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J H Hartlapp

Publications and source records attributed to J H Hartlapp.

At least 37 records · Page 2Linked to original sources
PubMed1986

Alternatives to CYVADIC combination therapy of soft tissue sarcomas.

The CYVADIC combination has been the preferred treatment for soft tissue sarcomas for the last 10 years. Other combination therapies are necessary, because the remission rate achieved with CYVADIC is only 30%. Alternative therapies for these tumors are combinations including cis-platinum, ifosfamide, epipodophyllin, and high-dose methotrexate. Our therapeutic results with combinations of cis-platinum and ifosfamide are comparable to those achieved with CYVADIC. However, the side-effects, such as nausea, vomiting and fatigue, of cis-platinum used in the palliative treatment of these tumors are intolerable for many patients. A combination of adriamycin and ifosfamide, which leads to a higher remission rate of 44% and has lower toxicity than CYVADIC, is giving encouraging results.

Adult↗
PubMed1986

[Epirubicin--results in breast cancer].

Patients with metastasized breast cancer are incurable. Remissions with longer survival can be induced by chemotherapy in 50 to 80%, with 10 to 20% complete remissions, however, recurrence is unavoidable. Therefore the strategy of therapy in breast cancer must include two aspects: first prolongation of overall survival by multiple remissions with regimes that are not cross-resistant and secondly conservation of quality of life by minimization of therapy conditioned side-effects. Epirubicin, the new anthracycline derivate and analogue of doxorubicin (probably the most active chemotherapeutic agent against breast cancer) exhibits the same high activity but lower side-effects compared with the parent compound. Complete and partial remissions in 33% of 313 breast cancer patients could be achieved with epirubicin. In three other studies the efficacy and side-effects of epirubicin were compared with the established drug doxorubicin. The remission rate was nearly the same but the side-effects such as nausea, vomiting, stomatitis, bone marrow toxicity and congestive heart failure were lower. Five different studies with epirubicin in combination with other cytostatics have shown comparable results as adriamycin combinations. In a randomized multicenter study, 520 patients were treated with epirubicin or doxorubicin in combination with cyclophosphamide and fluorouracil. The remission rates were 52 vs. 54%, respectively, but the toxicity of the epirubicin combination group was significantly lower.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

Alternatives to CYVADIC-combination therapy of soft tissue sarcomas.

The CYVADIC combination has been the preferred treatment for soft tissue sarcomas for the last 10 years. Other combinations of therapy are necessary because the remission rate achieved with CYVADIC is only thirty per cent. Alternative therapies for these tumours are combinations including cis-platinum, ifosfamide, epipodophyllin and high-dose methotrexate. Our therapeutic results with combinations of cis-platinum and ifosfamide are comparable to CYVADIC. However, side-effects such as nausea, vomiting and fatigue due to cis-platinum in the palliative treatment of these tumours are intolerable for many patients. A combination of adriamycin and ifosfamide, which exhibits a higher remission rate of 44% and lower toxicity than CYVADIC, is giving encouraging results.

Adult↗
PubMed1984

[Pharmaceutical, pharmacokinetic and dynamic interactions in tumor drug therapy].

Because of unfavourable therapeutic index application of cytostatic agents is often leading to adverse drug interactions. To avoid that kind of results it is important to know risks, early symptoms and possibilities of prevention. Recent observations show a potential occupational hazard for personnel handling cytostatic drugs by aerosols or direct contact (in-vitro-interactions). In cancer patients multimorbidity is not unusual. Drugs for the treatment of these diseases or the treatment or prevention of toxicity may interact with cytostatics (in-vivo-interactions) by influencing the absorption, protein binding, active drug transport, metabolism and excretion (pharmacokinetic interactions) as well as by changing mechanisms of the intracellular uptake of drugs or regulation of physiological functions and by blocking receptors (pharmacodynamic interactions). Inducing synergism or antagonism loss or potentiation of effectively as well as toxic reactions may result. In medical practice we have to pay attention to known clinically important interactions. The importance of other possible but still unknown interactions has to be investigated. To avoid adverse drug interactions in patients the application of drugs should be restricted to only a few but indicated drugs of established effectivity.

Antineoplastic Agents↗
PubMed1984

[Aspects of practical oncology. Oncologic dietetics--treatment of anorexia and cachexia].

