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Biomedical subjects

S B Lele

Publications and source records attributed to S B Lele.

At least 37 records · Page 2Linked to original sources
PubMed1987

1.5-5 years of uninterrupted cis-diamminedichloroplatinum II chemotherapy for metastatic cervical cancer.

In an attempt to prolong remission duration in patients with metastatic cervical cancer to cis-platinum based chemotherapy, patients were treated on an every other month basis after a minimum of 1 year of cis-platinum based chemotherapy. To date, five patients have received 5, 4.5, 2.3, 2.3, and 1.5 years, respectively, of uninterrupted cis-platinum based chemotherapy. All remain in complete remission after receiving a total dose of cis-platinum of 2523 mg (1530 mg/m2), 2.408 mg (1655 mg/m2), 1496 mg (880 mg/m2), 1325 mg (970 mg/m2), and 1640 mg (950 mg/m2), respectively. The only apparent toxicity has been asymptomatic hypomagnesemia. In contrast, three other patients in complete remission on cis-platinum based chemotherapy voluntarily discontinued such therapy and have subsequently developed uncontrolled recurrent cervical cancer. It is concluded that patients in complete remission from cis-platinum chemotherapy for metastatic cervical cancer can receive long-term cis-platinum based chemotherapy and that such therapy appears to be without significant toxicity.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Cisplatin plus VP16-213 in refractory ovarian carcinoma.

Twenty-five patients with FIGO stage III and IV ovarian carcinoma were treated with cisplatin plus VP16-213 chemotherapy as the second, third, or fourth line of therapy. There were two (8%) partial responses, 18 with stable disease and five with progression of disease. Neurotoxicity was observed in all patients, with two patients developing severe paresthesias and difficulty in walking.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Etoposide (VP-16) plus cisplatin (DDP): a new active chemotherapeutic combination in patients with stage III-IV ovarian adenocarcinoma.

Ten patients with Stage III-IV ovarian adenocarcinoma were treated with the drug combination etoposide (VP-16) plus cisplatin (DDP). All patients were in relapse following prior vigorous, uninterrupted treatment with three or more lines of chemotherapy that included (1) courses of weekly 1-mg/kg single-agent DDP, (2) DDP 50 mg/m2 in various combinations with or without cytoxan, adriamycin and hexamethylmelamine q 4 weeks and (3) high-dose methotrexate-leucovorin plus cyclophosphamide (MECY) q 4 weeks. The median duration of treatment prior to starting VP-16-DDP was 27.5 months (range 6 to 53 months). VP-16-DDP was given as a 2-day regimen repeated every 4 weeks. VP-16, 100-150 mg/m2, was given on days 1 and 2, and 50 mg/m2 of DDP on day 1 only. The finding of 50% partial response and 38% stabilization of measurable tumor was remarkable in patients so extensively pretreated. The responses were not due to increased DDP dosage, but rather to an apparent synergism between VP-16 and DDP.

Aged↗
PubMed1986

cis-Diamminedichloroplatinum plus dimethyl-triazenoimidazole carboxamide as second- and third-line chemotherapy for sarcomas of the female pelvis.

From 1981 to 1984, 20 patients with sarcomas of the female pelvis were treated with dimethyl-triazeno-imidazole carboxamide (DTIC) combined with cis-diamminedichloroplatinum II (DDP) in two sequential studies. Group 1 patients received low-dose (1 mg/kg) DDP plus DTIC; Group 2 patients received high-dose DDP (20 mg/m2 daily for 5 days) plus DTIC. Each regimen was repeated every 4 weeks depending on the patient and bone marrow tolerance. Of the 20 patients, 35% achieved an objective response. Of the 10 group 1 patients, 20% had an objective response (1 CR, 1 PR) both as second-line chemotherapy. For the group 2 patients, 50% (5) have responded (3 CR, 2 PR), one as third-line and 4 as second-line chemotherapy. These results suggest that DTIC plus DDP, especially at the higher dose (20 mg/m2 X 5), is effective chemotherapy for metastatic pelvic sarcomas.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Stage II invasive adenocarcinoma of the ovary: results of treatment by whole abdominal radiation plus pelvic boost versus pelvic radiation plus oral melphalan chemotherapy.

