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Biomedical subjects

S E Vogl

Publications and source records attributed to S E Vogl.

At least 37 records · Page 2Linked to original sources
PubMed1984

"Second-effort" surgical resection for bulky ovarian cancer.

Eighteen women with bulky ovarian cancer at the start of chemotherapy were brought to second laparotomy after 6 months of combination chemotherapy in an effort to resect previously unresectable tumor masses. Only one of 18 had significant resection of bulk tumor such that no gross tumor was remaining, although 8 of 15 had the residual uterus removed and 6 of 10 had resection of residual ovary or ovaries. Failure to resect tumor was due to absence of any gross tumor (33%), presence of myriad small seedlings not amenable to resection (22%), or massive residual tumor (18%). Partial resection was accomplished in 22%, but all relapsed promptly in spite of continued aggressive therapy with drugs and whole abdominal irradiation. It is concluded that 6-month "second-effort" surgical resection is unlikely to benefit many women with bulky ovarian cancer, and that surgical resection must be attempted early in the course of the disease if it is to be effective.

Adult↗
PubMed1984

Adriamycin and cis-diamminedichloroplatinum in the treatment of metastatic endometrial adenocarcinoma.

Adriamycin (50 mg/m2) and cis-diamminedichloroplatinum (50 mg/m2) were administered every 21 days to treat metastatic endometrial adenocarcinoma. This regimen resulted in three responses (one complete and two partial) in nine women (33%). Most patients had moderate or severe hematologic and gastrointestinal toxicity. One patient experienced moderate neurotoxicity. This combination of drugs did not appear effective in the treatment of recurrent endometrial adenocarcinoma, but may have a role in the therapy of primary widespread disease.

Adenocarcinoma↗
PubMed1984

Phase II study of methyl-glyoxal bis-guanylhydrazone (NSC 3296) in advanced ovarian cancer.

Thirty-nine patients received 600 mg/m2 OF MGBG intravenously every week for the treatment of advanced refractory ovarian cancer. Twenty-seven of these received adequate trials, and only two had partial remissions lasting 3 1/2 and 4 months each. Toxicity was substantial, with severe hematologic toxicity in 26%, diarrhea in 22% (severe in 7%), skin rash in 26% (severe in 7%), and vomiting in 70% (severe in 11%). Fatigue, facial paresthesias, and flushing during drug administration were frequent. It appears that MGBG in this dose and schedule has little activity against advanced ovarian cancer.

Blood↗
PubMed1984

Phase II study of PALA, amsacrine, teniposide, and zinostatin in small cell lung carcinoma (EST 2579).

Eighty-two patients with small cell lung carcinoma refractory to standard chemotherapy were entered in this phase II randomized study of PALA, amsacrine, teniposide, and zinostatin. Of the 66 evaluable patients, one partial response occurred among 17 patients treated with teniposide and no responses occurred with the other drugs. Two patients each treated with amsacrine and teniposide experienced life-threatening hematologic toxic effects and one patient treated with zinostatin died of thrombocytopenic pulmonary hemorrhage. The overall median patient survival was 9.6 weeks. Weight loss greater than or equal to 5% prior to therapy, extensive disease, and a nonambulatory status were associated with poor survival.

Aminoacridines↗
PubMed1983

Hydroxyurea fails to improve the results of MBD chemotherapy in cancer of the head and neck, but reduces toxicity.

Thirty-six patients with advanced squamous cancer of the head and neck received chemotherapy with hydroxyurea, 2 g/m2 orally two of three weeks, plus methotrexate, bleomycin, and cisplatin (MBD) on a previously established schedule. Nineteen patients had objective responses, including six complete remissions. Eight of 13 patients with regional disease without prior radiation responded, as did 1 of 3 with distant metastases without prior radiation, and 10 of 20 with recurrent disease after radiotherapy. The median duration of response in those with recurrent or metastatic tumor was 6 months, and median survival was 6.5 months. These results are no better than those previously achieved without the addition of hydroxyurea. Toxicity, however, was milder than had previously been observed with MBD, suggesting that higher doses or more intensive schedules of hydroxyurea could be safely administered together with the other three drugs.

Adult↗
PubMed1983

Cis-platin based combination chemotherapy for advanced ovarian cancer. High overall response rate with curative potential only in women with small tumor burdens.

