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Biomedical subjects

H Hausmaninger

Publications and source records attributed to H Hausmaninger.

At least 37 records · Page 2Linked to original sources
PubMed1997

Adjunctive interferon-alpha-2c in stage IIIB/IV small-cell lung cancer: a phase III trial.

Preliminary studies have shown bioactivity of interferons (IFNs) in the treatment of small-cell lung cancer (SCLC). The aim of the present study was to determine whether, in patients with advanced SCLC, a combination of recombinant IFN-alpha-2c and standard induction chemotherapy would improve response rates and survival at acceptable toxicity. Of the 85 patients recruited by 11 centres in Austria, 77 were evaluable for response after induction therapy; of these, 43 were randomized to receive the combined treatment (three cycles each of cyclophosphamide/vincristine/doxorubicin and cisplatin/etoposide plus subcutaneous IFN-alpha-2c), and 34 received chemotherapy alone. After the induction phase, patients in the IFN arm had higher rates of complete (30 vs 15%) and partial remission (42 vs 29%) than those who received chemotherapy alone. Accordingly, there was a lower rate of progressive disease in the interferon arm (21 vs 44%; p < 0.05). Whilst there were no significant differences in time to progression (7.6 vs 5.4 months) patients in the IFN arm survived longer than those in the chemotherapy arm (p < 0.02). Six of the patients treated with IFN (14%) survived for more than 2 yrs, whereas none in the chemotherapy arm did. We conclude that the addition of interferon-alpha-2c to induction chemotherapy may improve response rates and survival in advanced small-cell lung cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

CEOP-IMVP-Dexa in the treatment of aggressive lymphomas: an Austrian multicenter trial.

PURPOSE: This trial evaluated the efficacy, toxicity, and practicability of a new intensive chemotherapy regimen in a multicenter setting of university and community hospitals. PATIENTS AND METHODS: We tested a hybrid protocol of two non-cross-resistant regimens, cyclophosphamide, epirubicin, vincristine, and prednisolone (CEOP) and ifosfamide, etoposide (VP-16), methotrexate, and dexamethasone (IMVP-Dexa) given every fourth week, three to six times according to response, in patients with untreated intermediate- and high-grade non-Hodgkin's lymphoma. Ten Austrian centers entered 81 patients onto this multicenter trial. Eleven patients were excluded. The median age was 55 years. Twenty-six of 70 patients had stage III or IV disease. The distribution among international risk categories low, intermediate-low, intermediate-high, and high was 20%, 34%, 23%, and 23%, respectively. RESULTS: Of 70 eligible patients, 56 (80%) had a complete remission and seven (10%) a partial remission. After a median observation time of 36 months, the estimated time to relapse and overall survival rates are 67% and 72%, respectively. Age and Karnofsky index were the only independent risk factors for survival. Toxicity was primarily hematologic, with a median granulocyte nadir of 0.56 x 10(9)/L. Sixty-seven percent of patients had infections; 25.7% were severe World Health Organization (WHO) grade III or IV. There were three treatment-related deaths. CONCLUSION: CEOP-IMVP-Dexa chemotherapy is safe and feasible on a groupwide basis even when used in community hospitals. Neutropenic infections are the major complications. A 72% 3-year survival rate in patients with intermediate- and high-grade non-Hodgkin's lymphoma warrants further studies. These data are the basis for a randomized trial to compare cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) with CEOP/IMVP-Dexa.

Adolescent↗
PubMed1995

Randomised phase II study of epirubicin-vindesine versus mitoxantrone-vindesine in metastatic breast cancer.

The purpose of this study was to compare the activity and toxicity of epirubicin-vindesine (EV) with mitoxantrone-vindesine (MV) in patients with metastatic breast cancer. A total of 295 patients was randomly allocated to treatment with vindesine 3 mg/m2 combined with either epirubicin 40 mg/m2 or mitoxantrone 10 mg/m2. All drugs were given by intravenous push, treatment cycles were repeated at 3-4 week intervals. 255 patients were available for response, and 283 for toxicity. EV and MV yielded similar objective response rates (34 and 26%, respectively), response durations, times to progression and survival. Median time to remission was 1.8 and 3.1 months (P = 0.006) with EV and MV, respectively. In patients with visceral metastases, response rate was higher with EV than MV (40 versus 23%; P = 0.03). Patients receiving MV had less nausea/vomiting (P = 0.007) and alopecia (P = < 0.001) of WHO grade > or = 2. Bone marrow, cardiac and other toxicities were mild with both treatments. The observed differences in activity and toxicity between the two regimens appear to have clinical relevance. EV proved to be more active in visceral disease and to be able to induce remissions more rapidly. Accordingly, patients with visceral metastases or severe tumour-related symptoms may benefit from epirubicin-based treatment. Subjective toxicities, i.e. nausea/vomiting and alopecia, were less frequent and severe with MV. Thus, MV may prove useful in patients with more indolent disease and appears to warrant phase III evaluation in such patients.

