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D Pectasides

Publications and source records attributed to D Pectasides.

At least 55 records · Page 3Linked to original sources
PubMed1995

Chemotherapy for Merkel cell carcinoma with carboplatin and etoposide.

Merkel cell carcinoma is a rare malignant tumor of the skin. We treated three patients with Merkel call carcinoma with the combination of carboplatin and etoposide, which have been mostly used in the treatment of small cell lung carcinoma. Two patients experienced partial remission of short duration. The third patient received the combination on an adjuvant basis but relapse occurred briefly. Two of these patients failed to respond to second-line chemotherapy with cisplatin, ifosfamide, and epirubicin. The patient who had the first-line treatment on an adjuvant basis, responded completely with the second-line chemotherapy plus radiotherapy and remains disease-free for 5+months. Merkel cell carcinoma appears to be a sensitive tumor to chemotherapeutic regimens used for small cell lung carcinoma, but the responses are often brief.

Aged↗
PubMed1994

Clinical and histologic involvement of regional lymph nodes in malignant melanoma. Adjuvant vindesine improves survival.

BACKGROUND: This report is a study of prognostic factors, including adjuvant chemotherapy, that influence survival of patients with malignant melanoma who have clinical and pathologic involvement of regional lymph nodes. METHODS: A total of 169 evaluable patients with malignant melanoma metastatic to regional lymph nodes were registered consecutively and prospectively between June 1977 and December 1986 in the computerized data base of the melanoma registry at Westminster Hospital. Eighty-seven of these patients received adjuvant chemotherapy with vindesine after resection of palpable metastatic lymph nodes, and 82 had no systemic treatment after surgery. All were followed up for at least 2 years (median, 8 years) after involvement of regional lymph nodes was noted or until death. Statistical analyses included simple life-table comparisons, unadjusted for covariates. In addition, Breslow's thickness, ulceration of the primary lesion, its anatomical location, number of regional lymph nodes histologically involved, dissection site, patient age and sex, and adjuvant vindesine therapy were included as covariates in Cox regression models. RESULTS: The disease-free interval (P = 0.0001), time to dissemination from lymph node metastases (P < 0.0001), survival time after lymph node dissection (P = 0.0227) and overall survival time after initial diagnosis of malignant melanoma (P = 0.0095, log-rank chi-square test) were superior for the 87 patients who received adjuvant chemotherapy with vindesine. Cox regression analysis confirmed adjuvant vindesine as a highly significant variable influencing all of these outcomes, including overall survival time after first diagnosis (P = 0.003). CONCLUSIONS: The apparent effect of adjuvant vindesine on overall survival in this study is large (hazard ratio, 0.52) and highly statistically significant. Adjuvant vindesine therapy merits consideration for malignant melanoma metastatic to regional lymph nodes. However, these results observed in concurrent, but nonrandomized, patients clearly require confirmation.

Adult↗
PubMed1994

Adjuvant chemotherapy with dacarbazine, vindesine, and cisplatin in pathological stage II malignant melanoma.

Following curative lymph node dissection, 28 patients with pathological Stage II malignant melanoma (metastatic to regional lymph nodes) received adjuvant chemotherapy with dacarbazine, vindesine, and cisplatin (DVP); 32 more patients with similar characteristics refused adjuvant treatment. In the treated group, 15 patients (53%) developed dissemination of disease after 4 to 29 months; 20 (62%) of the patients who refused adjuvant treatment recurred after 4 to 25 months and received palliative treatment with DVP. No significant differences in survival or disease-free survival according to different patient characteristics could be detected between these two groups with the available patient population. Large and well-designed prospective randomized trials are required to determine if the adjuvant use of this treatment schedule, which includes the three most active drugs improves survival in patients with nondisseminated melanoma.

Adult↗
PubMed1994

Treatment of primary fallopian tube carcinoma with cisplatin-containing chemotherapy.