Thirty-eight women with advanced ovarian cancer were given monthly cycles of intravenous cyclophosphamide, Adriamycin (doxorubicin) and cis-platin, and oral hexamethylmelamine. Of 26 with tumor which would be evaluated for response, 42% had complete remission and 50% partial remission. Median time to disease progression from entry for all 38 patients was 13 months, and median survival 23.5 months. The bulk of tumor at the time chemotherapy was begun was the only significant prognostic factor for time to disease progression and survival. Of the seven women surviving free of disease a median of three years later, five had no mass greater than 2 centimeters in diameter at entry. Toxicity was predominantly myelosuppression and vomiting, with mild peripheral neuropathy in 27% and no significant renal or cardiac toxicity. The response rate of 92% is much higher than that previously reported with melphalan, and the survival considerably longer. The toxicity is acceptable, given the substantial improvement in results.

Adult↗
PubMed1983

An application of immunocytology to the analysis of the cell kinetics of upper respiratory and digestive tract squamous carcinoma.

An antinucleoside immunofluorescence technique (ANIF) facilitated evaluation of labeling index (LI) from frozen sections of 36 upper respiratory and digestive tract squamous cancers (URDTS) from a group of 35 patients. There were 35 URDTS of the larynx, oral cavity, or pharynx and the LIs of this population ranged from 0-39.4%, (mean, 14.7%); 6% of URDTS (2 of 36) were not assessable by ANIF. The administration of nontherapeutic radioactive materials, the establishment of cell cultures, and perturbations in cell growth implicit in the removal of tumor from host prior to assessment are unnecessary in the application of this technique.

Carcinoma, Squamous Cell↗
PubMed1983

Tumor mapping: new rationales, adjusted techniques, expanded applications.

Eleven consecutive patients with cancers of the oropharynx (4), hypopharynx (4), and oral cavity (3) were endoscoped and "tumor mapped" with a modified tattoo solution before beginning non-surgical antineoplastic therapy. The tattooed outlines were clearly visible at 7 weeks (5 patients after induction chemotherapy); at 14 weeks (2 patients after induction chemotherapy and radiotherapy); and between 12 and 16 weeks (4 patients after radiotherapy). The "tumor mapping" aided both the establishment of appropriate resection margins in cancers that had diminished in response to non-surgical therapy and the recognition of a tumor's lack of response to nonsurgical antineoplastic treatment.

Carbon↗
PubMed1983

A randomized phase II study of m-AMSA (NSC 249992) and neocarzinostatin (NSC 157365) in non-small cell bronchogenic carcinoma. An Eastern Cooperative Group Study.

Eighty-nine patients with advanced non-small cell bronchogenic carcinoma were treated with either m-AMSA 120 mg/m2 intravenously every 3 weeks or neocarzinostatin 2.0 mg/m2 intravenously daily X 5 every 4 weeks. There were no responses in 40 evaluable patients who received m-AMSA and three partial responses (7.5%) in 40 patients who received neocarzinostatin. Two patients receiving m-AMSA had drug-related deaths. For m-AMSA the major toxicities were hematologic, while for neocarzinostatin the major toxicities were hematologic, gastrointestinal, and fever. We conclude that m-AMSA is inactive while neocarzinostatin has minimal activity in non-small cell bronchogenic carcinoma.

Aged↗
PubMed1982

Methotrexate alone or with regional subcutaneous Corynebacterium parvum in the treatment of recurrent and metastatic squamous cancer of the head and neck.

Patients with advanced, incurable squamous cancer of the head and neck were randomly assigned to treatment with weekly methotrexate alone or methotrexate with Corynebacterium parvum given subcutaneously in weekly bilateral doses in sites around the neck. The addition of C. parvum did not alter the response rate, response duration, survival (either median or long-term) or severity of toxic effects compared to treatment with methotrexate alone. Response rates were higher for patients without distant metastases, ambulatory patients, and those younger than age 65 years. Median survival was improved for responders to chemotherapy and for those initially ambulatory. C. parvum given subcutaneously has no place in the treatment of far advanced cancer of the head and neck.

Adult↗
PubMed1982

Failure of effective initial chemotherapy to modify the course of stage IV (MO) squamous cancer of the head and neck.

