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Biomedical subjects

M L Samuels

Publications and source records attributed to M L Samuels.

At least 19 recordsLinked to original sources
PubMed1979

Management and results of localized Ewing's sarcoma.

Seventy-six patients with localized Ewing's sarcoma who received primary treatment at M.D. Anderson Hospital from 1948 through December 1975 were reviewed. Patients have been divided into four groups according to the different treatment regimens they received: Group I, moderate dose radiotherapy alone; Group II, high dose radiotherapy alone; Group III, radiotherapy plus vincristine and cytoxan; and Group IV, radiotherapy plus vincristine, Adriamycin, cytoxan and actinomycin. The problem of local recurrence appears to be solved with combined chemotherapy and radiation therapy with only one of 36 patients having a recurrence at the primary site in Groups III and IV. Multimodal therapy is the preferred treatment to obtain control of the primary lesion by radiation therapy while preserving good function. However, the major cause of failure remains distant metastases, 19 of 36 (53%) in Groups III and IV. In addition, 4 of 10 patients who have survived over 5 years have developed osteogenic sarcoma.

Antineoplastic Agents↗
PubMed1978

Chemoimmunotherapy of small cell bronchogenic carcinoma.

Thirty-one patients with small cell bronchogenic carcinoma were treated with a regimen of cyclophosphamide, Adriamycin and vincristine. Radiotherapy was given to patients with limited disease. Nonspecific immunotherapy consisting of BCG scarification was administered after each chemotherapy course. The results of treatment for this group were compared with those for a group of 45 patients treated similarly but with no immunotherapy. Therapeutic results, expressed in length of survival and rate of response, were similar. Myelosuppression was not modified by the addition of BCG scarification. This study showed no benefit from the use of such nonspecific immunotherapy.

Adult↗
PubMed1977

Combination chemotherapy and radiation therapy for small cell carcinoma.

A three-drug combination of the chemotherapeutic agents cyclophosphamide, vincristine sulfate, and doxorubicin hydrochloride was given to 45 patients with small cell bronchogenic carcinoma. In addition, patients with limited disease received radiation therapy to the primary tumor. The complete response rate was 44%, with a median survival of 50 weeks. The partial response rate was 29%, with a median survival of 35 weeks. Patients who did not respond to therapy showed a median survival of only 12 weeks. Twenty percent of the patients had their first recurrence in the brain, and the median survival from the time of disease recurrence was ten weeks. Bone marrow metastasis was encountered in 24% of the patient population, but this did not adversely affect survival.

Brain Neoplasms↗
PubMed1977

Survival with inoperable lung cancer: an integration of prognostic variables based on simple clinical criteria.

The objectives are to identify and integrate through regression analysis those fundamental clinical variables predicting survival of patients with inoperable lung cancer managed in a modern setting. Median survival time from first treatment in 129 patients with limited disease and 187 patients with extensive disease was 36 and 14 weeks, respectively. Within the proposed survival model for limited disease, weight loss was the major prognosticator followed by symptom status, supraclavicular metastases, and age. Within extensive disease, symptom status and age were dominant variables followed by weight loss and metastases to liver, opposite hemithorax, brain, and bone. Survival by cell type was similar within the limited and extensive disease groups. The data identify the essential factors which must be controlled or accounted for in studies analyzing survival as a dependent variable.

Age Factors↗
PubMed1977

Treatment of multiple superficial tumors of bladder with intravesical bleomycin.

Twenty-six patients with superficial Stage O or A transitional cell carcinoma of the urinary bladder, whose lesions were not amenable to transurethral resection, received bleomycin sulfate intravesically at weekly intervals for eight treatments. Five different drug regimens were tried, and the optimal concentration appeared to be 60 units dissolved in 30 cc. of sterile water. Serum determinations failed to reveal any significant absorption. There was a 27% complete response rate in patients with small tumor burdens. An additional 9% had partial responses which allowed the tumors to be readily managed transurethrally. However, no patients with extensive superficial tumor showed complete response to therapy. Although belomycin used intravesically is active against transitional cell carcinoma, the current cost of the drug precludes its routine use and restricts it to situations in which other agents are contraindicated.

Adult↗
PubMed1977

Complexity of branching dendritic trees: dependence on number of trees per cell and effects of branch loss during sectioning.

