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Biomedical subjects

R J Papac

Publications and source records attributed to R J Papac.

At least 19 recordsLinked to original sources
PubMed1999

Renal cell carcinoma: a paradigm of lanthanic disease.

Renal cell carcinoma is characterized by varied and sometimes obscure manifestations, which include unusual metastatic sites and paraneoplastic and vascular syndromes. In this review, uncommon metastatic sites and their clinical significance are discussed, particularly the thyroid, nasal structures, vagina, and gastrointestinal sites. Paraneoplastic syndromes appear to be related predominantly to cytokines or immunologic mechanisms. Vascular syndromes are related to the tendency of the tumor to spread by direct venous extension and to complications related to the vascularity of the tumor or its metastases. The recognition of unusual manifestations of renal cell carcinoma is important because these syndromes may lead to the diagnosis. Moreover, paraneoplastic syndromes and vascular findings may not indicate unresectability or incurability.

Carcinoma, Renal Cell↗
PubMed1995

Myelodysplasia. The clinical spectrum of 51 patients.

BACKGROUND: Over a 15 year period, the authors followed 51 male patients with myelodysplastic syndromes whose clinical findings, laboratory data, and evolution demonstrated a wide spectrum of disease. METHODS: The following characteristics were assessed: age at diagnosis, risk factors, clinical presentation, laboratory features, category of myelodysplasia, leukemic conversion, and overall survival. RESULTS: The clinical manifestations included hemolytic episodes in two patients, antibody-mediated thrombopenia in one, marked marrow fibrosis in two; thrombocytosis in three, and simultaneous lymphoproliferative disorders in two. There were 21 patients whose marrow was either normo- or hypocellular. Six patients presented with single cytopenia but not anemia. There were six instances of overlapping of the French-American-British classification. Eighteen patients progressed to acute leukemia and 1 to chronic myelomonocytic leukemia. CONCLUSIONS: These observations indicate that patients with myelodysplastic syndromes may have single cytopenia without anemia that progresses to acute leukemia and may, rarely, evolve into chronic myelomonocytic leukemia. The clinical aspects of these syndromes may include autoimmune phenomena and myeloproliferative features.

Adult↗
PubMed1994

Bone marrow metastases. A review.

Although bone marrow examination is a common procedure in the evaluation of patients with cancer, its role and contribution have been questioned in recent years. This review deals with the clinical and biologic aspects of metastasis to the bone marrow. The discussion is focused on the common tumor types that involve marrow and the application of newer techniques for tumor detection in the marrow. Therapeutic and prognostic implications of bone marrow metastasis are significant in several clinical settings. The mechanisms by which tumor cells affect marrow function have not been completely defined.

Animals↗
PubMed1993

Hormonal therapy for metastatic renal cell carcinoma combined androgen and provera followed by high dose tamoxifen.

The purpose of this phase II study was to determine the effectiveness of hormonal therapy with combined high dose androgen and provera or tamoxifen in patients with advanced renal cell carcinoma. 30 patients with metastatic renal cell carcinoma received testosterone propionate 100 mg intramuscularly (i.m.) 5 times weekly plus provera 400 mg (i.m.) twice weekly until disease progression developed. 20 patients, most of whom had previously failed to respond to androgen and provera, received tamoxifen 100 mg/m2 daily. Of the 30 patients treated with androgen and provera, 3 (10%) developed partial responses of brief duration. 2 of 20 patients (10%) experienced tumour response with tamoxifen, one instance of complete disappearance of pulmonary metastases in a patient whose primary tumour was questionably persistent at post mortem and another case demonstrating disease stability. Combined hormonal therapy offers very little therapeutic advantage in advanced renal cell carcinoma. Tamoxifen, in high dose, exerts anti-tumour effects in a small cohort of cases.

Aged↗
PubMed1989

Randomized clinical trial of mitomycin C as an adjunct to radiotherapy in head and neck cancer.

A randomized prospective clinical trial was carried out to assess the usefulness of the addition of mitomycin C to radiation therapy used alone or in combination with surgery for the treatment of squamous cell carcinoma of the head and neck region. One hundred and twenty patients with biopsy proven tumor of the oral cavity, oropharynx, larynx, hypopharynx, and nasopharynx were randomly assigned to receive or not receive mitomycin C; all other aspects were similar in the two treatment groups. One hundred and seventeen patients were evaluable with a median follow-up time of greater than 5 years. Acute and chronic normal tissue radiation reactions were equivalent in the two treatment groups. Hematologic and pulmonary toxicity were observed in the drug treated patients. Actuarial disease-free survival at 5 years was 49% in the radiation therapy group and 75% in the radiation therapy plus mitomycin C group, p less than 0.07. Local recurrence-free survival was 66% in the radiation therapy group and 87% in the radiation therapy plus mitomycin C group, p less than 0.02. The findings demonstrate that mitomycin C can be administered safely as an adjunct to radiation therapy in the treatment of head and neck cancer. The drug improves local tumor control without enhancing normal tissue radiation reactions.

Adult↗
PubMed1987

Improved local control of thoracic disease in small cell lung cancer with higher dose thoracic irradiation and cyclic chemotherapy.