Thirty-one patients with histologically confirmed FIGO Stage II adenocarcinoma of the ovary were prospectively treated in two sequential studies: 3000 rad of whole abdominal radiation therapy over 6 weeks by an open field technique followed by 2000 rad pelvic boost over 2 weeks (group 1, 16 patients, 1972-1974) or 5000 rad of pelvic radiation therapy over 5 weeks followed by a year of melphalan chemotherapy at a dose of 0.2 mg/kg/day for 5 days every 4 weeks (group 2, 15 patients, 1975-1982). Abdominal radiation included the entire peritoneal cavity and both diaphragms; the liver was not shielded. Only 2 patients had residual disease greater than 2 cm. No group 1 patients underwent pretherapy restaging laparoscopy prior to radiation or second look laparotomy after treatment. Eighty percent of group 2 patients underwent restaging laparoscopy (10) or staging laparotomy (2) prior to radiation. All group 2 patients underwent second look procedures if no evidence of disease. No patient developed intestinal complications secondary to radiation requiring surgery. Eighty-one percent of group 1 patients and to date 40% of group 2 patients developed recurrences. Size of residual disease prior to radiation, histologic grade, and substage (IIA, B, or C) did not correlate with recurrences. Five-year estimated survival was 40 and 50% for groups 1 and 2, respectively. Three thousand rad of wole abdominal radiation plus 2000 rad pelvic boost or 5000 rad pelvic radiation plus melphalan did not appear to improve survival over surgery alone. The role of radiation therapy in Stage II ovarian cancer remains unclear.

Adenocarcinoma↗
PubMed1986

Melphalan, 5-fluorouracil, and medroxyprogesterone acetate in metastatic endometrial carcinoma.

Fifty consecutive patients with recurrent and metastatic endometrial carcinoma were treated with melphalan, 5-fluorouracil, and medroxyprogesterone acetate with or without tamoxifen as first-line chemotherapy. The objective response rate was 48%, with 20% complete responses. The estimated median progression-free survival time was only five months (0.5 to 65 months) with estimated two- and five-year progression-free survival rates of 16 and 13%, respectively. The estimated median progression-free survival time was 24 months for complete responders; the progression-free survival times were significantly longer than the survival times (median = four months) for all other patients (P = .0002). Whether or not the addition of cytotoxic chemotherapy to progesterone hormonal therapy for metastatic endometrial carcinoma lengthens survival time is still open to question.

Adult↗
PubMed1986

Interval laparoscopy as predictor of response to chemotherapy in ovarian carcinoma.

Fifty-one patients with FIGO stage III and IV ovarian adenocarcinoma underwent six-month interval laparoscopy for assessment of chemotherapy response. Thirty-nine of these patients were followed by a second-look procedure at 12 months or to disease progression if it occurred earlier. A positive interval laparoscopy was predictive of disease in 91% of patients, whereas a negative interval laparoscopy showed absence of disease at second look in only 70.5% of patients. A positive laparoscopic biopsy at six months showed presence of disease at second look procedure in 100% (11 of 11) of patients. It is concluded that either an intensive initial chemotherapy or change in therapy such as intraperitoneal chemotherapy after positive interval laparoscopy is indicated in future studies.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

Long-term survival rates with various chemotherapeutic regimens in stages III and IV ovarian adenocarcinoma. The influence of optimum pretreatment surgical resection.

This report compares long-term survival rates for patients treated with four different chemotherapeutic regimens for Stages III and IV ovarian adenocarcinoma. The patients were entered into consecutive, prospective, randomized studies with an essentially common chemotherapeutic arm. The first study compared the single agent melphalan with actinomycin D, 5-fluorouracil, and Cytoxan. The second study compared 5-fluorouracil plus Cytoxan and methotrexate-leucovorin rescue plus Cytoxan. The patient characteristics in the two studies were very similar except for more aggressive tumor-reductive operations in the second study. Observed survival rates for the first 2 years in the second study were very much higher than in the first study. However, by the third, fourth, and fifth years, the survival rates of the 5-fluorouracil-Cytoxan-treated individuals had reached the same low levels seen in the first study. It appears that an optimum surgical procedure by itself may enhance survival during the first 2 years. Survival with methotrexate-leucovorin rescue plus Cytoxan was statistically significantly better than with melphalan or actinomycin D-5-fluorouracil-Cytoxan. Third-, fourth-, and fifth-year survival rates with methotrexate-leucovorin rescue plus Cytoxan were substantially higher than with 5-fluorouracil-Cytoxan; however, the survival distributions for these two treatments were not statistically significantly different. Long-term survival rate data for patients with Stages III and IV ovarian adenocarcinomas treated with chemotherapy are rare. The 19% 5-year survival rate with methotrexate-leucovorin rescue plus Cytoxan in the present study is considerably higher than other reported survival rates.

