Very-high-dose cisplatin with bleomycin infusion as initial treatment of advanced head and neck cancer.

1987 ◽  
Vol 5 (10) ◽  
pp. 1594-1600 ◽  
Author(s):  
I Haines ◽  
G Bosl ◽  
D Pfister ◽  
R Spiro ◽  
F Gerold ◽  
...  
Keyword(s):  
Head And Neck ◽  
Pulmonary Function Tests ◽  
Locally Advanced ◽  
Local Therapy ◽  
High Dose ◽  
Overall Response ◽  
Squamous Cancer ◽  
Chemotherapy Patients ◽  
Very High

Fifty-one patients with locally advanced squamous cancer of the head and neck (SCHN) were treated with up to three cycles of very-high-dose cisplatin, 187.5 mg/m2 (administered over five days) in hypertonic saline, and bleomycin infusion, 60 U/m2 (administered over five days), prior to definitive local therapy, in an attempt to improve complete remission (CR) and overall response rates. After chemotherapy, patients underwent surgery if the tumor was resectable for cure, (unless the operation involved total laryngectomy), and/or locoregional radiation therapy. Twelve patients (24%) achieved CR and 23 (45%) partial remission (PR) for an overall response rate of 69%. Thirty-nine of the 51 patients are evaluable following chemotherapy and locoregional treatment, and 28 (72%) have achieved disease-free status. Seven of these 28 (25%) have subsequently relapsed. Eleven of the 51 patients (22%) have died at median follow-up of 10+ months (3+ to 24+). Nausea and vomiting (94%) was the most severe acute toxicity. Myelosuppression was mild and nephrotoxicity was effectively prevented by the 3% saline diuresis. Bleomycin was withheld in 12 of 49 (24%) because of deterioration in pulmonary function tests. Ototoxicity in 12 of 49 (25%) and neurotoxicity in 19 of 49 (39%) were the most significant long-term toxicities. Very-high-dose cisplatin and bleomycin in this study was an effective chemotherapy regimen, but not more so than more conventional doses of cisplatin. Toxicity from both drugs was significant.

scholarly journals Evaluation of Soil S Pools under 23 Years of Maize Monoculture

Agronomy ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2376
Author(s):  
Pavel Suran ◽  
Martin Kulhánek ◽  
Jiří Balík ◽  
Jindřich Černý ◽  
Ondřej Sedlář
Keyword(s):  
High Dose ◽  
The Czech Republic ◽  
S Uptake ◽  
Biomass Yields ◽  
Entire Experiment ◽  
Initial Content ◽  
Phosphorus And Potassium ◽  
Very High ◽  
Sulfur Nutrition

Sulfur nutrition is a critical part of proper crop growth and development. In our study, biomass yields (BY) and S uptake were investigated on long-term maize monoculture on haplic luvisol soil during the 23 years of this trial, as well as changes in water extractable (Sw), adsorbed (Sads), mineral (Sav), and pseudo-total S (St) fractions. Treatments used in this study are: (1) Control (Cont); (2) ammonium sulfate (AS); (3) urea and ammonium nitrate (UAN); (4) UAN + phosphorus and potassium (UAN + PK); (5) UAN + phosphorus, magnesium, sulfur (UAN + PMgS); and (6) Fallow. Recently, the Mehlich 3 method started to be used in the Czech Republic to determine content of plant available S. Using this method, it was found that the content of S extracted by Mehlich 3 (SM3) closely correlates to Sav in both topsoil and subsoil (r = 0.958 in 1997 and 0.990 in 2019, both at p < 0.001). We also found that, on average, during the entire experiment, all treatments had increased yields over Cont (135–147%) and increased S uptake (291, 192, 180, and 246% of Cont for AS, UAN, UAN + PK, and UAN + PMgS, respectively). Examining the changes from 1997 to 2019 in topsoil (0–30 cm depth), we discovered a decrease of S content in Sw, Sads, Sav, and St fractions on all treatments to an average of 34.6%, 65.8%, 42.2%, and 78.6% of their initial values. The exception was AS treatment, which doubled its initial content in mineral fractions and maintained the same levels of St, and which we attribute to the very high dose of S on this treatment (142 kg ha−1 year−1). Using the simple balance method, AS and UAN + PMgS treatments lost 142.2 and 95.3 kg S ha−1 year−1 to other sinks, except plant uptake, from the entire soil profile (0–60 cm) during 23 years of experiment. Other treatments also show significant losses with the exception of Fallow. Given these results, it is clear that content of sulfur in soil is generally decreasing and attention should be paid mainly towards minimizing of its losses.

Locally Advanced Head and Neck Cancer

2013 ◽  
pp. 237-244
Author(s):  
Anthony J. Cmelak ◽  
Kyle Arneson ◽  
Nicole G. Chau ◽  
Ralph W. Gilbert ◽  
Robert I. Haddad
Keyword(s):  
Head And Neck ◽  
Multidisciplinary Approach ◽  
Locally Advanced ◽  
Surgical Techniques ◽  
Squamous Cell Carcinomas ◽  
Advanced Head ◽  
Organ Function ◽  
Definitive Therapy

Treatment of locally advanced head and neck squamous cell carcinomas requires a multidisciplinary approach to be able to offer patients definitive therapy while aiming to preserve organ function and minimize acute and long-term toxicities. Advances in surgical techniques will be reviewed for both primary sites and the neck and also in the salvage settings. Recent data on concurrent versus sequential chemoradiotherapy in these patients will be reviewed, with emphasis on identification of appropriate patients for sequential chemoradiotherapy. Finally, advances in modern radiotherapy modalities that have resulted in improved dosimetry and quality of life following treatment will be reviewed.

Cisplatin and fluorouracil chemotherapy does not yield long-term benefit in locally advanced head and neck cancer: results from a single institution.