Over the past decade, improvement in survival has developed for patients with small cell lung carcinoma (SCLC) due to treatment strategies that include: cyclic combination chemotherapy, thoracic irradiation, and prophylactic cranial irradiation. In this study, we assess the outcome of treatment with initial cyclic combination chemotherapy including: cyclophosphamide, VP 16-123 and methotrexate combined with radiotherapy (RT), 6000 cGY [corrected] to the thorax for patients with limited disease and 3000 cGy [corrected] for patients with extensive disease. Forty-six patients are evaluated: 26 patients with limited disease and 20 with extensive disease. In patients who received 6000 cGy [corrected], to thoracic lesions, in combination with chemotherapy, administered for 3 courses prior to and following RT, the rate of clinically detected failure in the thorax was 3.8%. Morbidity was considered acceptable, although the occurrence of encephalopathy in 6 of 19 cases who received cranial irradiation, 3000 cGy [corrected], and concomitant chemotherapy was a serious consequence. Control of the primary tumor achieved by the use of higher dose RT is shown to be superior to that observed at lower doses of RT. This suggests that for the small cohort of patients whose disease is truly limited at the time of diagnosis, therapeutic regimens, which include higher dose RT, could increase the number of long term survivors of SCLC.

Aged↗
PubMed1985

Medical aspects of head and neck cancer.

Certain medical aspects of advanced head and neck cancer observed in 191 patients referred to a medical oncology service over a 14-year period are presented in this review. While these tumors constitute an uncommon group of advanced neoplasms, the disability and impairment associated with this disease are great. Infections, folate deficiency, and hypercalcemia are frequent complications and generally detected. The occurrence of pulmonary tuberculosis, cardiovascular and neurologic sequelae were infrequent but may be generally under-recognized. Additionally, head and neck cancer patients were found to develop second malignancies in remote sites with surprising frequency as well as demonstrating the predilection to develop second primary tumors within the same area.

Adult↗
PubMed1984

Distant metastases from head and neck cancer.

Distant metastases were detected in 52 (30.7%) of 169 patients with advanced head and neck cancer observed from 1968 until 1982. Both clinical and autopsy findings are included in the assessment. The occurrence of distant metastases was related to primary disease site, stage of disease at presentation, and development of infectious complications during the course of the disease. The duration of survival was unrelated to the development of metastases. The incidence of distant spread was low for patients with floor-of-mouth lesions (11.8%) and high for patients with advanced disease arising in some regions of the larynx (58.6%). Patients who experienced wound infection, pneumonia, or bacteremia had infrequent development of metastatic disease.

Autopsy↗
PubMed1983

Small cell carcinoma of bronchus: 1970-1980. A retrospective analysis.

Seventy patients who had been referred to an oncology service during the past decade for management of small cell carcinoma of the bronchus were studied to determine survival in relation to different types of therapy as well as patterns of disease. Median survival for the entire group was 221 days. Treatments included radiotherapy, single agent chemotherapy, and combined modality treatment. Sites of metastatic disease did not influence outcome except as a sole extrathoracic site of disease. The biologic implications of these results are discussed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1982

Intralymphatic and regional surgical adjuvant immunotherapy in high-risk melanoma of the extremities.

A prospective, controlled study of surgical adjuvant immunotherapy with intralymphatic methanol-extractable residue (MER) of bacillus Calmette-Guerin (BCG) is preliminarily reported in 25 consecutive patients with high-risk malignant melanoma of the extremities. Patients were allocated on a random basis to receive preoperative intralymphatic immunotherapy with MER-BCG, surgical excision with regional lymphadenectomy and intraoperative infiltration of MER-BCG, and postoperative monthly intradermal vaccinations with BCG; or surgery and lymphadenectomy alone. Twenty patients followed for more than 1 year are the basis of this report. Fifteen patients accepted randomization, whereas four patients entered the immunotherapy group and one entered the control group at their own insistence. Immunotherapy improved the disease-free survival of patients in this trial. There was one recurrence with death in the 13 patients treated with preoperative intralymphatic MER-BCG; whereas four of seven patients in the control group had recurrence (P = 0.015), at all four of these patients died during the same interval.

Adjuvants, Immunologic↗
PubMed1980

Differentiation of human promyelocytic leukemia cells in vitro by 6-thioguanine.

The antineoplastic agent, 6-thioguanine, was found to be a highly potent inducer of differentiation of HL60 human leukemia cells in vitro, producing cells with predominantly myeloid characteristics, as judged by morphological, functional, and cytochemical criteria. Maturation of HL60 was attainable without significant cytotoxicity as measured by cell number; moreover, maximal differentiation occurred at a level of the purine antimetabolite below that producing 50% growth inhibition. The 6-thioguanine-induced differentiated cells had distinctive granulocytic morphology, and were capable of generating superoxide anion during the respiratory burst typical of mature phagocytic cells.

Cell Differentiation↗
PubMed1977

Lung carcinoma after radiotherapy and chemotherapy for Hodgkin's disease.

Two patients, aged 29 and 40, with nodular sclerosing Hodgkin's disease, in complete remission for four and six years respectively after intensive radiotherapy and combination chemotherapy, developed carcinoma of the lung in the previous radiation port. Although radiotherapy and chemotherapy can eradicate Hodgkin's disease involving the thorax, this treatment may be associated with the development of a secondary pulmonary malignancy, particularly in a previous radiation port, and several years may elapse before the new tumour becomes evident.

Adult↗