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E Marcuello

Publications and source records attributed to E Marcuello.

29 records · Page 2Linked to original sources
PubMed1997

A preliminary report of a phase II trial. UFT plus oral folinic acid as therapy for metastatic colorectal cancer in older patients. Spanish Group for the Treatment of Gastrointestinal Tumors (TTd Group).

The oral fluoropyrimidines have proved to be active in colorectal cancer in Japan and, recently, in the United States and Europe. Continuous oral administration simulates protracted fluorouracil (5-FU) continuous intravenous infusion. The purpose of this trial was to evaluate the tolerability and potential advantages of oral treatment for colorectal cancer in the elderly. The main inclusion criterion was age over 72 years. Patients were treated with UFT (tegafur plus uracil) 400 mg/24 hours (fixed doses) continuously plus folinic acid 45 mg/24 hours until toxicity. If grade 3 or 4 toxicity appeared, treatment was stopped until recovery. From September 1994 to November 1996, 126 patients were included. For the analysis in November 1996, 77 patients were evaluable for response, toxicity, and survival. The patients, including 34 women and 43 men, had a median age of 74 years (range, 72 to 82 years of age). The Karnofsky performance status was 60% to 80% for 41 patients and 90% to 100% for 36 patients. Liver metastasis was present in 48% of the cases, and 42% were locoregional and peritoneal. Toxicity was mild, with only one patient having grade 3 thrombocytopenia, 11 (14%) grade 3 or 4 nausea/vomiting, seven (9%) grade 3 or 4 diarrhea, and one grade 3 mucositis. Four patients (5%) had complete responses and nine (11.6%) partial responses, for an objective response rate of 16.9% (95% confidence interval, 9% to 27%). Twenty-two patients (28.6%) showed no change. The number of patients in whom disease did not progress (ie, patients with complete plus partial responses plus those with stable disease) was 35 (45.4%) (95% confidence interval, 34% to 57%). With a maximum follow-up of 24 months, the median actuarial survival is 14.4 months. The number without disease progression and the median survival in this preliminary analysis suggests that this schedule is a moderately effective, comfortable, treatment with only mild toxicity, that can be recommended for use in the elderly, and it warrants further study.

Aged↗
PubMed1997

Growing teratoma syndrome: experience of a single institution.

OBJECTIVE: To analyze the clinical outcome of patients diagnosed with growing teratoma syndrome (GTS) at a single center during a long follow-up. PATIENTS AND METHODS: Eleven patients with GTS are reported. GTS lesions were located in the metastatic sites involved at disease presentation. Involved sites were: retroperitoneum in 9 patients; lung in 3; supraclavicular lymph nodes in 2, and inguinal lymph nodes in 1. Surgical resection of the masses was the treatment of choice. RESULTS: Twenty-four surgical procedures were performed: 4 thoracotomies; 2 supraclavicular; 1 inguinal, and 17 retroperitoneal node resections. Three patients have not relapsed since surgery of the masses, at 37+, 110+ and 118+ months. Eight patients have relapsed, 6 with mature teratoma and 2 (22%) with cancer. To date, all the patients are alive, 6 of them without disease and 5 with teratoma after resection of the masses. CONCLUSIONS: GTS is an infrequent entity. Involved sites are only at locations previously affected by the disease. The treatment of choice is surgical resection but recurrence is common. Efforts should be done to complete resection of the masses.

Adolescent↗
PubMed1993

Unresectable nonmetastatic squamous cell carcinoma of the esophagus managed by sequential chemotherapy (cisplatin and bleomycin) and radiation therapy.

BACKGROUND: For patients with unresectable nonmetastatic squamous cell carcinoma of the esophagus (SCCE), the conventional treatment has been radiation therapy (RT). Because RT alone is unsatisfactory, there has been increasing interest in including chemotherapy (CT) in the management of these patients. METHODS: Twenty-five previously untreated patients with unresectable nonmetastatic SCCE were treated with sequential CT and RT. CT consisted of cisplatin 35 mg/m2/day for 3 days plus bleomycin 15 mg/day for 3 days as an 18-hour infusion every 3 weeks. After three courses of CT, RT was administered (dose, 200 rads/day with a planned total dose of 50-60 Gy). RESULTS: Nineteen tumors were T3; six were T2 and larger than 7 cm. Fifteen patients (60%) had severe dysphagia that required placement of nasogastric tubes in 14 and gastrostomy in 1. All patients were evaluable for response. Thirteen patients (52%) had a partial response to CT. After combined treatment, four patients had complete responses (16%), and nine had partial responses (36%; overall response rate, 52%). The median survival was 8 months; 20% were alive at 1 year, and 8% lived more than 4 years. The median survival for responders to CT was 8 months compared with 5 months for nonresponders (P = 0.005). Combined treatment improved dysphagia in 16 patients (64%) with complete resolution in 13. Toxicity was mild. CONCLUSIONS: The use of sequential CT (cisplatin and bleomycin) and RT in this group of patients is feasible; there is little additional toxicity, and good palliative effects can be achieved. The patient's response to CT is a good prognostic factor. The development of more effective combinations that induce more durable responses and higher rates of complete response are required.

Aged↗
PubMed1991

Radioimmunolocalization of colorectal carcinoma. A correlation among RIL results, surgical findings, serum tumor marker levels and the presence of CEA and CA 19.9 in tumor tissue: the experience of the Hospital de la Santa Creu i Sant Pau.

