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Biomedical subjects

L Barzan

Publications and source records attributed to L Barzan.

At least 73 records · Page 4Linked to original sources
PubMed1987

Local neurotoxicity after intra-arterial cisplatin in head and neck cancer.

Neurotoxicity after intra-arterial administration of cisplatin, alone or in combination with other chemotherapeutic agents, is not yet well-documented. In our experience with 63 previously untreated patients with head and neck cancer, we observed four patients with cranial nerve impairment ipsilateral to the cannulated artery. The first patient has already been reported, whereas the other three are the subject of the present report. Overall, all three patients developed cranial peripheral palsy a few days after the end of intra-arterial cisplatin and after a median total dose of 200 mg (range, 160-250). The nerves involved were the 12th in the first patient, the seventh in the second, and the ninth, tenth, 11th, and 12th in the third patient. Complete recovery of the palsy was noted only in the first patient. The patient reported previously had developed a cranial nerve palsy involving the ninth, tenth, 11th, and 12th nerves of the right side. The low incidence of this toxicity (6.3% in our experience) and the very high objective remission rate achieved by the intra-arterial administration of cisplatin justify the continuation of such an approach to obtain the maximum tumor regression and to research the individual predisposing factors.

Aged↗
PubMed1986

Cardiac arrhythmia: possible complication from treatment with cisplatin.

Cardiotoxicity is rarely observed during cisplatin chemotherapy. A possible synergistic toxic effect of cisplatin with etoposide on cardiac electrical activity is discussed. A case of a 60-year-old woman with squamous cell lung carcinoma who developed paroxysmal supraventricular tachycardia during cisplatin chemotherapy is reported. The potential cardiotoxicity should be considered when cisplatin is combined with other cardiotoxic agents or used in patients with cardiac disease.

Arrhythmias, Cardiac↗
PubMed1986

Intra-arterial continuous infusion of cis-diamminedichloroplatinum in untreated head and neck cancer patients.

The authors report the final analysis of a prospective phase I-II study in 53 previously untreated patients with squamous cell carcinoma (48 patients) and other histologic classifications (5 patients) of the head and neck region. Treatment consisted of cisplatin 10 mg infused intra-arterially in a 12-hour period, twice a day for 5 to 10 days via an external infusion pump. After a rest period of 5 to 7 days treatment could be restarted, with the same schedule, until a maximal total dose of 400 mg or toxicity. Patients who received at least 200 mg of cisplatin were considered evaluable for response. In 3 patients catheterization was not performed because of technical difficulties, in 9 treatment was stopped before reaching the total dose of 200 mg, (because of catheter-related toxicity in 7 patients, drug toxicity in 1, and both toxicities in 1); therefore, the patients evaluable for response, drug toxicity and catheter toxicity were 41, 43, and 49 respectively. Overall, 8 patients (19.5%) obtained a complete response (CR) and 20 (48.8%) a partial response (PR) with an objective response rate (RR) of 68.3%. Eleven patients obtained a minor response (MR), whereas only 2 (4.8%) developed a progressive disease (PD). The figures, limited only to squamous cell carcinoma of oral cavity and oropharinx (33 patients), are as follows: CR 8 (24.2%), PR 17 (51.5%), MR 7 (21.2%), and PD 1 (3.0%) for an objective RR of 75.7%. No grade IV and only 5 grade III toxicity were observed; whereas the most frequent grade I and II drug-related toxicities were anemia, transient renal impairment, and thrombocytopenia. Catheter-related toxicity accounted for five central nervous system complications (three transient motor weaknesses, one hemiparesis, one embolism) and six local problems (one coagulation of the catheter, one displacement, and four local extravasations). Intra-arterial cisplatin is, in our experience, an effective treatment and further trials employing cisplatin combination chemotherapy are needed in order to establish the exact role of the intra-arterial approach before definitive local treatments.

Adenocarcinoma↗
PubMed1986

[Role of computerized tomography in the TNM staging of laryngeal and hypopharyngeal neoplasms].

70 patients with squamous cell carcinoma of larynx and hypopharynx were examined by computed tomography; the TNM staging of tumors by CT, by endoscopy and by surgical operation was reviewed. CT proved to be reliable both to recognize the presence of neoplasms, with the exception of those very superficial, and their deep spreading to pre-epiglottic and para-laryngeal spaces, to the soft tissues of the neck and to the cartilages. Therefore CT is the examination of choice in laryngeal neoplasms staging, because it precisely completes the clinical and endoscopical informations.

Humans↗
PubMed1985

Phase II trial of oral VP 16-213 (etoposide) in patients with advanced head and neck cancer.

We tested VP 16-213 in 16 patients with advanced head and neck cancer after conventional treatments. VP 16-213 was administered orally at the dosage of 100 mg/mq for 5 consecutive days every 3 weeks. No patient achieved an objective response. Toxicity was mild. VP 16-213 given at this dose and schedule revealed no activity in pretreated patients with head and neck cancer.

