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Biomedical subjects

M Rørth

Publications and source records attributed to M Rørth.

At least 73 records · Page 4Linked to original sources
PubMed1989

Palliative irradiation of bone metastases.

Painful bone metastases is a common feature in patients with advanced cancer. The application of radiotherapy is often used as palliative treatment. A review of available data from the literature reveals that irrespective of the primary diagnosis palliation is achieved in 70-100% of cases. The biological basis of pain and the effects of radiotherapy is discussed. Treatment schedules for patients with single-bone lesions are reviewed. It is concluded that single-shot treatment in doses ranging from 5 to 8 Gy is as effective as multi-fractionated treatment. In addition, the possible role of radiotherapy in relation to patients with multiple lesions, and the use of combined surgery and radiotherapy in patients with impending and manifest fractures are discussed. It is concluded that the literature does not allow a definitive conclusion concerning an optimal use of radiotherapy.

Bone Neoplasms↗
PubMed1988

Effects of cisplatin on different measures of glomerular function in the human kidney with special emphasis on high-dose.

To investigate the effect of high-dose cisplatin (40 mg/m2 daily for 5 days), 51Cr-EDTA clearance was used as a measure of glomerular filtration rate (GFR). 51Cr-EDTA clearance decreased significantly from 109 +/- 3 ml/min * 1.73 m2 to 68 +/- 3 ml/min * 1.73 m2 after three cycles of cisplatin and remained at this decreased level during the observation period (24 months). To determine the reliability of creatinine as a measure of GFR, we compared the simultaneous clearance of creatinine to that of 51Cr-EDTA. A good correlation between 51Cr-EDTA clearance and creatinine clearance was observed before and 3 months after termination of treatment, but no correlation was found during treatment. S-creatinine decreased significantly during treatment, probably due to muscle wasting. We conclude that s-creatinine and creatinine clearance are unsuitable measures of glomerular function during high-dose cisplatin treatment. All patients developed proteinuria during treatment. The changes in clearance ratios of beta-2-microglobulin/albumin and IgG/albumin show that the proteinuria observed during cisplatin infusion is predominantly of tubular origin, whereas the proteinuria between the treatment periods is mainly of glomerular origin.

Adult↗
PubMed1988

Long-term effects on renal function and blood pressure of treatment with cisplatin, vinblastine, and bleomycin in patients with germ cell cancer.

Long-term effects of cisplatin on renal function were investigated in 34 patients with germ cell cancer observed for a median of 65 months (range, 43 to 97 months). All patients achieved a complete remission after treatment with cisplatin (median dose 583 mg/m2), vinblastine, and bleomycin. None of the patients relapsed during follow-up. During treatment the glomerular filtration rate (GFR) decreased by 18% (P less than .05). During follow-up kidney function recovered in ten patients and partly improved in eight patients. Changes in plasma creatinine did not consistently correspond to alterations in GFR. The mean increase in systolic blood pressure during follow-up did not differ from the increase seen in a group of age-matched healthy men. The mean increase in diastolic pressure, however, was significant (P less than .05), but was entirely due to hypertension observed in six patients. Renography of these patients was normal. We conclude that the decrease in GFR observed during treatment with cisplatin is partly reversible. Cisplatin-treated patients have an increased risk of developing hypertension years after treatment.

Adult↗
PubMed1988

Lung cancer.

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Adenocarcinoma↗
PubMed1987

Carcinoma-in-situ testis in patients with assumed extragonadal germ-cell tumours.

Testicular biopsies were done in 15 consecutive patients who were believed to have extragonadal germ-cell tumours. 8 patients (53%) had carcinoma-in-situ (CIS) in the gonads, although none had clinical signs of tumour. In addition, 3 of these patients had small areas of invasive tumour growth. Germ-cell tumours can only be diagnosed as being extragonadal in origin if testicular biopsy appearances are normal.

Adult↗
PubMed1987

Orchidectomy alone versus orchidectomy plus radiotherapy in stage I nonseminomatous testicular cancer: a randomized study by the Danish Testicular Carcinoma Study Group.

All Danish patients with stage I nonseminomatous testicular cancer diagnosed between December 1980 and January 1984 entered a randomized study comparing irradiation of retroperitoneal lymph nodes with surveillance only after orchidectomy. Twenty-four of the seventy-nine patients in the observation-only group have relapsed, three patients relapsing more than 2 years after orchidectomy. Ten of the seventy-three patients receiving irradiation have relapsed, all within 10 months after orchidectomy. The median time to relapse in both groups was 4.5 months. Irradiation prevented retroperitoneal relapses. Thirty-three of the relapsed patients were rendered disease free with chemotherapy, and one is still being treated. Four deaths have occurred, all unrelated to testicular cancer or antineoplastic treatment. Absence of embryonal carcinoma and presence of teratocarcinoma correlated with improved relapse-free survival. Patients with increased serum concentrations of tumour markers before orchidectomy had an increased risk of relapse. Surveillance-only is a reasonable treatment strategy in clinical stage I nonseminomatous testicular cancer. Preferably control and treatment of relapses should take place in specialized centres.

Carcinoma in Situ↗
PubMed1987

Management of advanced metastatic germ cell tumours.

