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Biomedical subjects

M E Stein

Publications and source records attributed to M E Stein.

At least 19 recordsLinked to original sources
PubMed2003

Primary lymphoma of bone--a retrospective study. Experience at the Northern Israel Oncology Center (1979-2000).

OBJECTIVE: This retrospective study describes our experience with the diagnosis, treatment, results and long-term follow-up of primary bone lymphoma (PBL). PATIENTS AND METHODS: Nineteen patients diagnosed with PBL were reviewed. Seven patients presented with stage I(E) disease, four with stage II(E) (regional lymphadenopathy), and eight with stage IV disease (disseminated bone involvement). Only one stage IV patient exhibited 'B' symptoms. The majority (72%) demonstrated diffuse, large cell, B-type lymphoma. All patients were treated with adriamycin-based chemotherapy and consolidation radiotherapy to the primary site (8 patients: early PBL) or the most bulky area (3 patients: stage IV PBL). RESULTS: Ten stage I(E)/II(E) patients are alive with no evidence of disease (NED) and only one died due to metastatic secondary lung cancer while with NED from his PBL. Eight stage IV patients are alive with NED. Median follow-up for all living patients: 77 months. Side effects were mild and did not necessitate delay in treatment. CONCLUSIONS: Our departmental policy of treating PBL patients with an anthracycline-based regimen and involved field radiotherapy proved to be successful in achieving excellent long-term, disease-free survival. Phase III randomized, controlled, clinical trials will determine the true role of consolidation radiotherapy in PBL, when considering severe late side effects, including radiation-induced bone tumors.

Adolescent↗
PubMed2000

Clinical activity of cisplatin and prolonged oral administration of etoposide in previously treated, anthracycline-resistant, metastatic breast cancer patients: a phase II study.

BACKGROUND: This phase II study evaluates the antitumor activity and tolerance of cisplatin and prolonged oral administration of etoposide in metastatic breast cancer previously exposed to anthracyclines. PROCEDURE: Twenty-seven patients with metastatic breast cancer who developed tumor progression following anthracyclines wer e entered in the study. The patients were treated with combination chemotherapy of cisplatin 50 mg/m(2) IV day 1 and oral etoposide 50 mg/m(2) days 1-17. Cycles were repeated every 29 days. RESULTS: Twenty-six patients were evaluated for toxicity and response. Complete remission was observed in 1 of 26 (4%) patients and partial remission in 12 of 26 (46%). Median duration of response was seven months. Pain relief was noted in 9 of 15 (60%) of the symptomatic patients. Myelosuppression was the major toxicity encountered and four (15%) patients required hospitalization for granulocytopenic fever. Nonhematologic toxicity was mild. CONCLUSIONS: The combination of cisplatin with prolonged oral etoposide is active and tolerable in the management of patients with relapsed metastatic breast cancer previously treated with an anthracycline-based regimen.

Administration, Oral↗
PubMed1999

Carboplatin and etoposide for recurrent malignant glioma following surgical and radiotherapy failure: A clinical study conducted at the Northern Israel Oncology Center.

BACKGROUND AND OBJECTIVES: We conducted a phase II study using carboplatin and etoposide on patients with recurrent malignant glioma to investigate tumor response. METHODS: From January 1995 to March 1997, 21 patients with recurrent malignant glioma were treated with a carboplatin (300 mg/m(2), day 1)/etoposide (100 mg/m(2), days 1-3) regimen every 3-4 weeks. The following radiologic parameters were evaluated: tumor size, central lucency, degree of contrast enhancement, and mass effect. No patient had received chemotherapy previously. Dose escalation corresponded to hematologic tolerance and to general and neurologic performance status. Most patients were treated postoperatively with involved field radiotherapy followed by a boost to the tumor area, as defined on the presurgery computed tomography scan or on magnetic resonance imaging. Mean interval to introduction of chemotherapy was 8.8 months (range, 7-36 months). Patients received a mean of four cycles [range, 2-8 cycles]. RESULTS: Only 2 patients showed moderate radiological response, while 12 patients died of progressive disease. Mean time to progression following discontinuation of chemotherapy was 5.8 months (range, 1-11 months). The other patients survived with persistent disease and are being treated palliatively. Toxicity was manageable (1, neutropenic sepsis; 1, thrombocytopenia (45,000/mm(3)); 2, temporarily elevated transaminase level; 2, steroid-induced erosive gastritis). CONCLUSIONS: This phase II regimen proved to be ineffective in recurrent malignant glioma. Further studies incorporating innovative drug regimens and schedules are warranted. J. Surg. Oncol., 1999;71:167-170.

