A model for the valuation of mass attendance and attendance duration of patients with malignant neoplasms (author''s transpl)

By means of a combination of two methods known in demography - life table and estimates for intercensal years - probabilities of prevalence of cancer patients and duration of disease from onset to death are calculated. Starting-points are the incidence know by cancerregistration and death certificates. The results of the model are compared with the results of a special point prevalence counting. Both methods gave about the same results.     

A case of inoperable advanced gastric cancer remarkably responding to combined chemotherapy with UFT-E, MMC and PSK

A 55-year-old male consulted a local doctor with the complaint of epigastralgia. Examination of the upper gastrointestinal tract revealed gastric cancer (Borrmann Type II) and he was referred to our hospital for operation. A few lymph nodes were palpable in the left supraclavicular fossa, and the biopsy of those lymph nodes revealed metastatic adenocarcinoma. The CT scan of the abdomen showed enlargement of paraaortic lymph nodes. Then, the patient was determined inoperable (T3, N4, H02 P01, M1 stage IVb). He was treated as an outpatient with UFT-E (300 mg/day, orally), Krestin (PSK 3.0 g/day, orally) and Mitomycin C (MMC 6 or 8 mg once a week, intravenously repeated interval of 4 weeks). The total dose of UFT-E, PSK and MMC was 219 g, 1,095 g and 136 mg, respectively. One month later, lymph nodes in the supraclavicular fossa disappeared, and the lesion in the stomach completely responded. We have followed the patient for more than one year. He visits our the outpatient department and has kept working until now.     

Evaluation of the optimal duration of chemotherapy in phase II trials for inoperable non-small-cell lung cancer (NSCLC)

PURPOSE: To determine the optimal duration of chemotherapy in phase II trials for patients with non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: The time from start of treatment until achievement of response according to WHO criteria was determined retrospectively in 8 phase II trials. RESULTS: Response to chemotherapy consisting of 4 complete and 39 partial remissions was registered in 43 of 333 patients. The median time from treatment start to response was 54 days. On day 84 on-study, 35 of the responding patients (81%) had achieved the response. Forty-three responses (98%) had occurred by day 168 and only one patient (2%) accomplished a response after 168 days of treatment. The responses had a median duration of 151 days (range 28-1559 days). CONCLUSIONS: The data indicate that patients with NSCLC included in phase II trials who have not yet achieved a response to chemotherapy after 168 days on study have a low likelihood (2%) of a subsequent response. Hence, treatment cessation at this point should be considered for non-responding patients. Continuation of treatment from day 84 to day 168 resulted in response in only 7 patients out of the total of 43 responses noted (16%). Thus, the toxic effects of the chemotherapy in addition to the inconvenience of hospital visits renders it questionable whether it is worthwhile to continue treatment in patients with inoperable non-small-cell lung cancer beyond day 84 in the absence of response.     

Accelerated hyperfractionated radiotherapy combined with induction and concomitant chemotherapy for inoperable non-small-cell lung cancer--impact of total treatment time

PURPOSE: To determine the importance of fall characteristics, body habitus, function, and hip bone mineral density as independent risk factors for hip fracture in frail nursing home residents. SUBJECTS AND METHODS: In this prospective, case-control study of a single, long-term care facility, we enrolled 132 ambulatory residents (95 women and 37 men) aged 65 and older, including 32 cases (fallers with hip fracture) and 100 controls (fallers with no hip fracture). Principal risk factors included fall characteristics, body habitus, measures of functional assessment, and hip bone mineral density by dual-energy X-ray absorptiometry. RESULTS: In multivariate analysis, including only those with knowledge of the fall direction (n=100), those who fell and suffered a hip fracture were more likely to have fallen sideways (odds ratio 5.7, 95% confidence interval [CI] 1.7 to 18, P= 0.004) and have a low hip bone mineral density (odds ratio 1.9, 95% CI 0.97 to 3.7, P=0.06) than those who fell and did not fracture. When all participants were included (n=132) and subjects who did not know fall direction were coded as not having fallen to the side, a fall to the side (odds ratio 3.9, 95% CI 1.3 to 11, P=0.01), low hip bone density (odds ratio 1.8, 95% CI 1.03 to 3, P=0.04), and impaired mobility (odds ratios 6.4, 95% CI 1.9 to 21, P=0.002) were independently associated with hip fracture. Sixty-seven percent of subjects (87% with and 62% without hip fracture) had a total hip bone mineral density greater than 2.5 SD below adult peak bone mass and were therefore classified as having osteoporosis using World Health Organization criteria. CONCLUSIONS: Among frail elderly nursing home fallers, the preponderance of whom are osteoporotic, a fall to the side, a low hip bone density, and impairment in mobility are all important and independent risk factors for hip fracture. These data suggest that, among the frailest elderly, measures to reduce the severity of a sideways fall and improve mobility touch on new domains of risk, independent of bone mineral density, that need to be targeted for hip fracture prevention in this high-risk group.     