Tumor- and/or therapy-related malnutrition can be a crucial factor in the success of treatment of neoplastic diseases. The aetiology of anorexia in many patients is still unknown. Impaired survival rates and the outcome of therapy are related to the nutritional status, although this has not been investigated in well controlled clinical studies. However, it is generally accepted that it is possible to improve therapy by balancing the diet. It is not known whether additional parenteral nutrition improves survival rates. Therefore, the individually adjusted diet which considers the patient's tastes and disease-related abnormalities (i.e. stomatitis or therapy-related mucosal dryness) should be preferred. Balanced formulas allow an additional caloric intake. In advanced disease status, a difficulty in swallowing or tumors which obstruct the oesophagus or the cardia may make tube feeding necessary. Total parenteral nutrition is possible via venous catheters for weeks or even months if antiseptic principles are followed very carefully. If a dietary concept is included early in cancer therapy, the quality of life is improved and surgical, radio- and/or chemotherapy, when performed, is made easier and more successful.

Anorexia↗
PubMed1983

Bilateral testicular tumor.

Of 396 cases of bilateral testicular tumors reported in the literature through 1979 the tumors were the same histologically in 217 cases (seminoma in 163 and nonseminoma in 54), different in 47 and malignant lymphomas in 68; no histological details were given in 64 cases. In our 18 cases of bilateral testicular tumors the tumors were the same histologically in 5 patients (seminoma in 4 and nonseminoma in 1), different in 6 and malignant lymphomas in 7. The epidemiology, interval between the first and second tumors, histology, diagnosis, therapy and prognosis are discussed. Diagnostic measures are determined by the histology of the first tumor and its treatment. Therapy of the second tumor depends on the interval between the 2 tumors as well as on histologic differentiation of the second tumor. The exceptions in the diagnosis, therapy and prognosis for malignant lymphomas are discussed. We do not believe that the prognosis in cases of bilateral germinal cell tumors is poor.

Adolescent↗
PubMed1983

[Vinblastine, 5-fluorouracil and prednisone (VFP) as "second-line" chemotherapy. Contribution to the problem of optimal therapy sequence in metastasizing breast carcinoma].

Chemotherapy results in metastatic breast cancer reached a plateau: Remission rate and duration are nearly equivalent for several regimens but not equitoxic. We analyzed the effect of vinblastine (6 mg/m2 once a week i.v.), 5-fluorouracil (600 mg/m2 once a week i.v.) and prednisone (10-20 mg daily p.o.) as second line treatment in BC resistant to one of the other established regimens with regard to prognostic factors and pretreatment. Our results show that it is possible to produce more than one or even two remissions by consecutively applicated combinations of cytostatics with increasing aggressivity.

Adult↗
PubMed1983

[Chemotherapy of malignant testicular tumors].

The role chemotherapy plays in the improvement of prognosis of malignant testicular germ cell tumors is discussed in the light of the development of chemotherapeutic conceptions and stage related strategies. The course of disease in 117 own patients being subjected to cytostatic treatment in 1978-1982 is analysed in detail. In 70% of the cases a complete remission was achieved. Partial remissions generally were of short duration. All toxic side effects are described, the vital threat of panmyelopathy with resulting septicaemia being emphasized. The therapeutic countermeasures are mentioned. Protocols of two prospective clinical trials attempting to answer some of the still open questions regarding chemotherapy are presented.

Adolescent↗
PubMed1982

[Side-effects of polychemotherapy in metastatic testicular neoplasms (author's transl)].

25 Patients with metastatic non-seminomatous testicular neoplasms were treated by surgery and cytostatic therapy using a combination consisting of Velban, Bleomycin, Cis-Platinum and/or Ifosfamid. In 22 patients this procedure induced a persistant complete remission with a mean observation time of 23 months. 2 patients died because of post-surgical complications after a second-look-lymphadenectomy. They suffered from rapidly progressive tumor disease. One patient died in a septicemia during chemotherapy. Our experience is that morbidity of an effective chemotherapy should not be underestimated. Transient bone marrow suppression, anorexia, alopecia and hyperpigmentation are unavoidable. However, severe vomiting, disturbed electrolyte metabolism, hemorrhagic cystitis, anemia and septicemia can well be managed by respective supportive care. Septicemia, for instance, may be treated with appropriate antibiotics without inducing tubular necrosis. Supportive measures also will avoid severe chronic defects of ear and kidney function.

Adult↗