperalimentation preoperatively and/or postoperatively for an average time of 21.5 days and had an average weight gain of 6.5 lb. There was no significant gastrointestinal morbidity, but one patient succumbed to aspiration pneumonia. All ten patients had postoperative gastrografin swallow radiography which showed no leaks in either anastomosis. With proper use of intravenous hyperalimentation, morbidity and mortality following colon interposition in the malnourished patient for either palliative or curative bypass can be decreased to acceptable levels.

Aged↗
PubMed1977

Assessment of the role of surgery for control of lung cancer.

When morphologically stratified, the classification of patients according to surgical stage provides an objective basis for evaluating the results of surgical treatment. In a review of 794 patients according to surgical staging criteria, the data supported concepts regarding differences in the behavior of each cell type as well as major differences in survival between each stage of disease. The overall cumulative five-year survival was 37% for squamous cell carcinoma, 27% for adenocarcinoma, and 27% for undifferentiated large cell carcinoma. Fewer than 1% of patients with undifferentiated small cell carcinoma survived. Survival for patients with surgical Stage I disease was 53%, for Stage II 29%, and for Stage III 16%. The results of surgical treatment for patients with limited disease extent are much better than is generally realized. Fifty to 60% of such patients in this series survived five years. Survival studies by surgical stage permit resonable estimates of the presence of occult metastatic disease and supply insights necessary to the design and appropriate selection of adjunctive therapeutic programs.

Adenocarcinoma↗
PubMed1977

The role of preoperative mesenteric arteriography in colon interposition.

In a series of mesenteric arteriograms, the marginal artery in the right colon was present in six of 20 studies (30 percent); in the left colon it was present in all of the 20 cases studied (100 percent). Such preoperative knowledge of the vascular pattern permits the surgeon to choose a suitable segment of bowel for successful colon interposition and assists him in shortening the operative time. When this information was applied in 19 consecutive left colon interpositions, only one major suture line dehiscence in the neck was encountered (5.3 percent).

Colon↗