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Y Z Patt

Publications and source records attributed to Y Z Patt.

At least 73 records · Page 4Linked to original sources
PubMed1986

Hepatic arterial infusion with floxuridine and cisplatin: overriding importance of antitumor effect versus degree of tumor burden as determinants of survival among patients with colorectal cancer.

Cisplatin (CDDP) was combined with floxuridine (FUDR) and delivered into the hepatic arteries of 29 patients as induction therapy for colorectal cancer metastatic to the liver. Mitomycin C and FUDR combination was substituted after progression or when response had peaked. Chemotherapy was delivered with an Infusaid pump (Infusaid Corp; Norwood, Mass; 14 patients), Medtronic programmable drug administration device (Medtronic, Inc, Minneapolis; two patients), or percutaneously placed catheters (13 patients). Complete disappearance of liver metastases was observed in four patients and 11 additional patients had a partial remission as determined by computed tomography (CT) scan and substantiated at times by angiography, for a total response rate of 52%. Response as determined by imaging techniques coincided with a concurrent decrease in carcinoembryonic antigen (CEA) and improvement in performance status. The severity of tumor burden was correlated with the response to therapy and survival. Among those patients who responded to arterial chemotherapy, differences in disease severity did not significantly influence survival. Median survival among responders with greater than 25% liver replacement by tumor was 14 months (P = .28), compared with 28 months for those patients with less than 25% liver replacement. In contrast, differences in tumor burden significantly affected survival among patients who failed to respond to chemotherapy; median survival among nonresponding patients with greater than 25% liver replacement was 4 months, compared with 8 months for those who had less than 25% liver replacement (P = .01). The presence of minimal extrahepatic disease at the time of initiation of intraarterial treatment did not seem to have a significant detrimental effect on survival. The study suggests that hepatic tumor response to arterial administration of CDDP and FUDR and mitomycin C and FUDR is clinically significant because it overrides the effect of tumor burden on survival among patients who have colorectal cancer with liver metastases and may offer effective palliation.

Adult↗
PubMed1986

A phase I study of intravenous azimexon therapy in human cancer.

Azimexon, a synthetic derivative of the 2-cyanaziridines, was given intravenously daily for 5 days to 19 cancer patients in a Phase I trial designed to determine the drug's tolerable dose, toxicity, and effects on immune and nonimmune host defense parameters. No myelosuppression, neurologic, renal, hepatic, or gastrointestinal toxicities could be detected. The only toxic side effect observed after 5 days of intravenous azimexon was a self-limiting dose-dependent hemolysis. Absolute lymphocyte count (ALC) increased from a pretreatment value of 0.96 X 10(3)/microliter to 1.56 X 10(3)/microliter on day 21 (p less than 0.05). This increase was induced primarily by the less hemolytic 200-250 mg/m2 doses of azimexon. Among 12 patients given this lower dosage. ALC increased from an average initial value of 0.90 X 10(3)/microliter to 1.86 X 10(3)/microliter on day 21 (p less than 0.01). Absolute number of OKT3+ cells increased from 0.524 to 0.914 X 10(3)/microliter (p less than 0.05) with lower drug doses. The mean absolute number of OKT4+ cells increased from 0.294 on day 0 to 0.574 X 10(3)/microliter on day 21 (p less than 0.05), and the number of OKT8+ cells increased from 0.202 to 0.388 X 10(3)/microliter, with no significant changes in helper/suppressor ratio. Significant increases in mitogenic responses to phytohemagglutinin (PHA) [from 13.4 to 35.7 X 10(3) net cpm (p less than 0.05)] and to concanavalin A (con A) [from 6.4 to 25.6 X 10(3) net cpm (p less than 0.05)] were also observed with higher drug doses. Azimexon may have a role in managing cancer-associated dysregulation of the immune response.

Adjuvants, Immunologic↗
PubMed1986

Modulation in vitro of immune parameters in homosexual males with the preclinical complex of symptoms related to acquired immune deficiency syndrome by azimexon.

