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Biomedical subjects

D C Ihde

Publications and source records attributed to D C Ihde.

At least 145 records · Page 8Linked to original sources
PubMed1980

Herpes zoster and small cell bronchogenic carcinoma.

In nine of 74 (12 per cent) consecutive, previously untreated patients with small cell bronchogenic carcinoma receiving combination chemotherapy herpes zoster developed. This is the highest frequenzy reported for this viral infection in patients with nonlymphoproliferative solid tumors. Cutaneous dissemination developed in six of the nine patients, but visceral involvement did not occur. The major difference between the patients with herpes zoster and those without was the superior duration of median survival for the infected patients. No relationship could be established between the development of herpes zoster and the extent of neoplastic disease, prior radiotherapy, treatment with specific chemotherapeutic agents or corticosteroids, cutaneous anergy or granulocytopenia. Serum specimens obtained from six of the nine patients prior to their infection demonstrated the preexistence of varicella zoster antibodies. As more effective and intensive chemotherapy prolongs the survival of patients with solid tumors, it is possible that the frequency of herpes zoster infection may approach that observed in patients with lymphoproliferative malignancies.

Adult↗
PubMed1980

Computed tomography in primary hepatocellular carcinoma.

Abdominal computed tomography was performed on seven patients with primary hepatocellular carcinoma. The liver appeared normal in one patient, while in the other six patients the tumor was identified as an area of decreased attenuation. In four cases, the tumor was seen better following intravenous administration of a contrast agent, and, in two of these cases, it was not seen on the precontrast scans. In only one case was the hepatoma better seen on the precontrast examination, and it could still be identified following contrast enhancement. Hepatomegaly and an irregular hepatic contour were other findings in these patients.

Adult↗
PubMed1980

Prospective staging evaluation of patients with cutaneous T-cell lymphomas. Demonstration of a high frequency of extracutaneous dissemination.

A prospective pretreatment staging evaluation was done on 49 consecutive patients with mycosis fungoides or the Sézary syndrome to study patterns of disease spread and prognostic factors. Routine staging procedures included complete blood count, blood chemistries, chest roentgenogram, lymphangiogram, radionuclide scans, bone marrow aspiration and biopsy, liver biopsy, and lymph node biopsy. Special evaluations included cytogenetic analysis, electron microscopy, and T-cell cytology. Extracutaneous lymphoma was documented by light microscopy in 51% of patients and by the three special procedures in 88%. Extracutaneous lymphoma was most frequent in blood and lymph nodes; 18% of patients had visceral involvement. Patients with generalized erythroderma had a higher frequency of extracutaneous disease than did patients with cutaneous plaques and tumors by both light microscopy and special studies. Survival was directly related to the type of skin involvement and the presence or absence of extracutaneous disease. Systemic dissemination of cutaneous T-cell lymphoma is frequent, generally asymptomatic, and develops early via the circulation. These findings may explain why cutaneous therapies are associated with a high frequency of relapse.

Adult↗
PubMed1980

Influence of histologic subtype of small cell carcinoma of the lung on clinical presentation, response to therapy, and survival.

Patients with small cell carcinoma of the lung (SCCL) were histologically subtyped according to the Working Party for Therapy of Lung Cancer classification and were treated with combination chemotherapy. Of the 103 patients studied, 54 had the lymphocyte-like (oat cell) subtype, 41 had the intermediate cell subtype, and 8 had a mixture of the two. No significant difference in initial performance status, extent of disease, chemotherapeutic response rate, or survival (median, 10.2 mo) was noted among the histologic subtypes. When the histologic subtype of the primary biopsy tissue was compared with the subtype of other pathology specimens from the same patient, concordance of subtype was present in 74% of the patients. In the remaining 26%, two or three histologic subtypes were present. This study demonstrates no clinically significant differences among the various histologic subtypes of SCCL in patients extensively staged and treated with aggressive cytotoxic therapy. Because of this and because concurrent biopsy tissues from multiple sites in the same patient may vary in subtype, we conclude that prognostic or therapeutic decisions should not be based on SCCL subtype.

