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Biomedical subjects

R Goerg

Publications and source records attributed to R Goerg.

At least 19 recordsLinked to original sources
PubMed1994

Radiotherapy alone versus chemotherapy with ifosfamide/vindesine followed by radiotherapy in unresectable locally advanced non-small cell lung cancer.

In a German multicenter trial, previously untreated patients with unresectable stages IIIA and IIIB non-small cell lung cancer were randomly assigned to receive either radiotherapy alone (arm A) or chemotherapy followed by radiotherapy (arm B). Chemotherapy in arm B consisted of ifosfamide 1,500 mg/m2 intravenously on days 1 to 5 and 29 to 33, and vindesine 3 mg/m2 intravenously on days 1 and 5 and 29 and 33. Radiotherapy started on day 1 in arm A and on day 56 in arm B. Single doses of 2 Gy were given 5 days a week for 3 weeks and after a 2-week interval for an additional 2 weeks. The total radiation dose was 50 Gy. Concurrent to radiotherapy, cisplatin was given as a radiosensitizer at a dose of 20 mg/m2 once a week. From July 1986 to March 1989, 85 patients were randomized, of whom 78 were evaluable. Main prognostic factors were well balanced. Of the patients receiving chemotherapy, 25% had a partial remission after two cycles, 46% showed no change, and 29% had progressive disease. After radiotherapy, response rates were 49% in arm A and 58% in arm B, including a 10% complete remission rate in both groups. After two thirds of the projected sample size had been included, an analysis of survival was performed and showed a statistically significant advantage for the treatment group including chemotherapy (P = .016). Median survival was 9.0 months versus 13.7 months and 2-year survival was 12% versus 24%, both in favor of the group receiving chemotherapy. These results caused premature discontinuation of patient accrual according to the study protocol and the recommendations of the Ethics Review Board of the Philipps-University Hospital. The results of this trial indicate that chemotherapy is able to prolong survival of patients with locally advanced unresectable non-small cell lung cancer and should be considered for treatment of these patients.

Adult↗
PubMed1993

[Extensive metastatic Kaposi sarcoma in chronic immune suppressed bronchial asthma].

In a severely ill 64-year-old man with multilocular Kaposi sarcoma HIV infection was excluded. The decisive factor in the pathogenesis, was long-term immunosuppression with systemic corticosteroids for bronchial asthma. The patient died from cardiorespiratory insufficiency in the course of tumour progression. Autopsy revealed a vast visceral manifestation of Kaposi sarcoma.

Administration, Topical↗
PubMed1992

[Histiocytosis X].

Explore the source record for details and available documents.

Diagnosis, Differential↗
PubMed1991

[Pulmonary histiocytosis X].

This is a report on 2 adult patients suffering from pulmonary histiocytosis X. The aetiology and the diagnostic and therapeutic approach are discussed on the basis of a review of the literature. This is a rare disease that is triggered by a virus and immunologically conditioned, the disposition being genetically transferred. It is characterised by cells known as histiocytosis X cells with typical X bodies and immunocytochemically identifiable S 100 antigen. It will usually be necessary to perform an open biopsy of the lung to determine the histology of histiocytosis X. Roentgenologically pathognomonic signs are in particular ring-shaped structures of up to 5 mm diameter with a marginal edge. Lung function analysis revealing hypoxaemia after stress and, less significantly, diffusion capacity and vital capacity, are also among the most sensitive data pointing to histiocytosis X. Indication for treating the patients, who usually do not display prominent signs and symptoms, should be discrete because spontaneous remissions occur very frequently. If the patients display relevant signs and symptoms, corticosteroid long-term treatment over 12 months with 0.5-1.0 mg/kg body weight per day is recommended employing a slowly and progressively reduced dosage schedule. Chemotherapeutic drugs or thymus extracts are administered in a few rare instances.

Adrenal Cortex Hormones↗
PubMed1989

Experience of a German multicenter study group with ifosfamide in small cell lung cancer.

In three German multicenter randomized trials, which included 718 patients, the activity of ifosfamide in small cell lung cancer (SCLC) was tested. In study 1, IE (ifosfamide, 1.5 g/m2, days 1 through 5; etoposide, 120 mg/m2, days 3 through 5) alternating with CAV (cyclophosphamide, 600 mg/m2, days 1 and 2; doxorubicin, 50 mg/m2, day 1; vincristine, 2 mg, day 1) was compared with a response-oriented treatment with IE therapy up to maximum response and subsequently an immediate switch to CAV. After chemotherapy, patients with limited disease received chest irradiation with 45 Gy. Prophylactic cranial irradiation (30 Gy) was given to all patients who achieved complete response (CR). A total of 324 patients were evaluable. Total response rate (CR + partial response [PR]) was 75% v 78% for the two treatment groups; the CR rate was 29% for both groups. Survival was nearly identical in both arms, with a median survival of 10.0 months for all patients, 12.0 months for those with limited disease (LD), and 7.5 months for those with extensive disease (ED). The 2-year survival rate was 11%. In study 2, IE was compared with PE (cisplatin, 90 mg/m2, day 1; etoposide, 150 mg/m2, days 3 through 5). A total of 141 patients were evaluable. Total response (CR + PR) rate was 65% for PE and 68% for IE; the CR rate for PE was 32% v 20% for IE. Survival favored PE with a median survival of 11.6 months v 9.4 months for all patients, 14.8 months v 11.0 months for LD, and 8.9 months v 7.5 months for ED. Two-year survival rates were 12% v 9% for all patients, 23% v 10% for those with LD, and 5% v 9% for those with ED. From these trials, we conclude that IE is an active and well-tolerated regimen for SCLC, and that PE may be superior to IE in limited-stage disease. Taking these results into account, we modified our chemotherapy protocols in study 3 and compared IAV (ifosfamide, 2 g/m2, days 1 to 5; doxorubicin, 25 mg/m2, days 1 and 2; vincristine, 2 mg, day 1) alternating with either PE or JE (carboplatin, 300 mg/m2, day 1; etoposide, 120 mg/m2, days 1 to 3). Interim results of 253 evaluable patients are as follows: CR + PR rate after 4 cycles was 68%; the CR rate was 28%; median survival was 11.6 months for all patients, 14.8 months for LD, and 10.2 months for ED.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed1982

[Lung function and operability. Importance of preoperative right heart catheterization in patients with bronchial cancer].

Lung resection may be followed by pulmonary hypertension leading to cardio-respiratory insufficiency. Therefore, pulmonary arterial pressure should be known before operation. To test the presence of pulmonary hypertension, results of lung function studies and right heart catheterization were compared in 100 patients with bronchogenic carcinoma. Mean pulmonary arterial pressure could be correlated with arterial partial pressures of oxygen and carbon dioxide as well as with total airway resistance and the Tiffeneau-test (FEV1/VC). A multiple regression analysis including 5 non hemodynamic variables, however, demonstrated a standard estimation error of mean pulmonary arterial pressure of 4.4 mmHg at rest and 8.0 mmHg during exercise thus proving that the multiple regression is of no clinical significance. Also by a discriminant analysis, patients could not be identified with clinically sufficient reliability as hemodynamically normal or pathological. Thus, right heart catheterization is an indispensable prerequisite to lung resection.

Airway Resistance↗