RESUMEN
Purpose of this study was to evaluate the efficacy of salvage chemotherapy given to women with breast cancer in relapse who had in the past received adjuvant treatment including adriamycin. Fourty-nine evaluable patients had an adjuvant chemotherapy with CMFAV in 6 or 12 cycles. On relapse these patients received either adriamycin 40 mg/m2, mitomycin 8 mg/m2 and vinblastine 6 mg/m2 (group A) or dibromodulcitol 500 mg, mitomycin 8 mg/m2 and vinblastine 6 mg/m2 (group B). In Group A, 22 patients with a mean age of 49.2 years relapsed 14 months on average after the end of adjuvant treatment. In 11 of them the main site of relapse was visceral. In group B, 27 patients with a mean age 49.5 years relapsed 6.5 months on average after the end of adjuvant treatment. In 15 of them the main site of relapse was visceral. According to the disease-free interval (DFI), in group A with DFI less than 12 months 3 patients (23%) responded partially whereas in patients with DFI longer than 12 months 4 patients (44.4%) had a partial response. In group B with DFI less than 12 months 4 patients (21%) responded partially, whereas 2 (25%) responded with DFI longer than 12 months. We conclude that salvage chemotherapy in this group of patients with an adriamycin-containing regimen is superior to a non-adriamycin regimen only if the DFI is longer than 12 months.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/mortalidad , Doxorrubicina/administración & dosificación , Esquema de Medicación , Femenino , Humanos , Persona de Mediana Edad , Tasa de SupervivenciaRESUMEN
The enzyme activity of cancerous tissue and the adjacent normal epithelium of 40 patients with breast cancer was determined. This enzymatic activity was correlated with the responsiveness of those tumors to the chemotherapy. It was found that the presence of cytochrome oxidase and alkaline phosphatase and the absence of leucine aminopeptidase, beta-glucuronidase and dehydrogenases in cancerous tissues was related to good response. On the contrary, the absence of alkaline phosphatase and cytochrome oxidase and the presence of leucine aminopeptidase, beta-glucuronidase and dehydrogenases in the cancerous tissues was related to poor response and therefore to poor survival.
Asunto(s)
Neoplasias de la Mama/tratamiento farmacológico , Fosfatasa Alcalina/metabolismo , Aminopeptidasas/metabolismo , Neoplasias de la Mama/enzimología , Complejo IV de Transporte de Electrones/metabolismo , Femenino , Glucuronidasa/metabolismo , Histocitoquímica , Humanos , Menopausia , Persona de Mediana Edad , Oxidorreductasas/metabolismo , PronósticoRESUMEN
From July, 1978 to September, 1981, 184 patients with localy advanced breast cancer (T3; T4a-b; any N; M0) regardless of their hormonal receptor status, entered a trial to evaluate the contribution of radiotherapy when added to an intensive preoperative chemoendocrine regimen. Seventy-eight patients were ultimately disqualified. All patients underwent sequentially: (1) two cycles of chemotherapy: Day 1--Oncovin 1.4 mg/m2, cyclophosphamide 350 mg/m2, Adriamycin 30 mg/m2; Day 2--methotrexate 20 mg/m2, 5-fluorouracil 350 mg/m2 (in addition, antiestrogens were given to postmenopausal patients); (2) mastectomy with complete axillary dissection combined with oophorectomy in patients before and one year after menopause; (3) radiotherapy randomly to one-half of the patients; and (4) ten additional chemotherapy cycles as above, with antiestrogens to all patients. No serious local sequellae were encountered from mastectomy or radiotherapy, but complications of chemotherapy were numerous, particularly in irradiated patients. One death due to toxicity occurred after preoperative chemotherapy. The results to date suggest that in irradiated patients metastases may become enhanced and that their local disease is not more effectively controlled than in patients not having radiotherapy. Two factors may have been largely responsible for the differences observed between the two groups: the delay of chemotherapy in irradiated patients and the sustained immunosuppression known to occur after mediastinal radiotherapy.
Asunto(s)
Antineoplásicos/administración & dosificación , Neoplasias de la Mama/radioterapia , Anciano , Antineoplásicos/efectos adversos , Neoplasias de la Mama/patología , Neoplasias de la Mama/terapia , Ensayos Clínicos como Asunto , Ciclofosfamida/administración & dosificación , Doxorrubicina/administración & dosificación , Quimioterapia Combinada , Femenino , Fluorouracilo/administración & dosificación , Humanos , Ganglios Linfáticos/patología , Mastectomía , Metotrexato/administración & dosificación , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Distribución Aleatoria , Vincristina/administración & dosificaciónAsunto(s)
Neoplasias de la Mama/enzimología , Neoplasias de la Mama/patología , Dihidrolipoamida Deshidrogenasa/metabolismo , Complejo IV de Transporte de Electrones/metabolismo , Femenino , Humanos , Metástasis Linfática , Menopausia , Oxidorreductasas/metabolismo , Monoéster Fosfórico Hidrolasas/metabolismoAsunto(s)
Carcinoma Basocelular/cirugía , Carcinoma Basoescamoso/cirugía , Carcinoma de Células Escamosas/cirugía , Melanoma/cirugía , Neoplasias Cutáneas/cirugía , Carcinoma Basocelular/diagnóstico , Carcinoma Basoescamoso/diagnóstico , Citodiagnóstico , Humanos , Melanoma/diagnóstico , Neoplasias Cutáneas/diagnósticoRESUMEN
Some problems on excision and reconstruction in maxillofacial cancer surgery were briefly discussed and three representative cases presented. One innovation presented concerned the use of an almost circular cheek skin flap containing branches of the superficial temporalis artery preserved intact.
Asunto(s)
Carcinoma de Células Escamosas/cirugía , Neoplasias Maxilomandibulares/cirugía , Sarcoma/cirugía , Adulto , Anciano , Femenino , Humanos , Masculino , Neoplasias Mandibulares/cirugía , Neoplasias Maxilares/cirugía , Persona de Mediana Edad , Disección del Cuello , Metástasis de la Neoplasia , Recurrencia Local de Neoplasia , Neoplasias Orbitales/cirugía , Osteotomía , Trasplante de Piel , Cirugía Plástica , Técnicas de Sutura , Trasplante AutólogoRESUMEN
Protein bound serum fucose levels were measured in women with cancer of the breast and in normal women serving as controls. Thirteen healthy women gave a mean value of 13.9 plus or minus 2.4 milligrams per cent, which was not significantly different from the figure of 15.0 plus or minus 3.1 milligrams per cent obtained from 11 patients with operable cancer of the breast, Stage I and II. Only the serums from nine patients with disseminated cancer of the breast showed a significantly elevated fucose concentration of 18.8 plus or minus 3.6 milligrams per cent. It is concluded that serum fucose determination is of no diagnostic value in the early stages of cancer of the breast.