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Biomedical subjects

M E McPhee

Publications and source records attributed to M E McPhee.

8 recordsLinked to original sources

Comparative study of calcipotriene (MC 903) ointment and fluocinonide ointment in the treatment of psoriasis.

BACKGROUND: The topical vitamin D analogue calcipotriene has been reported to be an effective treatment for patients with psoriasis. Comparative studies with topical steroids are informative in judging this new therapy. OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of calcipotriene ointment 0.005% versus fluocinonide ointment 0.05% in the treatment of plaque psoriasis. METHODS: This study was a randomized, double-blind, parallel-group, active-controlled trial in adults who had at least mild overall disease severity and plaque elevation of at least moderate severity. Treatments were applied twice daily for 6 weeks, and subjects were evaluated at weeks 0, 2, 4, and 6. Subjects were graded on a 9-point scale (0 to 8) for scaling, erythema, plaque elevation, and for overall disease severity. A physician's global assessment of improvement/worsening was performed at every visit. RESULTS: A total of 114 subjects were enrolled at six study sites. Ninety-nine subjects completed the trial. Mean scores for signs of scaling and plaque elevation in calcipotriene-treated subjects were significantly lower by week 2 than in the fluocinonide-treated subjects. These scores continued to be significantly lower than fluocinonide through week 6 (p < 0.05). Mean scores for erythema in calcipotriene-treated subjects were significantly lower than those in fluocinonide-treated subjects at weeks 4 and 6 (p < 0.05). Both the physician's global assessment and overall disease severity showed statistically significant treatment differences in favor of calcipotriene at week 4 (p < 0.05). This superior efficacy continued through week 6. Treatment-related adverse events were observed in 12 calcipotriene-treated subjects and 5 fluocinonide-treated subjects; all were considered minor. CONCLUSION: Calcipotriene was superior to fluocinonide in the treatment of plaque psoriasis.

Adult↗

Treatment of advanced ovarian carcinoma in the elderly.

This study retrospectively analyzes the treatment of advanced ovarian cancer (Stages III and IV) in elderly patients (> or = 65) compared to that in younger patients (< 65). The purpose of this study was to identify possible treatment bias toward the elderly and to statistically analyze the nature of these differences. Seventy patients were evaluated of which 29 were identified as elderly and 41 as young. All patients were treated with platinum-based chemotherapy. Chi 2, log rank, Kaplan-Meier, and Cox model analyses were performed for multiple variables including age, grade of tumor, adequacy of surgery, and dose intensity. The elderly significantly differed from the young in the following analyses: median length of hospitalization, 20 days vs 11 days (P < 0.001); optimum surgery, 79.3% vs 97.5% (P = 0.02); initial chemotherapeutic dose reduction, 15.4% vs 0% (P = 0.02); median survival compared to age, 19.2 months vs 36.7 months (P < 0.03). When survival analysis was performed comparing 17 elderly patients and 40 younger patients who had optimum surgery and optimum initial chemotherapy, the median survival remained essentially unchanged, 22.0 months vs 36.7 months. There were differences in treatment intensity between young and old, however, the indications generally were valid and when analyzed by the Kaplan-Meier and Cox model, these differences became insignificant. It was concluded that when elderly patients can undergo aggressive surgical and chemotherapeutic management, survival remained significantly decreased for aged compared to younger patients. Physician bias was not a major factor accounting for the poorer survival observed in elderly patients. Age was the most significant variable related to survival and could not be accounted for by differences in adequacy of surgery or dose intensity.

Adult↗

1.5-5 years of uninterrupted cis-diamminedichloroplatinum II chemotherapy for metastatic cervical cancer.

In an attempt to prolong remission duration in patients with metastatic cervical cancer to cis-platinum based chemotherapy, patients were treated on an every other month basis after a minimum of 1 year of cis-platinum based chemotherapy. To date, five patients have received 5, 4.5, 2.3, 2.3, and 1.5 years, respectively, of uninterrupted cis-platinum based chemotherapy. All remain in complete remission after receiving a total dose of cis-platinum of 2523 mg (1530 mg/m2), 2.408 mg (1655 mg/m2), 1496 mg (880 mg/m2), 1325 mg (970 mg/m2), and 1640 mg (950 mg/m2), respectively. The only apparent toxicity has been asymptomatic hypomagnesemia. In contrast, three other patients in complete remission on cis-platinum based chemotherapy voluntarily discontinued such therapy and have subsequently developed uncontrolled recurrent cervical cancer. It is concluded that patients in complete remission from cis-platinum chemotherapy for metastatic cervical cancer can receive long-term cis-platinum based chemotherapy and that such therapy appears to be without significant toxicity.

Antineoplastic Combined Chemotherapy Protocols↗

Familial Ovarian Cancer Registry.

Ninety-four families totaling 201 cases are reported in this first report of the Familial Ovarian Cancer Registry. The results of the Registry and future studies are presented.

Adenocarcinoma↗

Cis-diamminedichloroplatinum (II): second line induction chemotherapy in advanced ovarian adenocarcinoma.

Twenty-one evaluable patients received second-line chemotherapy for recurrent ovarian adenocarcinoma with induction Cisplatin given weekly followed by monthly combination chemotherapy. Forty-two percent of the patients responded to induction weekly Cisplatin. Of the responders, 77% are alive as compared to only 8% of the nonresponders. Maintenance of the responses by monthly combination chemotherapy remains a significant problem. Moreover, 83% and 70% of patients who received weekly Cisplatin as first- and third-line induction chemotherapy, respectively, had objective responses. Of the total 43 patients who received weekly Cisplatin as first-, second-, or third-line chemotherapy, 60% responded, including complete clinical responses in 14% and partial responses in 46%.

Adenocarcinoma↗