Adult↗
PubMed1990

Pirarubicin (4'-o-tetrahydropyranil-adriamycin) for treatment of advanced breast cancer. A Clinical Phase II study.

In a phase II study, 77 patients with metastatic breast cancer were treated with pirarubicin, 70 mg/m2 iv every 3 weeks. Most of them had received prior hormonal (n = 39) and/or chemotherapeutic drug treatment for advanced disease, including anthracycline-containing regimens in 17. After a median of 5.5 treatment cycles (range 1-14), objective tumor response was seen in 22/71 (31%) evaluable patients (4CR, 18 PR). Stable disease occurred in 34 (48%) patients, whereas the tumor progressed in 15 (21%). Significant hematologic toxicity (WHO grade III-IV) requiring interval and/or dose adjustments was observed in 41 (58%) patients. Other treatment-related side effects were generally mild, and included alopecia in 52 (73%), nausea and/or emesis in 50 (70%), and stomatitis and diarrhea in 3 patients each. There was no treatment-related death, nor was there any evidence of cardiac toxicity thus far. In summary, the early results of this trial suggest that pirarubicin is an active and rather well tolerated drug in pretreated patients with advanced breast cancer.

Adult↗
PubMed1990

Prognostic significance of tumor cell morphometry, histopathology, and clinical parameters in advanced ovarian carcinoma.

The prognostic value of clinicopathologic data and tumor cell morphometry was assessed in 49 consecutive patients with advanced epithelial ovarian carcinoma (Stage III-IV as defined by the International Federation of Gynaecologists and Obstetricians [FIGO]). Single-variant analysis proved that nuclear area at the 10th, 50th, and 90th percentiles and nuclear density were the strongest prognostic factors. To assess difference in prognostic influence between morphometric and clinicopathologic factors, Cox regression analysis was carried out and revealed nuclear density and age as prognostically significant (p less than 0.0003 and p less than 0.0004, respectively). Choice of chemotherapy, FIGO stage, histologic grade, and mitotic activity index (MAI) were not of additional prognostic importance. Objective measurement of morphometric factors is simple, highly reproducible, and adequate for routine work and promises to be of clinical value in therapeutic decision-making in advanced ovarian carcinoma.

Adult↗
PubMed1989

The value of morphometry to predict chemotherapy response in advanced ovarian cancer.

We evaluated the correlation of morphometric parameters to chemosensitivity. 63 patients with palliatively operated advanced epithelial ovarian cancer were investigated concerning their response to chemotherapy. Using multiple linear stepwise discriminant analysis of five morphometrical parameters 13 out of 17 responders and 37 out of 46 non-responders were correctly classified (76.5% sensitivity, 80.4% specificity, 79.4% efficiency). The five parameters were: nuclear area at the 10th percentile, standard deviation of the nuclear area, median value of the nuclear ovality, number of cells per area and mitotic activity index. To assess the performance of the discrimination formula when applied to new cases, the "leave one out" method was used. For our data the following corrected classification rates were obtained: 58.8% responders (10/17), 76.1% non-responders (35/46) (efficiency 71.4%). Morphometry is a fast and reproducible method to objectively record a tumor's morphology. Our results indicate that there is a correlation between morphometrical features, response to chemotherapy and survival, which should be tested in further studies.

Adult↗
PubMed1989

Vindesine-epirubicin versus vindesine-mitoxantrone in metastatic breast cancer.

UNLABELLED: The present study was designed to assess the toxicity and efficacy of two chemotherapy protocols in patients with metastatic breast cancer. Starting in December 1985, 230 patients were randomized to receive vindesine (V) (3 mg/m2 i.v.) and mitoxantrone (M) (10 mg/m2 i.v.) or V and epirubicin (E) (40 mg/m2 i.v.) every 3 weeks x 3 and every 4 weeks thereafter. Patients were stratified according to site of disease (visceral, bone or soft tissue dominant) and prior therapy. Patient groups were comparable with respect to menopausal status, age, estrogen receptor status and disease-free interval. About two-thirds of the patients presented with visceral recurrence and 30% with bone lesions: only 8% had soft tissue metastases. RESULTS: We observed a significant difference (p = 0.003) in the frequency of alopecia (WHO grade 3-4, 36% vs. 60% favoring regimen VM); gastrointestinal and hematologic side effects and neurotoxicity were mild and similar for both groups. In 182 evaluable patients there was a 26% response rate (CR + PR. UICC criteria) for VM and 35% for VE (not significant). NC was observed in 37% and 43% of patients treated with VM or VE respectively. There was no significant difference between these two groups with regard to time to progression and survival. The median time of follow-up was 8 months and therefore too short to draw definite conclusions. Both regimens were well tolerated and seem to be equally effective, although the response rate for VM and VE was lower than expected.