Aged↗
PubMed1985

High-dose versus low-dose cisplatin in advanced head and neck squamous carcinoma: a randomized study.

From November 1981 to February 1983, 64 patients with advanced head and neck squamous carcinoma were randomly treated with either high-dose (120 mg/m2) or low-dose (60 mg/m2) cisplatin. Of the 62 eligible patients, 59 were evaluable: the response rate observed in patients receiving high-dose and low-dose cisplatin was 16.1% and 17.8%, respectively. Survival was superimposable in the two treatment arms. No evidence of dose dependency of cisplatin activity in advanced head and neck squamous carcinoma was noted in this randomized trial.

Carcinoma, Squamous Cell↗
PubMed1981

Sequential combination chemotherapy of advanced head and neck carcinoma: re-evaluation of a highly effective regimen.

Twenty-seven evaluable patients with advanced head and neck squamous carcinoma were treated with a polychemotherapeutic regimen described in 1975 by Price et al. Chemotherapy consisted of vincristine, adriamycin, bleomycin, methotrexate, 5-fluorouracil, hydroxyurea, 6-mercaptopurine and citrovorum factor administered sequentially. One complete remission, 4 partial remissions, 7 minor responses were obtained for a total of 12/77 (44%) objective responses. Toxicity was acceptable. The results obtained were not better than those observed with less complicated regimens administrable on an outpatient basis.

Adult↗
PubMedDate not supplied

Induction intra-arterial cisplatin and bleomycin in head and neck cancer.

Fifty-two consecutive patients, affected by large T2 (greater than 3 cm), T3, T4, N0, or N1 previously untreated squamous cell carcinoma of the head and neck, entered this phase I-II study. Treatment consisted of a continuous 8-day infusion on the following daily schedule: cisplatin 25 mg and bleomycin 15 mg administered for 4 and 20 hours, respectively. Technical-related toxicities were 1 case each of coagulation and displacement of the catheter and 1 case of reversible monoparesis of the contralateral arm. Drug-related relevant toxicities accounted for 4 cass of grade 3 or 4 leukopenia and 2 cases of peripheral palsy of the 7th and 12th cranial nerve, respectively. Forty-five of 50 evaluable patients obtained an objective response. In particular, 13 patients obtained a complete response, 22 a partial response greater than or equal to 75%, and 10 a partial response greater than or equal to 50%. Furthermore, 5 of 31 patients showed a complete pathologic disappearance of the tumor, whereas in 12 of 31 only a microscopic residue was found.

Adult↗
PubMedDate not supplied

[The program for early diagnosis of the upper respiratory tract and digestive system neoplasms offered to alcoholics in the region of Friuli-Venice Giulia].

The present study deals with data from an on-going collaborative programme of early diagnosis for upper aero-digestive tract tumors established since 1990 by three ENT Departments of the Friuli-Venezia Giulia Region, Northeastern Italy. The aim of the study was firstly to evaluate the socio-economic characteristics and clinical features of alcoholics in treatment who were offered a free ENT check-up, and secondly to test the feasibility of this type of referral of high-risk patients from non-medical associations to the ENT specialist. A total of 683 patients, of which 151 (78%) were males and 151 (22%) were females, underwent ENT examination. About 25% of the patients were symptomatic, the most frequent symptom being dysphonia (50%) followed by cough (19%), while dyspnoea, dysphagia and pain were present in about 5% of the patients. Other than nearly 50% negative findings, ENT examination revealed a high percentage of inflammatory lesions (30%) of the upper aero-digestive tract. In 37 patients (6%) a precancerous lesion was found and in four cases an histologically confirmed tumor was diagnosed. Although the present study cannot be considered a complete screening, it did clearly evaluate the amount of response given by this high-risk population of alcoholics in treatment to the offer of an ENT examination and gives encouraging results concerning the feasibility of early diagnosis programmes for upper aero-digestive tract tumors which do not follow the normal routine of a sanitary referral by a general practitioner.

Adult↗
PubMedDate not supplied

[The cervicofacial manifestations of Kaposi's sarcoma and of non-Hodgkin's lymphomas in HIV-infected patients].

