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Biomedical subjects

P Alberto

Publications and source records attributed to P Alberto.

At least 19 recordsLinked to original sources
PubMed1992

ABEP as primary chemotherapy for Hodgkin's disease.

20 untreated Hodgkin's disease patients and 1 patient relapsing after radiotherapy (17 stage IIB-IV and 4 stage I-IIA) were given doxorubicin, bleomycin, etoposide and prednisone on a 21-day cycle. The response rate was 95% and 16 patients (76%) achieved complete remission. 4 patients have relapsed 2, 5, 22 and 50 months after treatment. Survival was 100% at a median follow-up of 35 months. However, due to dyspnoea on exertion in 2 patients, bleomycin will be abandoned, and the occurrence of two second malignancies questions the role of etoposide as a leukaemogenic agent.

Aclarubicin↗
PubMed1992

Feasibility of quality of life assessment in a randomized phase III trial of small cell lung cancer--a lesson from the real world--the Swiss Group for Clinical Cancer Research SAKK.

Between 1985 and 1990 the Swiss Group for Clinical Cancer Research (SAKK) for the first time assessed quality of life (QL) variables in 188 patients in a multicenter small-cell lung cancer trial that compared two different regimens of combination chemotherapy. QL-assessment was scheduled at the beginning of each of the six treatment cycles. The self-rating QL questionnaire included an early version of the EORTC QL questionnaire, a mood adjective checklist (Bf-S) and a single linear analogue scale (LASA) measuring general well-being. Compliance with completion of the scheduled questionnaires varied between 37% and 58% over the six cycles, and between 21% and 68% among the 7 participating institutions. Mean compliance was 49%. The institution was found the only significant factor predicting compliance (p < 0.001). Patient age, sex, education and biological prognostic factors at randomization were not predictors of compliance. Although compliance was poor, the data received was of high quality. We suggest practical guidelines for improving compliance with QL data collection in multicenter clinical trials.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1979

[Prognostic factors of survival and tumor recurrence following surgery and radiotherapy for breast cancer with positive axillary nodes. La Chaux-de-Fonds, 1968-1975].

Survival and treatment failure are analyzed in a homogeneous group of 70 pre- or post-menopausal patients with operable breast cancer and histologically involved axillary nodes. From March 1968 to December 1975, all patients underwent simple or radical mastectomy, followed by radiotherapy in 67. The period of observation varied from 11 months to 10 years. Treatment failures were observed on 34 patients: 10 loco-regional relapses, 21 distant metastatizations, and 3 tumors in the other breast. Analysis of actuarial survival curves shows a statistically significant difference between patients with 1 to 3 positive axillary nodes and patients with 4 or more, but no difference with regard to the volume of the tumor and the patient's age. Comparison of disease-free period curves shows statistically significant differences between patients aged below and over 55 years, tumor of less or more than 2 cm, and 4 or fewer axillary nodes. These results are comparable to those in the literature and form a contribution to a Swiss study of post-operative adjuvant chemotherapy in breast cancer with positive axillary nodes.

Adult↗
PubMed1978

[Curability of malignant neoplasms: value and limitations of chemotherapy].

Cancer chemotherapy was purely palliative until the early sixties. Tumor cures have been since obtained, first in malignant trophoblastoma and Burkitt's lymphoma, and more recently in Hodgkin's disease, diffuse histiocytic lymphoma, acute lymphocytic leukemia in children, Wilms's tumor and osteosarcoma. Preliminary data are suggestive of tumor cures in testicular teratomas and, possibly, in small cell carcinoma of the lung. Five patients with trophoblastoma, Hodgkin's disease, melanoma, chronic myelocytic leukemia and anaplastic carcinoma of the lung are briefly presented, all without evidence of tumor relapse 3 years or more after chemotherapy. Theoretical bases for improvement of the curative effect of cancer chemotherapy are discussed, including the development of new agents, and new pharmacological problems concerning drug interactions, complexes of drugs with macromolecules or immunoglobulins and liposomes are considered.

