PubMed Health⌕ Search

Biomedical subjects

T Khansur

Publications and source records attributed to T Khansur.

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

Systemic treatment of cancer in the elderly.

The goal of this review is to provide a readable and exhaustive reference in three major areas of geriatric oncology: complications of chemotherapy and radiotherapy, responsiveness of cancer to systemic treatment, social issues in the care of elderly patients with terminal illnesses. The conclusions of this study are: 1. Progressive deterioration of renal function is the most consistent change of aging. Adjustment of doses of renally excreted drugs to individual creatinine clearance may prevent life-threatening myelotoxicity in the elderly. 2. Intensive chemotherapy regimens (acute leukemia, non Hodgkin's lymphoma) cause more serious and prolonged myelotoxicity in the elderly. Elderly are more susceptible than younger patients to cardiotoxicity and central and peripheral neurotoxicity. Age is a poor predictor of complications in other organs or systems. 3. The prognosis of patients with Hodgkin's disease worsens with aging, possibly due to increased prevalence of mixed cellularity histology. It is controversial whether the prognosis of other neoplasias is poorer. Prognosis is not age-related in multiple myeloma. In general, elderly in good performance status may benefit from systemic cancer treatment to the same extent as younger patients, except for Hodgkin's disease. 4. The Informal Support Network, epitomized by the family, appears the most suitable environment to care for the elderly with cancer.

Aged↗
PubMed1988

Preoperative evaluation with radionuclide brain scanning and computerized axial tomography of the brain in patients with breast cancer.

To determine the roles of radionuclide brain scanning and computerized tomography of brain in the pretreatment evaluation of patients with primary and locoregional recurrence of breast cancer, we reviewed the clinical and radiologic findings in 226 patients with breast cancer who underwent one of these scans either preoperatively or within 6 weeks of operation and in 34 patients presenting with locoregional recurrence. Four of 131 radionuclide brain scans in primary breast cancer suggested calvarial metastasis, and the findings were confirmed with bone scans and skull radiographs. One of 95 computerized tomographic scans of the brain showed brain metastasis, and this patient had profound neurologic deficits. With respect to locoregional recurrence, the results of 2 of 23 radionuclide scans and 1 of 11 computerized tomographic scans were positive. All three patients had clinical evidence for brain metastasis. We conclude that in the absence of signs and symptoms, routine evaluation for brain metastasis is not justified in primary and locoregional recurrence of breast cancer.

Brain Neoplasms↗
PubMed1988

Surgery in small cell lung cancer.

Surgery in small cell lung cancer (SCLC) was abandoned in the late 1960s but is currently being cautiously reassessed, after the Armed Forces Asymptomatic Pulmonary Nodule Study demonstrated an unexpectedly prolonged 5-year survival (36%) with surgery. Subsequent prospective studies have reported five-year survival following resection in 22 to 83% of patients with Stage I disease and in 0 to 50% of patients with Stages II and III disease. Ten percent of patients with SCLC may be amenable to this approach. Additional patients may become candidates for resection following intensive combination chemotherapy. The optimal postoperative management remains unsettled. Combination chemotherapy and prophylactic cranial irradiation is recommended following complete resection. Postoperative thoracic irradiation may benefit patients with pathologically involved mediastinal nodes. Correlation of clinical response with our new understanding of the molecular biology of SCLC may further improve our approach to this disease.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Chemotherapy for advanced or recurrent gynecologic cancer.

Studies of chemotherapy in advanced or recurrent gynecologic cancer have focussed on ovarian, cervical, and endometrial carcinoma. For celomic epithelial carcinomas of the ovary, a large number of cytotoxic agents have been shown to be active. Dramatic improvement in frequency of response with lesser improvement in survival has been noted with the use of cisplatin-based combination chemotherapy as compared to single alkylating agents. More recent studies have evaluated alternative ways to employ cisplatin: higher dose schedules, intraperitoneal administration, and platinum compounds with a potentially better therapeutic index. None has yet been shown superior to a combination of relatively low-dose cisplatin plus an alkylating agent with or without doxorubicin. Cisplatin remains the best studied and most active single agent in patients with squamous cell carcinoma of the cervix. While a number of other agents have demonstrated moderate activity, no combination of drugs has as yet proved superior to single-agent cisplatin. In endometrial carcinoma, progestins and doxorubicin are the most active agents. Tamoxifen, cisplatin, and hexamethylmelamine appear to have moderate activity. No combination has yet been shown to be superior to single agents. Information on chemotherapy for less common gynecologic malignancies is largely anecdotal. Two observations are of note. Cisplatin-based combination chemotherapy is highly active against germ-cell neoplasms of the ovary. Cisplatin also has definite activity against mixed mesodermal sarcoma of the uterus.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Granular cell tumor. Clinical spectrum of the benign and malignant entity.

The clinical records of all patients with granular cell tumor seen at our institution over a 20-year period were reviewed. Three patients with malignant, and 37 with benign tumor, were identified. Eleven patients had multiple benign lesions. Three had a history of familial occurrence. Clinical and pathologic features and the management of this nebulous entity, in both its benign and malignant forms, are reviewed and discussed.

Adolescent↗
PubMed1987

Hepatic intra-arterial adriamycin in metastatic leiomyosarcoma: exploiting the steep dose-response curve.

