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Biomedical subjects

J J Lokich

Publications and source records attributed to J J Lokich.

At least 19 recordsLinked to original sources
PubMed1992

A study of oral etoposide, infusional cisplatin, and infusional 5-fluorouracil for locally advanced or metastatic non-small-cell lung cancer. A Mid-Atlantic Oncology Program study.

A combination of oral etoposide, infusional cisplatin (24-hr) and infusional 5-fluorouracil (5-day) was used to treat 87 patients with non-small-cell lung cancer in a Phase II trial. Twenty-six patients were Stage IIIB, and 61 patients were Stage IV (new international classification). The regimen was well tolerated, with 49% grade 3 or 4 toxicities of all types. Response rates, partial and complete, were 40%, (95% confidence interval: 30%, 51%) for Stage IV patients and 20% (95% confidence interval: 10%, 32%), in Stage IIIB. An additional 68% of patients in Stage IIIB and 45% of patients in Stage IV achieved stable disease and had a median survival of 8.8 months, similar to that of patients in partial remission. Median survival was 5.6 months (95% confidence interval: 4.4 months, 10.8 months) for Stage IV patients and 11.0 months (95% confidence interval: 8.8 months, 12.4 months), for Stage IIIB. Of interest was the finding of a higher response rate in patients with a shorter duration of symptoms (less than 6 months versus greater than 6 months).

Administration, Oral↗
PubMed1991

Dichloromethotrexate, infusional cisplatin, and infusional 5-fluorouracil for locally advanced or metastatic non-small cell lung cancer. A MAOP study.

The combination of dichloromethotrexate, cisplatin, and infusional 5-fluorouracil was evaluated as treatment for non-small-cell lung cancer in a phase II trial using 43 evaluable patients. Grade III or IV toxicity included thrombocytopenia (21%), leukopenia (14%), nausea/vomiting (14%), mucositis (9%), infection (5%), and other (16%). There were six responders (14%), with a 95% confidence interval of [5%, 28%]. Two additional patients achieved a 50% reduction in cross-sectional tumor size that was not documented twice. Median survival time was 6.5 months. This combination is not considered sufficiently active for further evaluation in this disease.

Adult↗
PubMed1991

A study of infusional cisplatin and infusional fluorouracil for locally advanced or metastatic non-small-cell lung cancer: a Mid-Atlantic Oncology Program study.

A combination of cisplatin administered as a 24-hour infusion and fluorouracil administered as a 5-day infusion was used to treat 97 patients with non-small-cell lung (NSCLC) cancer in a phase II trial. Thirty patients had stage IIIB disease; 67 patients, stage IV disease (new international classification). Patients with stage IIIB disease also received thoracic radiation after chemotherapy. The regimen was well tolerated, with 24% or less grade 3 or greater toxicities of all types. One toxic death was attributed to fluid overload. The response rate, partial and complete, was 43% (95% confidence interval, 27% to 63%), and median survival was 13.8 months for patients with stage IIIB disease. Response rates refer to the chemotherapy response. For patients with stage IV disease, the response rate was 34% (95% confidence interval, 24% to 47%), and median survival was 6.2 months. On this regimen, stable-disease patients with stage IV disease had survivals at least equal to responders.

Adult↗
PubMed1979

Gestational choriocarcinoma and thyrotoxicosis.

A case of a 26-year-old woman with metastatic choriocarcinoma and clinical and biochemical thyrotoxicosis is described. This represents the eighth reported case of the association of choriocarcinoma and thyrotoxicosis. Serial monitoring of serum thyroxine (T4) and thyroid stimulating hormone (TSH) levels correlated precisely with the beta sub-unit human chorionic gonadotropin (hCG) level and the quantitation of host tumor burden. The development of a hypermetabolic syndrome in patients with choriocarcinoma may be due to secondary thyrotoxicosis from either the TSH-like activity of hCG or from the concomitant production of molar thyrotropin by the tumor.

Adult↗
PubMed1979

Mesenchymal tumors associated with hypoglycemia: case report and review of the literature.

Hypoglycemia secondary to malignant tumors is rare. Mesenchymal tumors of nonpancreatic origin are the most common tumors associated with the hypoglycemia syndrome, and the clinical features of 115 reported cases are reviewed. The major anatomic distributions of the tumors are thoracic (30%) abdominal (65%), and uncommon locations (less than 5%). Approximately 50% of the tumors were resectable (59 patients), and in 60% the surgical procedure was curative. In the remaining 40% local recurrence predominated related to site of tumor and presence of contiguous organ invasion. The application of multimodality adjuvant therapy for hypoglycemia associated mesenchymal tumors should be based on an understanding of the natural history of the tumor.

Abdominal Neoplasms↗
PubMed1979

Pseudo-chondrosarcoma: solitary osseous metastases from atypical bronchogenic carcinoma.

A patient with bronchogenic carcinoma with a solitary metastases to the femur in whom the clinical, radiologic, and pathologic setting suggested that the primary tumor was the bone lesion (chondrosarcoma) and the pulmonary lesion was a solitary metastasis is presented. This case is added to the limited literature indicating that mucin-secreting tumors metastatic to bone may simulate primary bone tumors radiographically.

Adenocarcinoma, Mucinous↗
PubMed1979

Electrocoagulation: palliative surgery to control metastatic cutaneous malignancy.

The adaptation of the principles of electrocoagulation to controlling symptomatic cutaneous metastatic disease is discussed. The technique permits minimal anesthesia, excellent hemostasis, local control, satisfactory cosmesis with reduced hospitalization. Two illustrative cases are reported of metastatic malignant melanoma and metastatic leiomyosarcoma.