In search of potential therapeutic agents for the acquired immunodeficiency syndrome (AIDS) among homosexual males, we studied in vitro the immunorestorative effect of azimexon in patients with this syndrome. Since a reduction in the ratio between helper inductor and suppressor/cytotoxic T-cell subsets (OKT-4/OKT-8) seems to be the hallmark of the syndrome, we measured azimexon-induced numerical changes in T-cell subsets and correlated them with changes in a simultaneously tested T-cell function as measured by the xenogeneic local graft-versus-host reaction (GVHR). Following incubation of peripheral blood mononuclear cells from 10 homosexual subjects with 10 micrograms/ml of azimexon at 37 degrees C for 1 h, the median number of T cells defined by the OKT-8 phenotype declined from 0.6 X 10(3) to 0.33 X 10(3)/mm3 (p less than 0.02), resulting in an increase in the OKT-4/OKT-8 ratio from 0.65 to 1.37 (p less than 0.01). There were no numerical changes in T cells defined by OKT-3 and OKT-4 phenotypes. Similar decreases in OKT-8-defined T cell occurred among eight heterosexual controls. The restoration of the OKT-4/OKT-8 ratio among the homosexual subjects was associated with a significant improvement in their T-cell function. Thus, the median volume of the local GVHR increased from 38.2 to 63.5 mm3 (p less than 0.02). Parallel changes in OKT-4/OKT-8 ratio and changes in local GVHR following incubation with azimexon were observed. These results suggest that azimexon may be an important immunorestorative agent. Clinical trials with this agent in patients with AIDS or its preclinical complex of symptoms seem warranted.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Palliation of pelvic recurrence of colorectal cancer with intra-arterial 5-fluorouracil and mitomycin.

Twenty-one patients with inoperable colon cancer in the pelvis were treated with intra-arterial 5-fluorouracil (5-FU) and mitomycin C, given bilaterally into the internal iliac arteries. Seventeen of the 21 patients had failed previous radiation therapy and 15 had also failed systemic intravenous chemotherapy. Eighteen of the 21 patients received intra-arterial treatments because of pelvic pain. Effect of this treatment on the pain could be evaluated in 16 patients. A measurable decrease in pain medication occurred in 8 of 16, whereas a subjective feeling of pain relief was observed in 12 of 16 patients for a mean period of 3.5 months. However, objective tumor response was considered definite only if associated with a greater than 50% decline of an elevated plasma carcinoembryonic antigen level; this was observed in 5 of 11 patients (45%). Reduction in tumor mass as measured by imaging techniques was observed in two of ten patients in whom it was evaluable. Improvement in hydronephrosis was observed in five of seven evaluable patients. Hematuria was present in 12 patients and improved in 10 of those patients. The most significant side effect of chemotherapy was perineal and gluteal skin erythema, which was observed in 36% of the patients after the first course and in 24% during the second course. This frequently escalated to cutaneous vesiculation and desquamation. This side effect was prevented by concurrent administration of steroids. Pelvic arterial infusion of 5-FU and mitomycin C can offer temporary pain relief to patients who have failed other means of therapy. Objective antitumor effects may have also resulted but were much harder to assess in this group of patients.

Adolescent↗
PubMed1985

Arterial infusion of dacarbazine and cisplatin for recurrent regionally confined melanoma.

We treated nine patients who had metastatic malignant melanoma confined to one extremity (8/9) or the vulva (1/9) with arterial dacarbazine and cisplatin at respective doses of 800 and 90 mg/sq m. We percutaneously introduced catheters into the extremity or regional artery under fluoroscopy by the Seldinger technique, removed them at the end of the infusions, and repositioned them at four-week intervals for repeated treatment cycles. One patient achieved a complete remission, three patients had partial remissions, and five patients' disease was stable. The group median survival will exceed 19 months. Three patients with stable disease died 6, 18, and 19 months after treatment initiation, respectively. The toxic effects were primarily nausea and vomiting, pain in the infused extremity, and local erythema. Arterial dacarbazine and cisplatin offer a more effective and less toxic alternative to higher-dose single-agent arterial cisplatin for locally advanced malignant melanoma.

Adult↗
PubMed1984

Prospective evaluation of thymosin fraction V immunotherapy in patients with non-small cell lung cancer receiving vindesine, doxorubicin, and cisplatin (VAP) chemotherapy.