Because of the rarity of the primary fallopian tube carcinoma, optimal primary therapy is still not well defined, and there is little information available regarding the efficacy of combination chemotherapy in advanced disease. The experience obtained by treating 14 patients with fallopian tube carcinoma--most of them with advanced disease--using a combination of cisplatin, adriamycin, and cyclophosphamide (CAP) (10 patients) or carboplatin plus cyclophosphamide (4 patients) is reported. One patient had Stage Ic disease, 2 had Stage II, 9 had Stage III, and 2 had Stage IV. Eleven patients had clinically measurable disease (> 2 cm) at the start of chemotherapy. Eight of these patients had a complete clinical response (CR), 2 had partial response (PR), and 1 had progressive disease (PD). Of the 8 CR patients, 5 underwent second-look operation (SLO). Pathological complete response (pCR) confirmed in 4 out of 5 patients at SLO. The 3 patients without measurable disease (< 2 cm) after primary surgery had an indeterminate response to chemotherapy. Two of them (Stages Ic and II, respectively) had a negative SLO, while the third patient with Stage IV disease, who refused the SLO, remains disease-free 41+ months. This high response rate shows that this carcinoma is very responsive to cisplatin- or cisplatin analogue-containing regimens. One pCR and two clinical CR patients relapsed after 20, 14, and 16 months, respectively, from the completion of chemotherapy and died despite the second-line treatment. The toxicity of the regimens was moderate. The median survival was 40 months, and the actuarial 5-year survival rate was 48%. Carcinoma of the fallopian tube appears to respond favorably to cisplatin- or carboplatin-containing chemotherapy.

Adenocarcinoma↗
PubMed1994

Squamous cell carcinoma antigen, tumor-associated trypsin inhibitor, and carcinoembryonic antigen for monitoring cervical cancer.

A total of 120 patients with squamous cell carcinoma of the cervix were prospectively monitored with simultaneous serum level estimations of SCC, CEA, and TATI in different stages and phases of their disease. Positive values were observed for SCC in 72 patients (60%), for CEA in 47 (39%), and for TATI in 12 (10%). There was no increase in the SCC serum levels in the early stages of disease (IA, IB, IIA), whereas they increased significantly with advancing stage. Serum marker levels quickly dropped to normal in patients with advanced stages (IIB or higher) or recurrent disease who responded to treatment, as well as in patients with early-stage disease following local therapy. In addition, 28 patients, who had a renewed progression after a complete remission with normal marker levels, showed an increase in SCC in 26 cases (92%) and CEA in 7 (25%). TATI did not vary in these patients. In patients whose disease did not respond to treatment, a change in serum marker levels cannot be evidenced with the available numbers. This study indicates that the routine measurement of all three markers is not justified in squamous cell carcinoma of the cervix, and that SCC estimation is a potential tool for monitoring the efficacy of treatment in advanced stages or relapse.

Adult↗
PubMed1993

Intravesical administration of tumor-associated monoclonal antibody AUA1 in transitional cell carcinoma of the bladder: a study of biodistribution.

Forty-five patients known or suspected to have transitional cell carcinoma of the urinary bladder underwent intravesical administration of either AUA1 tumor-associated monoclonal antibody or 11.4.1. nonspecific monoclonal antibody. Antibodies were radiolabeled with iodine-131, diluted in 50 ml normal saline and remained in the bladder for up to 1 h. During cystoscopy or transurethral resection of the tumor, tissue samples were taken from normal and malignant areas and were counted for radioactivity in a gamma counter. Blood samples were also measured for radioactivity. Mean uptake of AUA1 at 2, 20, 40 and 60 h after administration (expressed as 10(3) x percentage of injected dose/gram of tissue) was: 1.77 +/- 3.2, 1.28 +/- 1.67, 0.72 +/- 0.94 and 0, respectively in the tumor and 0.79 +/- 0.83, 0.14 +/- 0.34, 0.033 +/- 0.06 and 0 in normal tissue. Mean uptake of 11.4.1 at 2 and 20 h was: 0.47 +/- 0.42 and 0.018 +/- 0.015, respectively, in tumor and 0.2 +/- 0.19 and 0.013 +/- 0.002 in normal samples. No remarkable radioactivity was found in blood samples. Conventional and immunoperoxidase staining were also performed. Mean uptake of AUA1 by the tumor increased as the degree of tumor differentiation decreased. Our findings indicate that intravesical administration of AUA1 results in selective immunolocalization of AUA1 in intermediate and high-grade transitional cell carcinoma. This may allow the development of a new method for bladder carcinoma treatment or prophylaxis against recurrence.

