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Biomedical subjects

M Al-Sarraf

Publications and source records attributed to M Al-Sarraf.

At least 73 records · Page 4Linked to original sources
PubMed1983

A randomized trial of the combination of cis-platinum, oncovin and bleomycin (COB) versus methotrexate in patients with advanced squamous cell carcinoma of the head and neck.

A prospective randomized trial was conducted at Wayne State University, Detroit, Michigan, to compare the efficacy of the combination of high-dose cis-diamminodichloroplatinum, Oncovin (vincristine) and bleomycin (COB) to that of weekly methotrexate (MTX) in the induction and maintenance of remission in patients with previously treated advanced squamous cell carcinoma of the head and neck. Complete response (CR) was observed in 11.1% of patients treated with COB and in 8.3% of patients treated with weekly methotrexate. The overall response rate (PR + CR) was 33.3% to methotrexate versus 40.7% to COB. This difference was not significant, nor was the survival of patients treated by either modality. Important variables affecting survival in this study proved to be good performance status (greater than or equal to 70) and response to therapy. Nausea and vomiting were the more common side effects of COB (56%), while hematologic toxicity was more frequent and more severe in the methotrexate arm (75%). Combination chemotherapy with COB is not more effective in producing response or prolonging survival than weekly methotrexate in patients with advanced head and neck carcinoma when both regimens are compared in a randomized study.

Adult↗
PubMed1983

Adjuvant chemotherapy with cis-diamminodichloroplatinum II and 120-hour infusion 5-fluorouracil in Stage III and IV squamous cell carcinoma of the head and neck.

A prospective study was carried out to investigate the effectiveness and toxicity of three courses of combination high-dose bolus CDDP and 120-hour continuous infusion 5-FU every three weeks prior to definitive surgery and/or radiation therapy in 35 patients with locally advanced Stage III and IV squamous cell carcinoma of the head and neck. Twenty-two patients (63%) achieved a CR and 11 (31%) a PR after three cycles of chemotherapy, for an objective response rate of 94%. Toxicity was clinically acceptable. Nausea and vomiting occurred in 23 of 35 (66%) without any patients discontinuing therapy for this reason. Leukopenia in 13 (37%) and reversible azotemia in six (17%). Following three courses of chemotherapy, 13 patients had surgical resection and 12 patients had radiation therapy. Ten of these 35 patients had no pathologic evidence of cancer in the surgical specimen or preradiation therapy biopsy. Only two patients of those achieving a complete objective response have relapsed. However, the median follow-up has been short. The authors concluded that three courses of CDDP and 5-FU is a highly effective and safe adjuvant treatment in patients with advanced carcinoma of the head and neck.

Carcinoma, Squamous Cell↗
PubMed1983

Ototoxicity associated with cis-platinum in three chemotherapy multi-drug regimens.

Hearing threshold differences postcis-platinum, relative to precis-platinum levels, were studied in 21 men from a Veterans Administration Medical Center. These patients had previously untreated advanced epidermoid cancers of the head and neck. Each patient received one of three drug combinations: (1) cis-platinum, Oncovin, and bleomycin (n = 9); (2) cis-platinum and 5-fluorouracil (n = 7); or (3) cis-platinum and bleomycin (n = 5). Wide variations in prechemotherapy hearing thresholds prevented analysis among various drug combinations. Therefore, the three groups were pooled to compare the thresholds by frequency. The frequencies tested and analyzed were: 250 Hz, 500 Hz, 1000 Hz, 2000 Hz, 4000 Hz, and 8000 Hz. Significant differences were found at 2000 Hz (P less than 0.01) and 8000 Hz (P less than 0.05). Any existing ototoxic effects of cis-platinum may have been overridden by already high prechemotherapy hearing thresholds at 4000 Hz. Since 2000 Hz was most sensitive to the ototoxic effects of cis-platinum it is suggested that this frequency be monitored routinely as a part of standard chemotherapy assessment.

Aged↗
PubMed1983

Phase II study of cisplatin in recurrent astrocytomas in adults: a Southwest Oncology Group Study.

