Biomedical subjects
D J Arnold
Publications and source records attributed to D J Arnold.
Survival following mastectomy for stage III breast cancer.
Patients with locally advanced breast cancer have been considered unsuitable for curative surgical therapy and are usually approached with other treatment modalities. Review of the results of radical mastectomy in 228 patients with stage III breast cancer demonstrates actuarial survival of 33 per cent at five years and 22 per cent at ten years. Treatment with preoperative or postoperative radiotherapy as employed did not lead to survival superior to that of mastectomy alone. Evidence of local or regional recurrence developed in 27 per cent of patients. In 73 per cent the first recurrence was systemic. This retrospective study suggests that the prognosis for locally advanced breast cancer is not as dismal as has been previously reported. The importance of nodal involvement is again emphasized. A randomized trial of mastectomy with adjuvant chemotherapy for locally advanced breast cancer is warranted. Such a study is in progress at our institution.
Systemic allergic reaction to adriamycin.
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Chemotherapy for bronchogenic carcinoma. Methotrexate, doxorubicin, cyclophosphamide, and lomustine.
A combination chemotherapy (MACC) consisting of methotrexate, doxorubicin hydrochloride (Adriamycin), cyclophosphamide, and lomustine (CCNU) was given to 41 patients with stage III bronchogenic carcinoma, 34 of whom had disseminated disease. The objective response rate was 46% for all patients with a median actuarial survival of nine months. Response was seen in all cell types, including four of ten patients with squamous cell carcinoma, six of 17 with adenocarcinoma, and six of seven with small-cell anaplastic carcinoma. Prolongation of survival was apparent for patients of all cell types. Toxic reactions were moderate and allowed for easy outpatient use.