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Biomedical subjects

S Hopfan

Publications and source records attributed to S Hopfan.

17 recordsLinked to original sources
PubMed1986

Limb preservation and tumor control in the treatment of popliteal and antecubital soft tissue sarcomas.

Soft tissue sarcomas of the antecubital and popliteal space often involve the neurovascular bundle and are prone to recurrence after surgical resection. Amputation has frequently been performed for control of these tumors. A multimodality treatment program consisting of limb-sparing resection, tumor-bed radiation using temporary iridium 192 implants, and adjuvant chemotherapy for high-grade lesions, has yielded satisfactory preservation of limb function and no local tumor recurrence in ten patients after a median follow-up time of 5 years. Eight of the ten patients are still alive, five of whom beyond 5 years; six of the eight survivors had high-grade tumors. These results are superior to those of 14 patients with similar tumors treated earlier by surgery alone: seven by amputation and seven by soft part resection; four of the latter resulted in local recurrence and all of the seven who had high-grade sarcoma died of disease. Multimodality treatment including limb-sparing resection merits consideration in the management of antecubital and popliteal soft tissue sarcomas.

Adolescent↗
PubMed1986

Intraluminal radiation therapy in the management of malignant biliary obstruction.

Fifteen patients with malignant biliary obstruction from carcinoma of the bile ducts, gallbladder, and pancreas (Group I) or metastatic disease (Group II) were treated with intraluminal radiation therapy (ILRT) at Memorial Sloan-Kettering Cancer Center. In 11 cases ILRT was used as a central boost in combination with 3000 cGy external beam radiation therapy (ERT). No significant treatment toxicity was observed. Cholangiographic response was observed in 2 of 12 evaluable patients. In no patient was long-term relief of jaundice without indwelling biliary stent achieved. Survival from treatment in eight Group I patients treated with ILRT +/- ERT was 3 to 13 months (median, 4.5). Survival in seven similarly treated Group II patients was 0.5 to 8 months (median, 4.0). Additional data for ten similar patients referred for ILRT but treated with ERT alone are presented. Analysis of this and other reports indicate the need for prospective controlled trials of the role of this regimen in the management of malignant biliary obstruction before wider application can be recommended.

Adolescent↗
PubMed1982

Combination chemotherapy of esophageal carcinoma using cisplatin, vindesine, and bleomycin.

Sixty-one patients with epidermoid carcinoma of the esophagus have been treated with a three drug combination of cisplatin, vindesine, and bleomycin. Of 53 patients currently evaluable for response, 29 (55%) have had partial remissions: 7/16 with metastatic, and 22/37 with local-regional disease. The median duration of response in metastatic patients is eight months. Of 28 patients treated preoperatively, 23 (82%) had resectable disease. The major toxicities seen were nephrotoxicity and myelosuppression. Cisplatin, vindesine and bleomycin is an effective combination in the treatment of esophageal carcinoma. Effects on long-term survival cannot yet be evaluated.

Acute Kidney Injury↗
PubMed1981

Combined modality therapy of esophageal carcinoma.

One hundred ten patients with epidermoid carcinoma of the esophagus were treated at the Memorial Sloan-Kettering Cancer Center (MSKCC) with combined modality techniques involving preoperative irradiation (RT) and surgery, and with preoperative chemotherapy (CT), surgery, and irradiation. For the 76 patients receiving preoperative RT during the period 1965-1976, the overall resectability rate was 54% with an operative mortality of 12%; long-term survivors (greater than 3 years) were few (7%). For 34 patients receiving preoperative CT with cisplatin and bleomycin, major objective tumor regression (greater than 50%) was seen by day 18 in 20%, with an additional 44% having smaller but definite improvement in the barium esophagram and in swallowing function. Of those receiving preoperative CT, 76% had resectable lesions, with an operative mortality of 11%. The median follow-up for this group is 24 months; of the 30 patients followed for at least 12 months, 20% are alive without evidence of disease. Although the resection rate following preoperative chemotherapy seems to be higher, thus allowing better palliation, neither preoperative radiation nor chemotherapy with cisplatin and bleomycin have had a major impact on long-term survival.

Adult↗
PubMed1980

Bone marrow transplantation for the therapy of refractory adult T cell acute lymphoblastic leukemia.