Neoadjuvant chemotherapy and radiotherapy for inoperable head and neck cancer: the LSU-Shreveport experience

A retrospective review of 8 years of treatment in 2 hospitals in Shreveport showed that neoadjuvant chemotherapy with radiotherapy was performed in 39 patients with inoperable, locally advanced head and neck cancer. Twenty-two individuals treated by definitive radiotherapy alone served as historical controls. The cumulative survival rate at 4 years was 34% in patients managed by neoadjuvant chemotherapy with radiotherapy and 7% in patients treated by radiotherapy only. With the exception of greater acute toxicity seen in patients receiving neoadjuvant chemotherapy with radiotherapy, differences in locoregional failure, distant metastasis, and late complication rates were not observed between the patient groups.     

Clinical and experimental results with acupuncture-analgesia (author''s transl)

Transfer RNA and aminoacyl tRNA synthetases were obtained from hormone dependent and independent mammary tumors of GR mice. We have studied the possible changes in the tRNA level by comparing the specific activities of the hormone dependent and independent mammary tumor tRNA's, but no differences were observed. Differences were found in the ability of enzymes from normal male GR mice liver, independent mammary tumor and dependent mammary tumor to cross-react with heterologous tRNA.     

Secretion of proteohormones and steroids in postmenopause and in women with corporal uterine cancer (author''s transl)

A recommended procedure carried out effectively on 132 patients and based on three essential criteria that may help the allergist in his decision to terminate immunotherapy in a patient is reviewed and discussed. These criteria, embodying clinical reappraisal of the patient, skin retesting and definitive RAST profile results, are offered as a new approach for consideration by the clinical allergist in the care of his patients.     

Combination chemotherapy with Tegafur. Uracil (UFT), etoposide, adriamycin and cisplatinum (UFT-EAP) for advanced gastric cancer

Thirty-four patients with advanced gastric cancer were treated with combination chemotherapy employing Tegafur-Uracil (UFT), etoposide, Adriamycin, and Cisplatinum (CDDP) (UFT-EAP therapy). An objective partial response was obtained in 16 patients (47%) and the median duration of remission was 12.2 months. The 50% survival time for all 34 patients was 10 months. Patients with moderately or well differentiated adenocarcinoma responded well (13/19, 68%), while those with undifferentiated adenocarcinoma showed a poor response (3/15, 20%). Six responding patients were noted to have no evidence of viable cancer at the primary site by endoscopic biopsy, and underwent gastrectomies. The resected specimens showed complete disappearances of the primary tumors in four patients. The median survival time for the patients receiving gastrectomies was 24 months. The regimen was very well tolerated, apart from moderate bone marrow suppression. Our results suggest that patients with advanced gastric cancer can be effectively treated with UFT-EAP chemotherapy.     

Intraarterial chemotherapy combined with radiation therapy for advanced cancer of the uterine cervix

The results of intraarterial chemotherapy (IACT) combined with definitive radiation therapy for 23 advanced and bulky carcinomas of uterine cervix are reported. IA-CT with cisplatin 50 mg and doxorubicin 30 mg was administered by one shot method in bilateral internal iliac arteries. The protocol consisted of one to three treatment session every 3 weeks. Nine of eleven patients with clinical stage III achieved a complete local response (82%), and the 3- and 5-year survival in these cases were 72% and 72%, respectively. These results were superior to the response (58%), 3- and 5-year survivals (68%, 58%) obtained in 19 patients treated mainly with radiation therapy alone. The side effect of grade 2 and 3 for the intestine, such as ileus and hemorrhagic colitis, was noted in 3 patients (15%). In addition, 3 of 8 patients with radical surgery and postoperative radiation therapy after IA-CT developed insufficient fracture of pelvic bone. These complications accompanied by IA-CT combined with radiation therapy and/or surgery increased slightly, compared with that by the previous therapy without IA-CT, but were not critical. The results suggest that IA-CT following radiation therapy is effective to improve the prognosis of patients with Stage III cervical cancer.     