Adult↗
PubMed1978

[Simultaneous hormonal and drug therapy, compared to hormonal therapy, followed by chemotherapy, in the treatment of metastasizing breast neoplasms. Preliminary results of an ongoing study].

The preliminary results of a still ongoing phase III study in patients with previously untreated metastatic breast cancer are reported. 210 cases are already evaluable. In this study patients are randomized to hormonotherapy either concurrently with combination chemotherapy or alone, chemotherapy being delayed until the occurrence of tumor progression. In both groups patients are further randomly allocated to 3 chemotherapy programs. So far there appear to be differences between remission rates, but not with regard to survival course.

Antineoplastic Agents↗
PubMed1978

[Medical treatment of primary pulmonary neoplasms].

Primary cancer of the lung is the most frequent malignant tumor in Switzerland among males and its frequency is rapidly increasing among females. The rate of failure after curative treatment including surgery and/or radiotherapy is about 80%. A large proportion of lung tumors are already inoperable at the time of diagnosis, a fact which accounts for the importance of chemotherapy as a palliative treatment for lung cancer. Single drug chemotherapies are relatively ineffective, with an overall response rate of 20% and a response rate of up to 50% for small cell tumors. Combination chemotherapies attain a 50 to 90% response rate in small cell tumors while the rate of failure is 50% or more in other cell types. Published results of post-surgical adjuvant chemotherapy of lung cancer are equivocal, possibly due to unwanted differences in the selection of patients and in therapeutic schedule. It is still not demonstrated that adjuvant chemotherapy improves lung cancer treatment.

Cyclophosphamide↗
PubMed1978

[Therapeutic progress. Critical analysis of controled and non-controled clinical studies].

Methods used in the evaluation of therapeutic results in clinical oncology are criticized on the basis of recent examples of studies including the most-used antitumor agents. The need for random allocation of patients in comparative studies is underlined and the practical, statistical, and ethical limitations on randomization procedures are reviewed.

Ethics, Medical↗
PubMed1978

[Antiestrogens: a new endocrine treatment possibility in metastasizing breast neoplasms. Experiences of the Swiss Cooperative Cancer Study Group with tamoxifen].

The detection of specific hormone receptors in normal and tumor tissue has brought new insight into the mechanisms of action of hormones and anti-hormones. The Swiss Cooperative Cancer Study Group (SAKK) has evaluated the antitumor effect of the new antiestrogenic substance tamoxifen in metastatic breast cancer. 158 postmenopausal patients treated with 20 mg/d tamoxifen by mouth are evaluable at present time. Complete and good partial remissions were achieved in 39 patients (25%) largely with soft tissue but also lung and bone metastases. Tamoxifen was well tolerated and caused few serious complications such as thrombosis/pulmonary embolism and hypercalcemia. These results confirm already published experience with tamoxifen, which may replace the estrogens as the primary endocrine treatment in postmenopausal mammary carcinoma metastasizing to soft tissues, lung and bone.

Bone Neoplasms↗
PubMed1978

Initial clinical experience with a simultaneous combination of 2,4-diamino-5(3',4'-dichlorophenyl)-6-methylpyrimidine (DDMP) with folinic acid.

DDMP, a diaminopyrimidine folate antagonist, was given to 26 tumor patients in a dosage of 50 mg/m2 per week orally, simultaneously with 3 mg CF i.m. or i.v. The CF dose was increased to 30 mg in patients showing evidence of toxicity, and withdrawn in the absence of toxicity. The dose-limiting toxicity was seen in myelosuppression, particularly thrombopenia and skin rashes. At the 3 mg CF level, 18 out of 26 patients developed toxicity. No toxicity was seen at the 30 mg CF level in 11 patients. After cessation of CF, toxicity occurred in five out of seven patients. After the onset of toxicity, CF was added as a delayed rescue, in a dosage of 15 mg every 8 h or 30-60 mg daily. One patient died of sepsis with agranulocytosis. All other patients recovered from myelosuppression within 1 or 2 weeks. Objective responses were observed in seven patients, four of the ten with epidermoid cancer of the head and neck, two out of eight with epidermoid cancer of the lung, and one out of three with melanoma.