Adenocarcinoma↗
PubMed1985

Evaluation of the nephrotoxicity of iproplatin (CHIP) in comparison to cisplatin by the measurement of urinary enzymes.

Levels of three enzymes, leucine aminopeptidase (LAP), N-acetyl-beta-D-glucosaminidase (NAG), and beta-glucuronidase (BGA) were measured in the urine of patients receiving hematologically toxic doses of iproplatin (a) with or (b) without pretreatment hydration. The maximum post-treatment increases in the levels of each of the enzymes were compared between these two groups of patients. In addition, the maximum increases in urinary enzyme levels in iproplatin-treated patients were compared with those in patients treated with 40 mg/m2 cisplatin, a known nephrotoxic agent. Increases in LAP levels after cisplatin treatment in the periods studied are significantly higher than those after iproplatin treatment (P less than 0.05). No differences were found in the increases in BGA and NAG levels between iproplatin treatment and cisplatin treatment. No differences were found in the increases in levels of any of the enzymes between patients receiving iproplatin with pretreatment hydration and no prior hydration.

Acetylglucosaminidase↗
PubMed1985

Small cell carcinoma of the ovary: a rapidly lethal tumor occurring in the young.

Two patients with metastatic small cell carcinoma of the ovary managed by the Clinical Gynecologic Oncology Service at Roswell Park Memorial Institute are presented. Despite intensive multimodal therapy after extensive cytoreductive surgery, both patients expired from this rare tumor within 6 months of diagnosis. Neither tumor was associated with hypercalcemia, previously reported in the only existing review of the tumor in the world literature. Because of the highly aggressive nature of this cancer, effective combination chemotherapy must be found if the natural history of this tumor is to be altered.

Adolescent↗
PubMed1984

Weekly cis-diamminedichloroplatinum II as induction chemotherapy in recurrent carcinoma of the cervix.

Twenty-four evaluable patients with recurrent carcinoma of the cervix after previous pelvic irradiation were treated with cis-diamminedichloroplatinum II (cis-DDP). Of the 14 patients who received low-dose (1 mg/kg) weekly induction cis-DDP, 10 (71%) responded, 6 (43%) of which were complete responses. Four (40%) of the ten patients who received high-dose (100 mg/m2) monthly cis-DDP responded, two of which were complete responses. Maintenance of these responses by combination chemotherapy which includes cis-DDP remains a significant problem.

Adenocarcinoma↗
PubMed1984

Cisplatin-MECY (methotrexate-leucovorin rescue plus cyclophosphamide) versus cisplatin-CHAD (cyclophosphamide, hexamethylmelamine, doxorubicin, and cisplatin) as initial chemotherapy in stage III-IV ovarian adenocarcinoma.

Thirty-three patients with advanced-stage ovarian adenocarcinomas, with no prior chemotherapy, were treated with weekly cisplatin (DDP) for four courses followed by five monthly courses of one of two randomly assigned multidrug combinations. These combinations were high-dose methotrexate-leucovorin plus cyclophosphamide (MECY) or cyclophosphamide, hexamethylmelamine, doxorubicin, and DDP (CHAD). Patients with no clinically measurable disease after 6 months of therapy were evaluated by laparoscopy. In the absence of disease progression at the time of the laparoscopy the study design called for a repeat cycle of four weekly DDP courses and another five monthly courses of the assigned multidrug combination. All patients with no evidence of disease after 1 year of treatment had a second-look laparoscopy which, if negative, was followed by a second-look laparotomy. This report includes all of the consecutively entered patients observed for a minimum of 1 year or to death. DDP-MECY and DDP-CHAD were similarly active for overall response rates and complete response rates according to laparoscopic criteria. However, DDP-MECY had a statistically significantly lower relapse rate (P less than 0.02) and a statistically significantly higher negative second-look laparotomy rate than did DDP-CHAD. Using all entered patients, with no exclusions from analysis, eight of 17 patients (47%) treated with DDP-MECY had negative second-looks after 1 year of treatment. This compares with one of 16 (6%) negative second-looks in patients treated with DDP-CHAD (P less than 0.02). The high negative second-look rate with DDP-MECY is exciting. Positive cytologic washings at the 6-month laparoscopic evaluation were highly predictive that residual disease would be found at the 1-year second-look surgery. Only one patient with positive peritoneal cytology after 6 months of treatment was found to have a negative second-look after 1 year of therapy.