Adult↗
PubMed1988

Steroid hormone receptors and prognosis in breast cancer.

The importance of steroid receptors for the prognosis of mammary carcinoma has been evaluated by investigating the course of disease in 163 patients for a median follow up time of 66 months after mastectomy. Multivariate analysis including estrogen receptor (ER), progesterone receptor (PgR), the presence of 8S and 4S ER together or 4S ER only, and the lymph node status revealed only the latter to have significant (p less than 0.001) predictive potency. Lymph node positive (N-pos) patients had a 3.3 (1.7-6.2) fold risk of death and 2.8 (1.7-4.7) fold risk of recurrence relative to node negative (N-neg) patients. When we compared overall survival (OAS) and disease-free survival (DFS) in the various receptor-positive groups with the groups that displayed neither ER nor PgR, significant differences in prognosis were only seen in N-neg patients. PgR did not turn out to be a better prognostic factor than ER, nor was the 8S ER a sign of increased OAS and DFS compared to total ER. However, the number of patients in this group was too small to allow a definite statement.

Breast Neoplasms↗
PubMed1988

Treatment of herpes zoster. Recombinant alpha interferon versus acyclovir.

Sixty-four patients received systemic alpha-interferon (10 million units subcutaneously daily) and 63 received systemic acyclovir (5 mg/kg body weight intravenously thrice daily) in a randomized study of acute herpes zoster. Start of healing, complete healing, development of new skin lesions in the primarily affected and in other dermatomes, and degree and duration of pain were evaluated. Both drugs proved equally clinically efficient without statistically different findings between the two groups; herpes zoster neuralgia was not prevented by either interferon or acyclovir therapy. Minor clinical side effects occurred slightly more frequently during interferon treatment and included fever and nausea. Transient and moderate leukopenia was observed in nearly all patients in the interferon group.

Acyclovir↗
PubMed1988

Vindesine-mitoxantrone (VM) versus vindesine-4'-epidoxorubicin (VE) in metastatic breast cancer: a prospective randomized trial.

182 patients with metastatic breast cancer were randomized to V (mg/m2 i.v.) and M (10 mg/m2 i.v.) or E (40 mg/m2 i.v.) every 3 weeks x 3 and then every 4 weeks; they were stratified by sites of disease (visceral, bone, or soft-tissue dominant) and by prior chemotherapy. In a preliminary analysis there is a significant difference regarding frequency of alopecia (WHO Grade 3 or 4) favoring regimen VM; gastrointestinal, hematologic and neurotoxic side effects were mild and similar for both groups. Of 114 evaluable women there is a response rate (CR + PR) of 26% and 34% for VM and VE respectively (n.s.), and there is no significant difference between the 2 groups in time to progression and survival. Both regimens are well tolerated and seem to be equally effective. The median follow-up time is too short to draw final conclusions.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

[Mitoxantrone in a combination regimen in advanced breast cancer].

The new anthracendione mitoxantrone, an anthraquinone derivate with structural similarities to doxorubicin (adriamycin) is active in the treatment of patients with metastatic breast cancer. It has less acute toxicity than doxorubicin, may be non cross resistant with doxorubicin and appears to have less cardiotoxicity. Phase-II-studies have confirmed antitumor activity ranging from 6 to 36%, mitoxantrone combined with conventional drugs produced response rates between 25 and 90%. 32 heavily pretreated patients--nearly 70% had visceral metastasis--were assigned to treatment with vindesine 3 mg/m2 i.v. and mitoxantrone 10 to 12 mg/m2 by i.v. infusion. Treatment cycles initially were repeated every 3 weeks. 25/32 patients are available for response. There were 1 complete remission (4%), 3 partial remissions (12%), 2 minor responses (8%) (remissions + minor responses = 24%), 7 no change (28%) and 12 failures (48%). Response durations were 11, 8, +5, +6 months. The acute toxicity was mild, nausea or vomiting grade greater than or equal to 2 were found only in 4/32 patients (12%), the rate of alopecia grade greater than or equal to 2 was 28% (only 2 patients [6%] required a wig). Myelosuppression on the other hand was moderate. Nearly two thirds of patients developed leucopenia less than 2,0 X 10(9)/I, in 22% of patients platelet nadir less than 100,0 X 10(9)/I was registered. In conclusion these preliminary results suggest an improvement in therapeutic index with this treatment regimen.

