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  • 1
    Electronic Resource
    Electronic Resource
    Correlation between clinical staging (FIGO) and prognostic groups with gestational trophoblastic disease (1993)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 100 (1993), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To compare the Charing Cross Hospital scoring system with FIGO staging for gestational trophoblastic disease.Design A retrospective analysis of patients referred to Charing Cross during the period 1979–1989.Setting National referral centre.Subjects Two hundred and seven women with gestational trophoblastic disease presenting between 1979–1989.Main outcome measures The women were classified according to the Charing Cross Hospital scoring system and FIGO clinical staging and the results of treatment compared.Results Of the 207 women studied, there were 102 low risk, 39 medium risk and 66 high risk according to the Charing Cross system and 26 stage 0,83 stage 1,23 stage 2,51 stage 3 and 24 stage 4 according to the FIGO system. If the FIGO system had been used to determine therapy, 17 women would have been at risk of under-treatment and nine of overtreatment. The main prognostic factors contributing to a higher Charing Cross score and thus more intensive chemotherapy from the outset were: HCG 〉 105, interval from antecedent pregnancy 〉12 months and term delivery.Conclusions The Charing Cross scoring system incorporates factors predictive of the presence of drug resistant tumour and thus allows more appropriate use of chemotherapy from the start of treatment than is possible with the anatomically based FIGO staging. Moreover, the system is easy to apply relying only on history and clinical examination in addition to a reliable quantitative HCG assay.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1993.tb15213.x
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  • 2
    Electronic Resource
    Electronic Resource
    The role of VP16-213 (Etoposide; NSC-141540) in gestational choriocarcinoma (1982)
    Springer
    Cancer chemotherapy and pharmacology 7 (1982), S. 211-214 
    Details
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Since 1976 we have used VP16-213 (Etoposide; NSC-141540) in several groups of patients with gestational choriocarcinoma. Initially we used VP16-213 in a dose of 100 mg/m2 by short i.v. infusion for 5 consecutive days in patients with drug-resistant gestational choriocarcinoma. Patients were monitored with twice weekly samples for serum human chorionic gonadotrophin (HCG) concentration and a partial response (PR) has been defined as a fall in the HCG concentration to less than one tenth and an improvement (IMP) as a fall in the HCG concentration to less than one half of the pre-treatment value. In gestational choriocarcinoma patients resistant to other drugs there were 7 (19%) PR, 14 (38%) IMP, and 16 (43%) of non-responders. Since 1979 we have used VP16-213 as the initial agent in patients in the medium risk category [1] and up to the 1st July 1981 we have treated 38 patients with VP16-213 in this group. There have been 13 (34%) PR and 17 (45%) IMP. There are currently 30 (79%) patients in complete remission. Six are still on treatment; only two required a change of treatment because of drug resistance and so far there has been only one relapse off treatment. We have also integrated VP16-213 in combination with methotrexate and actinomycin-D followed by vincristine and cyclophosphamide in the high risk category [1] and have so far treated 24 patients. There are 16 (67%) CR, four patients are still on treatment; only one patient failed to respond at all to therapy and there has been one relapse off treatment. There were three deaths in this high risk group. We think that VP16-213 should be regarded as one of the first line agents in trating patients with gestational choriocarcinoma who fall into the medium and high-risk categories.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00254552
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  • 3
    Electronic Resource
    Electronic Resource
    Acute neurological toxicity of intrathecal cytosine arabinoside (1986)
    Springer
    Cancer chemotherapy and pharmacology 16 (1986), S. 306-307 
    Details
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A patient developed severe neurological toxicity, with peripheral and cerebral components and hyponatraemia following one intrathecal injection of 80 mg cytosine arabinoside. The severity of his symptoms may reflect heavy prior neurotoxic chemotherapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00293998
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  • 4
    Electronic Resource
    Electronic Resource
    Effect of dose escalation of a monoclonal anti-CEA IgG on tumour localisation and tissue distribution in nude mice xenografted with human colon carcinoma (1986)
    Springer
    Cancer immunology immunotherapy 23 (1986), S. 107-112 
    Details
    ISSN: 1432-0851
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A monoclonal anti-CEA antibody (1H12) has been examined for the effect of dosage on tumour localisation in immunodeprived mice xenografted with human colon carcinoma. Increased doses produced a linear rise in the absolute concentration found in the tumour but this was found to depend on tumour size, with the smaller tumours (mean weight 44 mg) accumulating significantly more antibody compared to larger tumours (mean weight 146 mg). With the smallest tumour (18 mg), in which saturation was achieved, a 500 μg dose produced a concentration in tumour of 60 μg/g. In the larger tumours a dose of 256 μg produced a mean concentration of 5.2 μg/g. Prolonged retention of 1H12 by tumour up to 8 days, observed at doses of 4, 128 and 256 μg, indicated that the dynamics of localisation is unaffected by dosage. Increased doses of 125I-1H12 caused an increase in the levels of radioactivity associated with all normal tissues studied. Thus at 8 days after injection an increase from 4 to 128 μg produced 50% and 42% declines in the tumour to blood and liver ratios, respectively. Cumulative localisation of 1H12 in tumour, from 4 h to 8 days, relative to normal tissue clearance was diminished on increasing dosage. This study shows that attempted therapy with escalated amounts of intact antibody is likely to be limited by a protracted excretory process and measures aimed at accelerating circulatory clearance are necessary.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00199815
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  • 5
    Electronic Resource
    Electronic Resource
    Accurate quantification of131I distribution by gamma camera imaging (1990)
    Springer
    European journal of nuclear medicine 16 (1990), S. 361-365 
    Details
    ISSN: 1619-7089
    Keywords: Emission tomography ; SPET ; Scatter correction ; Radiolabelled antibody ; Targeted therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The development of targeted therapy requires that the concentration of the therapeutic agent can be estimated in target and normal tissues. Single photon emission tomography (SPET), with and without scatter correction, and planar imaging using131I have been compared to develop a method for investigation of targeted therapy. Compton scatter was investigated using line spread functions in air and water, these data were used to set a second peak, adjacent to the photopeak, for scatter correction. The system was calibrated with an eliptical phantom containing sources in background activity of various intensities. Scatter corrected reconstructions gave accurate estimates of activity in the sources regardless of background activity. For planar scanning and SPET without scatter correction there was an overestimate of activity in the source of 290% and 40% respectively. The validity of this method was confirmed in patients by comparing activity in the cardiac ventricles measured by SPET with scatter correction with that in a simultaneous blood sample. A coefficient of correlation of 0.955 was achieved with 25 data points. SPET with scatter correction was compared with planar imaging in measuring activity in the liver and spleen of patients receiving 75 mCi131I-antibody to CEA intravenously. Planar imaging gave significantly higher values than SPET for the spleen (t=5.4,P〈0.001 by the pairedt-test) but no significant difference for the liver. SPET with scatter correction forms a basis for an improved technique of quantifying the targeting efficiency.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00842793
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