Carcinoma, Small Cell↗
PubMed1979

Thymosin fraction V and intensive combination chemotherapy. Prolonging the survival of patients with small-cell lung cancer.

Patients with small-cell bronchogenic carcinoma who received intensive remission-induction chemotherapy randomly received either thymosin fraction V, 60 mg/sq m or 20 mg/sq m twice weekly, or no thymosin treatment during the initial six weeks of chemotherapy. Chemotherapy was then continued for two years. Thymosin administration did not increase the complete response rate. Patients receiving thymosin, 60 mg/sq m, had significantly prolonged survival times relative to the other treatment groups. This benefit was due to prolonged relapse-free survival in complete responders to treatment. The mechanism by which thymosin increased survival duration is unclear but may relate to restoration of immune deficits due to disease or treatment.

Antineoplastic Agents↗
PubMed1979

Response to thoracic radiotherapy in patients with small cell carcinoma of the lung after failure of combination chemotherapy.

Chest radiotherapy was given to 23 patients with small cell carcinoma of the lung after development of progressive intrathoracic tumor on chemotherapeutic regimens. Treatment schedules were variable, with a median dose of 3,200 rad (32 Gy) in 10 fractions. Objective tumor regression within the radiation portal was observed in 12 patients (52%). Only 3/12 responders did not develop clinically detectable local tumor recurrence before death. Actuarial median time to local tumor progression was 2.5 months in responding and 3.5 months in nonresponding patients. Relapse of intrathoracic small cell carcinoma despite combination chemotherapy was not effectively treated by chest irradiation in the doses utilized. If sustained local palliation is required in this population, higher doses of radiation should be considered.

Carcinoma, Small Cell↗
PubMed1979

Abdominal CT in the evaluation of small cell carcinoma of the lung.

Upper abdominal CT scans were performed on 45 consecutive patients with biopsy proven but previously untreated small cell carcinoma of the lung. Evidence of metastases was found in 16 (36%) patients. The most common site of metastases was the liver (27%). CT had a sensitivity of 88% and specificity of 94% as compared with biopsy results. Evidence of retroperitoneal metastases was found in seven (16%) patients.

Adrenal Gland Neoplasms↗
PubMed1979

Cyclic alternating combination chemotherapy for small cell bronchogenic carcinoma.

Sixty-one protocol-eligible patients with small cell bronchogenic carcinoma received cyclic alternating combination chemotherapy with two or three non-cross-resistant drug combinations. No chest or prophylactic brain radiation therapy was used. Twenty-eight months after starting treatment, disease-free survival was 23% for patients achieving a complete response (CR) and 13% overall. Initial treatment consisted of high-dose cyclophosphamide, methotrexate, and CCNU (CMC) for 6 weeks. Patients then received vincristine, adriamycin, and procarbazine (VAP) for 6 weeks. The addition of VAP increased the CR rate from 42% to 74% in limited-disease patients and from 24% to 36% in extensive-disease patients. Half of the patients were randomized to a third combination of VO-16-213 and ifosfamide. These patients were cycled at 6-week intervals through the three drug regimens while the remaining patients were cycled between CMC and VAP. The addition of VP-16-213 and ifosfamide did not increase the CR rate or prolong survival. Only complete responders survived beyond 24 months. Sequential use of non-cross-resistant drug combinations represents one method for increasing the CR rate.

Antineoplastic Agents↗
PubMed1978

Cardiac candidiasis in cancer patients.

Histologically proven infection of the heart by Candida organisms occurred in 17 (10%) of 168 cancer patients with candidiasis studied at necropsy. All 17 patients were among the 85 patients with disseminated Candida infection; none of the 83 patients with localized candidiasis had involvement of the heart. Abscesses in the myocardium were present by histologic examination in all 17 patients and in 8 were evident on gross inspection as well. The mural endocardium was also affected in 5 patients from direct extension of a myocardial abscess. The valves were uninvolved. Pericardial infection was detected in 2 patients. The 17 patients with cardiac Candida infection had a higher frequency of positive premortem blood and cerebrospinal fluid cultures and of presence of Candida in the heart's blood than did the 68 patients with disseminated candidiasis but without involvement of the heart. Symptoms or signs of cardiac dysfunction resulting from the cardiac Candida infection were not readily detected in any patient. The clinical and pathologic features of cardiac candidiasis in cancer patients are distinct from those observed in Candida endocarditis.