Thirty-one evaluable adults with recurrent astrocytomas were treated with Cisplatin 35 mg/m2 I.V. daily for three days every 3-4 weeks. All patients had previously been irradiated and most had previously received chemotherapy. Approximately half had poor performance status. Two patients experienced complete remissions and two additional patients experienced partial remissions. Three patients stabilized. Gastrointestinal toxicity was generally mild. Further studies are planned of Cisplatin in combination with other agents.

Adolescent↗
PubMed1982

Combination chemotherapy plus BCG in the treatment of disseminated malignant melanoma: a Southwest Oncology Group Study.

The Southwest Oncology Group performed a randomized study comparing combination chemotherapy alone versus combination chemotherapy plus BCG versus DTIC plus BCG in the treatment of disseminated malignant melanoma. A 31% response rate was noted with combination chemotherapy alone, a 27% response rate with combination chemotherapy plus BCG, and an 18% response rate with DTIC plus BCG. Survival was not influenced by type of therapy, but the responders had significantly longer survival than the nonresponders. There appeared to be some significant differences in response as related to age wherein those patients between the ages of 30 and 60 years had a higher response rate to combination chemotherapy as compared to DTIC plus BCG. Those patients older than 60 years of age had a higher response rate in the BCG groups. Furthermore, in those patients older than 60 years of age who responded, their duration of response was longer if they received BCG than those who did not receive BCG. It should be emphasized that those differences noted in various age groups could occur by chance alone. These differences should be studied in the future, by appropriate pretreatment stratifications. Patients with higher peripheral lymphocyte counts had significantly better response rates and those patients with higher numbers of positive delayed hypersensitivity skin tests had significantly greater survival. A significant improvement in survival was noted in patients whose PPD converted from negative to positive during therapy.

Adult↗
PubMed1982

Cis-platinum and 5-fluorouracil as induction therapy for advanced head and neck cancer.

Sixty-one patients were treated with a three course induction regimen of 5-fluorouracil and cis-platinum for advanced squamous cell carcinoma of the head and neck area. Thirty-three patients (54 percent) had complete clinical remission with the administration of these drugs. Twenty-four patients (39 percent) showed a 50 percent or greater reduction in tumor size, for a significant response rate of 93 percent. The toxicities were within acceptable limits, and only three patients did not complete all three courses. Surgery and radiation therapy were supposed to follow the chemotherapy but several patients refused surgery after the disappearance of their lesion. This has created a problem in patient management.

Carcinoma, Squamous Cell↗
PubMed1982

Cisplatin hydration with and without mannitol diuresis in refractory disseminated malignant melanoma: a southwest oncology group study.

In a prospective phase II randomized trial, a dose of 100 mg/m2 iv cisplatin every 3 weeks plus forced hydration with or without mannitol diuresis was tested in patients with previously treated advanced malignant melanoma. A total of 67 patients were evaluated: 33 not given mannitol and 34 in the mannitol arm. Two partial remissions (of 2+ and 6.5 months) were achieved in the no-mannitol arm and one complete response and four partial responses (of 1, 2, 2.5, 5.5, and 8 months) were seen in the mannitol arm. Moderate, severe, and life-threatening renal toxicity was less in the mannitol arm, and patients tolerated more doses of cisplatin. The renal toxicity occurred mostly after the first dose of chemotherapy and did not seem to be cumulative. Other side effects were comparable in both arms. We concluded that renal toxicity is less severe in patients treated with cisplatin, hydration, and mannitol and that the use of cisplatin alone or in combination with other active agent(s) should be considered for further evaluation in previously untreated patients with malignant melanoma.

Cisplatin↗
PubMed1982

Phase II evaluation of 4'-(9-acridinylamino)-methanesulfon-m--anisidine (AMSA) in patients with advanced head and neck cancers.

