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Biomedical subjects

T J Priestman

Publications and source records attributed to T J Priestman.

At least 37 records · Page 2Linked to original sources
PubMed1988

A phase II study of oral idarubicin (4-demethoxydaunorubicin) in advanced breast cancer.

Idarubicin (4-demethoxydaunorubicin: DMDNR) is an orally active analogue of daunorubicin that has shown promising activity in animal and early clinical studies. We gave idarubicin in a phase II study to patients with advanced breast cancer unresponsive to hormonal manipulation and in some cases to standard chemotherapeutic agents. Idarubicin was given orally every 21 days at a starting dose of 40 mg/m2 with dose escalation until myelosuppression occurred. Nadir blood counts showed that patient compliance was good. Of 33 patients studied, 32 are evaluable for response: 4 (13%) had partial responses (95% confidence interval 1%-23%) with a duration of response between 32 and 59 weeks; 8 (25%) had static disease for between 17 and 48 weeks; and 20 failed to respond. For patients not previously exposed to chemotherapy, the response rate was 3/19 (16%). Toxicity was mild, with little or no gastro-intestinal disturbance in the majority of patients, no severe haematological toxicity and little alopecia. Two patients however, were withdrawn from the study because of toxicity; one with a skin rash and one with severe vomiting. Idarubicin produces little toxicity when given orally at a dose of 40 mg/m2 every 21 days, but its activity in breast cancer is insufficient to justify its further use with this schedule. Further studies should be undertaken only if direct comparison can be made with doxorubicin.

Adult↗
PubMed1988

The pharmacokinetics of medroxyprogesterone acetate following two different loading dose schedules in advanced carcinoma of the breast.

A loading dose of MPA employing a regimen of 1,000 mg six hourly for 8 doses can achieve plateau levels above 100 ng ml-1 within the first 36 h of treatment, without any untoward toxicity. This raises the possibility of shortening the time to response for this agent. The additional factor of the time required to achieve adequate serum levels may explain the apparent contradictions between reports correlating response rates and dose and those correlating serum level and response.

Antineoplastic Agents↗
PubMed1987

A double-blind randomised cross-over comparison of nabilone and metoclopramide in the control of radiation-induced nausea.

Forty patients who were suffering from radiation induced emesis were entered into a prospectively randomised double-blind cross-over study comparing nabilone with metoclopramide. Only patients who had at least five treatments remaining of their planned course of irradiation were randomised, in order to allow an adequate time to monitor the degree of symptom control and any adverse effects of the two drugs. Patient characteristics and the incidence and severity of nausea and vomiting were similar for the two groups. There was no difference in the efficacy of the two drugs but the incidence and severity of adverse reactions was significantly greater in those patients who received nabilone.

Antiemetics↗
PubMed1987

Presentation of information to cancer patients: a comparison of two centres in the UK and USA.

A questionnaire survey was carried out to compare the views of cancer patients at a UK and USA hospital with respect to the nature and sources of the information they received about their condition. Although there were many similarities, differences did emerge in the way the diagnosis was confirmed to the patient, the desire for additional information and the sources of such information. Among the UK patients 20 per cent reported that confirmation of their diagnosis had been delegated to junior staff, 30 per cent felt that their doctors did not have sufficient time to talk to them and 70 per cent stated that they relied on non-medical sources for information about cancer. These findings indicate that there is considerable scope for improvement in communicating with cancer patients in the UK.

Adult↗
PubMed1987

Radiotherapy for pain relief in locally recurrent colorectal cancer.

Eighteen patients with local recurrence of colorectal cancer have been treated by external beam radiotherapy for pain relief. Seven received a fractionated course of 4500cGy and the remainder received single fractions of 1000cGy, a number being treated more than once. The median survival for all patients once recurrence had produced pain was 7 months. Treatment benefit was recorded in 71% treated by fractionated courses and in 66% by single fractions. The duration of pain relief was 3 months for each method. The repeatability of single fraction treatment indicates that this is a worthwhile alternative technique, particularly for those in poor general condition.

Colonic Neoplasms↗
PubMed1987

Rectal carcinoma: a new technique to allow safer postoperative irradiation of the pelvis.

Local recurrence after abdomino-perineal excision of the rectum for Dukes C carcinoma is common. The influence of postoperative radiotherapy in reducing this is currently under investigation, and one of the potential complications is radiation damage to the small bowel. This paper describes a simple and quick method of excluding the small bowel from the pelvis which, combined with more sophisticated radiation field planning, could dramatically reduce the incidence of enteric effects.

