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Biomedical subjects

R G Vincent

Publications and source records attributed to R G Vincent.

At least 19 recordsLinked to original sources
PubMed1984

Cyclic alternating combination chemotherapy for small cell lung cancer.

Sixty-two patients with small cell carcinoma of lung received cyclic alternating non-cross-resistant combination chemotherapy. Radiation to the chest was given to all the patients. Patients were given a course of VP16, adriamycin and vincristine (VAV) followed by radiation (3,000 rads) to the chest and then a second course of VAV. Three weeks later, a course of cytoxan, CCNU, and methotrexate (CCM) was given (6 weeks). Subsequently, the treatment was cycled between two courses of VAV (6 weeks) and one course of CCM (6 weeks). Overall objective response rate of 73%, with 45% complete response, was noted. Overall median survival was 50 weeks, with 83 weeks for complete responders. Median survival for patients with regional disease was 58 weeks compared to 40 weeks for extensive disease. All the patients headed for complete response did so prior to receiving CCM. These results were not superior to conventional combination chemotherapy regimens.

Adult↗
PubMed1984

Photoradiation therapy in advanced carcinoma of the trachea and bronchus.

Photoradiation therapy is a new technique being investigated for the treatment of solid malignant tumors. In this study, 17 patients with advanced, recurrent, biopsy-proven malignant lesions of the trachea or main-stem bronchus were treated by photoradiation therapy. Patients received hematoporphyrin derivative intravenously three days prior to light therapy. The light was delivered from a fiberoptic fiber attached to the output beam of a dye laser (633 +/- 3 nm). The fiber was passed through the large channel of a bronchoscope (Olympus BF 2T). Of the 17 patients, two had no measurable response to the photoradiation therapy, six had partial necrosis of the tumor, seven patients had a greater than 50 percent reduction in the intraluminal volume of tumor, and two were lost to follow-up. Survival ranged from 5 to 210 days (median survival, 40 days). Complications of the treatment were significant in this group of advanced-stage patients and included excessive secretions, fever, pneumonia, and abscess formation.

Adenocarcinoma↗
PubMed1983

Comparison of chemotherapy alone versus chemotherapy and radiation therapy of extensive small cell carcinoma of the lung.

In a randomized study 145 patients with extensive small cell carcinoma of the lung were treated with chemotherapy alone (Cytoxan, CCNU, methotrexate) or with the same drug regimen and with radiation therapy to the brain, chest, and abdomen. One hundred eighteen of these patients were evaluable. Those patients receiving radiation had a better response rate (55% vs 31%, P = .016) but significantly greater toxicity. There was no significant difference in rates of complete response (7% vs 8%) or in survival (median 18.4 vs 15.3 weeks) between the two groups overall. The median survival of those patients with a partial response to therapy was 18 weeks; for those achieving a complete response it was 46 weeks. However, a clear difference in survival comparing responders with non-responders was evident only for patients who were assigned to chemotherapy alone. Partial regressions have little, if any, correlation with improvement in survival. Therapy in this disease must be oriented toward inducing complete response.

Aged↗
PubMed1982

Diamminodichloroplatinum combination chemotherapy in non-oat cell carcinoma of the lung.

A comparison is made between four different but similar approaches to the chemotherapy of 250 patients with nonoat cell bronchogenic carcinoma of the lung. Combination chemotherapy, particularly in regimen where platinum is included, provided no significant advantages over single agent chemotherapy. Side effects attributed to platinum tend to distract from any modest therapeutic gains achieved through its use. Responses rates were not significantly increased through use of platinum in the chemotherapy combination reported in this study.

Carcinoma, Bronchogenic↗
PubMed1981

Isolation, characterization and clinical evaluation of a pancreas cancer-associated antigen.