4-(9-Acridinylamino) methanesulfon-m-anisidine (AMSA) was evaluated in 26 patients with advanced head and neck cancer in a phase II study. All patients were previously treated with one or combinations of the three modalities, namely, surgery, radiation treatment, or chemotherapy. Among the 23 evaluable patients, 2 achieved a partial response, 4 a minimal response, 9 with stable disease, and 8 with disease progression. Side effects were mainly granulocytopenia with mild GI symptoms. AMSA may have activity in recurrent squamous cell cancers of the head and neck and further evaluation in previously untreated patients or combination of AMSA with other chemotherapeutic agents should be considered.

Adenocarcinoma↗
PubMed1982

Clinical trial of cisplatin and 5-FU infusion as initial treatment for advanced squamous cell carcinoma of the head and neck.

Initial treatment with drug combinations that include cisplatin and bleomycin has been effective in reducing tumor in patients with previously untreated epidermoid cancers of the head and neck. Because of the threat of pulmonary complications from bleomycin, patients with poor pulmonary function were excluded from those studies. We conducted a trial using the combination of cisplatin (100 mg/m2) and a 96-hour infusion of 5-FU (1000 mg/m2/day) and achieved a response rate of 88.5% in 26 patients treated with two courses. Five of these patients had complete remissions and 18 had partial remissions. Nausea and vomiting (experienced by 70% of the patients) was the predominant toxic effect, and 26% experienced leukopenia. Although all patients were initially inoperable, six underwent resection following chemotherapy, and another six underwent resection after chemotherapy and irradiation. Two additional patients were treated with radiation therapy after clinically achieving complete remissions following chemotherapy, and another ten received X-ray therapy after chemotherapy. Cisplatin and 5-FU infusion are effective without being as toxic as bleomycin in patients with previously untreated advanced carcinoma of the head and neck.

Adult↗
PubMed1981

A complete response in metastatic malignant thymoma to cis-platinum, doxorubicin and cyclophosphamide: a case report.

Systemic chemotherapy as a mode of therapy in metastatic malignant thymoma has never been systematically evaluated. Chemotherapeutic agents, including doxorubicin, cyclophosphamide, cis-platinum, nitrogen mustard, prednisone or combination of agents like MOPP have produced tumor remission. A case report of complete remission of malignant thymoma in which the combination of cyclophosphamide, doxorubicin and cis-platinum (CAP) was used is reported.

Cisplatin↗
PubMed1981

The practicality of chronic hepatic artery infusion therapy of primary and metastatic hepatic malignancies: ten-year results of 124 patients in a prospective protocol.

Ten-year results are presented of 124 patients with malignancy apparently limited to the distribution of the hepatic artery, treated to prospective protocol with continuous infusion of 5-FUdR through an hepatic artery catheter. Nearly all patients had moderate to massive hepatic replacement. Of 88 patients with colorectal carcinoma, 64 (73%) had clinically objective and subjective remission. Median survival for responders was 13 months; for the entire group, ten months. Of 13 patients with hepatoma, nine had clinically significant regression with a median survival of 11 months. Ten patients had carcinoma of the gall bladder or bile duct with seven obtaining clinically significant regression. Complications encountered are discussed and are similar to other series. Of the patients experiencing clinically significant remission, all but one reached the complete independence performance status, and 84% reached normal activity levels. Thus, for hepatic localized tumor, this therapy is worthwhile and practical.

Adenocarcinoma↗
PubMed1981

Phase II study of hexamethylmelamine for disseminated prostatic carcinoma.

Hexamethylmelamine (NSC-13875) was given to 15 patients with disseminated prostatic cancer in a daily x 21 schedule at 6-week intervals. The schedule was 320 mg/m2/day in four divided doses for good-risk patients and 240 mg/m2/day for poor-risk patients. No response was observed in 14 evaluable patients, but seven patients had stable disease. Limiting toxicity was nausea and vomiting which developed in 80% of the patients and it was the reason for discontinuation of therapy in one patient. Hematologic toxicity was acceptable, and occurred in 80% of the patients. Leukopenia was more frequent than thrombocytopenia, occurring in 80% and 20%, respectively. All patients had been previously treated with hormones, but 6/15 were never exposed to cytotoxic chemotherapy.

Aged↗
PubMed1980

Combination chemotherapy with cis-diamminedichloroplatinum, oncovin, and bleomycin (COB) in advanced head and neck cancer: phase II.

