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Biomedical subjects

M Merlano

Publications and source records attributed to M Merlano.

At least 55 records · Page 3Linked to original sources
PubMed1986

Alteration of chemotherapy (cisplatin and 5-FU) and radiotherapy in the management of advanced or recurrent head and neck cancer: a phase II study.

Between July '84 and July '85, 20 patients with very advanced or relapsing carcinomas of the upper aerodigestive tract were treated with polychemotherapy (cisplatin 20 mg/m2 days 1 to 5, and 5-fluorouracil 200 mg/m2 days 1 to 5, q. 3 weeks), alternated with radiation (3 split courses, 20 Gy each). Toxicity was moderate and in particular, mucositis and other relevant side effects including leukopenia, thrombocytopenia and nausea, were rare. Antitumoral activity consisted of nine complete responses and six partial responses (75% objective responses). Our conclusions are that cisplatin and 5-FU can be alternated with radiation with acceptable toxicity. The treatment has shown interesting antitumoral activity. Its role in cancer management must be investigated with controlled clinical trials.

Adult↗
PubMed1985

Failure of second-line therapy to modify survival in relapsed squamous cell carcinoma of the head and neck.

Between August 1979 and August 1984, 47 consecutive patients with recurrent squamous cell carcinoma of the head and neck entered one of three consecutive second-line treatments. Response rates with each treatment were very different (70% vs 5.9% vs 75%), but there was no statistical difference in actuarial survival (survival: 30% vs 29% vs 20%, respectively, at 260 days). In light of this observation, the efficacy of the second-line therapy appears doubtful and the survival of relapsing patients seems unrelated to the response achieved.

Adult↗
PubMed1985

Non-functioning parathyroid carcinoma: a case report.

Non-functioning parathyroid carcinoma is a very rare disease. Only 12 cases have been reported in the literature. The clinical behavior is characterized by the appearance and growth of a neck mass or nodule, which often has been present for many years, and is not accompanied by clinical or laboratory evidence of hypercalcemia or elevated levels of parathyroid hormone (PTH) in peripheral blood. Pathologic findings are similar to those of functioning tumors, and the proof of malignancy is established on the basis of an increased mitotic index only. Data on survival from cases reported in the literature are not conclusive; however, the non-functioning type of parathyroid carcinoma seems to be a more aggressive disease. Radiotherapy seems to be effective in the local control of the disease, but most patients become metastatic. Even if no data are available on response to chemotherapy, the course of the disease is relatively indolent.

Adenoma↗
PubMed1985

Phase I-II trial with cisplatin and 5-FU in recurrent head and neck cancer: an effective outpatient schedule.

Thirty patients with squamous cell carcinoma of the head and neck were treated with a combination of cisplatin (20 mg/m2) and 5-FU (400-200 mg/m2) by iv push on Days 1-5 every 21 days. All patients but two had relapsed disease. Twenty-seven patients were evaluable for response: there were four complete responses and 12 partial responses (objective response rate, 59.2%). The response rate falls to 53.3% if it is calculated on the total number of patients entered. Twenty-seven patients were evaluable for toxicity: myelosuppression occurred in ten patients (37%), while renal toxicity, nausea and vomiting, and stomatitis were quite rare and moderate. These results look encouraging and suggest the need for further studies.

Adult↗
PubMed1984

Ineffectiveness of 5-fluorouracil and cis-platin as second-line chemotherapy in head and neck cancer.

Seventeen patients with heavily pretreated head and neck squamous cell carcinoma were submitted to a combination of 5-fluorouracil, 500 mg/m2 on days 1-4, and cis-platin, 50 mg/m2 on day 5, repeated every 21 days. Before administration of 5-fluorouracil, N5,N10-methyltetrahydrofolate, 200 mg/m2 i.v., was given. Only 1 partial response and 4 stable disease were observed, and the median survival of the entire group was 5 months. Although all patients had been heavily pretreated and a considerable percentage (6/17, 35.2%) of these showed resistance to first-line therapy, this combination seems to be ineffective as second-line therapy in head and neck cancer.