A pancreas cancer-associated antigen (PCAA) was identified and isolated from ascites fluid of human pancreatic cancer. Purified PCAA was homogeneous as determined by polyacrylamide gel electrophoresis. PCAA was a glycoprotein with a molecular weight of approximately 1,000,000 and consisted of 20% carbohydrates and 80% peptides, had an isoelectric point of 4.7, and migrated to alpha 2-beta region. It possessed a sedimentation coefficient of 14S and appeared to be a fibrous or fibroglobular protein. Immunoreactivity of PCAA was sensitive to proteolytic enzymes, perchloric acid, KSCN, glycine-HCl at pH 2.5, urea and lithium diiodosalicylate; and insensitive to neuraminidase or beta-glucosidase. Immunohistochemical technique revealed that PCAA was located in the cytoplasm of ductal epithelial cells of malignant pancreas. Using heteroantiserum raised against purified PCAA, horseradish peroxidase and CNBr-activated Sepharose 4B, an enzyme-immunoassay (EIA) for circulating PCAA has been developed. From a group of 40 healthy blood donors, an upper limit of 16.2 micrograms of PCAA/ml of serum has been tentatively determined. An elevated PCAA was shown in 67% (29/43) of patients with pancreas cancer, as well as in 30% (11/36) of lung cancer patients, 27% (10/37) of colonic cancer patients, and in 16% (6/36) of breast cancer patients. The reactive antigen in sera of these cancers was shown to be immunologically identical. PCAA also was detected in extracts of various human tissues, particularly pancreatic tumors, colonic tumors, and in a normal colon. Further, PCAA exhibited heterogeneity in molecular weight, isoelectric point, and electrophoretic mobility.

Animals↗
PubMed1981

Progress in the chemotherapy of small cell carcinoma of the lung.

A comparison was made between six different approaches to the chemotherapy of small cell carcinoma of the lung. The value of single-agent chemotherapy was compared to combination chemotherapy and radiation therapy, and with cyclic alternating combination chemotherapy in 161 patients. Cyclic alternating chemotherapy with modest radiation therapy to the primary site provided significant advantages over single-agent or combination chemotherapy. A combination of VP-16 + Adriamycin + vincristine seemed particularly effective in inducing an initial objective tumor response rate of 83%, with a projected median survival of 13.2 months. Of patients treated with cyclic alternating therapy, 51% were alive at one year. It thus appears that where complete response is achieved, prolonged disease-free survival can be expected.

Antineoplastic Agents↗
PubMed1981

Surgical treatment of locally far-advanced lung carcinoma.

It has been our policy to employ radical lung resection as a primary treatment whenever possible in locally far-advanced lung cancer. In order to assess the therapeutic results, a total of 132 patients with locally far-advanced lung cancer who had radical lung resection were reviewed. Postoperative mortality was 10%. A significant difference in survival was seen between those patients receiving no adjuvant therapy, radiation or single agent chemotherapy and those receiving cis-platinum-based polychemotherapy and/or immunotherapy (respective median survivals 14.25 and 25.68 months, P less than 0.05 Breslow test or failure rats). Aggressive surgery followed by effective adjuvant therapy in locally far-advanced Stage III lung carcinoma appears to produce acceptable survival results.

Adenocarcinoma↗
PubMed1981

Bronchio-alveolar carcinoma. A clinical overview and bibliography.

Clinical aspects of bronchio-alveolar carcinoma are reviewed through over 1,000 cases abstracted from the literature and 58 new cases. This form of lung carcinoma is more equally distributed among the sexes than other forms, and has a better prognosis when diagnosed early. Suggestions that the tumor has a multicentric origin are seen to have arisen from early experience with advanced cases.

Adenocarcinoma↗
PubMed1981

Surgical management of metastases to the lung.

Our experience with 234 patients having resection of metastatic lesions of lung is reviewed. Most bilateral lung metastases were removed though a median sternotomy. Exploration of the contralateral lung with simultaneous removal of all lesions is possible through such an incision, and moreover, it appears to give less pain postoperatively. The over-all median survival time of the patients was 21.4 months, with a surgical mortality of 2.6 per cent. The therapeutic results were analyzed according to various factors. Incomplete resection and the presence of a positive hilar mediastinal node, or both, resulted in poor survival rate of the patients. Generally, the survival rates of the patients were found to be proportional to the disease-free interval and the tumor doubling time. Patients with a solitary lesion and those with two lesions removed had the best survival time. There was no difference in the survival rates of patients with unilateral and bilateral pulmonary multiple metastases. Treatment of metastases to the lung should be carefully planned in consultation with physicians who are acquainted with the natural history of the primary tumor, as lung resection is a part of the multimodal therapy of patients with solid tumor.