One hundred five patients with advanced non-small cell lung cancer were randomized to receive thymosin fraction V immunotherapy during remission induction chemotherapy with vindesine, doxorubicin, and cisplatin (VAP). Fifty-four patients received VAP alone. Fifty-one patients received VAP + thymosin. Both groups were comparable; most patients were male, with a good performance status and with the diagnosis of adenocarcinoma. Among 99 evaluable patients, response was seen in 24 (2 CRs, 22 PRs) of 53 (45%) patients treated with VAP and 10 (all PRs) of 46 (22%) patients treated with VAP + thymosin (p = 0.03). VAP-treated patients responded better than those treated with VAP + thymosin in each tumor category: adenocarcinoma, 50% of 36 patients versus 22% of 27 patients; squamous cell carcinoma, 29% of 14 patients versus 21% of 13 patients; undifferentiated carcinoma, 67% of three patients versus 17% of six patients. Median survival duration was 34 weeks versus 25 weeks in favor of the VAP-treated group (p = 0.14). Thymosin treatment resulted in decreased graft-vs.-host reaction (p = 0.01) and increased suppressor effect on normal mitogen response to Con-A (p = 0.17). The activity of VAP chemotherapy is comparable with the most effective multidrug regimens of the present time in patients with advanced non-small cell tumors. The addition of thymosin immunotherapy appeared to have a negative effect on the activity of VAP.

Adenocarcinoma↗
PubMed1984

Prognostic factors influencing survival of patients with advanced colorectal cancer: hepatic-artery infusion versus systemic intravenous chemotherapy for liver metastases.

In this study of 232 patients with histologically confirmed large bowel carcinoma, patient- and tumor-related characteristics were examined and their effect on prognosis was determined. Serum alkaline phosphatase and albumin concentrations, symptom duration prior to diagnosis of the primary tumor, and the status of the primary tumor showed the strongest relationship to survival after diagnosis of surgically noncurable disease. Patients who had normal serum alkaline phosphatase and albumin concentrations, patients whose symptoms lasted over 12 months before diagnosis, and patients whose primary tumor had been resected before diagnosis of noncurable disease had a good prognosis. Performance status, weight loss, sex, presence of liver metastasis, hemoglobin concentration, and absolute lymphocyte or monocyte counts in the peripheral blood, at time of diagnosis of surgically noncurable disease, were significant factors when examined individually. One hundred seventy-nine patients with metastatic colorectal cancer confined to the liver were selected from 601 patients who received chemotherapy for advanced colorectal cancer over 10-year periods to compare the efficacy of hepatic-artery infusion therapy with that of intravenous 5-fluoropyrimidine--containing chemotherapy. The two groups were similar with respect to prognostic factors. The hepatic-artery infusion chemotherapy produced a higher response rate than intravenous chemotherapy, but did not result in significant prolongation of survival.

Alkaline Phosphatase↗
PubMed1983

Hepatic arterial chemotherapy and occlusion for palliation of primary hepatocellular and unknown primary neoplasms in the liver.

Eighteen patients with malignant liver disease were treated with hepatic arterial infusion (HAI) of floxuridine (FUDR), Adriamycin (doxorubicin), and mitomycin C (FUDRAM). Twelve of the patients had primary hepatocellular carcinoma and six had metastatic liver carcinoma originating from an unknown primary site. One complete remission and seven partial remissions (greater than or equal to 50% reduction in tumor size) were observed among 12 hepatocellular cancer patients, while only one partial remission was achieved among six patients with unknown primary liver neoplasms. When arterial occlusion was added to HAI of FUDRAM, a prolongation of median survival to 14 months as opposed to six months in patients with an intact arterial tree was observed (P = 0.02). Arterial occlusion had its effect on survival particularly among patients who failed to respond to HAI of FUDRAM. Thus, among nonresponding patients, the addition of arterial occlusion resulted in a median survival of 10.5 months while median survival in those without arterial occlusion was six months (P = 0.08). With procedure-related morbidity being minimal, we conclude that arterially administered FUDRAM offers a notable palliation to patients with primary hepatocellular carcinoma. In patients with unknown primary liver neoplasms and those with hepatocellular cancer who fail HAI of FUDRAM, arterial occlusion can offer additional palliation.