Salmonella colitis. Report of two cases and literature review (author''s transl)

Uterine activity was measured for a 30-minute preinjection period and a 30-minute postinjection period for six drugs commonly used in labor. Uterine activity was quantitated by measuring the area below the uterine pressure curve with an on-line technic utilizing a voltage control oscillator. Uterine activity readings were obtained every 2.5 minutes and reported in uterine activity units (UAU). Unmedicated labor demonstrated a relatively static increase in UAU per unit of time in labor. On comparing total UAU before and after injection, only magnesium sulfate was noted to cause a decrease in total UAU. Utilizing 10-minute summations of UAU, the pre- and postinjection periods were compared to the calculated expected UAU for the 30 minutes following the preinjection period (assuming no drug had been used). For each of the other drugs, the positive slope of the calculated expected UAU shifted to a negative slope of the actual observed UAU following drug administration.     

Palliative chemotherapy with CMF after the same adjuvant regimen for breast cancer. The Breast Cancer Study Group

BACKGROUND: The results of palliative chemotherapy with cyclophosphamide, methotrexate and 5-fluorouracil (CMF) in patients with advanced breast cancer who received adjuvant therapy with the same regimen were investigated. RESULTS: Of 47 patients, 14 (30%) achieved an objective remission (median duration 9.5, range 5-21 months) and 8 (17%) stabilisation of disease (median duration 6, range 3-17 months). Objective remissions were observed in premenopausal as well as in postmenopausal women, in patients with all categories of dominant localisation of disease and regardless of the oestradiol receptor status of the primary tumour or eventual previous endocrine therapy. One of 4 and 13 of 43 patients who started palliative chemotherapy within or later than 12 months after the last adjuvant course obtained an objective remission. The median survival time from start of therapy of all treated patients was 12 (range 1-40) months. Patients with an objective remission or stable disease and patients with progressive disease had a median survival time of 20 (range 6-40) and 6 (range 1-35) months respectively (p < 0.0001). CONCLUSIONS: Palliative treatment with CMF should not be rejected for patients who have relapsed after adjuvant chemotherapy with the same modality.     

Studies on organosulfur compounds. XV. Substituent effects on 2-(2-pyridyl)-3-substituted-phenyl-4(3H)-quinazolinone cyclization (author''s transl)

The recovery process of HeLa continuous cells after prolonged storage at nitrogen liquid temperature (--196 degrees C) has been analysed. The karyologic analysis evidence indicates a high stock cell karyostability. A study of cell division, generation cycle parameters and DNA synthesis by autoradiography demonstrated cell adaptation to a continuous passage to be due to the increase of proliferative pool and to the intensitification of generation processes in the multiplicated population. Cell structure changes during adaptation were reversible.     

New combination therapy with FTM [5-FU, pirarubicin (THP) and MMC] for treatment of inoperable advanced gastric cancer

Clinical usefulness of a new combination FTM therapy consisting of 5-FU, Pirarubicin (THP) and MMC for the treatment of advanced gastric cancers was investigated. 5-FU, THP or MMC was administered at a dose of 600 mg/m2 on day 1, 8, 22 and 29, 30 mg/m2 on days 1 and 22, and 10 mg/m2 on day one only of each course, respectively. Eighteen patients with inoperable advanced gastric cancer were treated with FTM. All drugs were investigated by intravenously by one shot. The tumor response rate was 50% [9 of 18 showed PR]. The survival rate was higher in responders than in nonresponders (18.1% vs 11.1%) (p < 0.05). Side effects in the gastrointestinal tract were minimal. Cardiotoxicity and nephrotoxicity were not detected, but myelosuppression was prominent in most cases. G-CSF was given in sixteen patients (88%), and platelet transfusion was performed in two patients (11%). New combination FTM therapy is an effective treatment regimen even for advanced inoperable gastric cancer.     

Endoscopic ultrasonography for assessment of the response to combined radiation therapy and chemotherapy in patients with esophageal cancer

The current classification of cutaneous melanoma was developed in 1972 and revised in 1982. Since that time new concepts and terminology have evolved that require consideration of a further revision. This paper reviews some of the concepts that will form part of that process. Regional meetings of interested parties have been held to review the classification and there will be an open meeting on the topic at the 1997, 4th World Conference on Melanoma in Sydney, Australia. A questionnaire is included that will allow the interested reader to provide comments on the topic.     

Etiology and treatment of the psychological side effects associated with cancer chemotherapy: A critical review and discussion.

