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Biomedical subjects

F R Eilber

Publications and source records attributed to F R Eilber.

At least 73 records · Page 4Linked to original sources
PubMed1982

"Early" carcinoma of the breast: evaluation of regional therapy and features influencing prognosis.

Between 1944 and 1969, 192 women with carcinoma of the breast were treated at The University of Texas System Cancer Center M. D. Anderson Hospital and Tumor Institute by standard radical mastectomy for small outer quadrant lesions and pathologically negative axillary lymph nodes. Twenty percent of these patients with "localized disease" eventually had disseminated breast cancer. Various patient, hormonal, genetic, and pathologic factors were found to have little influence on the prognosis. Patterns of metastatic disease revealed that these patients did not have a unique form of breast cancer, but apparently an earlier stage in the spectrum of advancing disease. The results of this study appear to represent the best that can be obtained with regional therapy for carcinoma of the breast and emphasize the need for reliable adjuvant therapy.

Adult↗
PubMed1981

Retroperitoneal sarcomas: a reappraisal of treatment.

Retroperitoneal sarcoma, regardless of the histopathologic grade of malignancy, has a high incidence of local recurrence that is usually fatal. Surgical resection is mandatory and resectability may be improved by a midline transabdominal approach. However, even with total tumor excision, recurrence is high. A preliminary study, combining resection and preoperative adriamycin, found to be effective for established disease, suggests potentially improved prognosis. Further clinical trials employing combined with adjuvant chemotherapy are warranted.

Adolescent↗
PubMed1980

Neurofibrosarcoma.

Case histories of 10 patients with neurofibrosarcoma, including 14 (70%) with neurofibromatosis, evaluated over 10 years were reviewed to determine the incidence of local and systemic recurrence and the most effective means of therapy for this rare neoplasm. Initial therapy resulted in complete local disease control in only 11 (55%) patients. Local excision, or local excision plus radiation or chemotherapy resulted in local recurrence in 8 of 12 patients. Radical surgery alone, or radical surgery combined with radiation and chemotherapy resulted in local recurrence in 1 of 6. Even with complete local disease control, 7 of 16 (44%) patients died of metastases. Both A.J.C. Clinical Stage II and III patients had a similar poor prognosis. Associated neurofibromatosis did not worsen prognosis. These data suggest that both moderate and high-grade primary neurofibrosarcoma are highly malignant neoplasms and should be treated by radical resection. Preoperative intraarterial Adriamycin and radiation--found to be successful for other highly malignant sarcomas--may be of benefit. Since distant disease occurs despite local control, postoperative adjuvant chemotherapy trials are warranted.

Adolescent↗
PubMed1980

Is amputation necessary for sarcomas? A seven-year experience with limb salvage.

The rationale for amputation for local tumor control of skeletal and soft tissue sarcomas was based on results obtained from surgical therapy alone. However, our previous results from a pilot trial of multimodality therapy of preoperative chemotherapy and radiation therapy followed by surgical resection indicated that limb salvage (without amputation) could be accomplished in most patients with little morbidity and low recurrence rate. This report summarizes our experience in a prospective trial from January 1972 to December 1979. A total of 105 consecutive patients with soft tissue sarcomas (65 patients) or bone sarcomas (40 patients) were treated with preoperative intraarterial adriamycin, 3500 rads of rapid-fraction radiation and radical en bloc resection of primary tumor. Diseased bones were replaced with cadaver allografts (22 patients), metallic endoprostheses (10 patients) autologous bone (2 patients), or no replacement (ilium or fibula-4 patients). Salvage of a viable, neurologically intact, functional extremity was achieved in 98/105 patients (98%); 97% of limb salvage patients were free of local recurrence after a median follow-up period of 28 months. Major complication rate that required amputation was 3/105 patients (2%). Postoperative adjuvant chemotherapy with cyclical adriamycin and high-dose methotrexate was employed for all patients with osteosarcoma and 35 patients with grade III soft tissue sarcomas. The overall disease-free rate is 50% (18/35) for osteosarcomas and 65% (42/65) for soft tissue sarcomas. These results indicate that local tumor control can be achieved in 91% of patients without amputation. Their functional capabilities are excellent with a low complication rate. Since the advent of adriamycin and methotrexate has significantly improved the overall survival for patients with skeletal and soft tissue sarcomas, the quality of this survival has become even more important. Preoperative multimodality therapy is a major advance in this direction and since results of limb salvage procedures appear to be equal or superior to those achieved by amputation we believe these alternatives should be offered to all patients.

Adolescent↗
PubMed1979

Internal hemipelvectomy--excision of the hemipelvis with limb preservation. An alternative to hemipelvectomy.

Our results indicate that it is technically possible to resect the hemipelvis and maintain a viable extremity. Functional results are remarkably good and tumor control has been equivalent to standard hemipelvectomy. Excision of the ilium with preservation of the extremity in selected cases would appear to be a reasonable alternative to the standard hemipelvectomy, which involves amputation of the extremity.

Adolescent↗
PubMed1978

Effect of adriamycin and high-dose methotrexate chemotherapy on in vivo and in vitro cell-mediated immunity in cancer patients.