Adenocarcinoma↗
PubMed1984

Pseudomyxoma peritonei: possible prevention of mucinous ascites by peritoneal lavage.

Combined use of intraperitoneal lavage with dextrose 5% and water and an aggressive surgical approach has thus far successfully prevented reaccumulation of pseudomyxoma peritonei originating from bilateral ovarian mucinous cystadenoma associated with multiple peritoneal implants. Three and a half years after treatment the patient remains without clinical or ultrasonographic evidence of recurrence.

Ascites↗
PubMed1983

Cis-diamminedichloroplatinum (II): second line induction chemotherapy in advanced ovarian adenocarcinoma.

Twenty-one evaluable patients received second-line chemotherapy for recurrent ovarian adenocarcinoma with induction Cisplatin given weekly followed by monthly combination chemotherapy. Forty-two percent of the patients responded to induction weekly Cisplatin. Of the responders, 77% are alive as compared to only 8% of the nonresponders. Maintenance of the responses by monthly combination chemotherapy remains a significant problem. Moreover, 83% and 70% of patients who received weekly Cisplatin as first- and third-line induction chemotherapy, respectively, had objective responses. Of the total 43 patients who received weekly Cisplatin as first-, second-, or third-line chemotherapy, 60% responded, including complete clinical responses in 14% and partial responses in 46%.

Adenocarcinoma↗
PubMed1983

Cyclophosphamide, Adriamycin, and platinum chemotherapy in treatment of advanced and recurrent cervical carcinoma.

The chemotherapeutic combination of cyclophosphamide, doxorubicin (Adriamycin), and cis-dichlorodiammineplatinum was used in the treatment of women with metastatic or recurrent cervical carcinomas not amenable to surgery or radiotherapy. A total of 20 patients with evaluable parameters were treated. Three partial remissions and one complete remission were obtained, giving an overall response rate of 20%.

Adenocarcinoma↗
PubMed1983

Prophylactic anticoagulation as a possible cause of inguinal lymphocyst after radical vulvectomy and inguinal lymphadenectomy.

From 1957 to 1982, 115 patients underwent radical vulvectomy and bilateral inguinal lymphadenectomy for invasive squamous carcinoma of the vulva. From 1957 to 1971, 57 patients received perioperative prophylactic sodium warfarin (Coumadin) as prophylaxis against pulmonary embolism. From 1971 to 1976, 27 consecutive patients received dextran-40 as prophylaxis for pulmonary embolism and to improve the microcirculation to the inguinal skin flaps. Because of the report that dextran-40 is a cause of acute renal failure, this study was terminated and the subsequent 19 patients were treated with mini-dose heparin because of the reported benefit as prophylaxis against thromboembolic disease. During the 25-year period, 12 patients received no prophylactic anticoagulants. Mini-dose heparin resulted in a significant morbidity not previously reported in patients undergoing inguinal lymphadenectomy: 43% (8/19) of the mini-dose heparin patients, 7% (2/27) of the dextran-40 patients, 0% (0/57) of the sodium warfarin patients, and none of the 12 patients not receiving perioperative prophylaxis developed inguinal lymphocysts (P less than .001). There was no significant difference in the prevention of pulmonary embolism between the mini-dose heparin (0/19), dextran-40 (0/27), and no treatment groups (0/12) as compared to the 5% (3/57) incidence in the sodium warfarin patients (.10 less than P less than .50). The significant relationship between prophylactic heparin and the subsequent development of inguinal lymphocysts and the need to reassess its role in prevention of pulmonary embolism in patients undergoing lymphadenectomy is discussed.

Aged↗
PubMed1982

Intraperitoneal chromic phosphate in peritoneoscopically confirmed stage I ovarian adenocarcinoma.

From December 15, 1975 to June 16, 1980, 20 evaluable patients with International Federation of Gynaecology and Obstetrics Stage I invasive adenocarcinoma of the ovary were entered into a prospective study, including pretherapy restaging peritoneoscopy followed by treatment with intraperitoneal chromic phosphate if there was no evidence of residual macroscopic tumor. During a follow-up of 1 1/2 to 6 years (median, 3 years and 1 month), the survival rate without evidence of recurrent ovarian carcinoma was 95%. Moreover, there was a total absence of complications with the use of the sequential steps of pretherapy peritoneoscopy, a normal preinjection peritoneogram, injection of chromic phosphate in large volumes of solution, frequent change of position of the patient after injection, and abdominal scans after injection. This method appears to be safe and is associated with a significantly high survival rate.

Adenocarcinoma↗