Adolescent↗
PubMed1980

Chemotherapy of extensive large cell and adenocarcinoma of the lung: a randomized trial in 210 patients.

Two hundred ten patients with advanced adenocarcinoma of the lung were entered into a two-arm randomized trail. Cytoxan + CCNU + methotrexate was compared to Adriamycin and procarbazine. The tumor response to CCM was significantly higher than the tumor response to Adriamycin and procarbazine. No significant difference existed between the two treatments with respect to survival. Initial performance status, weight loss prior to therapy, and response to therapy were all found to be significant prognostic factors. Median survival time relative to responders in both treatment groups was 31.7 weeks and 15.8 weeks for non-responders.

Adenocarcinoma↗
PubMed1979

The value of carcinoembryonic antigen in patients with carcinoma of the lung.

Carcinoembryonic antigen levels in 682 lung cancer patients have been studied in order to assess their value in the screening of high-risk populations, monitoring total surgical ablation and projecting the effectiveness of therapy. The initial values are shown to be related to the histology of the tumor and to the extent of the disease. All histologic types of lung cancer produce elevated CEA but adenocarcinoma characteristically produces higher values than small, large or squamous cell carcinomas. CEA has its most precise value in distinguishing at an early date cured patients subsequent to surgical resection from those patients who will eventually fail because of recurrent disease.

Adenocarcinoma↗
PubMed1979

Fluorescence bronchoscopy for detection of lung cancer.

A system using the fluorescence bronchoscope has been designed for localization of small, early bronchogenic carcinoma by the fluorescence of previously injected hematoporphyrin derivative. The system included a 200W mercury vapor lamp and primary filter, flexible fiberoptic bronchoscope with special violet-transmitting light conductor, secondary filter, and image intensifier tube. Tests indicated the system could detect a tumor only 100 micron thick at the expected concentration of hematoporphyrin derivative: 1 microgram/gm at 48 to 96 hours following intravenous injection at a dosage of 2.5 mg/kg. Examination of resected specimens (six of lung, one of esophagus) showed positive fluorescence in all cases, with fluorescence visible beyond the region visible under conventional white light examination. Fluorescence bronchoscopy has been performed on four patients thus far. Positive fluorescence was observed in all three cases where the tumor had been known to occur. Positive fluorescence was also observed in the patient with sputum positive for lung cancer, but negative x-ray film findings. However, additional examinations are required to demonstrate the smallest lesion that can be detected in vivo.

Bronchoscopes↗
PubMed1979

Evaluation of sternal bone marrow aspiration for detection of tumor cells in patients with bronchogenic carcinoma.

We evaluated sternal bone marrow aspiration as a routine pretreatment procedure in patients with bronchogenic carcinoma. The overall rate of identification of tumor cells by this technique was found to be low. When oat cell bronchogenic carcinoma was considered as a separate entity, the positive rate was higher. However, in no instance did the bone marrow aspiration result in a change in clinical staging.

Adenocarcinoma↗
PubMed1977

'Silent' brain metastasis from lung carcinoma determined by computerized tomography.

Computerized tomography (CT) was utilized as a preoperative screening procedure in a series of 50 patients with lung carcinoma who were neurologically asymptomatic and whose radionuclide brain scans and skull roentgenograms were normal. Three patients (6%) were discovered to have metastasis (cerebellum, occipital, corpus callosum). The metastatic lesions were only directly visualized after administration of contrast substance. The CT findings greatly influenced the therapeutic planning in these patients, and surgery was avoided in two. When feasible, patients with lung carcinoma should have CT examinations (with contrast administration) prior to thoracic surgery even if they do not have neurologic symtoms.

Adult↗