1991 ◽  
Vol 9 (8) ◽  
pp. 1376-1384 ◽  
Author(s):  
E E Vokes ◽  
R Mick ◽  
E P Lester ◽  
W R Panje ◽  
R R Weichselbaum
Keyword(s):  
Head And Neck Cancer ◽  
Adjuvant Chemotherapy ◽  
Head And Neck ◽  
Induction Chemotherapy ◽  
Neck Cancer ◽  
Survival Data ◽  
Locally Advanced ◽  
Local Therapy ◽  
Complete Response ◽  
Advanced Head

Fifty-one patients with locally advanced head and neck cancer were treated with three cycles of cisplatin at 100 mg/m2 followed by 5-day continuous infusion fluorouracil (5-FU) at 1,000 mg/m2/d as induction chemotherapy. Subsequent local therapy consisted of surgery for patients with resectable disease and/or radiotherapy. Three cycles of adjuvant chemotherapy were administered to patients with partial response (PR) or complete response (CR) to induction chemotherapy. Twenty-two patients (43%) had a clinical CR that was pathologically confirmed in 12 patients (24%), and 24 patients (47%) had a PR for an overall response rate of 90%. Local therapy included surgery in 24 patients (47%) and radiotherapy alone in 22 patients (43%). Adjuvant chemotherapy was administered to 32 patients (63%) frequently at great dose reduction. At a median follow-up of 90 months, the median survival is 22 months (95% confidence interval, 15 to 36 months), and the 5-year survival is 25%, with only five patients known to be alive and disease-free at this time. The median time to progression is 14 months, with 29 patients (57%) having documented progression of their head and neck cancer and eight (16%) having progression of a second neoplasm. Seven patients died of intervening medical events. This high incidence of second malignancies supports the continued investigation of chemoprevention for patients in CR. Despite the known high response rates achieved with cisplatin and 5-FU induction chemotherapy, the overall poor survival data reported here should lead to a thorough reexamination of the frequent administration of this regimen in the community.

scholarly journals Can very high-dose anti-tumor necrosis factor blockade at onset of rheumatoid arthritis produce long-term remission?

2002 ◽  
Vol 46 (7) ◽  
pp. 1971-1972 ◽  
Author(s):  
Philip G. Conaghan ◽  
Mark A. Quinn ◽  
Philip O'Connor ◽  
Richard J. Wakefield ◽  
Zunaid Karim ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Tumor Necrosis Factor ◽  
Tumor Necrosis ◽  
High Dose ◽  
Very High ◽  
Necrosis Factor

Long-Term Results of a Phase II Trial of Concomitant Cisplatin-Paclitaxel Chemoradiation in Locally Advanced Cervical Cancer

2016 ◽  
Vol 26 (6) ◽  
pp. 1162-1168 ◽  
Author(s):  
María Isabel Martínez-Fernández ◽  
Jairo Legaspi Folgueira ◽  
Germán Valtueña Peydró ◽  
Mauricio Cambeiro ◽  
Jaime Espinós ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Locally Advanced ◽  
High Dose Rate ◽  
External Beam Radiation Therapy ◽  
External Beam Radiation ◽  
Long Term Results ◽  
High Dose ◽  
External Beam ◽  
Beam Radiation

ObjectivesThe aim of this study was to determine the long-term results of a 7-week schedule of external beam radiation therapy, high dose rate brachytherapy, and weekly cisplatin and paclitaxel in patients with locally advanced carcinoma of the cervix.MethodsThirty-seven patients with International Federation of Gynecology and Obstetrics stages IB2 to IVa cervical cancer were treated with 40 mg/m2 per week of intravenous cisplatin and 50 mg/m2 per week of intravenous paclitaxel combined with 45 Gy of pelvic external beam radiation therapy and 28 to 30 Gy of high dose rate brachytherapy.ResultsSixteen patients (43.2%) were able to complete the 6 scheduled cycles of chemotherapy. The median number of weekly chemotherapy cycles administered was 5. Thirty-six (16.2%) of 222 cycles of chemotherapy were not given because of toxicity. The mean dose intensity of cisplatin was 29.6 mg/m2 per week (95% confidence interval, 27.0–32.1); that of paclitaxel was 40.0 mg/m2 per week (95% confidence interval, 36.9–43.1). Thirty-four patients (91.8%) completed the planned radiation course in less than 7 weeks. Median radiation treatment length was 43 days. After a median follow-up of 6 years, 7 patients (18.9%) experienced severe (RTOG grade 3 or higher) late toxicity. No fatal events were observed. Ten patients have failed, 1 locally and 9 at distant sites. The 14-year locoregional control rate was 96.7%, and the 14-year freedom from systemic failure rate was 64.6%. Fourteen-year actuarial disease-free survival and overall survival rates were 44.8% and 50%, respectively.ConclusionsThis study demonstrates excellent very long-term results and tolerable toxicity although the target weekly dosage of cisplatin and paclitaxel needs to be adjusted in the majority of the patients.

scholarly journals Long-Term Survival After High-Dose-Rate Brachytherapy for Locally Advanced or Recurrent Colorectal Adenocarcinoma

2015 ◽  
Vol 22 (7) ◽  
pp. 2168-2178 ◽  
Author(s):  
Stephanie Terezakis ◽  
Lisa Morikawa ◽  
Abraham Wu ◽  
Zhigang Zhang ◽  
Weiji Shi ◽  
...  
Keyword(s):  
Dose Rate ◽  
Colorectal Adenocarcinoma ◽  
Locally Advanced ◽  
High Dose Rate ◽  
High Dose ◽  
Term Survival ◽  
High Dose Rate Brachytherapy ◽  
Long Term Survival
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