Twenty-four patients with advanced squamous cancer of the head and neck without distant metastases were given combination chemotherapy including methotrexate, bleomycin and diamminedichloroplatinum before planned local treatment with irradiation or surgery. Of 22 evaluable patients, 17 had objective partial or complete remission to initial chemotherapy. However, only ten patients ever had complete clearing at any time of all tumor on clinical evaluation. Median survival was ten months, and only two patients remained alive 14 and 29 months, respectively, from entry. Toxicity was minimal with the three-drug treatment, but the addition of mitomycin-C at the start of chemotherapy substantially increased toxicity without improving efficacy. Subsequent surgery and radiotherapy were accomplished without unusual difficulty.

Adult↗
PubMed1982

Efficacy study of intensive cis-platin therapy in advanced non-small cell bronchogenic carcinoma.

Thirty patients with advanced non-small cell bronchogenic carcinoma were treated with cis-platin, 75 mg/M2 weekly for three weeks, then every three weeks. Eighteen were ambulatory, 22 had distant metastases, 14 had prior irradiation, and none had prior chemotherapy. Ten patients (33%) had objective remissions lasting a median of three months. Responders lived a median of five months, compared to three months for nonresponders. Transient mild azotemia was noted in twelve patients. Cis-platin has definite but modest activity in non-small cell bronchogenic carcinoma.

Adenocarcinoma↗
PubMed1982

Mitomycin-C, methotrexate, bleomycin and cis-diamminedichloroplatinum II in the chemotherapy of advanced squamous cancer of the head and neck.

Thirty-four patients with advanced squamous cancer of the head and neck were treated with an outpatient regimen combining mitomycin-C, cis-diamminedichloroplatinum (II), methotrexate and bleomycin. Five had complete remissions and 15 partial remissions, for an overall response rate of 59%. Responses were noted on 11 of 13 patients (85%) with disease above the clavicles without prior irradiation. Median duration of partial remission was four months. Response rate was independent of age, performance status, presence of distant metastases and primary site. Hematologic toxicity was substantially more severe with this program than had been observed in a prior study using the same regimen without mitomycin-C. Since neither complete nor partial response rates, nor response durations improved with the addition of mitomycin, we conclude that it adds little to the efficacy of the other three agents.

Adult↗
PubMed1982

Sequential chemotherapy of advanced colorectal cancer with standard or high-dose methotrexate followed by 5-fluorouracil.

Thirty patients with advanced measurable colorectal cancer were randomized to receive either methotrexate (MTX) 200 mg/m2 or 40 mg/m2, followed in four hours by 5-fluorouracil (5-FU) 600 mg/m2. Patients receiving the higher dose MTX were given leucovorin rescue 24 hours later. Eight of 13 patients treated with 200 mg/m2 MTX + 5-FU developed severe hematologic toxicity, leading to two toxic deaths. In addition, 9/13 developed mild azotemia, and three patients had severe gastrointestinal toxicity. No patients with prior chemotherapy responded to either regimen. Among those without prior chemotherapy, there were two of six and three of eight partial responses, respectively, in the 200 mg/m2 and 40 mg/m2 MTX regimens. Sequential 200 mg/m2 MTX followed by 5-FU after four hours has unacceptable toxicity. Sequential treatment with standard dose MTX + 5-FU is tolerable and merits further study.

Aged↗
PubMed1982

Cervical cysts: cancer until proven otherwise?

A cystic neck mass can be either malignant or benign; 22% of patients (4/18) admitted with the tentative diagnosis of branchial cyst in a recent 2-year period (1977-1979) had metastatic carcinoma: epidermoid, thyroid or salivary gland. Preoperative fine needle aspiration was diagnostic in 1 instance and unhelpful in 2. Frozen section analysis of the gross specimen invariably provided the correct diagnosis. All patients with malignancies had subclinical primary disease and in 1 instance random biopsies identified its origin. The prudent surgeon will avoid untoward results if he approaches a neck cyst in an adult as if it were malignant. Guidelines he can follow to prevent the inadvertent removal of a metastasis under the misapprehension that it is a benign neck cyst include: 1. Prior to operation, perform a thorough head and neck examination to identify a primary carcinoma; 2. Do a fine needle aspiration of the mass for cytology. A negative report must be considered inconclusive; 3. Make a gross examination in the operating room of the opened cyst and frozen section processing of suspicious areas; 4. Follow with a panendoscopy and random biopsies of appropriate areas and complete the neck dissection on the involved side, after a metastatic deposit has been recognized. The preoperative procurement of contingency consent for these procedures is understood.

Adult↗