We report a case of extensive leiomyosarcoma of the liver that failed on systemic Adriamycin. Hepatic intra-arterial chemotherapy with Adriamycin has resulted in a lasting clinical remission. This report illustrates the importance of the dose-response curve of drug to tumor in regional chemotherapy as with Adriamycin used in sarcoma, and the need to further explore such therapy in moderately chemosensitive tumors that are surgically unresectable for anatomic reasons.

Adult↗
PubMed1987

Evaluation of bone scan as a screening work-up in primary and local-regional recurrence of breast cancer.

To evaluate the use of radionuclide bone scan in staging patients with primary and local-regional recurrence of breast cancer, we reviewed the results in 265 patients with primary breast cancer who had the scan either preoperatively or within 6 weeks of surgery, and in 39 patients presenting with their first local-regional recurrence. All patients were clinically staged according to the revised 1983 criteria of the American Joint Committee for Cancer Staging and End-Results Reporting. None of the 92 with stage I and four of 95 patients with stage II had a positive scan. Eleven of 41 with stage IIIA and 13 of 37 with stage IIIB had a positive bone scan. In patients with their first local-regional recurrence, 12 of 39 had a positive scan. Follow-up scans were available in 61 patients with clinical stage I and II breast cancer who had adjuvant chemotherapy for pathological involvement of axillary node. There were six conversions observed in 61 scans obtained during the first year. Seven converted in follow-up scans in 47 patients in the second year. We conclude that although bone scans have a low positive yield in stage I and II breast cancer, their use in the preoperative setting and in the follow-up of patients with axillary node involvement detects early converters. Bone scans are justified in stage IIIA and IIIB breast cancer and in patients being evaluated for local-regional recurrence.

Adult↗
PubMed1986

Nutrition, cancer, and aging: an annotated review. II. Cancer cachexia and aging.

The interactions of cancer and malnutrition are discussed with the focus on aging. To establish whether the elderly are more likely to develop cancer cachexia and its complications, this review encompasses the pathogenesis of malnutrition in cancer; the age-related alterations of appetite, gastrointestinal function, energy expenditure, and protein turnover; the diagnosis of malnutrition; and the effectiveness of nutritional support in the elderly. Although metabolic and physiologic changes induced by cancer and age appear synergistic in causing cachexia, more frequent complications of malnutrition have not been observed in the geriatric cancer patients. This may be due to only a small proportion of the elderly with cancer being enrolled in clinical studies or to a reduced cachexia-inducing ability of tumors in these patients. A limited number of studies indicate nutritional replenishment is obtainable in malnourished elderly by hyperalimentation. As restoration of the lean body mass may be slower in older patients, early institution of nutritional support is recommended in malnourished elderly or elderly at risk for malnutrition during neoplastic treatment.

Aged↗
PubMed1986

Nutrition, cancer, and aging: an annotated review. I. Diet, carcinogenesis, and aging.

The interrelationships of diet and carcinogenesis are discussed with the focus on aging. To establish whether the elderly are more susceptible to dietary carcinogens and whether dietary prevention of cancer is a reasonable goal for this population, the mechanisms of chemical carcinogenesis, the age-related metabolic and physiologic changes, and the current cancer preventive dietary strategies are reviewed. Vulnerability to dietary carcinogens results from a combination of factors that may increase or decrease the occurrence of cancer in the elderly, and it is, therefore, a very individualized feature, unpredictable when based solely on a subject's age. Dietary prevention of cancer may be effective in advanced age, and the dietary guidelines of the National Academy of Sciences should be implemented in this population.

Aflatoxins↗
PubMed1985

Identification of desmosomes in the granular cell tumor. Implications in histologic diagnosis and histogenesis.

Electron-microscopic examination of a malignant granular cell tumor revealed cells with abundant granular and glycogen-containing cytoplasm and eccentric nuclei. Numerous junctional structures including desmosomes were identified between tumor cells which, moreover, displayed a pattern of gland formation with the presence of short microvilli in one pole of the cell. The presence of junctional structures may provide a feature for positive identification of this tumor by electron microscopy. The findings may also have implications to further our understanding of the histogenesis of this tumor. This case further raises the question of familiar occurrence of this tumor.

Adult↗
PubMed1985

Extrapulmonary small cell cancer of the retroperitoneum.

Small cell cancer is common in the lung, but may also be found in extrapulmonary sites, given the widespread distribution of the APUD cell, from which this tumor originates. We believe this is the first report of a small cell cancer in the retroperitoneum. An initial good response of the tumor to chemotherapy was followed six months later by appearance of metastases and patient's death. This clinical behavior is usual in extrapulmonary small cell cancer.

Aged↗
PubMed1984

Fulminant and fatal angioedema caused by bleomycin treatment.

We encountered a case of fulminant and fatal angioedema involving skin and lungs. This reaction, hitherto unreported, occurred 48 hours after termination of a course of bleomycin sulfate. It was not predictable by skin testing, nor was it reversible with steroid therapy. The only predictive clue was the development of eosinophilia during the course of therapy. Fulminant angioedema should be added to the list of potential reactions to bleomycin.

Aged↗
PubMedDate not supplied

Carcinomatous meningitis in small cell lung cancer.

Carcinomatous meningitis was diagnosed in 13% of our patients with small cell lung cancer. Although half the patients with this complication responded to treatment, the medium survival from diagnosis was only six weeks. Asymmetric peripheral neuropathy and urinary retention are very specific signs of carcinomatous meningitis. Their recognition may prompt an earlier diagnosis and the institution of more effective treatment.

Adult↗