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Biomedical subjects

J E Goodnight

Publications and source records attributed to J E Goodnight.

14 recordsLinked to original sources
PubMed1992

Gamma probe location of 111indium-labeled B72.3: an extension of immunoscintigraphy.

Eight colorectal and 5 ovarian cancer patients were evaluated with preoperative immunoscintigraphy and intraoperative gamma probe detection of 111indium-labeled monoclonal antibody B72.3. Immunoscintigraphy detected the presence of tumor in every patient shown to have tumor at surgery. There was one false-positive scan. A total of 21 pathologically verified lesions were identified at surgery in the 11 patients with tumor. Immunoscintigraphy localized 12 (57%) and intraoperative gamma probe detection located 17 (81%) of the lesions. Intraoperative probe detection located 6 of 8 lesions smaller than 1 cm and 3 lesions that were not identified on initial surgical exploration. The gamma probe offers information that is complementary to immunoscintigraphy in that (1) it aids the surgeon in locating intra- and extra-abdominal lesions previously identified by immunoscintigraphy, (2) it locates lesions too small to be seen by immunoscintigraphy alone, (3) it locates lesions that otherwise might be missed at surgery, and (4) it provides objective evidence for adequacy of surgical resection of cancer in the abdominal cavity.

Aged↗
PubMed1992

A simplified technique to resect abnormal bony radiolocalizations using a gamma counter.

A simplified technique for localizing and verifying the correct biopsy site of lesions identified on a bone scan has been utilized. A hand-held gamma counter was used for localization of incision placement, determination of extent of bone to be resected, and verification that appropriate tissue was resected. This technique was used to guide biopsy of bony lesions in five patients and to guide resection of a pubic ramus chondrosarcoma. We conclude that intraoperative use of a gamma counter to guide biopsy of bony lesions minimizes surgery time, increases the confidence of obtaining correct tissue, and makes a frequently frustrating procedure very simple. In addition, the probe may assist with determining adequate margins at definitive resection of tumours which accumulate technetium-99m MDP.

Adult↗
PubMed1991

Composite tissue transfer in limb-salvage surgery.

After extensive resection due to extremity sarcoma, the inability to cover the defect for satisfactory healing and limb function has been an indication for amputation rather than limb salvage. We report herein our experience with seven limb-salvage cases in which we closed difficult and complex defects with composite tissue transfers utilizing microvascular techniques. Free-flap transfers were used to cover soft-tissue defects after extensive resection of primary and locally recurrent tumor and to manage radiation-induced complications. The grafts healed well when infected irradiated tissue was covered, and the grafts tolerated postoperative irradiation. Composite tissue transfer also provided soft-tissue coverage around distal joints that would not have been adequately protected with a skin graft. Complications were minimal, and all patients maintained good extremity function. No patient who underwent composite tissue transfer has had a local recurrence. A free-flap composite tissue transfer can extend the indications for limb-salvage surgery and offers an alternative to amputation in selected patients.

Adolescent↗
PubMed1991

Results of resection and proposed guidelines for patient selection in instances of non-colorectal hepatic metastases.

Resection of hepatic metastases from carcinomas of the colon and rectum appears to extend the survival time in appropriately selected patients. Selection criteria have been widely published. Similar data for patients with hepatic metastases from primary sites other than the colon and rectum are lacking. To determine which, if any, patients in the latter category benefit from resections, we reviewed ten such instances treated at our institution plus 141 instances of resection for noncolorectal hepatic metastases previously reported. The over-all five year survival rate after resection of noncolorectal hepatic metastases is 20 per cent. When Wilms' tumor is excluded, the five year survival rate is 15 per cent. Approximately four of ten patients with metastases to the liver from Wilms' tumor or carcinoid survived five years after resection. Similar benefit is rarely obtained after resection of hepatic metastases of the breast, kidney, adrenal gland and carcinomas of the stomach; malignant melanoma, and leiomyosarcoma. No extension of survival is apparent for resection of hepatic metastases of gynecologic malignancies or carcinoma of the pancreas. Specific guidelines for selection are discussed in view of the limited prognosis when tumors other than carcinomas of the colon and rectum metastasize to the liver. Careful patient selection and minimization of complications are required.

Adult↗
PubMed1990

Intralesional cis-diamminedichloroplatinum and purified collagen treatment of human metastatic malignancies: a feasibility study.

A feasibility study of the treatment of advanced superficial human malignant tumors utilizing direct intralesional injections of cisplatin mixed with purified bovine collagen was performed. The purpose of using intralesional injection of cisplatin mixed with collagen was to limit the drug exposure to normal tissues while increasing the dose and duration of exposure to the tumor. Fourteen evaluable superficial tumors in four patients (melanoma, breast CA, squamous CA from larynx) received a total of 65 treatments in the outpatient clinic setting. All patients had failed prior treatment with systemic intravenous cisplatin. Lesions were treated at least three times at two-week intervals. After intramuscular meperidine premedication, multiple injections of cisplatin mixed with collagen were made into the tumors. There was minimal normal tissue toxicity and minimal systemic toxicity. Tumor regression or stabilization occurred in 86% (12/14) of tumors; 50% (7/14) of lesions regressed more than 50% in size. This study suggests that intralesional colloidal cisplatin can overcome resistance to systemic intravenous cisplatin.

Adenocarcinoma↗
PubMed1979

Intratumor bacillus Calmette-Guerin therapy for chest wall recurrence of carcinoma of the breast.

