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  • 1
    ISSN: 1524-4741
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: In many parts of the United States, lymphatic mapping and sentinel lymph node biopsy has almost replaced axillary lymph node dissection (ALND) as the axillary staging procedure of choice for small, clinically node-negative breast cancers. However, the long-term outcome of patients undergoing a sentinel lymph node biopsy as the only axillary procedure in patients with tumor-free sentinel nodes remains to be determined. We present the first reported case of axillary recurrence in a patient with breast cancer following a tumor-negative sentinel lymph node biopsy. Whether sentinel lymph node biopsy can replace ALND in the management of patients with early breast cancer remains to be answered.
    Type of Medium: Electronic Resource
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  • 2
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    Oxford : Periodicals Archive Online (PAO)
    Journal of the History of Medicine and Allied Sciences. 13:1 (1958:Jan.) 111 
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  • 3
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A series of 24 experiments was carried out, in which treatment effect was determined in vivo on rats bearing measurable implants, of 13762 adenocarcinoma treated with a variety of chemotherapeutic agents, alone or in combination. In 11 experiments, a reduction in mean tumor are was observed after treatment (response) while 13 showed no such effect (no response). For each experiment, cells from tumor-bearing animals were placed in suspension culture (10 experiments) or in two-layer soft-agar culture (14 experiemnts) after 24 h of exposure to drug-containing plasma or control plasma. Cells were harvested from cultures at 24-h intervals thereafter for determination of the thymidine labeling index in treated versus control populations. The sum of labeling indices in control plasma divided by that in treated plasma was determined to combine the available data over time (overall ratio). Critical values for this ratio were defined, which demonstrated significant depression of the labeling index. Significant labeling index depression occurred in nine of 11 experiments where response in vivo occurred, and in one of 13 in which no response was seen (P=0.0004 by Fisher's exact test). When experiments carried out in soft agar culture or in suspension culture were examined separately, the association of labeling index depression in vitro and response in vivo remained statistically significant. In this model system, labeling index depression by drug-containing plasma is highly predictive of response to therapy.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Cancer chemotherapy and pharmacology 23 (1989), S. 259-262 
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Dipyridamole (DP) blocks nucleoside salvage by inhibiting uptake at the cell membrane. At the usual oral doses DP has no cytotoxic activity, but when combined with an antimetabolite, it results in synergistic cell kill in vitro. In this study, 45 patients with advanced solid tumors were treated with oral DP and i.v. or i.m. methotrexate (MTX) to define the toxicity of this combination. The DP dose was 75 mg b.i.d. in the first 16 patients, 150 mg b.i.d. in the next 2, and 75 mg q.i.d. in the remaining 27 patients. MTX was given weekly at an initial dose of 10–30 mg/m2 and increased weekly by 5–10 mg/m2 to the maximum tolerable dose (MTD) or a maximum of 60 mg/m2; thereafter that dose was given every other week. DP levels ranged from 2.76 to 11.46 μM, with a mean of 5.67 μM in four patients taking 75 mg q.i.d. The combination of oral DP and MTX was generally well tolrated and did not appear to result in any more myelotoxicity or mucositis than that expected for MTX alone. One patient experienced severe headaches related to DP, ten patients experienced grade 3 or 4 neutropenia and/or thrombocytopenia, and four patients had grade 3 mucositis. Although this trial was not designed as a phase II study, one partial remission was observed in a patient with metastatic pleomorphic adenoma of the parotid gland and seven patients showed significant improvement.