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  • 1
    Electronic Resource
    Electronic Resource
    Zur cytostatischen Therapie der Hoden-Tumoren (1974)
    Springer
    Journal of cancer research and clinical oncology 82 (1974), S. 307-328 
    Details
    ISSN: 1432-1335
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Chemotherapie maligner Hodentumoren hat ihre Wirksamkeit in bestimmten Grenzen erwiesen. Die endgültige Heilungsquote bei disseminierter Metastasierung ist noch zu gering. Die kombinierte Chemotherapie, bestehend aus Cyclophosphamid, Vinblastin und Amethopterin, erreicht bei metastasierenden Seminomen Vollremissionen von 50%. Maligne, disseminiert metastasierte Hodenteratome reagierten unter kombinierter Chemotherapie, bestehend aus Actinomycin-D, Cyclophosphamid, Vinblastin und Amethopterin, in 42% mit Remissionen, von denen 4% Vollremissionen und 38% Teilremissionen darstellten. Die in dieser Studie vorgelegten Ergebnisse betreffen ein nicht-selektiertes Krankengut unter Einschluß auch weit fortgeschrittener Krankheitsstadien. Infolgedessen können die wiedergegebenen Zahlen als Resultat der kombinierten Chemotherapie bei Hodentumoren unter ungünstigen Bedingungen aufgefaßt werden. Auf die Verbesserung der chemotherapeutischen Ergebnisse unter frühzeitig einsetzender Therapie wird auch anhand der Kasuistik hingewiesen. Die Probleme, welche bei nachgewiesener Verlängerung des Lebens und Verzögerung der Metastasierung die faktische spätere Resistenz bewirken, sind nicht geklärt. Die Rolle der Chemotherapie im Stadium I ist noch offen. Die bisher in der Literatur wiedergegebenen Resultate sind nur bedingt miteinander vergleichbar, so daß die Forderung nach einer kontrollierten prospektiven Studie gerechtfertigt erscheint.
    Notes: Summary Chemotherapy has proven to be effective in malignant testicular tumours. The cure rate in the presence of disseminated metastases is low. Complete remissions were obtained in 50% of metastasising seminoma with a combination chemotherapy consisting of Cyclophosphamide, Vinblastine and Amethopterin. In metastasising teratocarcinoma of the testis 42% remissions — 4% complete remissions, 38% partial remissions — were observed with a combination of Actinomycin D, Cyclophosphamide, Vinblastine and Amethopterin. All patients with metastasising testicular malignancies were entered into this study, none was excluded because of far advanced disease or poor general condition. Our remission rates therefore reflect the results of combined chemotherapy in a mixed patient population including those with poor prognosis. With early chemotherapy treatment results are better as is shown by our case studies. The reasons for the development of secondary chemotherapy resistance are not yet known. The indication for chemotherapy in Stage I disease is still subject to discussion. The results reported in the literature are difficult to compare, a controlled clinical trial therefore seems necessary.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00285566
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  • 2
    Electronic Resource
    Electronic Resource
    Chemotherapy in stage II testicular tumours (1976)
    Springer
    Journal of cancer research and clinical oncology 86 (1976), S. 103-108 
    Details
    ISSN: 1432-1335
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei 26 Patienten mit malignen Hodenteratomen im Stadium II (Metastasierung in die retroperitonealen Lymphknoten) wurde im Anschluß an die retroperitoneale Lymphadenektomie sofort oder nach einer zusätzlichen Bestrahlung des Retroperitoneums mit einer Cytostaticatherapie begonnen. Bis heute zeigten 8 Patienten (30,5%) ein Rezidiv. Die mittlere Dauer vom Zeitpunkt der Diagnose bis zum Nachweis des Rezidivs betrug 21 Monate. Die 3-Jahres-Überlebensrate liegt bisher bei 85,7%. Die mittlere Überlebenszeit beträgt mehr als 36 Monate. Die eigenen Ergebnisse sowie bisherige Literaturmitteilungen zeigen einen Vorteil des frühen Chemotherapiebeginns gegenüber der Einleitung einer Cytostaticatherapie erst bei Nachweis einer disseminierten Metastasierung. Ob die frühe Cytostaticatherapie eine Fernmetastasierung ganz verhindern kann oder lediglich deren Hinauszögerung bewirkt, läßt sich z. Z. noch nicht entscheiden.