Cancer patients receiving chemotherapeutic treatments routinely experience a wide range of distressing side effects, including nausea, vomiting, and dysphoria. Such symptoms often compromise patients' quality of life and may lead to the decision to postpone or even reject future, potentially life-saving, treatments. In this article, we discuss the hypotheses that have been offered to explain the development of such symptoms. We also review, in greater detail, the research evidence for the efficacy of five treatments for such symptoms: hypnosis, progressive muscle relaxation training with guided imagery, systematic desensitization, attentional diversion or redirection, and biofeedback. We discuss the implications of this treatment research, paying particular attention to factors associated with treatment outcome, mechanisms of treatment effectiveness, and issues associated with clinical application. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patterned (single) alternation in infant rats after combined or separate lesions of hippocampus and amygdala.

The role of the developing hippocampus and the amygdala on patterned (single) alternation (PA) in the infant rat was investigated in 4 experiments. In Exps 1 and 2, Ss were given 2 bilateral electrolytic hippocampal lesions or sham surgeries at 10 or 11 days of age and were trained 6 days later in a straight runway. In Exp 1, there were 120 trials in 1 day, with an 8-, a 15-, or a 30-s intertrial interval (ITI). PA learning occurred in lesion and sham Ss at the 8- and 15-s ITIs. In Exp 2, training was extended to 240 trials over 2 days, with a 30- or 60-s ITI. Sham and lesion Ss showed PA at the 30-s ITI, but the emergence of PA was delayed in the lesion pups at the 60-s ITI. In Exp 3, amygdaloid lesions had no effect on PA learning at the 8-s ITI. However, when Ss with hippocampal and amygdaloid lesions were trained at the 8-s ITI, the emergence of PA was delayed, and its size was reduced (Exp 4). Results argue for a role of the hippocampus in PA learning at long ITIs and suggest that, even in 16-day-old Ss exposed to an 8-s ITI, the combined hippocampal and amygdaloid lesion produces a deficit greater than either the hippocampal or the amygdaloid lesion. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hemopoietic stem cells and antitumoral drugs. 1. Variations of in vitro and in vivo colony forming cells following single dose administration of cyclophosphamide, vinblastine and azathioprine (author''s transl)

Disaggregated cell suspensions made from transplanted solid tumors, either chemically-induced fibrosarcomas, or spontaneous mammary carcinomas, can contain very high numbers of Fc receptor-bearing cells which are of host origin. Because most types of lymphoreticular cells have Fc receptors, and because T cells--most of which are Fc receptor-negative--appear to infiltrate such tumors only to a very limited degree, the possibility that Fc receptor cells could serve as a reliable and simple marker for host lymphoreticular cell infiltration of solid tumors was tested. This was accomplished by comparing the ratios of Fc rosetting cells to serologically detectable host cells in H2d or H2k haplotype tumor cell suspensions grown in (H2d X H2k)f1 hybrid mice, where host cells could be distinguished from tumor cells by treatment with the appropriate anti-H2 serum. Ratios of 0.8 to 1.08 were obtained for four different tumors including the SaD/2 fibrosarcoma, a CBA spontaneous fibrosarcoma, and the T1699 and CaD/2 mammary carcinomas. Analysis of the results showed that enumeration of Fc rosettes was a reliable host cell maker for at least three of the four tumors tested. The mean non-malignant host cell content of the various tumors, as assessed by anti-H2 cytotoxicity tests, ranged from 23% to 41%.     

Effectiveness of biofeedback and relaxation training in reducing the side effects of cancer chemotherapy.

Assessed the effectiveness of electromyograph (EMG) and skin-temperature (ST) biofeedback and relaxation training (RXT) in reducing the aversiveness of cancer chemotherapy (CHEMO). 81 cancer patients (aged 18–75 yrs) were randomized to 1 of 6 groups formed by a 3?×?2 factorial design. Outcome was assessed with physiological, patient-reported, and nurse-reported indices taken over 5 consecutive CHEMO treatments. RXT patients showed decreases in nausea and anxiety during CHEMO and physiological arousal after CHEMO. EMG and ST biofeedback reduced some indices of physiological arousal but had no other effects on CHEMO side effects. RXT may be effective in reducing the adverse consequences of CHEMO. It is suggested that the positive effects found for biofeedback were due to the RXT that was given with the biofeedback, not to the biofeedback alone. (PsycINFO Database Record (c) 2010 APA, all rights reserved)