Infection from human immunodeficiency virus (HIV) is well known for the particular host susceptibility to a variety of opportunistic infections and unusual malignant neoplasms. Although no tumor develops exclusively in concomitance with HIV infection, malignancies in these patients have different clinical behaviour, response to treatment and prognosis than the pattern observed in HIV negative hosts. Kaposi's sarcoma (EKS) and non-Hodgkin's lymphoma (NHL) are tumors per se diagnostic of AIDS in patients with HIV infection. From 1987 to 1991, 210 HIV positive patients underwent ENT examination without symptom-related selection: 128 were intravenous drug users, 50 homosexual males, 22 heterosexuals, 4 intravenous male homosexual drug users, 3 blood recipients and 3 subjects without known risk factors. Sixteen were allocated in group II, 37 in III, 9 in IV A, 2 in IV B, 31 in IV C1, 37 in IV C2, 48 in IV D and 30 in IV E. Fourteen had head and neck EKS localization. All were males, with a median age of 40 of which 11/14 were homosexuals. The concomitant involvement of skin and mucosa was the most common manifestation and the palate was the most frequently affected mucosal site. Twenty-four had NHL localized within the head and neck: 21 males and 4 females with a average age of 38, 10 intravenous drug users, 9 homosexual males, 3 heterosexuals, 1 blood recipient, 1 subject without known risk factors. Extranodal localization was the most frequent characteristic while the gums were the most commonly involved site. The main characteristics of head and neck manifestations of EKS and NHL are reported with references to literature. The majority of HIV infected patients with EKS or NHL have ENT localizations, perhaps because lymphatic tissue, a HIV target, is well represented in this area and contamination by infectious agents (such as Epstein-Barr virus and cytomegalovirus, probably involved in the pathogenesis of EKS and NHL) can easily occur in the head and neck. The otolaryngologist should be aware of the various, and sometimes misleading, characteristics of these diseases.

Adolescent↗
PubMedDate not supplied

[Free forearm skin flap with vascular microanastomosis in the reconstruction of the posterior pharyngeal wall].

The posterior wall of the oropharynx and hypopharynx is a single anatomo-functional structure which is artificially divided into oro and hypo by an imaginary line at the valleculae floor level. From the oncological point of view this division serves merely for classification purposes. In fact, the tumors of the posterior wall of both the oro and hypopharynx have the same risk factors, the same lymphatic drain, the same clinical behaviour, the same means of treatment and, almost certainly, the same prognosis. One of the most important problems after posterior pharyngeal wall resection and larynx preservation, is reconstruction without interfering with laryngeal functions. Between April 1990 and April 1991 four patients with squamous cell carcinoma of the posterior pharyngeal wall underwent, surgery after a complete staging including CT and panendoscopy. All underwent bilateral neck dissection, resection of the tumor preserving the larynx and free forearm flap reconstruction. The anastomosis between the radial and superior thyroid arteries and between the venae comitantes and the branches of the internal or external jugular veins were performed under operating microscope with the microvascular technique. The overall average surgical time was 8 hours. No flap necrosis, fistulae or donor site morbidity were observed. Postoperative radiotherapy was initiated without delay. This approach was chosen because, in the authors' experience, in cases of advanced posterior pharyngeal wall cancer, the results of radiotherapy alone are quite disappointing. The feasibility of surgical resection with good, radical macroscopic margins, easily allows margins which are microscopically free of disease and this is an important prognostic factor.(ABSTRACT TRUNCATED AT 250 WORDS)

Anastomosis, Surgical↗
PubMedDate not supplied

[Pilot study of screening for the early diagnosis of tumors of the upper respiratory and digestive tracts in individuals at risk in the Friuli-Venezia Giulia region].

A pilot study on a screening program for tumours of the upper respiratory and digestive tracts was conducted from December 1988 to May 1989 in the Friuli-Venezia Giulia Region (Northern Italy), an area showing high mortality rates for cancers of these sites. Six hundred seventy-one patients at risk (i.e. habitual smokers and/or drinkers) were referred to an E.N.T. specialist by 16 general practitioners for free examination. Of these 436 (65%) actually underwent examination and, among them, 55 (12.6%) precancerosis and 8 (1.8%) epithelial tumors were detected. Although some low risk patients (mainly females) were eventually seen as well, two non-epithelial tumors being found, this pilot study would appear to have accomplished its purposes, namely to establish a closer relationship between GPs and ENT Specialists so as to discover cancerous and precancerous lesions early on and to address an educational message against smoking and heavy drinking to at risk subjects.

Adult↗
PubMedDate not supplied

[Role of the otorhinolaryngologist in HIV infections].

The spreading of HIV infection and the importance of otorhinolaryngological examination in serum positive patients has given rise to some literature regarding the E.N.T. manifestations of this infection. In particular these works underline the nasopharyngeal lymphatic tissue hypertrophy (NLTH). The present work reports data drawn from two years of experience with 69 HIV patients most of which were intravenous drug users (IVDU). The nasopharyngeal findings, divided into 4 classes both in regard to clinical and anatomopathological characteristics, showed that there was a higher incidence of NLTH in HIV+ patients than in the control group. NLTH was particularly found during the initial stages of the disease, in patients ranging in age from 20 to 29 and in IVDU. The most common manifestations found both in the 69 patients examined and in the literature are listed and the main clinical aspects of the various stages of the disease, from contacting AIDS are dealt with. The peculiarity of NLTH is discussed and a viral etiology is suggested even though further study is required to better clarify the physiopathology of the nasopharyngeal lymphatic tissue during an HIV infection. Finally, the importance of a thorough examination of the initial portion of the aerodigestive tract is stressed in all HIV+ cases.

Acquired Immunodeficiency Syndrome↗