Administration, Intravesical↗
PubMed1992

Cisplatin-containing regimen in advanced or recurrent granulosa cell tumours of the ovary.

The efficacy of combination chemotherapy in advanced or recurrent disease of granulosa cell tumours is still not well defined. Ten patients with advanced or recurrent granulosa cell tumours were treated with cisplatin, adriamycin and cyclophosphamide (CAP). Prior to chemotherapy all patients underwent surgical treatment. No patient received prior hormonochemotherapy or radiotherapy. Five complete responses (three pathologically documented) and one partial response were obtained for a total response rate of 60%. One pathologically-complete responder relapsed after 48 months from the onset of chemotherapy, but responded completely to debulking surgery and radiotherapy and remains well with no evidence of disease 87+ months. Five patients are still alive with no evidence of disease at 10+, 26+, 41+, 46+, 87+ months, 1 is still alive with disease and 4 have died at 20, 22, 28 and 60 months despite further treatment. Additional cooperative clinical trials are required to determine the exact efficacy of cisplatin chemotherapy in granulosa cell tumours.

Adult↗
PubMed1992

Cerebrovascular accidents following hormonochemotherapy in cancer patients.

It has become increasingly apparent that the administration of cytotoxic drugs or hormones may be associated with life-threatening vascular episodes. We report on seven women and one man who developed cerebrovascular accident (CVA) during or immediately after the administration of several hormonochemotherapeutic regimens. No patient died from the stroke. Five patients made a complete recovery; one showed remarkable improvement, and two, slight improvement. Several explanations for CVA were proposed, but the pathophysiological basis of the relationship between the arterial occlusive complication and hormonochemotherapy is unclear.

Adult↗
PubMed1991

Correlation of abdominal computed tomography scanning and second-look operation findings in ovarian cancer patients.

Abdominal computed tomography scanning (CT scan) was performed in 35 patients with ovarian carcinoma prior to undergoing a second-look operation. All patients were in complete clinical remission following 6 courses of chemotherapy. Results of the CT scans were compared and correlated with surgicopathological findings at second look. There were 9 true-positive, 12 true-negative, 2 false-positive, and 12 false-negative CT scan results. The sensitivity was 0.42, the specificity 0.85, diagnostic accuracy 0.6, positive predictive value 0.81, and the negative predictive value 0.50. Sensitivity was poor for omental, mesenteric, and peritoneal disease, better for metastases in lymph nodes, good for abdominal masses, and very good for ascites and disease in the liver. False-positive CT scan findings were due to either anatomic variations or adhesions and scarring resulting from postoperative changes. Four false-negative studies resulted from microscopic disease found at second look. In the remaining 8 false-negative studies, nodules or plaques more than 2 cm in diameter were not detected in the omentum (4 patients), in the mesentery and peritoneum (2 patients), and in the lymph nodes (2 patients). Due to a high false-negative rate, a normal CT scan cannot replace a second-look operation for accurate assessment of disease status.

Abdominal Neoplasms↗
PubMed1990

Immunoscintigraphy with 131I-labelled H17E2 monoclonal antibody compared with conventional lymphangiography and computed tomography in the detection of metastases in patients with testicular germ cell tumours.