Adenocarcinoma↗
PubMed1985

Stress and breast cancer.

In order to assess whether exposure to stress was associated with an increased risk of breast cancer, 100 women presenting with carcinoma of the breast completed a standard life events inventory documenting life stresses experienced during the previous three years. The same questionnaire was completed by 100 women presenting with benign breast lumps and 100 apparently healthy controls. Both groups of patients with breast disease also completed the Eysenck personality inventory. There was no difference in the number of stressful life events experienced by the patients with benign and malignant breast lesions and the nature and severity of those stresses encountered were similar for both groups. The personality indices were also the same for both groups. The controls, however, recorded significantly higher levels of stress exposure than the patients with breast disease. On the basis of this series, there is no evidence to support the hypothesis that stress predisposes to breast cancer development.

Adult↗
PubMed1984

An initial evaluation of Nabilone in the control of radiotherapy-induced nausea and vomiting.

Nabilone is a cannabinoid anti-emetic which has been extensively evaluated in control of chemotherapy-induced vomiting. A pilot study was undertaken to assess the efficacy of Nabilone in controlling radiotherapy-induced vomiting resistant to a conventional anti-emetic (metoclopramide). Thirty patients receiving wide-field upper abdominal irradiation were prospectively monitored. Fourteen developed no significant nausea or vomiting and in 10 symptoms were controlled by metaclopramide. All six patients who failed to respond to this agent responded to Nabilone. Toxicity with both drugs was minimal. Although patient numbers were small, this initial assessment suggests that Nabilone may be a useful agent in the control of resistant radiation-induced sickness.

Adult↗
PubMed1984

An evaluation of high-dose medroxyprogesterone acetate (MPA) therapy in women with advanced breast cancer.

The efficacy of high-dose intramuscular MPA therapy in controlling progressive measurable metastatic breast carcinoma was assessed in 32 women. In addition serial measurements of MPA blood levels were carried out in 20 of the patients and subjective effects of treatment were monitored in detail in 18 of the women. Overall 6 patients (19%) gained an objective response and a further 7 (22%) experienced disease stasis from 4-17 months whilst on treatment. Significant differences in serum MPA levels were seen between responders and non-responders, objective tumour shrinkage only being seen in those patients who rapidly attained, and sustained, blood levels in excess of 100 ng ml-1. Subjective assessment showed no evidence of a euphoriant effect of MPA therapy in the non-responders group.

Adult↗
PubMed1983

Evaluation of human lymphoblastoid interferon in advanced malignant melanoma.

Seventeen patients with metastatic disease from malignant melanoma received treatment with injections of Human lymphoblastoid interferon. Fifteen of these had the drug by intramuscular injections. One started treatment by the intramuscular route but later proceeded with slow intravenous infusions. The remaining patient had interferon injected into the tumor only. With one exception, all patients had been pretreated with other methods for advanced regional or blood-borne metastases. A partial response (UICC criteria) lasting six months was seen in one patient who was treated with intramuscular injections for intransit cutaneous metastases in one leg. Human lymphoblastoid interferon appears to have minimal activity relating only to skin metastases in advanced and previously treated malignant melanoma. This activity is not superior to existing treatments.

Adult↗
PubMed1983

Interferons and cancer therapy.

A variety of human interferons, alpha, beta and gamma are now recognised. Three types of alpha-interferon have been submitted to clinical assessment. Overall, the results have been disappointing. Attention is now directed towards their use in combination with conventional cytotoxic agents.

Animals↗
PubMed1982

The present status of clinical studies with interferons in cancer in Britain.

Although the evaluation of cloned interferons is now under way, the only clinical results currently available from U.K. studies in cancer come from trials using the (Wellcome) lymphoblastoid preparation. Dose toxicity studies for intravenous and intramuscular administration are now complete and show that on a daily schedule the maximum tolerated dose intramuscularly is 12 x 10(6) units (12 Mu) whereas by 24 h intravenous infusion doses of up to 300 Mu may be given without undue toxicity. A programme of studies has been initiated to assess the efficacy of lymphoblastoid interferon in a variety of tumours. A number of therapeutic responses have been seen but only one study, in malignant melanoma, has completed patient entry. In this series of 16 patients who had metastatic disease and had failed on conventional cytotoxic therapy one patient experienced a remission for 8 months as a result of interferon administration. In another study the combination of interferon with conventional cytotoxics is being evaluated in advanced breast cancer. Preliminary results indicate that the combination is well tolerated but it is too early to detect any therapeutic advantage from combining the two modalities.

Antineoplastic Agents↗