We have investigated whether the complexity of dendritic trees is correlated with the number of primary dendrites per neuron (trees per cell). In estimating the average number of branches of centrifugal orders 1-5 per tree we used statistical methods to compensate for loss of parts of trees during sectioning. Limitations of these methods are discussed. Neurons from four populations, stained by the Golgi-Cox method, were examined: stellate cells from layer IV, area 17 of visual cortex, in normal and dark-reared cats; the pyramidal cells from layer V, somatosensory cortex, in two strains of rats. In all four groups of neurons the average number of branches of higher orders (3, 4, 5) per tree tended to be smaller in neurons bearing more trees. Thus all trees from a population of neurons should not be assumed to be equivalent. The decreasin high-order branches per tree tended to offset the increase in number of trees per cell. In three of the four groups these opposed tendencies maintained the average number of high-order branches per neuron nearly independent of the number of trees per cell. Natural selection may have favoured near-constancy in the number of high-order branches to reduce dispersion among neurons of one type in functional input-output rleations.

Animals↗
PubMed1977

Random censoring and dendritic trees.

The motivating problem is the estimation of the branching parameters of dendritic trees when some of the branches are cut. A primary element of this problem is the estimation of a bivariate discrete distribution when, because of partial censoring, some of the observations are incomplete. (This is similar to the problem of a multinomial cross-classification with supplemental partially cross-classified data.) Tests for randomness of censoring and estimators of parameters under random censoring are derived. The results on random censoring are applied in the dendritic tree context to obtain estimators for certain branching and cutting parameters. The testing and estimation procedures are applied to a set of dendritic tree data.

Dendrites↗
PubMed1976

Large-dose bleomycin therapy and pulmonary toxicity. A possible role of prior radiotherapy.

Bleomycin sulfate pulmonary toxicity was encountered in nine of 101 patients receiving high-dose therapy for widespread testicular cancer. The pulmonary presentation was separable into two categories: (1) an early or minimal from with dyspnea on exertion, minimal roentgenographic findings, and normal arterial partial pressure of oxygen at rest and (2) a severe form, with prominent roentgenographic findings and hypoxemia at rest. All five patients with the severe form died, while the remaining four patients with the minimal presentation recovered. Prior thoracic radiotherapy appeared to predispose to bleomycin pulmonary toxicity, as this complication developed in five of 12 patients receiving prior chest radiotherapy vs four of 89 not receiving radiotherapy (p less than .001). The fatality rate of 5% with high-dose bleomycin therapy is acceptable in view of the 75% response rate and substantially improved survival achieved with bleomycin combination chemotherapy in metastatic testicular cancer.

Adolescent↗
PubMed1976

Metastases from testicular carcinoma. Study of 78 autopsied cases.

The necropsy records of 78 patients with histologically proved germ cell tumors of the testis, who died as a direct result of their malignant disease, were reviewed to determine the usual modes of spread, distribution of metastasis, the histologic characteristics of the metastatic foci as compared with the morphology of the primary tumor and the specific cause of death. The sites of metastases in order of decreasing frequency for all cases were lung, retroperitoneal lymph nodes, liver, mediastinal lymph nodes, brain, kidney, gastrointestinal tract, bones, adrenals, peritoneum and spleen. The absence of metastases solely in the anterior mediastinum without involvement of other mediastinal nodes (middle/posterior) strongly supports the premise for a primary extragonadal origin whenever the anterior mediastinum alone is involved with malignant disease having the histologic appearance of a primary germ cell tumor. The histologic features of the metastatic lesions were usually similar in nature to those of the primary tumor except for seminoma in which the metastatic lesions proved to be of a different histologic pattern in almost one third of the patients dying from the disease. It should be axiomatic that whenever a patient with seminoma fails to respond appropriately to radiotherapy that his treatment be immediately discontinued and that appropriate biopsies be obtained to substantiate the histologic pattern present.

Adolescent↗
PubMed1976

Retroperitoneal lymphadenectomy as adjunctive therapy in selected cases of advanced testicular carcinoma.

The findings in 10 patients with advanced non-seminomatous testicular malignant disease in whom either complete remission or reduction in clinical stage was achieved with chemotherapy and later retroperitoneal lymphadenectomy are presented. The procedure in these selected instances allowed for a more accurate assessment of the disease status. The operative findings served as an accurate guide to determine the need for further drug therapy.

Adolescent↗
PubMed1976

Bleomycin (NSC-125066) followed by cyclophosphamide (NSC-26271), vincristine (NSC-67574), methotrexate (NSC-740), and 5-fllorouracil (NSC-19893) for non-oat cell bronchogenic carcinoma.