Adult↗
PubMed1983

Effective retreatment of patients with colorectal cancer and liver metastases.

Twenty-two patients with colorectal cancer and metastatic liver disease in whom systemic intravenous therapy with 5-fluorouracil previously had failed were given fluorodeoxyuridine and mitomycin C by hepatic arterial infusion. Ten of the 22 patients (45.4 percent) had a partial response and median survival of 14 months, as opposed to a median survival of six months among the 12 patients who did not have response to the treatment (p = 0.02). Hepatic arterial occlusion was effected in seven of the 10 patients who responded and in seven of the 12 nonresponding patients. Such manipulation of hepatic arterial blood flow did not have a significant effect on the survival duration in either group. Retreatment of patients with colon cancer and liver metastases by hepatic arterial infusion of fluorodeoxyuridine and mitomycin C can result in significant prolongation of survival in patients with response to this treatment.

Adenocarcinoma↗
PubMed1982

99mTc-labeled macroaggregated albumin in intrahepatic arterial chemotherapy.

One hundred eighty-four 99mTc-labeled macroaggregated albumin (99mTc-MAA) perfusion studies were carried out in 39 patients with histologically proven primary (four) and metastatic (35) hepatic neoplasms. Three different patterns of tumor perfusion were observed: (1) increased central radioactivity (33%); (2) decreased central radioactivity (33%); and (3) mixed and/or diffuse radioactivity (33%). Extrahepatic perfusion as evidenced by radioactive localization in the region of the stomach, pancreas, and small bowel was noted in 51%. Its presence was associated with a higher incidence of gastrointestinal complications (45% vs. 16%). Tumor arteriovenous shunting was demonstrated in 38%, showing localization of radiotracer activity in the lungs, and decreased as tumors decreased in size. The use of 99mTc-MAA infusion studies in intrahepatic arterial chemotherapy offers an excellent evaluation of catheter placement and tumor perfusion, in addition to helping to avoid gastrointestinal complications.

Adult↗
PubMed1981

Intraarterial cis-platinum for patients with inoperable skeletal tumors.

Twenty-three patients with inoperable skeletal tumors were treated with intraarterial cis-platinum prior to attempted surgery. The antitumor effect of intraarterial cis-platinum was monitored clinically by radiologic imaging techniques, and whenever possible, evaluated histopathologically by examinatin of surgical or biopsy tumor specimens. Objective responses were noted in 12 patients (52%) and included 2 complete, 7 partial and 3 less-than-partial remissions lasting from 14 to 70 weeks. Limb-saving surgery or hemipelvectomy became subsequently feasible in four and one patients respectively. Preoperative intraarterial cis-platinum is a safe procedure which might be used effectively in combination with other, more conventioal postoperative adjuvant chemotherapy against skeletal tumors.

Bone Neoplasms↗
PubMed1981

The palliative role of hepatic arterial infusion and arterial occlusion in colorectal carcinoma metastatic to the liver.

Fifty-five patients with metastatic colorectal carcinoma confined to the liver were treated with hepatic arterial infusion of floxuridine and mitomycin C. Tumour response rate was 43.4% and median overall survival was 11 months. Prolonged survival was associated with intentional or inadvertent occlusion of the hepatic artery. The median survival of twenty-four patients with arterial occlusion (15 months) was significantly higher than that of thirty-one patients without arterial occlusion (8 months).

Antineoplastic Agents↗
PubMed1981

Sequence of regional chemotherapy and surgery. Management of colorectal adenocarcinoma confined to the liver.

Four patients with clinically nonresectable unilobar hepatic metastases from colorectal cancer were treated with a sequentially combined approach of intrahepatic arterial chemotherapy followed by surgery. Partial regression (greater than or equal to 50%) induced by chemotherapy and associated with a decline in plasma carcinoembryonic antigen level was followed successfully by a complete hepatic tumor resection in three out of four patients. All three patients continue to be free of disease from 13+ to 21+ months. This combined approach may improve the salvage rate of patients with regionally confined hepatic metastases.

Adenocarcinoma↗
PubMed1981

Hepatic artery infusion chemotherapy: gastroduodenal complications.