Intratumor bacillus Calmette-Guerin administration is effective for treating chest wall recurrence from carcinoma of the breast in selected patients. Our results suggest that bacillus Calmette-Guerin therapy can be used alone, with systemic chemotherapy, hormonal therapy or in previously irradiated tissue. It represents local treatment for local disease that is well tolerated. Intratumor bacillus Calmette-Guerin treatment is a useful clinical method for the treatment of local chest wall disease.

Adult↗
PubMed1978

Clinical trials of immunotherapy: present status.

This brief review of the more promising clinical trials suggests that immunotherapy is indeed beneficial for selected cancer patients. Because of its limited potency, it should not be used as primary treatment for malignant disease except as local immunotherapy for certain accessible tumors. It is effective for eradication of primary neoplasms of the skin as well as cutaneous metastases of malignant melanoma and breast carcinoma. The most important role for immunotherapy is in combination with other modalities. It may help control occult micrometastases that cause recurrence and death following surgical procedures or irradiation. Results of adjuvant immunotherapy appear promising for malignant melanoma, for carcinoma of the lung, breast, and colon, and for soft-tissue sarcomas. In combination with chemotherapy, immunotherapy appears to prolong remission and survival in acute myelogenous leukemia and in disseminated tumors of the lung and breast. Clearly, immunotherapy is not a panacea for malignant disease, but it could become an important arm in a multimodality attack on cancer.

Breast Neoplasms↗
PubMed1978

Adjuvant immunotherapy.

Because systemic spread occurs early in the growth of many malignancies, control of occult micrometastases must be an integral part of cancer treatment. For this reason, surgery and radiation therapy alone may fail to achieve a cure despite eradication of the primary tumor. Chemotherapy is potent and systemic in its effects but kills tumor cells by first-order kinetics so the last cancer cell may not be eliminated. An agent is needed that can selectively attack and destroy small numbers of tumor cells on a systemic basis without a significant increase in toxicity. Experimental observations indicate that immunotherapy could fill this role. Immunotherapy has been tested as an adjuvant to surgery, radiation therapy, and chemotherapy, and is clearly beneficial for selected cancer patients. There are many unresolved questions regarding the underlying mechanisms as well as the practical application of adjuvant immunotherapy, but the initial investigations indicate that it could play a vital part in the treatment of cancer. There is evidence that stimulation of host resistance can result in control of systemic micrometastases.

Animals↗
PubMed1976

Serum-blocking factors versus specific cellular tolerance in long-term survival of rat heart allografts.

Long-term survival of Ag-B compatible rat heart allografts was obtained by short-term treatment of the recipients with antilymphocytic serum (ALS). Graft survival apparently was based on a specific change in the hosts rather than on persistent nonspecific effects of ALS. The hosts were not fully tolerant in that they were able to reject secondary skin allografts from the heart donor strain, although in a delayed fashion. The long-surviving heart allografts retained their immunogenicity as they were rejected when retransplanted to new hosts. The passive transfer of serum from long-term heart graft acceptors to new hosts receiving fresh allografts delayed rejection by several days. This effect was seen only with the serum from long-term acceptors suggesting that serum-blocking factors were involved in long-term survival of the heart allografts. However, the ability of adoptively transferred lymphoid cells to break tolerance to a heart allograft residing in a classically tolerant host was tested. In contrast to normal lymphoid cells, cells from the long-term acceptors were unable to break tolerance, suggesting that a specific cellular tolerance had been induced in this cell population. Moreover, a serum from the long-term acceptors failed to block the breakage of tolerance by normal lymphoid cells.

Animals↗
PubMedDate not supplied

Radioimmunotherapy for breast cancer: treatment of a patient with I-131 L6 chimeric monoclonal antibody.

We report the first treatment of metastatic breast cancer by systemic radioimmunotherapy. The serial therapy doses were chosen based on quantitative imaging data in a treatment planning approach. A terminally ill patient with aggressive, locally advanced breast cancer who had failed radiation treatment and chemotherapy was injected intravenously with radiolabeled I-131 chimeric L6, a human-mouse chimeric lgG1 monoclonal antibody to adenocarcinoma. Initially, an imaging 10 mCi dose of I-131 chimeric L6 (dose 1) deposited 8.8% of the injected dose in her chest wall tumor at 48 hours. Ten days later the patient was given a 150 mCi I-131 chimeric L6 dose (dose 2) followed three weeks later by a 100 mCi dose (dose 3). Tumor uptake and retention were comparable for doses 1 and 2, and decreased for dose 3. Following dose 3 the patient developed a manageable thrombocytopenia and transient Grade IV granulocytopenia. The tumor was observed to decrease in size with peak tumor regression occurring two weeks after dose 3. This partial response (PR) was achieved by radioimmunotherapy at a time when conventional therapy had been unable to impact the growth of the patient's massive and aggressive tumor.

Antibodies, Monoclonal↗
PubMedDate not supplied

Cis-dichlorodiammineplatinum(II) alone and combined with DTIC for treatment of disseminated malignant melanoma.

Twenty-one patients with disseminated malignant melanoma were treated with cis-dichlorodiammine-platinum(II) (cis-DDP): ten with cis-DDP alone at a dose of 20 mg/m2 iv x 4 days every 4 weeks and 11 with cis-DDP at a dose of 15 mg/m2 iv x 4 days combined with DTIC at a dose of 200 mg/m2 iv x 5 days every 4 weeks. Two of 21 patients (10%) showed a partial response to therapy. There were no complete responses and no apparent increases in length of survival for responders compared to nonresponders. One drug-related death occurred. Otherwise, drug toxicity was acceptable and appeared to be diminished by iv hydration and prolonged administration. In this study, cis-DDP was not effective for treatment of disseminated malignant melanoma.

Adolescent↗