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Biomedical subjects

R Joss

Publications and source records attributed to R Joss.

At least 55 records · Page 3Linked to original sources
PubMed1984

Whole-abdomen radiation in patients with advanced ovarian carcinoma after surgery, chemotherapy, and second-look laparotomy.

Forty-three patients with ovarian carcinoma were treated with whole-abdomen radiation (moving strip +/- pelvic radiation), 15 patients had not received prior chemotherapy, and 28 patients were irradiated following chemotherapy and second-look laparotomy. Ten of these had been treated with a variety of chemotherapy regimens (L-PAM, CHAD, Hexa-CAF). Eighteen patients were treated in an ongoing prospective trial with combination chemotherapy consisting of melphalan, cis-platinum, and hexamethylmelamine++ (HexaPAMP). Thrombocytopenia was the limiting toxicity. A temporary pause in the radiation schedule allowing platelets to recover made it possible to complete treatment in 80% of the patients. The acute toxic effects, which included the expected side effects of radiation therapy on intestine, liver and lung, were not more frequent or more severe in the patients who had received prior chemotherapy than in those who had radiation therapy alone. Thirty-four of 43 patients (stage I, seven patients; stage II, seven patients; stage III, 27 patients; stage IV, two patients) are alive and without evidence of disease 26 + months (range 7 to 64 months) after entering the postsurgical treatment program.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1983

[Lung cancers--marking time?].

The causal relationship between smoking and lung cancer is now generally accepted. Nevertheless, the incidence of lung cancer is increasing. No significant improvement in the curative treatment of non small cell lung cancer has been achieved in the last 20 years, and there has been no substantial improvement with surgical adjuvant therapies. Possible ways of improving current results are discussed. In contrast to non small cell lung cancer, treatment of small cell carcinoma has been improved substantially during the last 15 years and there is now a consistent percentage of longterm disease-free survivors.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1983

[High-dosage methylprednisolone as an antiemetic in cytostatic-induced vomiting].

The antiemetic efficacy of 375 mg methylprednisolone given as slow i.v. push injection was assessed in 27 tumor patients receiving strongly emetic cytostatic treatment. 13 of 27 patients were partially or completely protected from nausea and vomiting. Only minor side effects from methylprednisolone were observed: two patients complained of increased fatigue and four patients experienced facial rash with swelling 1 to 24 hours after the injection of methylprednisolone. High-dose methylprednisolone is an effective antiemetic treatment for patients receiving cancer chemotherapy.

Adult↗
PubMed1983

Phase II study of amsacrine in solid tumors: a report of the EORTC Early Clinical Trial-Group.

A total of 239 patients with advanced solid tumors were treated in this phase II trial. Amsacrine was administered as a single i.v. dose of 120 mg/m2 repeated at 21-day intervals. The initial dose was reduced to 90 mg/m2 in the case of extensive prior therapy. Some antitumor activity was detected in head and neck cancer but the drug appears to lack significant efficacy in epidermoid lung cancer as well as in carcinoma of the breast, melanoma, renal cell cancer, colorectal cancer and non-seminomatous testicular cancer. Leukopenia was the major toxic effect encountered in this trial and was similar at 90 and 120 mg/m2.

Adult↗
PubMed1983

Phase II trial of diaziquone (AZQ) in advanced malignant melanoma.

Forty-two evaluable patients with malignant melanoma received AZQ 27 mg/m2 i.v. every 4 weeks. In 5 patients with poor marrow reserve this dose was reduced to 20 mg/m2. Doses were rapidly escalated when no significant myelosuppression was encountered in previous courses. Twenty-five patients had received no prior chemotherapy. A single partial response was obtained for 3 months. Inconsistent myelosuppression was the main toxic effect in this trial. The median WBC and platelet nadirs were 3200/mm3 (900-19,500) and 105,000/mm3 (33,000-530,000) respectively. In 2 patients leukopenia was complicated by a transient episode of infection. One-third of the patients did not experience significant myelosuppression. Non-hematologic adverse reactions were generally mild to moderate and consisted of nausea and vomiting in 26 patients and alopecia in 1. It is concluded that at this dose schedule AZQ is ineffective against malignant melanoma.

Adult↗
PubMed1983

Acute cerebrovascular accident after treatment with cis-platinum and methylprednisolone.