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Patients with extensive small-cell lung cancer were given induction chemotherapy consisting of cyclophosphamide, vincristine, cisplatin, and etoposide (COPE) every 3 weeks for four cycles. Responding patients then received chest and elective whole-brain irradiation. Patients presenting with brain metastases received therapeutic brain irradiation during the first cycle of chemotherapy. No maintenance therapy was given, but two late intensification cycles of COPE were given at weeks 24 and 48. Among the 34 evaluable patients, the response rate to induction chemotherapy was 59%, with 10% achieving a complete response (CR) and 49%, a partial response (PR). Of the 18 patients who completed chest irradiation, 3 achieved a CR, producing an overall CR rate of 18%. Five patients completed the projected course of treatment. The median duration of response for all patients was 8 months (range, 2–30+ months) and the median survival was 9 months (range, 1–30+ months). Complete responders had a median response duration of 9 months and a median survival of 11 months. This regimen produced significant myelosuppression, with 5 neutropenic deaths (13%) occuring in the 38 patients evaluable for toxicity; an additional 16% required hospitalization for fever while neutropenic. Only six patients (13%) had nadir platelet counts of 〈50,000/mm3 with no episodes of thrombocytopenic hemorrhage. Nausea, vomiting, and neurotoxicity were mild to moderate in all patients. One patient with no evidence of disease died of radiation pneumonitis at 6 months. While producing significant toxicity, this regimen did not result in a CR rate or survival advantage that would suggest its superiority over standard regimens for small-cell lung cancer.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-0843
    Keywords: Key words Edatrexate ; Carboplatin ; Non-small-cell lung cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Edatrexate and carboplatin are each active single agents in the treatment of non-small-cell lung cancer (NSCLC). Preclinical studies in NSCLC lines have demonstrated schedule-dependent synergy of edatrexate followed by carboplatin. In a phase I trial, we demonstrated the tolerability of this combination, the ability of ice-chip cryotherapy to ameliorate dose-limiting mucositis, and promising activity in NSCLC. This phase II trial (SWOG 9207) was undertaken to investigate the efficacy of this regimen in stage IV NSCLC. Methods: A total of 24 patients with stage IV disease were accrued to this Southwest Oncology Group (SWOG) multicenter study. Treatment consisted of edatrexate 80 mg/m2 (50% dose on day 8) intravenously weekly for 5 weeks, then every other week, and carboplatin 350 mg/m2 every 28 days. Results: Of the 24 patients, 23 were assessable for toxicity and response; one was ineligible for study entry. Myelosuppression was the most significant toxicity; grade 3–4 neutropenia was seen in 8/23 patients. Two patients died of neutropenic sepsis during the first cycle of therapy, in both instances associated with the presence of pleural effusions. Although mild mucositis was common, it was dose-limiting (grade 3) in only three patients. Objective response was observed in 3/23 patients (13%). The median survival time was 7 months, and 30% of patients remained alive at one year. Conclusions: This study suggests that ice-chip cryotherapy is effective in reducing the severity of mucositis typically associated with this edatrexate schedule of administration. However, unexpectedly severe myelosuppression resulted in death from neutropenic sepsis in two patients with third space fluid collections, leading to a protocol amendment to exclude such patients from study entry. Furthermore, response and median survival with this dose schedule of edatrexate and carboplatin do not appear to be improved compared to other chemotherapeutic regimens tested by SWOG in this patient population.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Suggestions of a dose-response effect for cisplatin in non-small-cell lung cancer have contributed to the development of very high-dose cisplatin regimens (200 mg/m2 per cycle). We treated 53 eligible patients with metastatic or recurrent non-small-cell lung cancer with a combination of 100 mg/m2 cisplatin and 4 mg/m2 vinblastine, each given on days 1 and 8 of a 28-day cycle. We observed no complete response and 4 partial responses (8%). Median survival was 6 months. Toxicities of grade III or greater included leukopenia (11 cases), nausea/vomiting (6 cases), thrombocytopenia (2 cases), anemia (2 cases), and elevation of transaminase (1 case). Neurotoxicity has been reported to be a major problem in several other very high-dose cisplatin regimens. The low level of neurotoxicity observed in this study may be attributable to the median cumulative cisplatin dose of 〈600 mg/m2. This vinblastine/very high-dose cisplatin regimen showed minor activity against non-small-cell lung cancer. The level of activity did not surpass that of standard-dose (100 mg/m2 per cycle) cisplatin-containing regimens.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Cancer chemotherapy and pharmacology 1 (1978), S. 225-227 