We report a prospective study in two groups of colorectal cancer patients carried out by radio-immunolocalization (RIL) with F(ab') fragments of monoclonal antibodies against CEA and CA 19.9 labeled with 131-I. Twenty-two patients were studied before radical surgery and 12 patients after initial surgery, when progressive increase in CEA was registered. Scintigraphic images obtained in vivo in RIL studies were compared with scintigraphic images of the corresponding surgical specimens. Results were compared with known serum marker levels and with the presence and localization of markers in the excised specimens. RIL images correctly identified 13 of 23 (52%) primary tumors, with only one false positive image. Scintigraphy of surgical specimens correlated with RIL findings in 14 of 19 cases (74%). Four specimens which showed antibody uptake had not been visualized preoperatively in the RIL study. Two of them were retrovesical and were obscured by residual activity in the bladder. Nine of 13 (64%) patients with at least one elevated tumor marker were imaged. Staining pattern or intensity of antigen staining in the specimens did not correlate with RIL findings. Recurrent disease was confirmed by laparotomy or other exploration in 10 of the 12 patients with progressive CEA elevation during follow-up. Spontaneous normalization of CEA levels was observed in the remaining 2 patients. RIL studies were positive in 7 of the 10 patients with confirmed recurrent disease. Of the 3 false negative patients 2 had liver metastases and one developed clinical lung, bone and adrenal metastases 11 months later. No false positive studies were observed in this group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1990

[Clinical application of radioimmunolocalization in colorectal cancer].

We present preliminary results of radioimmunolocalization (RIL) of colorectal cancer with 131I labelled F(ab')2 fragments from monoclonal anti CEA and anti CA 19.9 antibodies in 22 patients with colorectal cancer and in one patient with metastases of unknown origin and high CEA value. Positive images were obtained in 7 of 11 primary tumors from 10 patients evaluated preoperatively; in 2 of 3 recurrences; in 9 of 12 metastatic localizations and in the unknown primary tumor localized, finally in the cecum. One local recurrence was not detected by any diagnostic methods, but RIL. There was not false-positive images. Therefore, RIL appears as a promising method for the diagnosis and follow-up of colorectal cancer.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1989

[Oat cell carcinoma of the esophagus].

Extrapulmonary locations of undifferentiated small cell carcinoma of the "oat cell" type are uncommon. In spite of its rarity, the appearance of this type of tumor has been described in various organs of the economy. Of these, the esophagus is the most common location, constituting 0.05 to 7.6% of esophageal carcinomas. Of uncertain histopathologic origin, these tumors are characterized by their extreme aggressiveness, which carries a poor short term prognosis. Surgery, radiotherapy and chemotherapy, separately or in combination, have produced discouraging results in the treatment of primitive esophageal "oat cell" carcinoma. In this paper are presented four cases of esophageal "oat cell" carcinoma treated in the Hospital de la Santa Cruz y San Pablo in 1979-1988, out of a total of 260 carcinomas in the same location. The clinical evolution and pathological findings of this type of tumor are commented. The literature on this unusual histological type of carcinoma is reviewed.

Aged↗
PubMed1988

Cisplatin and intravenous continuous infusion of bleomycin in advanced and metastatic esophageal cancer.

Thirty-four patients with locally advanced or metastatic esophageal cancer were treated with cisplatin 35 mg/m2/day x 3 days in bolus, plus bleomycin 15 mg/day x 3 days, as an 18 h infusion, every 21-28 days. Twenty-nine are evaluable for response. Objective response was seen in 15 (52%, 95% confidence limits 35-69%) patients. Toxicity was mild. Twelve patients with locoregional disease were treated with this combination followed by radiotherapy and three of them are alive without disease at 18, 22 and 36 months. This combination warrants further study in the setting of combined treatment.

Aged↗
PubMedDate not supplied

[Determination of nutritional parameters affected in patients with gastric adenocarcinoma who are candidates for surgery according to tumor stage].

An attempt is made to determine the nutritional parameters which are affected in patients with a gastric adeno-carcinoma, who are candidates for surgery, and to relate these parameters to the surgical technique employed, and to the tumor stage. Later, they aim to determine the parameters which may be indicative of the surgical prognosis of these patients. To this end, between January 1992 and October 1994, 66 patients, distributed in two groups, were studied. Group A included the patients who had undergone a total gastrectomy or a partial gastrectomy, and group B included those individuals subjected to an exploratory laparotomy, gastro-intestinal derivation, and subtotal or palliative gastrectomy. When analyzing the results obtained in the two groups of patients, it is observed that all of them have one or more altered nutritional parameters, and that the means of these parameters are more altered in group B than in group A. However, only the percentage of weight loss and the serum albumin level present significant differences between the two groups. That is to say, we observe that patients with serum albumin levels lower than 35 g/l, and with a weight loss of > 6%, have a greater risk of being subjected to an exploratory laparotomy, a gastro-intestinal derivation, or a total or subtotal palliative gastrectomy, than do patients with serum albumin levels > 35 g/l and a weight loss of < or = 6%. We may conclude that the loss of weight and the serum albumin level may help to decide a more or less aggressive surgical approach, and to predict the possible resectability of the tumor.

Adenocarcinoma↗