Forty patients with poor prognosis germ cell tumours were treated with a combination of cisplatin 40 mg/m2 and VP-16 200 mg/m2, both given days 1-5 every 3 weeks, and bleomycin 15 mg/m2 every week. Of thirty-three previously untreated patients twenty-eight (85%) patients obtained complete remission (CR) and four (12%) patients partial remission (PR). One patient was not evaluable for response. Twenty-four patients are alive 2-32 months after completion of therapy without evidence of disease (median observation 18.5 months). Of seven patients previously treated with cisplatin, five obtained CR (71%), one PR (14%) and one patient had progressive disease. Five patients are still alive, four without evidence of disease after a median follow-up of 22 months (range 16-25 months).

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Immature ovarian teratoma in a postmenopausal woman.

We report the first case of immature ovarian teratoma occurring after menopause in a 57-year-old, 3 years postmenopausal woman. Within one year after resection of the teratoma she developed peritoneal botryoid rhabdomyosarcoma, which probably originated from initially unrecognized rhabdomyoblasts in the teratoma. The patient died 6 months later from progressive disease after a transient adriamycin-induced tumor response. The literature on ovarian immature teratoma and ovarian rhabdomyosarcoma is briefly reviewed, and the available treatment is discussed.

Cyclophosphamide↗
PubMed1987

Lung cancer.

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Adenocarcinoma↗
PubMed1987

Modification of beta-2-microglobulin in sera from patients with small cell lung cancer: evidence for involvement of a serine protease.

Modification of beta-2-microglobulin has been shown to occur in vitro in serum of patients suffering of small cell lung cancer, where it clearly correlated to the clinical course of disease. The cause of serum beta-2-microglobulin modification occurring in these patients is investigated in the present study. This revealed that modification of beta-2-microglobulin is due to cleavage by a serine protease, which is dependent on divalent cations and has a trypsin-like specificity. The process showed the following characteristics: pH optimum at 8.5, heat inactivation by incubation at 56 degrees C for 20 min and temperature optimum at 20 degrees C.

Carcinoma, Small Cell↗
PubMed1986

Carcinoma in situ of contralateral testis in patients with testicular germ cell cancer: study of 27 cases in 500 patients.

Carcinoma in situ in the contralateral testis was diagnosed in 27 of 500 patients (5.4%) with unilateral testicular germ cell cancer. Eight of the 27 patients received intensive chemotherapy for spread of their initial testicular cancer. Follow up biopsy studies did not detect changes of carcinoma in situ in any of these patients, and none developed a contralateral testicular tumour (observation time 12-88 months). Of the remaining 19 patients with carcinoma in situ, seven developed contralateral testicular cancer. The estimated risk of developing invasive growth was 40% within three years and 50% within five years. None of the 473 patients without carcinoma in situ detected by screening biopsy developed contralateral testicular cancer (observation time 12-96 months). No serious complications arose from the biopsy procedures. All patients with unilateral testicular germ cell cancer should be offered biopsy of the contralateral testis.

Adult↗
PubMed1986

Acute and long-term nephrotoxicity of cis-platinum in man.

To detect whether the nephrotoxicity of cis-diamminedichloroplatinum (DDP) is acute and can be demonstrated at an early stage in man, a method for estimating the function of the kidneys during intensive hydration was devised. The method includes a calculation of the clearance of 125I-orthoiodohippurate and an estimation of the glomerular filtration rate (GFR) from fast changes of the extracellular volume (ECV) and the mean transit time of 99mTc-DTPA in this volume. We examined nine patients with testicular cancer on 2 consecutive days for acute nephrotoxicity while they were undergoing treatment with cis-platinum. Placebo was given on day 1, cis-platinum on day 2. On both days the patients were hydrated with 4 l saline, glucose, and mannitol (0.51) over a period of 4 h, which resulted in an increase of 125I-orthoiodohippurate clearance on both days (P less than 0.01). The increase was, however, lower on the day of treatment with cis-platinum than on the day with placebo (P less than 0.05). There were no acute changes in the GFR. This indicates that treatment with DDP inhibits the active transport of 125I-orthoiodohippurate in the tubules; that is to say there is an acute effect on the kidney function. There were no acute changes in the GFR, but in the long-term followup study we found that the GFR had decreased significantly (P less than 0.05) after 2 months of treatment. During the first year after the initiation of treatment the GFR changes were found to progress. A significant increase in se-creatinine was not observed until 6 months after the initiation of treatment (P less than 0.05). The degree of chronic nephrotoxicity did not correlate in individual patients with the acute changes in kidney function.

Acute Disease↗
PubMed1986

Treatment of persistent or relapsing advanced germ cell neoplasms with cisplatin, etoposide and bleomycin.

Twenty-six patients, previously treated with cisplatin, vinblastine and bleomycin (pVB) had residual or recurrent germ cell tumors and were treated with cisplatin, etoposide and bleomycin (peB). Six patients obtained complete response and 11 patients partial response. Of the 11 patients with partial response 5 were disease free after post-chemotherapy surgery. Seven patients are still alive without evidence of disease with a median follow-up of 40 months (range 14+ - 57+ months). One patient died from acute non-lymphocytic leukemia without evidence of germ cell cancer. Toxicity was modest with only three patients having leukopenic fever. Retrospectively, the patients were analyzed in two groups according to their initial prognostic features. Thirteen patients were considered to have unfavourable prognostic factors and all had progress/relapse after treatment with peB. It is concluded that peB might be useful as first line therapy because of modest toxicity and considerable activity in pretreated patients and that more intensive therapy is necessary in patients with unfavourable prognostic features.

Adolescent↗