Adolescent↗
PubMed1999

Sustained complete remission after chemobiohormonal therapy for metastatic melanoma.

The combination of carmustine, cisplatin, dacarbazine, interferon, and low-dose tamoxifen is widely used in treating metastatic melanoma and was originally reported to achieve a 20% complete response rate. Among 29 patients who completed the authors' phase II study with the regimen, five (17%) achieved complete remission, and the median duration of response was 8 months (range, 2-14 months). The aim of the study was to evaluate briefly the value and toxicity of this regimen in treating metastatic malignant melanoma.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1998

Radiation-induced tumors in irradiated stage I testicular seminoma: results of a 25-year follow-up (1968-1993).

BACKGROUND AND OBJECTIVES: Testicular seminoma is a very radiosensitive and curable cancer, with survival rates following radiation therapy within the range of 90-98% without apparent severe side effects. However, long-term survival following exposure to moderate-dose radiation therapy can result in radiation-induced tumors. METHODS: The incidence of radiation-induced tumors was determined in 81 irradiated stage I testicular seminoma patients treated at the Northern Israel Oncology Center (NIOC) from 1968 through 1993. RESULTS: Three (4%) patients developed second cancers within the high-dose volume. Indeed, those patients received a higher than usual dose to the para-aortic and pelvic regions. One patient, who developed inoperable pancreatic carcinoma, was treated with "hockey stick" field and mediastinal irradiation, plus, as a result of relapses, multiple cisplatin and VP-16 based regimens. CONCLUSIONS: The elimination of causative factors through lower total doses and field size reduction may reduce the, albeit very low, incidence of radiation-induced cancer in cured testicular seminoma.

Adenocarcinoma↗
PubMed1998

Metastatic spinal cord compression as initial presentation of follicular thyroid carcinoma.

Follicular thyroid carcinoma, initially presenting as spinal cord compression due to metastatic lesions, is a less reported event. We present two cases of well-differentiated thyroid carcinoma that led to spinal cord compression. A thorough search of the literature revealed only five similar cases. We summarize the clinical characteristics of these cases, the therapeutic measures used, their outcome, and the prognosis.

Adenocarcinoma, Follicular↗
PubMed1998

Postsurgical etoposide-ifosfamide regimen in poor-risk nonmetastatic osteogenic sarcoma.

This prospective study was designed to test the activity of an ifosfamide-etoposide (VP-16) regimen on poor-risk, nonmetastatic, osteogenic sarcoma. A total of 13 patients with nonmetastatic osteogenic sarcoma with a poor histologic response to primary high-dose methotrexate-doxorubicin (Adriamycin)-cisplatinum chemotherapy received a total of six 5-day courses of ifosfamide (1,800 mg/m2) and etoposide (100 mg/m2) at three weekly intervals. The protocol was well tolerated, with only one case of transient renal failure. At present, eight patients (62%) have been in sustained complete remission with no evidence of recurrent disease for a mean follow-up of 3.4 years (range, 1.5-7.0 years). One patient is alive with lung metastases, and four have died of progressive disease. This prospective, albeit small, study confirms the efficacy of an ifosfamide-VP-16-based regimen in poor-risk, extremity, nonmetastatic osteogenic sarcoma. The demonstrated activity should spark large trials of ifosfamide-containing regimens in osteogenic sarcoma.

Adolescent↗
PubMed1998

A rare event of 5-fluorouracil-associated peripheral neuropathy: a report of two patients.

5-Fluorouracil (5-FU) is known to cause multifocal cerebral demyelination, which is pathologically related to a central inflammatory demyelinating process. To date, no case of peripheral neuropathy has been described after the administration of 5-FU alone. The authors describe two patients who had peripheral neuropathy that developed while they were receiving 5-FU-based chemotherapy.