A 53-year-old woman with recurrent ovarian cancer sustained an intracerebral hemorrhage after the 4th course of a chemotherapy regimen which included cis-platinum (DDP). She received high-dose methylprednisolone as an antiemetic along with the DDP. No metastases or abnormal vascularity were found on histological examination of the right frontal lobe which had been removed surgically. Causes of cerebrovascular accidents during and following chemotherapy are discussed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1983

Role of radiation therapy in small cell anaplastic carcinoma of the lung.

The previously established roles of radiotherapy in the management of small cell anaplastic carcinoma of the lung have changed with the development of improved chemotherapy. A group of the International Association for the Study of Lung Cancer has concluded that while there is established evidence that the addition of chemotherapy improves the results of radiation therapy, the value of the addition of loco-regional radiation therapy to chemotherapy is uncertain and more difficult to assess. No advantage in short-term (median) survival has been shown in randomized studies, but current data suggest a possible advantage in long-term control of loco-regional disease. Further results of prospective trials are needed to resolve this question. Prophylactic cranial irradiation reduces the incidence of cerebral metastases but so far has not resulted in improved survival. Pending the results of further randomized studies, its routine use in all patients is not advocated. The palliative role of radiation therapy is valuable in symptomatic treatment. Various current modifications of technique to improve the results of conventional radiation treatments with an altered fractionation schedule and use of sensitizers and large fields are not believed to show major advantages. The clear documentation of treatment details and the definition of the criteria for the assessment of results are important if further comparisons of results are to be made possible. In particular, the need for reporting long-term survival at 2 years in contrast to the more usual median survival time is stressed.

Antineoplastic Agents↗
PubMed1982

[Current status of esophageal neoplasms. I].

In Europe, carcinoma of the esophagus is a relatively rare disease with an annual mortality rate of 4-7 deaths per 105 inhabitants. Institution of appropriate therapy for esophageal carcinoma depends mainly on accurate diagnosis and staging. Computed tomography displays the anatomy of the esophagus and mediastinum with a high degree of accuracy and is a good method of assessing extra-esophageal spread of carcinoma. Preoperative nutritional support may reduce operative mortality and morbidity in high-risk patients. Today there is still no alternative to resection of the carcinoma. Esophagogastrectomy with (cervical) esophagogastrostomy with or without thoracotomy is the treatment of choice for patients with squamous cell carcinoma of the esophagus. Prognosis is still poor, with a 5-year survival rate of less than 20%. If resection is technically impossible, an endoesophageal tube can be inserted or a bypass procedure carried out to increase the quality of life with near normal ability to swallow. Radiotherapy can be used when surgery primarily is not applicable for medical reasons or is refused. Preoperative radiotherapy does not produce statistically significant short- or long-term benefit in the management of esophageal squamous cell carcinoma. Chemotherapy or combination chemotherapy have so far been insufficiently tested and cannot be recommended today for routine use. A combined modality approach is promising but needs further evaluation.

Adenocarcinoma↗
PubMed1982

[Prevention of cytostatic-related hair loss by hypothermia of a hairy scalp using a cooling cap].

82 patients treated with adriamycin alone or in combination with other cytostatic agents underwent scalp hypothermia by application of a gel cap. The cap ws applied 10 minutes before the injection of the drugs and maintained until 30 minutes after the administration of the chemotherapy. Prevention of hair loss was achieved in 47 patients (57%). The prophylaxis was successful in 16 out of 21 males (76%) compared with 31 out of 61 female patients (p less than 0.05). No statistically significant difference was found between patients receiving higher or lower doses of adriamycin or between patients wtih or without liver dysfunction. The tolerance of the gel cap was excellent; only one patient did not tolerate the cap because of anxiety during application.

Alopecia↗
PubMed1982

[Stomach cancer. Spontaneous course, therapy and prognosis].

The incidence of gastric cancer in Switzerland has decreased remarkable in the last fifty years and now constitutes 4% of all newly diagnosed neoplasms. Nutrition plays an important role in the pathogenesis of this tumor. The pathology, natural history and the staging of stomach cancer are reviewed, with special emphasis on early gastric cancer. Radiological and gastroscopic diagnosis is correct in almost all cases. Surgery remains as it was 100 years ago when Billroth performed the first gastrectomy, the only curative treatment. In the last few years combination chemotherapy for gastric cancer has been markedly improved, and with modern cytostatic regimens objective tumor responses are achieved in one third to half of patients. The value of adjuvant chemotherapy in radically resected patients remains to be proven. The poor prognosis of gastric cancer can be improved by early diagnosis, better understanding of the pathogenesis of this tumor, elimination of carcinogens from our food and incorporation of effective systemic treatment in the primary treatment plan for stomach cancer.

Age Factors↗