    Notes: Summary Twenty-six patients with stage II testicular teratomas (metastatic spread to the retroperitoneal lymph nodes only) were treated after retroperitoneal lymph node dissection (RLD) by cytostatic chemotherapy with or without radiotherapy. So far, eight patients (30.5%) have recurrent disease, with a median interval of 21 months from time of diagnosis to relapse. The 3-year survival rate for the total group (relapse-free and relapsed patients) was 85.7%. The median survival is not yet reached after 36 months. The own results and reports of the literature show an advantage of early cytostatic treatment over its institution in widespread disease only. It remains to be clarified whether chemotherapy in stage II disease prevents or only delays metastatic spread.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00304940
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  • 3
    Electronic Resource
    Electronic Resource
    Adriamycin, Cyclophosphamid und Fluorouracil in der Therapie des metastasierenden Mamma-Carcinoms (1976)
    Springer
    Journal of cancer research and clinical oncology 86 (1976), S. 135-145 
    Details
    ISSN: 1432-1335
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In einer prospektiven Studie wurden 11 Patientinnen mit metastasierendem Mamma-Carcinom mit einer Cytostaticakombination aus Fluorouracil, Adriamycin und Cyclophosphamid (FAC) behandelt. Bei drei Patientinnen konnte eine Vollremission (vollständiger Rückgang aller meßbaren Tumorparameter für mehr als 4 Wochen) erreicht werden, die in zwei Fällen (4 und 13 Monate) noch andauert. Partielle Remissionen (Größenabnahme der meßaren Herde über 50% für mehr als 4 Wochen) wurden in 5 Fällen verzeichnet, von denen 3 noch anhalten. Die Zeit bis zum Erreichen der Remissionen betrug 1–3 Monate. Die mittlere Dauer der Vollremission lag bei mehr als 13 Monaten, die der Teilremissionen bei 6,5 Monaten. Zwei Patientinnen zeigten einen Stillstand des Metastasenwachstums über 4 und mehr als 11 Monate. Nur in einem Fall kam es zur Krankheitsprogression. Die mittlere Überlebenszeit ab Beginn der Cytostaticatherapie betrug für die gesamte Patientinnengruppe dieser Studie 7,5 Monate. Für die Fälle mit Voll- und Teilremission lag sie bei mehr als 18 Monaten. Außer in einem Fall wurde die Therapie regelmäßig auf ambulanter Basis durchgeführt. Tierexperimentelle Untersuchungen über den therapeutischen Synergismus von Adriamycin, Cyclophosphamid und Fluorouracil und der Vergleich mit den Remissionsraten unter der alleinigen Kombination aus Adriamycin und Cyclophosphamid lassen weitere Untersuchungen zur optimalen Cytostaticakombination für die Remissionsinduktion des metastasierenden Mamma-Carcinoms notwendig erscheinen.
    Notes: Summary In a prospective study eleven patients with metastasizing breast cancer were treated with 5-fluorouracil, adriamycin, and cyclophosphamide (FAC). Complete remission occurred in three patients, with two of them still in remission four and thirteen months later. Partial remission (50% decrease in tumour size for more than four weeks) was achieved in five cases, with three of them still in remission. Time for remission induction was one to three months. The mean duration of complete remissions is not yet reached after thirteen months, that of partial remissions was 6.5 months. Two patients showed stable disease for four and more than eleven months, respectively. Only in one case progressive disease was noticed. Mean survival time from the start of therapy was 7.5 months for all patients. For complete and partial responders mean survival is not yet reached after eighteen months. With one exception therapy was given on an outpatient basis. Experimental and clinical data on therapeutic synergism of adriamycin, cyclophosphamide, and 5-fluorouracil show no advantage of the three-drug combination over the combination of adriamycin and cyclophosphamide alone.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00284001
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  • 4
    Electronic Resource
    Electronic Resource
    Invasive bronchopulmonary aspergillosis leading to rapidly progessive respiratory failure in a patient with severe aplastic anemia (1987)
    Springer
    Journal of molecular medicine 65 (1987), S. 530-532 
    Details
    ISSN: 1432-1440
    Keywords: Invasive aspergillosis ; Severe aplastic anemia ; Antilymphocyte globulin ; AIDS
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A 22-year-old man with severe aplastic anemia was treated with antilymphocyte globulin, prednisone, and oxymetholone. Fourteen days after initiation of treatment he developed a fulminant mediastinal and subcutaneous emphysema leading to respiratory failure refractory to mechanical ventilation. Fiberoptic bronchoscopy showed nodular lesions typical of aspergillus. Cultures of bronchial mucus revealedAspergillus fumigatus as the responsible pathogen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01721043