131I-labelled H17E2 monoclonal antibody (MAb) was administered to 16 patients with germ cell tumours of the testis (GCT). Eleven patients had non-seminomatous GCT and five seminoma. The MAb was administered into the webs between the second and third toes of both feet in 12 patients and intravenously in four patients at a dose of 1.5-2mCi. 131I-labelled 2-118 MAb (non-specific) was administered subcutaneously into the webs between the second and third toes of both feet in two patients and intravenously in one patient with non-seminomatous GCT. All three patients had only computed tomography (CT) scan. Patients were scanned immediately after until 7 days post-injection. For comparison all patients had CT scan and eight out of 16 patients had conventional lymphangiography (LG). When the radiolabelled MAb was given subcutaneously, the immunoscan (IS) was true positive in 9/12 (75%) patients and true negative in 2/12 (16.5%) and equivocal in 1/12 (8.5%). The LG gave true positive results in 6/8 (75%) patients and true negative results in 2/8 (25%) and the CT scan true positive results in 8/12 (66.6%) patients, true negative results in 2/12 (16.3%) and false negative results in 2/12 (16.3%). There was an excellent correlation of IS images with the LG results (true positivity 100%). When the radiolabelled MAb was given intravenously, both IS and CT scan gave true positive results in four cases. Our findings showed that the true positivity of IS reached 93.8%, whereas that of CT scan 87.5%. In all three patients who had the 131I-labelled 2-118 non-specific MAb, the IS was false negative, whereas the CT scan was true positive. Thus, this procedure may offer information complementary to that provided by existing conventional imaging methods.

Antibodies, Monoclonal↗
PubMed1989

Treatment of metastatic malignant melanoma with dacarbazine, vindesine and cisplatin.

Twenty-seven patients with disseminated malignant melanoma were treated monthly with cisplatin (CDDP) 120 mg m-2 on day 1, vindesine (VDS) 3 mg m-2 on day 2 and dacarbazine (DTIC) 250 mg m-2 on days 2-6. None of them had received prior chemotherapy. All patients are evaluable for response and toxicity. There were five (19%) complete (CR) and seven (26%) partial (PR) responses for a total response rate of 45%. We conclude that the combination of DTIC, VDS and CDDP is capable of producing a relatively high rate of response in patients with advanced metastatic malignant melanoma, but responses are short.

Adult↗
PubMed1989

First line combination chemotherapy with cisplatin and etoposide in advanced ovarian cancer.

Thirty-one consecutive patients with advanced epithelial ovarian cancer entered a phase II study with cisplatin and etoposide combination chemotherapy. None of them had received prior chemotherapy or radiotherapy. Most patients had advanced (88%) or far advanced (61%) disease. All 31 patients are evaluable for toxicity which was significant and led to removal of five (16%) patients from the study. Of the 23 patients evaluable for response there were four clinical complete (CR) and eight partial (PR) responders for a total clinical response rate of 52% of evaluable patients and 39% of all patients. Eight patients (four clinical CR and four good PR) have undergone second look laparotomy with pathological CR in one of the clinical CR patients. Median survival time for responders and non-responders is 19 and 8 months respectively. The results obtained appear to be inferior to other cisplatin based combinations. Although this could be attributed to the unusually high proportion of patients with bulky disease and stage IV patients, we feel that the study suggests that etoposide did not add any benefits for this patient population to cisplatin as a single agent.

Adult↗
PubMed1989

Treatment of disseminated germ cell tumours of the testis.

Between 1979 and 1987 64 men with non-seminomatous germ cell tumours of the testis were treated with chemotherapy. Nearly half of these patients had large volume disease. The most frequently used combinations were VAB-6 and POMB/ACE. Chemotherapy lasted 3.9 months for small volume disease and 5.5 months for large volume disease. Seven patients (11%) underwent resection of residual masses; viable malignancy was found in only 1 of these. Relapse occurred in 6 complete responders, 3 of whom were salvaged with further chemotherapy. Fifty-three patients are presently alive and have received no treatment for periods of 5 to 86 months. Life table analysis forecasts a survival of 81%. Adverse prognostic factors have been recognised and include high initial serum concentrations of beta-human chorionic gonadotrophin (beta-HCG) and alpha fetoprotein (AFP), large volume disease and prior irradiation. Although the survival time of patients with advanced disease has improved in recent years, it remains considerably below that of patients who present with less advanced disease. Such patients should be treated aggressively from the outset in order to obtain maximum benefit from chemotherapy. Selected cases also require adjunctive surgery.