Adult↗
PubMed1978

ARA-C analogs.

Ara-C, a phase-specific antitumor agent, is rapidly deactivated by the enzyme cytidine deaminase. A prolongation of the biological activity of ara-C can be achieved either by the concomitant use of a cytidine deaminase inhibitor or by the development of ara-C derivatives with increased resistance to deamination and a longer half-life in serum. Among such derivatives are cyclocytidine (cyclo-C), anhydro-ara-5-fluorocytidine (AAFC) and the N4-acyl-derivatives. AAFC has been recently shown to be active in human leukemias and in solid tumors of the digestive tract. The tolerance to AAFC is sufficient for clinical use, and AAFC does not produce parotid pains and hypotension, characteristic side effects of cyclo-C. The main toxicity consists of myelodepression, nausea and vomiting. The schedule dependence of AAFC is far less pronounced than for ara-C, so that a weekly application by rapid i.v. injection of 30-40 mg/kg (1,200-1,500 mg/m2) reaches the level of activity with acceptable toxicity. AAFC seems to be as active as ara-C in acute leukemias and is probably active too in malignant lymphomas. In a large phase II trial of the EORTC on selected solid tumor types, AAFC showed a significant activity in GI tract adenocarcinomas with 2 responses/3 evaluable in pancreas, 7/14 in stomach and 2/32 in colorectal tumors (4/30). Hints of activity were also detected in breast cancer (1/17) and anaplastic small cell carcinoma of the lung (1/9). No responses were obtained in 27 patients with epidermoid carcinoma of the lung. These results confirm that ara-C, or newer ara-C analogs, are potentially active in various solid tumor types, and suggest that an extensive further clinical study of such new derivatives is warranted.

Clinical Trials as Topic↗
PubMed1977

[Retrospective study of 99 cases of ovarian carcinoma, stages I to IV].

A retrospective study on the survival of 99 patients with ovarian carcinoma stages I-IV has been conducted. A bad prognosis for early stages is emphasized. 38 of the 64 patients treated by chemotherapy presented an objective therapeutic response: 24 cases showed complete or partial remission of a duration between 4 to 26 months, while 14 cases showed no change or progressive disease. The effects of chemotherapy on survival have been statistically analyzed for these 38 cases and have shown a longer survival for responders. These results suggest that the use of chemotherapy as an adjuvant to surgery in ovarian cancer deserves further investigation.

Aged↗
PubMed1977

[Therapeutic results and prognostic factors in acute lymphatic leukemia in the adult].

Induction chemotherapy consisting of vincristine, prednisone and L-asparaginase was given to 22 adult patients with acute lymphatic leukemia. Manintenance treatment consisted of methotrexate, 6-mercaptopurine, prednisone and vincristine. Of the 22 patients treated, 14 had a complete remission. The median remission duration was 14 months and the median survival 20 months. 8 further patients were included in an attempt to determine the significance of prognostic factors, but none of the parameters studied influence the course of disease with statistical significance. In general, younger patients and those with lower leukocyte counts at the time of diagnosis seemed to fare better.

Adult↗
PubMed1977

[Combination chemotherapy in acute blast crisis of chronic myeloid leukaemia (author's transl)].

Sixteen patients in an acute blast crisis of chronic myeloid leukaemia (CML) were treated with a combination of vincristine, 6-mercaptopurine, hydroxyurea and prednisone. Only two of these patients had complete remission on this treatment, while four had partial remission. This experience, comparable to that reported by others, suggests that aggressive treatment in the terminal phase of CML is justified only as part of a prospective and well-controlled study.

Adolescent↗