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Biomedical subjects

E M Greenspan

Publications and source records attributed to E M Greenspan.

At least 19 recordsLinked to original sources
PubMed1994

Breast cancer.

Explore the source record for details and available documents.

Breast Neoplasms↗
PubMed1994

Chemotherapy for angiosarcoma of the breast: case report of 30-year survival and analysis of the literature.

Angiosarcoma of the breast is a rare and highly malignant neoplasm with few long-term survivors. Little is known about the effects of chemotherapy for patients with disseminated disease or its role in the adjuvant setting. We report the case of a patient with metastatic angiosarcoma of the breast who achieved a long-term clinical and pathological remission after treatment with methotrexate. The 30-year course of her disease is the longest reported survival with documented metastatic angiosarcoma of the breast. Analysis of the role of chemotherapy in the adjuvant setting and its effects in relation to histological subtype is undertaken. Adjuvant chemotherapy for patients with poorly differentiated angiosarcoma of the breast results in a higher proportion of patients relapse-free (29.2%) compared to patients not receiving adjuvant chemotherapy (4.4%) (p < 0.05). Patients with well-differentiated tumors do not appear to derive benefit from adjuvant chemotherapy. The effects for patients with disseminated disease are reported.

Adult↗
PubMed1986

Commentary on September 1985 NIH Consensus Development Conference on Adjuvant Chemotherapy for Breast Cancer.

The conservative recommendations of the second (1985) NIH Consensus Development Conference on Adjuvant Chemotherapy for Breast Cancer may result in needless premature deaths. The failure to recommend chemotherapy for high-risk postmenopausal patients is contrary to current practice among American oncologists. A recent Chemotherapy Foundation survey of medical oncologists revealed that 75% employed adjuvant polychemotherapy for high-risk postmenopausal women. Valid statistical data supporting the survival benefit of tamoxifen are derived from both Stage I and Stage II postmenopausal patients. While recommending tamoxifen as treatment of choice for Stage II, the Consensus lost an opportunity to encourage increased survival in Stage I patients and also discouraged chemoprevention trials such as those now underway in England. The curative potential of chemotherapy for high-risk women regardless of age was ignored despite several large studies ongoing now for 8-19 years which indicate 10-27% increased disease-free survival. As many as 10,000-15,000 lives per year could be saved in the United States by more realistic recommendations and the application of early aggressive chemotherapy for high-risk patients and tamoxifen for Stage I postmenopausal patients.

Aged↗
PubMed1985

A randomized comparison of cyclophosphamide, Adriamycin, and 5-fluorouracil with triethylenethiophosphoramide and methotrexate, both as sequential and as fixed rotational treatment in patients with advanced ovarian cancer.

The combinations of triethylenethiophosphoramide and methotrexate (TM) and cyclophosphamide, Adriamycin (doxorubicin), and 5-fluorouracil (CAF) were compared, both as sequential and fixed rotational treatments for advanced ovarian cancer, with L-phenylalanine mustard (L-PAM). Treatment with CAF produced a higher response rate (25% complete responses plus 31% partial responses) than treatment with L-PAM (15% complete responses plus 18% partial responses). A fixed rotation of TM and CAF resulted in longer survival (median of 15 months and 75th percentile of 27 months) than sequential treatment with TM initially, followed by CAF upon failure (median of 12 months and 75th percentile of 22 months). The fixed rotation of TM and CAF also increased progression-free survival (median of 12 months and 75th percentile of 24 months) over that achieved by initial treatment with TM (median of 6 months and 75th percentile of 15 months) or L-PAM (median of 9 months and 75th percentile of 21 months). Most patients (96%) on the fixed rotation were treated with both TM and CAF. Fewer patients (62%) on the sequential schedule with TM actually received both combination regimens, and even fewer patients (37%) beginning on CAF ever crossed over to TM. Patient age of 50 years or younger was a favorable prognostic factor for response, survival, and time to first treatment failure (progression-free survival). Disease Stage IIIA or IIIB, surgery including a bilateral salpingo-oophorectomy plus hysterectomy, and treatment within 6 months of initial diagnosis were favorable predictors for both survival and time to first treatment failure. Ambulatory performance status and well-differentiated disease were favorable prognostic factors for survival. Patients with unevaluable disease failed later than those with evaluable disease who, in turn, failed later than patients with measurable disease.

Adenocarcinoma↗
PubMed1984

Phase I study of mitoxantrone on a daily X 5 schedule.

Mitoxantrone (NSC-301739) is a synthetic amino anthraquinone DNA intercalater active in several experimental tumor systems. Thirty-three patients with advanced cancer received the drug on a daily X 5 schedule. Myelosuppression, especially leukopenia, was the dose-limiting toxicity and was reversible. Nausea and vomiting occurred sporadically. No definite hepatic, renal, or cardiac toxicities were noted. The recommended dose for phase II evaluation in solid tumor patients with little or no prior therapy is 4.2 mg/m2/day X 5. Patients with prior myelosuppressive therapy but adequate bone marrow reserve may be started at 2.6 mg/m2/day X 5.

Adult↗