Aged↗
PubMed1979

Septic arthritis: a complication of BCG immunotherapy.

A new complication of cutaneous vaccination for immune therapy is reported: non-acid-fast bacteremia with metastatic septic arthritis. Systemic antibiotics should be administered prophylactically in patients with signs and symptoms of local infection, particularly in the presence of orthopedic prostheses or valvular heart disease.

Adult↗
PubMed1979

L-asparaginase effect on antithrombin-III levels.

The effect of L-asparaginase (L-asp) therapy on circulating antithrombin-III (AT-III) was monitored in three patients with acute lymphoblastic leukemia. Serial determination for AT-III by both a functional assay and an immunologic assay demonstrated a rapid decrease in serum AT-III levels, followed by a protracted recovery beyond the period of L-asp exposure. One of the three patients developed a reversible venous thrombosis of the arm. The mechanism of the L-asparaginase effect may be related to peripheral degradation of AT-III or to inhibition of production.

Adult↗
PubMed1979

Pleural effusion secondary to tumor regression.

2 patients with metastatic cancer (Ewing's sarcoma and breast cancer) developed pleural effusions while undergoing systemic therapy for pulmonary metastases. Thoracenteses failed to reveal malignant cells and in both instances the characteristics of the fluids were those of transudates. The effusions developed in association with dissolution of pulmonary lesions and presumably represent a reactive process to tumor regression.

Adolescent↗
PubMed1979

Intralesional immune therapy: methanol extraction residue of BCG or purified protein derivative.

6 patients with cutaneous malignant melanoma and multiple secondary cutaneous lesions were treated with intralesional methanol extraction residue of bacillus Calmette Guerin (MER-BCG). Separate lesions were injected with purified protein derivatives (PPD) in 5 of the study patients. 5 of the 6 MER-BCG injection lesions developed marked inflammation clinically. Excisional biopsy 7-14 days later demonstrated complete dissolution of tumor in 2 patients and was accompanied by infiltration with acute and chronic inflammatory cells; 3 lesions revealed necrosis with residual tumor, and in 1 patient there was no apparent host response. Clinical tumor regression was not observed with PPD applied intralesionally, although histopathologic analysis revealed a granulomatous inflammatory response in 3 of 5 patients. No patient demonstrated regression of uninjected cutaneous lesions (4 evaluable patients) or visceral lesions (2 patients). The critical determinants of tumor regression are the size, site and depth of the lesion in relationship to the cutaneous surface. The mechanism of tumor eradication may be related to 'innocent bystander' necrosis secondary to nonspecific inflammation rather than immunologically mediated via host sensitization.

Adult↗
PubMed1979

Preoperative chemotherapy in soft tissue sarcoma.

The preoperative use of chemotherapy in the management of soft tissue sarcoma is a recent concept in the multidisciplinary management of neoplasia related to the development of more effective drug combinations. The reason for chemotherapy preoperatively is to define the effectiveness of drug treatment, permitting a rational basis for long term adjuvant treatment. In addition, major surgical morbidity may be precluded if chemotherapy is effective, allowing lesser surgical procedures, such as limb-sparing local resection. Patient selection for this approach must be individualized and is based upon the major determinants of prognosis, including the stage of the tumor according to the TNM and G--grade--classification. Radiation therapy is an essential component of the multimodality approach to soft tissue sarcomas, and the interaction of all three therapeutic modalities must provide optimal tumor control and minimal morbidity.

Adult↗
PubMed1978

Primary malignant melanoma of the rectum: rationale for conservative surgical management.

A case of malignant melanoma arising in the rectum is described and the literature is reviewed. The natural history of melanoma of the rectum is distinctive from that of other tumors of the perineal area in that local recurrence is uncommon and systemic dissemination is frequent, with a low cure rate (2/66 in a literature review). Conservative surgical approaches (fulguration, local resection) are recommended in preference to abdominoperineal resection in that palliation is the realistic goal of surgical therapy.

Humans↗
PubMed1978

Tumor markers: hormones, antigens, and enzymes in malignant disease.

Tumor markers (TM) represent a critical area of clinical investigation in cancer management. The mechanism of TM production and release are discussed for the three classes of TM: non-endocrine tumor produced hormones, tumor associated antigens, and tumor related enzymes. The concept of TM as a means of screening large patient populations for detection of early cancer has not been worthwhile, related in part to the uncommon occurrence of elevated levels of circulating TM, and in part to the fact that TM are generally abnormally elevated in patients with advanced and clinically detectable disease. Tumor markers as sequential monitors or quantitative measures of disease and response to therapy have similarly demonstrated limited utility, related to the heterogeneity of the tumors and to the lack of a precise quantitative relationship between circulating TM levels and tumor volume or mass.

Antigens, Neoplasm↗
PubMed1978

Osseous metastases: radiographic monitoring of therapeutic response.

The application of standard radiographs (metastatic series) and radionuclide scanning in the serial evaluation of patients treated for metastatic osseous lesions is reviewed. False positive interpretations of bone scans are related to the inability to distinguish osteoblastic healing response from osteoblastic response to progressive tumor. False negative scans are uncommon and are related generally to symmetrical osteoblastic activity or to inadequate (subthreshold) osteoblastic response to tumor. Standard radiographs are preferable to bone scans in the serial evaluation of the effectiveness of therapy for osseous metastases in that anatomic quantitation of lesions as well as the dynamic evolution of lytic lesions to "blastic" healing may be appreciated. Serial bone scanning should be performed in conjunction with standard radiographs of abnormal areas of radionuclide accumulation.

Adult↗