Hepatic artery infusion chemotherapy is a recognized treatment of unresectable hepatic neoplasms. Because the arterial supply to the stomach and duodenum originates from the celiac and hepatic arteries, unavoidable infusion of the gastroduodenal and right gastric arteries may result in gastrointestinal complications. Of 174 patients (266 infusions) treated with hepatic artery infusion chemotherapy during a 12 month period, 18 developed severe dyspepsia. Ten of these 18 patients had gastrointestinal pathology documented by either endoscopy or upper gastrointestinal series; six had gastric ulcer and gastritis, two had duodenal ulcer, one pyloroduodenitis, and one pancreatitis. Endoscopically, the hepatic artery infusion chemotherapy-induced ulceration and gastritis were located in the distribution of the infused arteries. Radiographically, the gastric abnormalities ranged from typical benign ulcers to a pattern of multiple ulcerations with nodular fold mimicking malignancy. Angiographic correlation could be made on eight of the 10 patients. Vascular trauma, observed in five of these eight patients, seemed to contribute to gastrointestinal complications in hepatic artery infusion chemotherapy.

Adult↗
PubMed1981

Immune restoration and/or augmentation of local xenogeneic graft versus host reaction by Cimetidine in vitro.

The immunorestorative effect of Cimetidine in vitro on the T cell-induced local GVH reaction in vivo was studied in 43 cancer patients and 43 normal healthy donors. Both low dose (10(-5) M) and high dose (10(-4) M) Cimetidine induced significant, albeit partial, immune restoration among GVHR-negative cancer patients (p less than 0.05, p less than 0.01, respectively) with the high dose being significantly more effective (p less than 0.05). In contrast, similar Cimetidine doses induced only moderate augmentation (p greater than 0.05) among GVHR-positive cancer patients and a marginal one among normal healthy donors. In the latter 2 groups, Cimetidine was found to be occasionally detrimental in that it induced a conversion from a positive to a negative GVH reaction. These results support the concept of anti-suppressor cell activity ascribed to Cimetidine. However, the possibility of a detrimental effect should be born in mind in planning future clinical trials. We propose that the use of Cimetidine be limited to cancer patients with documented increase in suppressor cell activity associated with defective T cell function under close serial monitoring.

Cimetidine↗
PubMed1980

Percutaneous hepatic arterial infusion (HAI) of mitomycin C and floxuridine (FUDR): an effective treatment for metastatic colorectal carcinoma in the liver.

The response rate of metastatic colorectal carcinoma confined to the liver to HAI of FUDR alone is at the range of 50% and to mitomycin C by hepatic arterial infusion (HAI) at the range of 35%. Mitomycin C was added to FUDR by continuous infusion and given by HAI to 12 patients with colorectal cancer confined to the liver. Catheters were placed subselectively in the hepatic artery, and infusion continued for five to six days when the catheter was removed. Cycles were repeated every 30 days. Chemotherapy consisted of mitomycin C 15 mg/m2 administered on day 1 followed by FUDR 100 mg/m2 by continuous infusion daily for five days. Response to treatment was evaluated by serial determinations of plasma CEA and by imaging techniques consisting of a computerized tomography, sonography, and radionuclide scanning of liver as well as by angiography. In 2 patients, complete remission was achieved; in 4 patients a 75% and in another 4 patients a 50% decrease in liver metastasis was observed, while 2 patients had stable disease. Thus, a response rate of 83% with a median duration of six to seven months was achieved. The median survival of the these patients was 16 months. Eight of the 12 patients have failed previous, i.v. 5-FU containing regimens. Complications related to 45 treatment cycles were the following: catheter displacement in 11.1%, an intimal tear, usually in the hepatic artery in 4.4%, gastric ulcerations in 5.4%, and septicemia in 2.7% of the cycles. In addition, aneurysmal dilation of the hepatic artery occurred in 4 patients (8.8% of the treatment cycles), all of whom continued treatment. Chemotherapy-related complications included primarily thrombocytopenia and stomatitis. Mitomycin C + FUDR by hepatic arterial infusion is an effective treatment for colorectal carcinoma metastatic to the liver. The high response rate justifies the adjuvant treatment of Dukes class C colon cancer patients with this treatment.

Adult↗