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  • 5
    Electronic Resource
    Electronic Resource
    Zur Wirksamkeit von IFN-γ und IFN-α bei der Haarzellenleukämie (1987)
    Springer
    Journal of molecular medicine 65 (1987), S. 706-712 
    Details
    ISSN: 1432-1440
    Keywords: Hairy-cell leukemia ; Interferon gamma ; Interferon alpha-2b
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung 6 Patienten mit einer Haarzellenleukämie wurden 3–35 Monate nach Splenektomie mit IFN-γ (4 × 106 E/m2/2. Tag sc) behandelt. Während einer Therapiedauer von 9–35 Wochen konnte bei keinem Patienten eine signifikante klinische oder hämatologische Befundbesserung erzielt werden. Nach einem therapiefreien Intervall von 0–13 Wochen erhielten alle Patienten IFN-α-2b (zunächst 4 × 106 E/m2/2. Tag, Erhaltungstherapie 1 × 106 E/2. Tag). Zum Zeitpunkt der Beendigung der jeweiligen IFN-α-2b-Gabe war bei 5 von 6 Patienten (1 Patient mit postthrombotischem Syndrom verstarb an einer Lungenembolie) eine deutliche Befundbesserung eingetreten. Nach einer Beobachtungszeit von jetzt 9–14 Monaten konnten 1 CR, 3 PR und 1 MR induziert werden. Die Nebenwirkungen beider Interferon-Präparationen unterschieden sich nicht signifikant.
    Notes: Summary Six patients with hairy-cell leukemia were treated with gamma-(IFN-γ) and alpha-(IFN-α-2b) interferon; 3–35 months following splenectomy, treatment was started with 4 × 106 U/m2 IFN-γ sc (iv) every second day for 9–35 weeks. Although the white blood cell counts decreased during therapy from 4.1–49 × 109/1 to 1.5–43 × 109/1, no hematological or clinical improvement was obtained. Subsequently (interval 0–13 weeks), IFN-α-2b was given at an initial dose of 4 × 106 U/m2 sc every second day to all patients. After a treatment period corresponding to that of IFN-γ administration, a significant hematological improvement was observed in five patients (one early death due to pulmonary embolism). At the last follow-up (9–14 months after start of treatment; maintenance therapy, 1 × 106 U every second day), these patients exhibited normal peripheral blood cell counts, and in bone marrow biopsy specimens a marked decrease of hairy cells was seen (1 CR, 3 PR, 1 MR). Adverse reactions including fever, headache, nausea, dryness of the mouth, myalgia, and fatigue did not significantly differ between the two interferon preparations. Whereas IFN-γ is unlikely to have any significant impact on the course of hairy cell leukemia, IFN-α-2b does result in improvement of hematological values and well-being in almost all patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01875510
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  • 6
    Electronic Resource
    Electronic Resource
    Gastric cancer in very young adults: apropos four patients and a review of the literature (2000)
    Springer
    Journal of cancer research and clinical oncology 126 (2000), S. 233-237 
    Details
    ISSN: 1432-1335
    Keywords: Key words Age factors ; Gastric cancer ; Pregnancy ; Preoperative chemotherapy ; Signet-ring cell ; Undifferentiated gastric cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Whether gastric cancer in young adults differs from gastric cancer in older patients has been a controversial issue. It has long been suspected that young patients with gastric cancer have different biological features with a more aggressive course of disease and a poorer prognosis than older patients. This, however, has not been firmly substantiated. We report on the clinical course of four patients (three female and one male) with locally advanced (n  =  1) or metastasized (n  =  3) non-resectable gastric cancer diagnosed under the age of 29 years (23, 25, 27, 28 years). Prior to diagnosis, all three women had recently been pregnant (1–22 months). Diagnosis was endoscopically biopsy-proven and staging work-up was performed by primary explorative surgery (n  =  1), laparoscopy and explorative surgery (n  =  1) or CAT scan and ultrasound (n  =  2). The delay between initial symptoms and diagnosis was 8–22 weeks (median, 10 weeks). The histology was signet-ring cell (n  =  2) or undifferentiated (n = 2) gastric cancer. All patients had the diffuse type of gastric cancer according to Lauren. Patients were treated with the FLAP polychemotherapy regimen consisting of leucovorin, 5-fluorouracil, doxorubicin and cisplatinum, as previously reported. The best response after chemotherapy was partial in two patients. Two patients showed progressive disease. Secondary surgery was performed in three responding patients (one of them responded only locally). One patient achieved no evidence of disease after complete tumor resection (R0). In two patients surgery was palliative (R2/exploration). Three patients died 6, 4 and 8 months after diagnosis. One patient is still alive. In our series, very young adults with gastric cancer had adverse clinical and pathological features. In accordance with other reports, we observed a predominance of female patients and a possible association with recent pregnancies. Though the delay between the first symptoms and diagnosis in our patients was no different from that reported for older patients, special emphasis should be given to prompt referral and diagnostic investigations, ensuring the diagnosis of gastric cancer early in the course of disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004320050038