Two adult patients with T cell acute lymphoblastic leukemia (ALL) received an intensive multiagent therapeutic regimen and failed to enter remission. Following cytoreduction with cyclophosphamide (60 mg/kg x 2) and total body irradiation (1000 rads) they underwent bone marrow transplantation. One patient received marrow from his identical twin brother and the other from his HLA-matched sister. Both patients promptly went into remission. The identical twin recipient is alive and free of disease at 20+ months, but the allogeneic patient died of P. carinii pneumonia at eight months with no evidence of leukemia. These results suggest that even some refractory patients whose disease has multiple negative prognostic features may respond to pretransplant chemoradiotherapy and attain a clinically useful complete remission. Additional patients with longer follow-up will be necessary before the curative potential of bone marrow transplantation in T cell ALL can be assessed.

Adult↗
PubMed1979

Results of treatment of Ph'+ chronic myelogenous leukemia with an intensive treatment regimen (L-5 protocol).

Thirty-seven patients with Philadelphia-chromosone-positive (Ph'+) chronic myelogenous leukemia who were untreated or minimally pretreated were entered on the L-5 protocol. This protocol consisted of sequential treatment with splenic irradiation, splenectomy, arabinosylcytosine and 6-thioguanine, and L-asparaginase. Maintenance therapy was hydroxyurea or a multiple-drug regimen. The median survival of the 37 patients is 50 mo. Twelve patients showed a temporary reduction in the percentage of Ph'+ marrow metaphases to less than one-third of the initial values and in 7 of these patients none were found. The duration of the Ph'+ chromosome reduction ranged from 1 to 43 mo. The median survival of the responders has not yet been reached. It is concluded that whereas overall survival is not appreciably extended, patients who have a reduction in Ph'+ cells in the marrow may survive longer than the average; also, the reduction occurs most frequently in patients who have relatively small spleens at diagnosis. The reduction is difficult to maintain, and it may be reinduced in some patients with intensive chemotherapy.

Adolescent↗
PubMed1978

cis-Dichlorodiammineplatinum(II) and bleomycin in the treatment of esophageal carcinomas.

Forty-seven patients with squamous cell carcinoma of the esophagus were treated with a combination of cis-dichlorodiammineplatinum (II) (cis-DDP) and bleomycin by infusion. cis-DDP at a dose of 3 mg/kg with mannitol and prehydration was given on Day 1. On Day 3, bleomycin was started as a 10--15-unit/m2 loading dose followed by a 10--15-unit/m2 24-hour infusion for 4--7 days. Three groups of patients were treated: group 1 (no clinical evidence of metastatic disease) included 25 patients, all with no prior therapy; group 2 (measurable metastatic disease) included 13 patients, eight previously treated with surgery and/or radiation; group 3 (known nonmeasurable metastatic disease) included nine patients, all previously treated with surgery and/or radiation and/or chemotherapy. A second course of therapy was given on Day 28 to groups 2 and 3, and as soon after surgery as possible in group 1. Nineteen percent of patients had complete or partial responses with another 44% having minor regressions. Toxic effects were mainly renal effects, alopecia, nausea and vomiting, and stomatitis. There were two drug-related deaths. The combination of cis-DDP and bleomycin is useful in the treatment of patients with squamous cell carcinoma of the esophagus.

Adult↗
PubMedDate not supplied

cis-Dichlorodiammineplatinum(II) and VP-16-213: an active induction regimen for small cell carcinoma of the lung.

Thirty-eight patients with small cell carcinoma and no prior therapy were treated with a combination chemotherapy program including 60 mg/m2 of cis-dichlorodiammineplatinum(II) (cis-platinum) iv on Days 1 and 22 and 120 mg/m2 of VP-16-213 iv on Days 4, 6, 8, 25, 27, and 29. This was followed by 1000 mg/m2 of cyclophosphamide, 40 mg/m2 of Adriamycin, and 1.4 mg/m2 of vincristine, all given iv on Days 42, 63, 84, and 105. The program was then recycled, with cis-platinum and VP-16-213 beginning on Day 126 and the regimen repeated as above. All patients received prophylactic whole-brain radiation (usually at a dose of 3000 rads in ten fractions) between Days 42 and 63. The projected duration of treatment is 18 months in the absence of relapse. In 21 patients with limited disease, the complete response rate was 52% (5.75+--15.25+ months) and the partial remission rate was 48% (2.25--10.5 months). The extensive-disease group showed a complete remission rate of 41% (4.75--11+ months) and a partial remission rate of 47% (3.75--11.5+ months). Response to therapy with cis-platinum and VP-16-213 was very rapid and invariably maximal by the end of the 6-week induction period. Survival for the limited-disease group appears encouraging but followup time is insufficient. Toxicity included nausea and vomiting, myelosuppression, alopecia, and renal insufficiency which was dose-limiting in two patients. The cis-platinum and VP-16-213 combination is clearly an active induction regimen in small cell carcinoma of the lung, but whether it will play a role in increasing long-term survival rates remains to be seen.

Adult↗