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L V Beex

Publications and source records attributed to L V Beex.

68 records · Page 4Linked to original sources
PubMed1986

[Breast carcinoma in elderly patients; clinical aspects and treatment].

The incidence of breast cancer increases with age. Results of initial staging of the disease are similar in groups of younger and older women. The relative survival rates of younger and older patients with primary or advanced breast cancer are about equal, although the number of patients suitable for initial standard surgery and for chemotherapy declines with increasing age. In this context it has to be considered that the incidence of hormone dependent tumors increases with age. Therefore aged women with primary or advanced breast cancer are more often likely to respond to (alternative primary) endocrine therapy than younger ones. Trials exploring the possibilities of limited primary surgery and/or primary or adjuvant endocrine therapy in elderly patients are in progress. Until the present, it is recommended to treat elderly patients with breast cancer according to the general rules for this disease with the proviso that the general condition of the patient allows for this. Finally, older patients in whom early breast cancer is easily detectable by mammography, might optimally benefit from breast cancer screening programs.

Aged↗
PubMed1985

A randomized comparative trial of combined versus alternating therapy with cytostatic drugs and high-dose medroxyprogesteron acetate in advanced breast cancer.

A prospective multicenter trial was conducted in 155 consecutive patients with Stage IV breast cancer randomly allocated to receive either (1) vincristin (V) 1.2 mg/m2 (maximum dose, 2 mg), Adriamycin (A) (doxorubicin) 40 mg/m2, and cyclophosphamide (C) 500 mg/m2, all intravenously on day 1, every 4 weeks, in combination with medroxyprogesteron acetate (MPA) 600 mg orally on days 1 through 14, 500 mg intramuscularly on days 1 through 28, and twice weekly afterwards (combined chemoendocrine approach) or (2) the same combination chemotherapy (VAC) for three cycles alternating with MPA in the above-mentioned dosage during 8 weeks (alternating chemoendocrine approach). Results show an overall response rate of 73% with 26% complete responses in the combined treatment arm, whereas in the alternating arm, an overall response rate of 76% with 20% complete responses was observed. In patients with more than one metastatic site, response rate was higher in the combination treatment, and only in this arm were complete responses observed in these patients. Although the median duration of response was long in both treatment arms (combination, 19 months versus alternating, 21 months), the median overall survival in both groups was not definitely prolonged (22 versus 24 months, respectively). However, results in subsets of patients suggest that the alternating chemoendocrine approach may be better for estrogen receptor (ER)-negative patients, for patients younger than 51 years of age, and for patients with a disease-free interval of 1 year or less. Patients with these parameters probably belong to the same population. It is concluded that combination of chemotherapy and high-dose MPA may be indicated in ER-positive patients when a clinical response is urgently needed. In ER-negative patients, the alternating use of both treatment modalities deserves further investigation.

Aged↗
PubMed1985

Disease-free interval and estrogen receptor activity in tumor tissue of patients with primary breast cancer: analysis after long-term follow-up.

Specific estrogen receptor activity (ER) was found in 115 of 175 (66%) tumors of patients treated for primary breast cancer in the period 1974-1981; 60 patients had ER-negative tumors. All patients were under observation for at least 48 months (median 76 months). The 24 patients who received adjuvant chemotherapy as part of their initial treatment, were excluded from the analysis of the disease-free interval (DFI). Groups of patients with ER-positive or ER-negative tumors did not differ significantly in clinical characteristics. Patients with ER-positive tumors had a significantly longer DFI than those with ER-negative tumors only in the first year after initial treatment. After prolonged observation a significant difference in recurrence rates was no longer found. In premenopausal women, the DFI was not different for those with ER-positive compared to those with ER-negative tumors, not even in the first year of observation. However, in postmenopausal women, those with ER-positive tumors had a significantly longer DFI up to 3 years after initial treatment but not thereafter. There was no difference in DFI between the ER-positive and ER-negative groups when the tumor stage was taken into account. It is concluded that the ER status of the primary tumor affects prognosis only on the short term.

Breast Neoplasms↗
PubMed1984

Estrogen and progestin receptors in colonic cancer?

Adenocarcinomas of the large bowel in 28 consecutive patients were examined for the presence of estrogen and progestin receptor proteins. None of the specimens showed specific high affinity receptor binding. Our findings suggest that adenocarcinoma of the large bowel does not contain cytoplasmic receptor sites for estrogen and progestin.

Adenocarcinoma↗
PubMed1984

Concordance and discordance of estrogen and progesterone receptor content in sequential biopsies of patients with advanced breast cancer: relation to survival.

In 75 patients with advanced breast cancer, sequential biopsies were analyzed for estrogen receptor (ER). In 50 of these patients progesterone receptor (PgR) was also measured. All pairs of biopsies met the following criteria: (i) interval between the two biopsies: at least 6 weeks; (ii) biopsies performed at least 6 weeks after stopping endocrine therapy; and (iii) concordant histology. Discordance in ER was found in 14 of 75 patients (18.7%); PgR was discordant in 14 of 50 patients (28.0%). No significant differences were found between concordant and discordant groups of patients in age at first diagnosis, menopausal state, diameter of the primary tumor, time interval between the two biopsies and intervening therapy. The initial ER level in patients whose ER changed from positive to negative was significantly lower than in patients whose ER remained positive. PgR levels exhibited a rise only when ER rose at the same time. Sequential assays have increased the prognostic significance of ER and as a consequence the estimated survival time for patients whose tumors were ER-negative in both biopsies was significantly shorter than for patients whose tumors were ER-negative in only one of the two biopsies. We found no prognostic significance for PgR in either single measurements or repeated biopsies.

Adult↗
PubMed1982

Enhancement of gonadotrophin induced 17,20-lyase suppression one week after human chorionic gonadotrophin priming.

A single injection of 1500 IU of human chorionic gonadotrophin (hCG) in normal men, induced a block in the conversion of 17-hydroxyprogesterone (17-OHP) to testosterone (T) which reached its maximum 24 h after hCG loading. One week after hCG administration both basal 17-OHP (3.8 +/- 0.6 vs 5.1 +/- 0.5 nmol/l, P less than 0.02) and T levels (15.1 +/- 1.7 vs 18.5 +/- 2.3 nmol/l, P less than 0.05) were about 20% lower than before hCG exposure. The ratio 17-OHP to T (0.29 +/- 0.04 vs 0.31 +/- 0.04, P greater than 0.10) was however similar, suggesting recovery from the prior 17,20-lyase suppression at a lower overall capacity of T synthesis. hCG administration one week after the priming dose elicited an increase in the ratio 17-OHP to T, which was about twice as high as after the first hCG injection. Together the data suggest: 1) suppression of testicular steroidogenesis proximal to 17-OHP one week after hCG priming, 2) enhanced hCG induced 17,20-lyase suppression one week after hCG exposure.

Adult↗