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Biomedical subjects

H E Windschitl

Publications and source records attributed to H E Windschitl.

26 records · Page 2Linked to original sources

A comparison of three chemotherapeutic regimens in the treatment of advanced pancreatic and gastric carcinoma. Fluorouracil vs fluorouracil and doxorubicin vs fluorouracil, doxorubicin, and mitomycin.

Three hundred five patients with advanced pancreatic and gastric carcinoma were randomly assigned to treatment with fluorouracil, fluorouracil plus doxorubicin (Adriamycin) (FA), or fluorouracil plus doxorubicin plus mitomycin (mitomycin C) (FAM). All regimens were equivalent with regard to patient survival. There is no reasonable likelihood that either the FA or FAM regimen could produce a meaningful survival advantage over fluorouracil alone. Interval to disease progression, objective response rates, and palliative effects (improved performance, body weight, or symptoms) were essentially equivalent among the three regimens. With regard to toxicity, the FAM regimen produced more anorexia, nausea, vomiting, leukopenia, thrombocytopenia, and cumulative bone marrow suppression. Fluorouracil alone produced more stomatitis and diarrhea. Because of a failure to produce improved survival or palliation, unrewarded toxicity, and excessive cost, neither the FA nor FAM regimen can be recommended for the treatment of advanced pancreatic or gastric cancer.

Adenocarcinoma↗

A controlled evaluation of combined 5-fluorouracil, doxorubicin, and mitomycin C (FAM) for the treatment of advanced non-small-cell lung cancer.

One hundred eighty-six patients with advanced non-small-cell lung cancer were randomly assigned to treatment with combined 5-fluorouracil, doxorubicin, and mitomycin C (FAM) or combined methotrexate, doxorubicin, cyclophosphamide, and lomustine (MACC). Respective objective regression rates were comparable at 20% and 16%. Distribution of intervals to progression (overall median, 2.8 months) and survival times (overall median, 5.0 months) were essentially identical between the two regimens. The comparability of therapeutic effect was also evident within the subset of 81 patients who had adenocarcinoma cell type, although MACC showed a small advantage in survival after covariate analysis. In large-cell carcinoma, MACC showed a higher regression rate than that of FAM as well as a small advantage in survival. In squamous-cell carcinoma, however, FAM was superior to MACC in regression rates (32% v 4%) and also provided somewhat longer survival. With regard to toxicity, MACC produced a higher incidence of nausea and vomiting, whereas FAM produced more frequent and severe thrombocytopenia. From an overall standpoint, the therapeutic accomplishments of both regimens were disappointing. Our study does, however, provide additional evidence that mitomycin C-containing regimens may be selectively effective for squamous-cell carcinoma of the lung.

Adenocarcinoma↗

Randomized clinical trial of cyclophosphamide, 5-FU, and prednisone with or without tamoxifen in postmenopausal women with advanced breast cancer.

The purpose of this study was to determine if tamoxifen added to the efficacy of a CFP (cyclophosphamide, 5-FU, and prednisone) regimen. One hundred thirty-one postmenopausal women with advanced breast cancer without prior chemotherapy exposure were randomized to receive CFP alone or combined with tamoxifen; six were disqualified because of ineligibility. Objective responses were seen in 68% of the eligible patients receiving CFP and in 61% of those receiving CFP plus tamoxifen. Median times to progression were 287 days for CFP and 158 days for CFP plus tamoxifen (two-sided log-rank test of equality of progression distributions, P = 0.07). Median survival times were 544 days for CFP and 394 days for CFP plus tamoxifen (two-sided log-rank test of equality of survival distributions, P = 0.14). The addition of tamoxifen to CFP was not associated with longer time to progression or survival in any Cox covariate model. On the basis of our data, it can be concluded that the addition of tamoxifen to CFP does not substantially improve either the time to disease progression or survival in women with metastatic breast cancer.

Adult↗