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In a large study of combination chemotherapy for patients with extensive squamous carcinoma of the lung, 44 of 247 patients (18%) achieved〉50% regression of tumor mass. The likelihood of response was significantly (and independently) higher for females and for fully ambulatory patients. Bone and liver were the most commonly involved metastatic sites, with documented involvement pretreatment in 32 and 16% of patients, respectively. Recurrence in the ipsilateral hemithorax after radiation therapy was the only clinical evidence of disease in 24% of the patients. There were no significant differences in response rate by individual metastatic sites, or for single compared to multiple sites. The median time to response was 4 weeks, with response noted by 8 weeks in 74%. Clinically evident relapse has occurred in 39. Among these, the primary site was the only clinical site of failure in 14, of whom 7 never received radiation therapy. The brain was the only site of initial failure in 6, only 1 of whom had preexisting evidence of brain involvement. Failure in a single area of previously evident disease or the brain accounted for 74% of recurrences in the responding group. These observations suggest that sequential, planned radiation therapy to sites of previous clinical involvement, together with ‘prophylactic’ whole-brain radiation, may be of benefit in the drug-responsive subpopulation of patients with extensive disease.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    European archives of psychiatry and clinical neuroscience 185 (1950), S. 690-700 
    ISSN: 1433-8491
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Zusammenfassung 1. Die vorliegende Arbeit beschäftigt sich mit der Analyse von Augenbewegungen nach elektrischer Reizung der frontalen und occipitalen oculomotorischen Rindenregionen. 2. Die Tatsache, daß diese Regionen weit voneinander liegen, und daß innerhalb dieser Zonen eine genaue topographische Repräsentation der Augenbewegungen vorliegt, spricht für eine funktionelle Verschiedenheit, die auch durch elektrisch genau kontrollierte Reizerfolge zutage tritt. 3. Diese Unterschiede werden mit dem Parameter der Reizung, insbesondere mit der hier gebrauchten Reizfrequenz deutlich. 4. Es konnte gezeigt werden, daß Reizung einzelner Punkte des frontalen Augenfeldes mit niedrigen Frequenzen von 1 c/s bis 9–12 c/s zur konjugiertenipsilateralen Deviation der Augen führt. 5. Reizung derselben Punkte mit hohen Frequenzen (30–60 c/s) gibt ohne weiteres und immer konjugiertekontralaterale Deviation. 6. Es muß betont werden, daß die Narkose außerordentlich leicht sein muß, um diesen Reizerfolg mit niedriger Frequenz zu erhalten. 7. Unter günstigen Bedingungen ist es möglich, durch eine Veränderung der Reizfrequenz ein Verschieben der Augen von einer Seite zur anderen vom gleichen Rindenpunkt aus zu erhalten. 8. Die Latenzzeit, die für den Übergang von der kontralateralen zur ipsilateralen Richtung notwendig ist, ist wesentlich länger als beim Wechsel in der umgekehrten Richtung. Unter diesen Umständen erfolgt ipsilaterale Wendung langsamer, wenn keine Pause zwischen den Reizungen gemacht worden ist. Dies läßt die Vermutung aufkommen, daß derselbe nervöse Prozeß, der die hohe Frequenz bewirkt, auch nach Frequenzänderung noch während einiger Zeit wirksam bleibt. 9. Frequenzeffekte dieser Art werden nicht nach Erregung der occipitalen oculomotorischen Rinde gesehen. Die Blickrichtung nach Reizung hängt hier von dem Rindenpunkt und nicht von der Reizfrequenz ab. 10. Es wird vermutet, daß der Frequenzeffekt sich auf einen subcorticalen Abschnitt auswirkt, und daß die Endigungen der efferenten Bahnen, die von beiden corticalen oculomotorischen Hauptfeldern herführen, mit den Augenmuskelkernen verschiedenerweise verbunden sind.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Journal of cancer research and clinical oncology 123 (1997), S. 461-466 
    ISSN: 1432-1335
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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