Twenty-eight consecutive patients with advanced head and neck epidermoid carcinoma were treated with a single course of combination chemotherapy which included high dose cis-platinum II, vincristine, and bleomycin. All patients except one were evaluable for drug response and toxicity. The overall toxicity was mild and tolerable except in one patient who had fatal nephrotoxicity. Thirteen patients (48%) had a partial regression, and five with minimal response did improve, giving an overall response rate of 67%. More responses were noted in previously untreated patients, especially those with oral or hypopharyngeal tumors without distant metastases. Definite histological changes were seen in a few patients in remission. Objective tumor response was associated with subjective improvement, and possibly, a prolonged survival.

Adult↗
PubMed1980

Combined modality therapy for advanced head and neck cancer.

Seventy-five patients with stage III and IV squamous cell cancer of the head and neck, previously untreated, had two courses of chemotherapy with cis-platinum, Oncovin and bleomycin, followed by radical surgery, radiotherapy or both. Response to chemotherapy (complete and partial) was high (80 percent). In 36 patients radical surgery became possible. The overall survival improved statistically in patients who achieved complete or partial response to chemotherapy compared with those who had minimal or no response. Patients with well to moderately well differentiated cancer, or stage III disease, had a statistically better prognosis than patients with poorly differentiated cancer, or stage IV disease.

Bleomycin↗
PubMed1980

Carcinoma of prostate metastatic to breast.

Clinically diagnosed breast metastasis from prostatic carcinoma is rare. Primary breast carcinoma in patients with prostatic primary is also uncommon. Four patients who presented with breast malignancies in the course of their prostatic carcinoma are described. All but one of them had diffuse metastatic disease. Three of them were on estrogens at the time breast malignancy was diagnosed. Difficulties always arise in differentiating primary lesions from metastasis clinically and histopathologically. The development of histochemical methods for acid phosphatase, and the newest indirect immunofluorescent antibody technique, used in one of our patients, helped in making the differentiation between primary lesion and metastatic disease. Diagnosis of prostatic carcinoma metastatic to breast carries a poor prognosis, and may be an indication for aggressive therapy.

Adenocarcinoma↗
PubMed1980

Combination of cis-platinum, oncovin, and bleomycin (COB) prior to surgery and/or radiotherapy in advanced untreated epidermoid cancer of the head and neck.

A prospective study was carried out to investigate the effectiveness and feasibility of two courses of combination therapy with COB every three weeks prior to surgery and/or radiotherapy in 70 patients with advanced untreated epidermoid cancer of the head and neck. Of 65 patients evaluable after two courses of chemotherapy, 16 had a complete remission (CR) and 36 had a partial remission (PR; > 50% -- < 100%) for a total major response rate of 80%. After completion of therapy with surgery and/or radiotherapy, 61% of the responders were still in CR with disease free survival ranging from four to 22 months (median eight plus months), while only 15% of non-responders were in CR. Drug toxicity was tolerable with no severe or life threatening side effects, and no added risks after surgery or radiotherapy were encountered. We concluded the effectiveness and feasibility of COB were established.

Bleomycin↗
PubMed1980

Phase II study of 5-fluorouracil and adriamycin in transitional cell carcinoma of the urinary tract.

A prospective study was carried out to determine the effectiveness and tolerance of the combination of 5-fluorouracil (600 mg/m2) and Adriamycin (50 mg/m2) given iv every 3 weeks to patients with disseminated transitional cell carcinoma of the urinary tract. Twenty-one of 23 patients entered in the study were evaluable for both response and toxicity. Two patients had complete responses and six had partial responses (greater than or equal to 50% reduction), yielding an overall response rate (complete plus partial) of 38%. Leukopenia (72.7%) and thrombocytopenia (54.5%) were common. Toxicity was life-threatening in one patient. Other common side effects were alopecia, nausea and vomiting, and a generalized feeling of weakness. Responders had a median survival time of 29 weeks compared to a median survival time of 9 weeks for nonresponders.

Adult↗