Adolescent↗
PubMed1988

Immunoscintigraphy with 131I-labelled monoclonal antibodies HMFG2 and HMFG1 F(ab')2 versus abdominal CT scan in the detection of residual disease in ovarian cancer patients.

131I-labelled HMFG2 or HMFG1 F(ab')2 monoclonal antibody (MAb) was administered intraperitoneally to 15 patients with epithelial ovarian cancer who had completed chemotherapy and were in complete or good partial remission. Each patient received 2-3 mCi. Patients were scanned immediately after and until 7 days post-injection. In 3/15 patients the immunoscan failed because extensive adhesions from the previous surgery prevented MAb diffusion. Of the remaining 12 patients, 9 underwent second-look laparotomy (SL). Immunoscan was true positive in 8/9 (89%) patients and equivocal in 1/9 (11%), whereas the abdominal CT scan gave true positive results in 6/9 (67%) patients. In 8 out of 9 patients there was a good correlation between distribution of all sites of abnormal uptake and the surgical findings at SL. Of the 3 patients not undergoing SL, the immunoscan was positive in all, whereas clinical examination and abdominal CT scan were negative. All 3 patients relapsed after 3, 4 and 5 months. Thus the total true positivity of immunoscan reached 92%, CT scan remaining at 50%. Immunoscan with intraperitoneal administration of 131I-labelled MAbs can thus accurately detect the presence of residual disease in ovarian cancer patients and appears more sensitive than abdominal CT scan.

Adult↗
PubMed1988

Immunoscintigraphy with 131I-labelled HMFG2 and HMFG1 F(ab')2 in the pre-operative detection of clinical and subclinical lymph node metastases in breast cancer patients.

Radiolabelled specific monoclonal antibodies (MAbs) HMFG2 and HMFG1 F(ab')2 and non-specific 11.4.1 and 4C4 F(ab')2 were injected into the webs between the 2nd and 3rd fingers of both hands in 31 patients with clinical diagnosis of breast cancer. We studied 10 patients with clinically obvious axillary lymph-node disease (group A) and 10 patients with clinically negative axilla (group B) using HMFG2, 5 patients with clinically negative axilla (group C) using HMFG1 F(ab')2 and 6 patients with clinically positive axilla (group D) using non-specific 11.4.1 and 4C4 F(ab')2 MAbs. In group A, 7 patients had true positive scans. There were also 3 false negative scans, due to problems related to proper iodination at the beginning of this study. In group B there were 4 true positive scans, 4 true negative, I false positive and I false negative. In group C there were 4 true negative scans. In one patient the radiolabelled antibody was arrested in the middle of the arm, because of lymphatic obstruction. In group D, there were 3 false negative scans with 11.4.1 antibody and 3 false negative scans with 4C4 F(ab')2 MAb. The results of immunoscintigraphy were in accordance with the histopathology and immunoperoxidase staining findings. These results indicate that this non-invasive approach can accurately detect metastatic involvement in the axillary lymph nodes and can be used for the diagnosis and staging of breast cancer.

Adult↗
PubMed1986

Antibody-guided irradiation of malignant pleural and pericardial effusions.

Tumour-associated monoclonal antibodies (HMFG1, HMFG2 and AUA1) radiolabelled with iodine-131 were given intracavitary (intrapleurally and intrapericardially) to patients with malignant effusions. Ten out of 13 effusions (3 pericardial and 7 pleural) responded completely with no fluid reaccumulation between 3 and 18 months. No clinical or other toxicity was observed. This new method of treatment for recurrent malignant effusions is non-toxic and effective resulting in improved quality of life, and, in some cases, prolongation of survival.

Adult↗