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  • 7
    Electronic Resource
    Electronic Resource
    Bendamustine as salvage treatment in patients with advanced progressive breast cancer: a phase II study (1998)
    Springer
    Journal of cancer research and clinical oncology 124 (1998), S. 627-632 
    Details
    ISSN: 1432-1335
    Keywords: Key words Bendamustine ; Breast cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A phase II pilot study of bendamustine as salvage treatment in patients with advanced breast cancer was performed to determine the objective response rates and make further observations on the toxicity of this drug. A group of 37 patients, pretreated with chemotherapy for advanced disease, entered the trial. Treatment consisted of 150 mg/m2 bendamustine on days 1 and 2 of a 4-week treatment course. Patients continued to receive treatment until complete remission and then two further courses, until tumour progression or unacceptable toxicity ensued. A total of 36 patients received at least one treatment course and were assessable for toxicity; 33 patients were evaluable for treatment results. Dose-limiting grade 3 and 4 WHO toxicity occurred in 5 and 3 patients respectively; 27% of patients entered complete or partial tumour remission. The median time to tumour progression was 2 months with a range of 1–14 months. The efficacy of bendamustine was apparently independent of pretreatment with anthracyclines, suggesting a lack of cross-resistance between bendamustine and anthracyclines. It can be concluded that bendamustine in the dose and application schedule used here is active in the salvage therapy of women with advanced breast cancer. The toxicity was acceptable. Future studies have to confirm the data of this pilot trial and to define the role of bendamustine in the combination chemotherapy of metastatic breast cancer that has been suggested by previous trials.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004320050225
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  • 8
    Electronic Resource
    Electronic Resource
    Pharmacoeconomic evaluation of high-dose chemotherapy and peripheral blood stem cell support in high-risk or poor-prognosis malignancies (1998)
    Springer
    Journal of cancer research and clinical oncology 124 (1998), S. 288-290 
    Details
    ISSN: 1432-1335
    Keywords: Keywords Pharmacoeconomics ; High-dose chemotherapy ; Peripheral blood stem cell support
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Discussion of the total costs and cost-effectiveness ratios of patients receiving high-dose chemotherapy (HDC) and peripheral blood stem cell support (PBSCS) is controversial. In Germany, no reliable data are available, whereas in other countries this issue has been extensively studied. We performed a pharmacoeconomic evaluation on all patients (n = 37) treated with HDC and PBSCS at our institution between July 1994 and June 1997. Patients suffered from high-risk or poor-prognosis breast cancer (n = 24), Hodgkin's disease (n = 3), high-grade non-Hodgkin's lymphoma (n = 4), multiple myeloma (n = 2), small-cell cervical cancer (n = 1), malignant hystiocytosis (n = 1) and testicular cancer (n = 2). For pharmacoeconomic evaluation, the period from initiation of induction chemotherapy (IC) until reconstitution after the last course of HDC and PBSCS was considered. A total of 18 patients received IC/HDC/PBSCS for locally advanced or systemic disease, and 19 patients received adjuvant or consolidation IC/HDC/PBSCS. Treatment protocols were heterogeneous. Patients were treated with two to five courses (median two) respectively of IC and sequential mono-HDC (n = 26), tandem-HDC (n = 10) or triple-HDC (n = 1). All patients received granulocyte/macrophage-colony-stimulating factor (G-CSF) for stem cell mobilisation and for amelioration of neutropenia after HDC. The relative costs (based on supplier prices) for the total amount of drugs prescribed during the in-patient period was 29.8% for G-CSF, 35.8% for blood products 18.5% for chemotherapy, 2.4% for antiemetics, 5.9% for antimicrobial drugs and 7.6% for other drugs. Contrary to expectations, antimicrobial drugs had only a minor pharmacoeconomic impact during IC/HDC/PBSCS in patients with high-risk or poor-prognosis malignancies, indicating that prolonged septic complications were uncommon in our institution. We conclude that pharmacoeconomic evaluations in IC/HDC/PBSCS might be integrated into the effort to ensure quality control and monitoring.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004320050170