Adult↗
PubMed1984

Combined radiotherapy and CMF-B cytotoxic regimen in stage III-IV head and neck squamous cell carcinoma.

Twenty patients with stage III-IV squamous cell carcinoma of the head and neck were treated with the combination of a multidrug cytotoxic regimen CMF-B (cyclophosphamide, methotrexate, 5-fluorouracil, bleomycin) and radical radiotherapy. All the patients were evaluable: 7 (35%) achieved clinical complete response (CR), 10 (50%) partial response (PR) and 3 (15%) stable disease (SD). The median survival of the whole group is 14 months (range 3-26+); 21+ months for complete responders (range 4+-22+). Hematologic and gastrointestinal toxicity was moderate, 9 patients (45%) developed mucositis but only one needed total parenteral nutrition. It is concluded that the combination of CMF-B regimen and radiotherapy is effective and well tolerated in these patients and needs to be evaluated in further controlled studies.

Adult↗
PubMedDate not supplied

Integration of chemotherapy in an MFD--radiotherapy plan for advanced inoperable squamous cell carcinoma of the head and neck.

From January 1987 to May 1988, 16 patients with advanced squamous cell carcinoma of the head and neck received combined treatment, based on an alternating schedule of chemotherapy and multiple fractions per day (MFD)-radiotherapy. The chemotherapy regimen consisted of cisplatin, 20 mg/m2, followed by 5-fluorouracil (5-FU), 200 mg/m2 i.v. push, from days 1 to 5 during weeks 1, 5, and 9. Radiotherapy was administered in two courses of 32 Gy each (total dose, 64 Gy) during weeks 2 and 3 and 6 and 7. Each course was given in two fractions per day, 5 days per week. The 16 patients were evaluated for toxicity and response. We observed 7 complete responders, 6 partial responders, and 3 nonresponders. The overall response rate was 81%. Toxicity was heavy: 44% of the patients developed grade III-IV mucositis. Our results suggest that cisplatin and 5-fluorouracil alternating with MFD-radiotherapy is effective; however, a new less toxic scheduling must be determined.

Adult↗
PubMedDate not supplied

Combined polychemotherapy and radiotherapy in advanced inoperable squamous cell carcinoma of the head and neck.

Between August 1979 and August 1984, 46 untreated, inoperable patients with advanced squamous cell carcinoma of the head and neck were submitted to a combined modality of treatment based on four courses of polychemotherapy (vincristine, bleomycin, and methotrexate), rotated with three courses of radiotherapy, 20 Gy each. Forty-six patients entered the study: 45 were evaluable for their response to the treatment and 46 for toxicity effects. We observed 26 complete responses (57.7%) and 14 partial responses (31.1%); overall actuarial survival was 28% at 55 months. Mucositis occurred in 11 patients, 3 patients suffered from nausea and vomiting, 2 patients developed fever, and 1 had a platelet count of 50,000/mm3. One toxic death occurred: one patient developed an acute renal failure related to Methotrexate.

Adult↗
PubMedDate not supplied

[Lymphoma of the Waldeyer's ring: experience at the National Institute for Cancer Research of Genoa].

Malignant lymphomas account for 3% of all malignant disease in the head and neck area. Twenty-five to fifty percent of all lymphomas arising in this region develop in extra-nodal structures, mostly in the Waldeyer ring. Lymphomas of the Waldeyer ring are comparable to any other lymphomas and prognosis is strictly related to stage and histology. The present paper reports 51 patients with malignant lymphomas arising in the head and neck (25 patients with Waldeyer ring involvement) recorded at the National Institute for Cancer Research, Genoa, Italy, from 1985 to the present. The characteristics of patients with Waldeyer ring involvement are comparable to those reported in the literature. Differences can be found in the median age (older in the present series) and in the incidence of Hodgkin's disease (8%). Patients were treated according to stage: stage I and II received radiation therapy and, in a few selected patients, this was combined with chemotherapy; stage III-IV received chemotherapy followed, in a few selected patients, by radiation therapy. In the present series, survival was related to the involvement of the Waldeyer ring: analysis has shown that survival is better in those patients with only nodal involvement. Nevertheless, these patients usually have a more advanced stage (p = less than 0.03). This finding is quite surprising since all the known prognostic factors are better in the Waldeyer group.