Adjuvant chemotherapy with adriamycin (ADR) and high-dose methotrexate (HDM) with citrovorum rescue appears to hold promise for preventing recurrence of sarcomas following surgery. However, the effect of prolonged treatment with these agents on both in vivo and in vitro cell-mediated immunity (CMI) is unknown. To assess in vitro CMI, cryopreserved lymphocytes from 18 patients, collected before and at monthly intervals following initiation of biweekly ADR and HDM therapy, were tested simultaneously for stimulation to phytohemagglutinin, poke-weed mitogen, Concanavalin A, and pooled allogeneic lymphocytes by a micro-test technique. In vivo CMI was determined by serial skin-testing with 2,4,-dinitrochlorobenzene (DNCB). No significant overall change was noted for any of the in vitro lymphocyte function tests. DNCB skin test ratings, peripheral leukocyte counts and absolute lymphocyte counts did not change significantly during the study. Lymphocytes from a second group of patients were tested before, at 24 and 48 hours after HDM therapy. In vitro lymphocyte function tests were significantly depressed 24 hours following treatment, but returned to pretreatment levels at 48 hours. Long-term adjuvant ADR and HDM therapy does not appear to alter in vivo and in vitro CMI, although transient depressions were noted. The preservation of intact CMI may account in part, for the effectiveness of these agents as surgical adjuvants.

Adult↗
PubMed1978

Preliminary results of a randomized trial of adjuvant immunotherapy in patients with malignant melanoma who have lymph node metastases.

This study evaluates the effect of adjuvant immunotherapy with BCG alone, or combined with melanoma cell vaccine, on the recurrence and survival rates of patients with metastatic melanoma in the regional lymph nodes who were treated by lymphadenectomy. Patients were prospectively randomized and stratified on the basis of age, sex, site of primary tumour, and clinical estimate of the regional nodes. During the past four years, 134 patients were entered into this trial, and to date, the incidence of recurrence among the two arms mentioned and the control arm is not significantly different; however, patients receiving BCG alone had longer survival than those in either the tumour cell vaccine or control groups. The improved survival in the BCG-only group was found to be due to the fact that patients survived longer with their recurrent disease than the patients in the other two groups. At the present time, these differences do not appear to be significant enough to justify routine adjuvant immunotherapy in patients with melanoma metastatic to regional nodes. Longer follow-up will be necessary to evaluate the role of adjuvant immunotherapy of Stage II melanoma.

Adult↗
PubMed1978

Limb salvage using preoperative intraarterial adriamycin and radiation therapy for extremity soft tissue sarcomas.

Surgical therapy has been the accepted method for management of most soft tissue sarcomas of the extremities, although it has been associated frequently with local treatment failure. Even when local control was achieved, over 50% of the patients with soft tissue sarcomas eventually developed and succumbed to distant metastases of their disease. Therefore, single modality therapy for soft tissue sarcomas by operation alone results in an unacceptably high incidence of treatment failure. Fortunately, new adjuvant treatment techniques have been developed that seem to have activity against these neoplasms. It is the purpose of this article to discuss our experience with a number of these techniques.

Doxorubicin↗
PubMed1978

Adjuvant therapy for osteosarcoma: preoperative and postoperative treatment.

Seventeen consecutive patients with osteogenic sarcoma participated in a prospective study to ascertain first, whether postoperative adjuvant chemotherapy or chemoimmunotherapy could reduce the incidence of distant metastases and second, whether in situ tumor cell destruction could be achieved with preoperative chemotherapy and radiation therapy. To date 14 of 17 patients (85%) are alive and free of disease for a median survival time of 11 months. Three patients developed recurrent disease, one with local recurrence in the tibia and two with pulmonary metastases. Limb salvage was attained in 12 patients by cadaver allografts and in one patient by radiation alone at 6 months.

Adolescent↗
PubMed1978

Selective reduction of human tumor cell populations by human granulocytes in vitro.

Human peripheral blood granulocytes at a 10:1 effector cell:target cell ratio were shown by an in vitro semiquantitative staining procedure to reduce the number of human tumor cells, but not that of normal cells. Microscopic observations revealed that this selective reduction of tumor cells by granulocytes was a function of both detachment and cytolysis. The cytotoxic effect of granulocytes on the tumor cells was confirmed by a quantitative 5-[125I]iodo-2-deoxyuridine release assay. The data indicate that human granulocytes at a relatively low effector:target cell ratio (10:1) have the capacity to recognize and destroy human tumor cells in vitro.

Animals↗
PubMed1977

Failure of adjuvant immunotherapy to prevent central nervous system metastases in malignant melanoma patients.

A review of our experience using BCG immunotherapy as a postsurgical adjunct in the treatment of melanoma shows that the incidence of systemic metastases appears to have been reduced. However, central nervous system (CNS) metastases continue to develop in these patients and represent the single most frequent cause of death. Serial studies of immune competence in these patients reveal that those with CNS metastases usually retain normal immune responses, whereas those with metastases at other sites exhibit progressive immunosuppression with advancing disease.

Adjuvants, Immunologic↗