Adenocarcinoma↗
PubMed1997

Cisplatin-based chemotherapy in advanced seminoma: experience of the Northern Israel Oncology Center: 1981-1994.

BACKGROUND: The efficacy of cisplatinum combined chemotherapy modalities was investigated in a variety of trials for patients with advanced seminoma. Results regarding remission rates and survival are encouraging. METHODS: Between December 1981 and January 1994, 13 patients with either relapsed (following radiotherapy failure) or primarily advanced seminoma were treated with cisplatin-based chemotherapy at the Northern Israel Oncology Center. RESULTS: Eleven (84%) patients achieved complete clearance of all sites of disease. One patient demonstrated clinically and radiographically remarkable shrinkage of an abdominal mass, and laparotomy revealed fibrotic/necrotic tissue without viable tumor cells. After a mean follow-up of 58 months (range 4-168), 12 patients (92%) are alive and well without evidence of malignancy. One patient, in whom a 2-cm abdominal mass is stable radiographically, is under observation with no sign of tumor activity. Side effects were tolerable; no patient developed chemotherapy-induced sepsis. One patient developed spontaneous pneumothorax a few days after completion of his first chemotherapy cycle, which resolved with treatment. CONCLUSIONS: Our results confirm the efficacy and safety of cisplatin-based chemotherapy in the treatment of advanced seminoma, even in pre-irradiated patients.

Adult↗
PubMed1997

Failure analysis in irradiated stage I testicular seminoma. Results of long-term follow-up (1968-1993).

A retrospective analysis of 81 stage I seminoma patients irradiated at the Northern Israel Oncology Center between 1968 and 1993 was undertaken. During this period, 5 (6%) patients relapsed, all outside the initial treatment volume, with a median time of 6.6 (range 1-12) months to relapse. Three patients were salvaged with cisplatin-based chemotherapy. The policy of adjuvant radiotherapy resulted in a high probability of cure and decreased relapse rate. Early relapse is a rare event in properly irradiated stage I seminoma which is highly curable with a cisplatin-containing regimen. Recurrences tend to occur outside the treated radiation volume.

Antineoplastic Agents↗
PubMed1996

Postradiotherapy hypothyroidism: radiation dose response and chemotherapeutic radiosensitization at less than 40 Gy.

To analyze our experience with iatrogenic hypothyroidism, we prospectively followed 84 patients, seen from 1984 to 1990, who had been diagnosed with either Hodgkin's disease (HD) or head and neck (H&N) carcinoma and subsequently treated with radiotherapy. Within these two diagnostic groups were subgroups whose treatment differed as to dose of therapeutic irradiation received or adjunctive use of chemotherapy. Approximately 50% of all patients and of each subgroup developed either clinical or subclinical hypothyroidism during follow-up. However, among the HD patients who received irradiation plus chemotherapy, a dose-response relationship below a threshold limit of dose received, probably 40 Gy, was observed.

Adolescent↗
PubMed1996

A phase II study of cisplatin/ifosfamide in recurrent/metastatic undifferentiated nasopharyngeal carcinoma among young blacks in southern Africa.

Recurrent/metastatic, undifferentiated nasopharyngeal carcinoma (UDNPC) is known to be chemosensitive but has rarely been studied in Phase II methodology. No studies concerning its chemoresponsiveness among southern Africans have been demonstrated to date. From 1990 through 1994, 18 African patients from the Johannesburg metropolitan area with recurrent (following radiotherapy failure) or primarily metastatic (bone) UDNPC were treated with ifosfamide (3 g/m), mesna, and cisplatin (50 mg/m) for 2 days. Three patients (15%) attained complete remission and eight (44%) partial remission, yielding an overall response rate of 59%. Median response duration was 28 weeks. Two patients (11%) had stable disease with symptomatic improvement and five (30%) progressed on therapy. Treatment was generally well tolerated but there was one treatment-related death (neutropenic sepsis). The combination of ifosfamide/cisplatin appears to be promising in UDNPC commonly seen in young patients in southern Africa. However, the duration of response still tends to be brief.

Adolescent↗