The in vivo observation that bleomycin may be used as a synchronizing agent provides the basis for testing 4 days of continuous bleomycin infusion followed by 5 days of intensive chemotherapy with cyclophosphamide, vincristine, methotrexate, and 5-fluorouracil. Thirty-eight patients with extensive non-oat cell bronchogenic carcinoma (adenocarcinoma[17 patients], squamous cell carcinoma[14 patients], and poorly differentiated carcinoma [seven patients]) were registered for chemotherapy. There were 11 patients with 50% regression of all measurable lesions and four with improved but poorly measurable radiographic lesions, providing a crude response rate of 39% (15 of 38 patients). An overall survival median of 19 weeks compares favorably with Veterans' Administration Lung Cancer Study Group control data, but was not substantially better than our own historical controls (P = 0.15). The median survival for responders was 36 weeks compared to 16 weeks for historical controls (P = 0.001) and 12 weeks for nonresponders (P less than 0.001).

Adenocarcinoma↗
PubMed1975

Bleomycin combination chemotherapy in the management of testicular neoplasia.

Eighty-three patients with Stage II or Stage III germinal neoplasia of the testis and 7 patients with extragonadal primary tumors were treated with bleomycin plus vinblastine, or a five-drug program, bleomycin plus cyclophosphamide, vincristine, methotrexate, and 5-fluorouracil. Of the 70 Stage III patients, there were 53 responses (75%), 22 complete and 31 partial. The mean survival of the complete responders is 100+ weeks, with 3 dead. The mean survival of the partial responders and nonresponders is 38 weeks and 33 weeks, respectively. There is a highly significant difference between complete responders vs. partial and nonresponders (p less than 0.01). Thirteen patients with nonmeasurable disease (Stage II and Stage III postresectional status) but at great risk to develop widespread metastasis were treated prophylactically after conventional therapy. Nine continue in complete response to 36 months. The 7 extragonadal primary patients showed 4 partial responses, none complete. Major toxicity was myelosuppression and also bleomycin pneumonitis in 5 of the 90 evaluable patients.

Abdominal Neoplasms↗
PubMed1975

Alpha fetoprotein determinations in germ cell tumors of testis.

Alpha fetoprotein was demonstrated in 15 of 115 patients with histologically proved germinal testicular neoplasms. Alpha fetoprotein was detected in patients only with embryonal carcinoma and teratocarcinoma; determinations were negative in all cases of pure seminoma, teratoma, and choriocarcinoma. Of 15 patients having detectable alpha fetoprotein, 14 had Stage III disease and one had Stage II disease. When alpha fetoprotein is present, it usually heralds progression of the disease and therefore may serve as a valuable biologic marker to monitor response to therapy.

Choriocarcinoma↗
PubMed1975

Is nephrectomy justified in patients with metastatic renal carcinoma?

The survival data of 93 patients with metastatic renal carcinoma are discussed with respect to the site of metastasis and whether nephrectomy was performed as part of the initial treatment. Analysis of the cumulative survival rates revealed that nephrectomy significantly increased survival only for those patients pesenting exclusively with osseous metastases. Nephrectomy did not alter survival for patients with pulmonary and/or soft tissue metastases.

Adult↗
PubMed1975

Cyclophosphamide, vincristine and sequential split-course radiotherapy in the treatment of small cell lung cancer.

Thirty-nine patients with small cell lung cancer were treated with large dose intravenous cyclophosphamide combined with vincristine. Sequential split-course radiotherapy was added when the gross disease was limited to one hemithorax and draining scalene nodes. Fifteen of 16 patients in the limited disease category showed objective response, eight of which were complete. Fourteen of 23 patients in the extensive disease category yielded an objective response, six of which were complete. The median survival for complete responders was 48 weeks, 38 weeks for partial responders and 14 weeks for non-responders. The difference between responders and non-responders was statistically significant. The major toxicity was myelosuppression with a median leukocyte nadir of 500/mm-3 noted on treatment day no. 15. Prompt recovery was the rule. Toxicity appeared to be cumulative for patients receiving radiotherapy. These results are superior to those evolving from treatment with cyclophosphamide as a solitary agent.

Adult↗
PubMed1975

Chemotherapy for advanced Kaposi sarcoma.

Kaposi sarcoma is a rare disorder, usually controlled with conservative localized treatment. However, prognosis is serious for patients with aggressive cutaneous disease, and aminous for those with visceral involvement. Two cases of advanced Kaposi sarcoma are reviewed to illustrate a chemotherapeutic approach to patients with this disease. The first case represents a verified response of visceral Kaposi sarcoma to chemotherapy. The second provides an example of the control of aggressive dermatologic disease.

Aged↗