Adult↗
PubMedDate not supplied

[Alternating chemotherapy and daily multiple-fraction radiotherapy in the treatment of advanced spinocellular carcinoma of the head and neck].

From January 1987 to May 1988 sixteen pts with advanced squamous cell carcinoma of the head and neck received a combined treatment based on an alternation of chemotherapy and MFD--radiotherapy. The chemotherapy regimen consisted of CDDP 20 mg/m2 and 5-FU 200 mg/m2 i.v. push, from day 1 to day 5 during weeks 1, 5 and 9. Radiotherapy was administered in two courses of 32 Gy each (total dose 64 Gy), during weeks 2-3 and 6-7. Each course was given in 2 fractions per day, five days per week. All sixteen patients could be evaluated for toxicity and fifteen for response. The following were observed: 7 CR, 6 PR, 1 SD and 1 PD. The overall response rate was 86.6%. Toxicity was high; 43.7% of the patients developed grade III-IV mucositis. These results suggest that CDDP and 5-FU alternating with MFD-radiotherapy is feasible, although new, less toxic scheduling must be determined.

Adult↗
PubMedDate not supplied

Multidrug chemotherapy (vincristine, bleomycin, and methotrexate [VBM]) with radiotherapy in stage III-IV squamous cell carcinoma of the head and neck.

Thirty-three patients with stage III-IV squamous cell carcinoma of the head and neck previously untreated with chemotherapy or radiotherapy were given a multidrug cytotoxic regimen, VBM (vincristine, bleomycin, and methotrexate), in combination with radical radiotherapy. Of the 32 evaluable patients, 11 (34.4%) achieved clinical complete response with negative biopsy, 15 (46.8%) achieved partial response, three (9.4%) had no change, and three (9.4%) had disease progression. At 30 months, the actuarial survival rate for complete responders with negative biopsy was 62.2% and the overall survival rate was 30.8%. Hematologic and gastrointestinal toxicity was moderate, but one patient developed life-threatening mucositis and one patient died due to acute renal failure. Our data do not confirm prior more favorable results obtained with the same treatment.

Adult↗
PubMedDate not supplied

Concomitant administration of two standard regimens of chemotherapy and radiotherapy in advanced squamous carcinoma of the head and neck: a feasibility study.

BACKGROUND: In advanced squamous cell carcinoma of the head and neck, the superiority of a chemo-radiotherapy combination over radiotherapy alone has been strongly suggested. However, the best modality to combine the two treatments has still to be determinated. A pilot study was designed, testing a combination of two standard chemo- and radiotherapy regimens concomitantly administered. MATERIALS AND METHODS: 26 patients, with unresectable squamous cell carcinoma of the head and neck, were treated with three cycles of chemotherapy (cisplatin 20 mg/m2/day and fluorouracil 200 mg/m2/day as an intravenous bolus, for 5 consecutive days, every 21) simultaneously delivered with radiation (66-70 Gy/33-35 fractions/7 weeks). In order to reduce the mucoseal toxicity. observed in the first 15 patients, 1 week of pause was inserted after the third week of treatment in the subsequent 11 patients. RESULTS: Grade III-IV mucositis was detected in 40% of patients treated without pause after the third week of treatment and in 9% of those treated with. Complete responses were obtained in 13/26 patients (50%) and partial responses in 8/26 (31%). 1 stable disease, 3 early deaths (1 because of toxicity) and 1 lost before being evaluated were considered as treatment failures (19%). CONCLUSIONS: This concomitant chemo-radiotherapy approach showed a good antitumour activity but mucoseal toxicity is too high if no pause is planned during the treatment.

Adult↗