Adolescent↗
PubMed1978

Growth rates of small cell bronchogenic carcinomas.

In reviewing a series of 144 patients with small cell bronchogenic carcinoma, 12 were found to have serially measurable roentgenographic lesions prior to therapy. Although caliper-based measurements and a silhouette cutout method gave comparable sets of tumor doubling time data, inter-observer variability was less with the silhouette cutout method. Tumor doubling times in small cell bronchogenic carcinoma ranged between 25 and 160 days, with a median of 77 days, a log mean of 81 days, and an arithmetic mean of 91 days. There was no apparent relation between tumor doubling time and tumor location, histologic subtype, response to therapy, or patient survival. The data indicate that small cell bronchogenic carcinoma of the lung is a relatively slowly growing tumor. Assuming that late subclinical disease exhibits growth characteristics that are similar to those seen in the clinical stages of growth, it can be estimated that residual body tumor burdens of 1 X 10(6) cells may be followed by tumor recurrence times of 2 years or longer; the likelihood of "cure" should not be entertained in patients with disease-free intervals shorter than 4-5 years.

Carcinoma, Bronchogenic↗
PubMed1978

Serial fiberoptic bronchoscopy during chemotherapy for small cell carcinoma of the lung: early detection of patients at high risk of relapse.

Serial fiberoptic bronchoscopic examinations were performed during intensive chemotherapy with a combination of drugs in 77 previously untreated patients with small cell carcinoma of the lung. Before treatment, bronchoscopic examination revealed evidence of cancer in 93 percent (70) of the 75 patients studied at that time, including 8 percent (six) in whom the tumor was not evaluable on the chest x-ray film. After therapy was initiated, 36 percent (29) of the 81 procedures performed in patients with a complete response radiographically and 62 percent (33) of the 53 bronchoscopic procedures in those with a partial response or no response showed evidence of tumor. In both of these groups, patients with abnormal findings on endoscopic examination had a much higher rate of relapsing tumor of the chest within a 12-week period. Progression of intrathoracic tumor was first detected solely by bronchoscopic examination in 22 percent (seven) of the 32 episodes of progression. In our hands, repeated fiberoptic bronchoscopic procedures during chemotherapy for small cell carcinoma have yielded information not apparent from the chest x-ray film in a significant number of patients.

Bronchoscopy↗
PubMed1978

Streptozotocin in advanced small cell bronchogenic carcinoma: an ineffective nonmyelosuppressive agent.

Thirteen patients with advanced small cell bronchogenic carcinoma (SCBC) received at least three weekly cycles of iv streptozotocin (STZ). There were no objective responses. Four patients progressed by the third week of therapy and an additional eight by the fourth week. Toxicity was acceptable especially in view of the extensive prior therapy. STZ is unlikely to be of benefit in combination chemotherapy regiments for SCBC.

Aged↗
PubMed1978

5-fluorouracil, methyl-CCNU, adriamycin, and mitomycin C in the treatment of advanced gastric cancer.

Eighteen previously untreated patients with advanced nonresectable adenocarcinoma of the stomach were treated with a four-drug regimen consisting of 5-fluorouracil, methyl-CCNU, adriamycin, and mitomycin C. Objective responses occurred in only two patients (11%); the majority of patients had stable disease for greater than or equal to 8 weeks (61%). The median survival of 27 weeks was similar to that reported in other combination chemotherapy trials. Numerous staging and restaging procedures and strict response criteria were utilized and each was evaluated for its effectiveness in following responses. None of these parameters was useful for evaluating response of intra-abdominal tumor. We conclude that this four-drug combination is no better than previously described two-drug regimens.

Adenocarcinoma↗