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  • 9
    Electronic Resource
    Electronic Resource
    A phase II study of weekly high-dose 5-fluorouracil and leucovorin plus biweekly alternating doxorubicin and cisplatin for advanced gastric carcinoma (1998)
    Springer
    Journal of cancer research and clinical oncology 124 (1998), S. 335-340 
    Details
    ISSN: 1432-1335
    Keywords: Key words Gastric carcinoma ; High-dose 5-FU ; Leucovorin ; Doxorubicin ; Cisplatin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract On the basis of recent clinical data suggesting that high-dose continuous 5-fluorouracil (5-FU) is able to overcome resistance to 5-FU bolus application in gastric carcinoma, a phase II study was performed to evaluate the activity and toxicity of weekly high-dose 5-FU and leucovorin plus biweekly alternating doxorubicin and cisplatin as the first-line treatment in patients with advanced gastric carcinoma. Between October 1995 and September 1997, 24 consecutive patients with locally advanced (n = 4) or metastatic (n = 20) gastric carcinomas were treated with a combination of 500 mg/m2 leucovorin as a 2-h infusion, followed by 2.0 g/m2 5-FU as a 24-h continuous infusion once weekly for 6 weeks, plus 20 mg/m2 doxorubicin as a bolus application and 50 mg/m2 cisplatin as a 1-h infusion, week 1, 3 and 5 (FLAP regimen). Response, toxicity and survival data were evaluated. A total of 20 patients were evaluable for response and 24 for toxicity. Objective responses were observed in 11 patients (55%) with no complete remission. Four patients (20%) showed stabilization and 5 patients (25%) experienced progressive disease. The median time to disease progression was 8 months and the overall duration of survival was 14 months. Myelosuppression was significant. In 2 patients, grade 4 WHO thrombocytopenia and leukopenia/anaemia respectively were registered, but there were no treatment-related deaths. We conclude that the weekly alternating FLAP regimen is effective in advanced gastric carcinoma with tolerable toxicity. However, significant myelotoxicity and frequent hospitalization suggest that FLAP should not be preferred to other regimens used in metastatic disease. Currently we intend to establish this regimen in the neoadjuvant setting in patients with primary unresectable localized gastric carcinomas.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004320050179
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  • 10
    Electronic Resource
    Electronic Resource
    Correlation between granulocyte/macrophage-colony-forming units and CD34+ cells in apheresis products from patients treated with different chemotherapy regimens and granulocyte-colony-stimulating factor to mobilize peripheral blood progenitor cells (1998)
    Springer
    Journal of cancer research and clinical oncology 124 (1998), S. 341-345 
    Details
    ISSN: 1432-1335
    Keywords: Key words Mobilization ; Chemotherapy ; Correlating CFU-GM and CD34+ cells
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We examined the efficiency of disease-specific “standard” chemotherapies epirubicin, cyclophosphamide (EC); cyclophosphamide, vincristine, doxorubicin, etoposide, prednisolone (CHOEP); epirubicin, ifosfamide (EPI/IFOS) for peripheral blood progenitor cell (PBPC) mobilization in comparison to well-characterized mobilization protocols, i.e. etoposide, ifosfamide, cisplatin, epirubicin (VIPE) and dexamethasone, carmustine, etoposide, cytarabine, melphalan (DexaBEAM). Twenty-seven patients with various malignancies underwent 75 apheresis procedures for PBPC collection. Median cell yields from all 75 aphereses were 1.18 × 105 mononuclear cells/kg [range (0.28–3.7) × 108], 1.4 × 105 granulocyte/macrophage-colony-forming units (CFU-GM)/kg [range (0.2–11) × 105] and 3.3 × 106 CD34+cells/kg [range (0.35–17.7) × 106. CD34+/CD90+ cells could be mobilized by all mobilization regimens used. The difference observed in the mobilization of CD34+ cells was only of low significance when the mobilization regimens were compared, whereas the mobilizations of MNC and CFU-GM were significantly different between the groups. Breast cancer patients treated with the VIPE regimen (including pretreated women) had a significantly higher CFU-GM rate than patients treated with EC (P = 0.0005). Mobilized CD34+ PBPC were correlated with CFU-GM in all apheresis products. The linear correlation coefficients differed for the various mobilization groups: DexaBEAM (r=0.9, P 〈 0.0001), VIPE (r = 0.68, P = 0.0024), CHOEP (r = 0.52, P = 0.022), EPI/IFOS (r=0.34, P=0.11) and EC (r=0.23, P=0.2). We conclude that clonogenic assays can provide additional information about the autotransplant quality, particularly when alternative or new mobilization regimens are being investigated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004320050180
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