Anthraquinones↗
PubMed1984

[Adjuvant endocrine forms of therapy in breast cancer].

Determination of oestrogen receptor (ER) and progesterone receptor (PgR) allows a prediction of response to endocrine treatment in patients with metastasizing breast cancer. Randomized trials of ovariectomy or irradiation of the ovaries showed a prolonged recurrence-free interval in these patients as compared with a non-castrated control group, but no influence on the overall survival rate. All these studies were performed without prior knowledge of the ER and PgR status of the primary tumour. Randomized trials with the anti-oestrogen, tamoxifen showed a prolonged recurrence-free interval; one study showed significantly prolonged overall survival. Studies employing combined chemo-hormonal therapy showed a lower recurrence rate in postmenopausal patients with ER + PgR + tumours, as compared with patients treated by chemotherapy alone. Adjuvant treatment prolongs the recurrence-free interval in postmenopausal patients. The follow-up periods are too short as yet to allow final conclusions regarding influence on the overall survival rate to be drawn. An optimal adjuvant endocrine treatment schedule in premenopausal patients with ER + PgR + tumours needs to be established in future studies.

Breast Neoplasms↗
PubMed1983

[Results of a multidisciplinary treatment protocol for advanced squamous cell carcinoma in the ORL region].

49 previously untreated patients with advanced stage III or IV epidermoid cancer of the head and neck were included in a controlled study. Prior to and after radiotherapy or surgery, 41 patients received regimen I with platinum and bleomycin, 8 patients in regimen II were treated with bleomycin, cyclophosphamide, methotrexate and 5-fluorouracil. After initial chemotherapy and radiotherapy (2000 rad) 31 patients (76%) in regimen I and all patients in regimen II showed an objective complete or partial response. At the end of radiotherapy or surgery 37 of 49 (75%) patients achieved complete tumour clearance. The median follow-up in our study is 17 months and the median survival 22 months (preliminary results). The combined modality approach demonstrated substantial antitumour activity, but we will have to await the results of randomized studies to assess the value of adjuvant chemotherapy in advanced head and neck cancer.

Austria↗
PubMedDate not supplied

Toxicity and preliminary results with a new eight-drug regimen (CEOP-IMVP-DEXA) in the treatment of aggressive lymphomas.

A combination of two non-cross-resistant regimens, CEOP and IMVP-Dexa given every 4 weeks, three to six times according to response was tested in patients with untreated histological proven high and intermediate grade non-Hodgkin's lymphoma. To date eight Austrian centres entered 37 patients in this multicentre trial. Data are available from 33 patients, three were excluded, two because of pretreatment, one because of wrong histology. Twenty-five patients are evaluable for response, 21 had a complete and three a partial remission, two of them entered a complete remission after radiotherapy to residual disease, resulting in a complete remission rate of 92 per cent. Only one patient progressed during therapy. Until now three patients relapsed after achieving a remission. Observation time is 0.4-23.8 months, median 8.8 months. Toxicity was primarily hematologic with 53.3 per cent of patients having granulocyte nadirs below 0.5 x 10(9)/L and 3.3 per cent below 0.1 x 10(9)/L. Although 60 per cent of patients had infections, there was only one life-threatening infection in an AIDS patient. CEOP-IMVP-Dexa can be safely given even in smaller hematologic centres and is able to achieve a high rate of complete responses in patients with high and intermediate grade malignant non-Hodgkin's lymphomas.

Adult↗
PubMedDate not supplied

Male breast cancer: Austrian experience.

Data were collected on 169 men treated for breast cancer at 36 surgical departments in Austria between 1970 and 1991. We report here several of their clinical features and assess the importance of established prognostic factors. After a median observation period of 51 months 60 patients (35%) suffered a recurrence. The estimated 5-year recurrence-free survival for the entire group was 55%, and the estimated 5-year overall survival was 62%. Although stage-adjusted data are comparable to those for female breast cancer, the outcome in this series may be attributed to a relatively high frequency of advanced tumor stages. Tumor size (recurrence-free survival p = 0.00001; overall survival p = 0.03) and axillary lymph node status (recurrence-free survival p = 0.0001; overall survival p = 0.0001) proved to have a prognostic impact. Using a multivariate analysis, axillary lymph node status (recurrence-free survival p = 0.001; overall survival p = 0.01) still had prognostic influence. The various procedures used had no effect on local recurrence.

Adult↗