Adjuvant CMFP versus CMFP plus tamoxifen versus observation alone in postmenopausal, node-positive breast cancer patients: three-year results of an Eastern Cooperative Oncology Group study.

After mastectomy, 265 postmenopausal patients with node-positive breast cancer were stratified according to pathologic nodal status and estrogen-receptor (ER) status and randomized to receive either 12 cycles of cyclophosphamide, methotrexate, 5-fluorouracil, and prednisone (CMFP), or CMFP plus tamoxifen (CMFPT), or observation alone. Patients entered the study between March 1978 and July 1981. Cox regression analysis indicated that, compared to observation alone, chemotherapy (CMFP and CMFPT groups combined) led to a significant reduction in relapses by the end of the first year of study in every examined prognostic subgroup.

Short term high density systemic therapy for metastatic breast cancer.

Twenty-three patients with metastatic breast carcinoma were induced with a complex systemic therapy regimen in an attempt to ascertain if a complete remission rate greater than 50% could be obtained with intensive drug exposure. The durability of the remissions was observed by discontinuing therapy after 3 cycles in complete remission or after 6 cycles of treatment, whichever was longer. In 13 patients consolidation radiation therapy to the pre-treatment sites of disease was administered after discontinuing systemic therapy.

CHROMOSOME POLYMORPHISM IN GOBIUS PAGANELLUS, LINNEO 1758 (PISCES, GOBIIDAE).

In the present investigation the diploid numbers 2n = 45, 2n = 46, 2n = 47, and 2n = 48 have been determined for Gobius paganellus. Specimens of different sex were found to have exactly the same karyotype. This species is characterized by two fundamental numbers: NF = 47, and NF = 48.

Inherited aplastic anemia with abnormal clones in bone marrow and increased endoreduplication in peripheral lymphocytes.

Cytogenetic studies in peripheral blood and bone marrow cells from a female patient (aged 31 years) with inherited aplastic anemia and without other congenital anomalies are reported. Endoreduplication was increased in stimulated peripheral lymphocytes in several investigations. Chromosome breaks were shown to be near the control frequency, although chromatid exchange figures and dicentrics were present.

Cytogenetic studies in five patients with myelofibrosis and myeloid metaplasia.

Chromosome studies of five patients with myelofibrosis and myeloid metaplasia were carried out on bone marrow cells and/or on peripheral blood without PHA. Abnormal clones were found in three patients. Such clones were a minority, compared with the number of cells with normal karyotypes in all three patients.

Cisplatin, doxorubicin, cyclophosphamide, lomustine, and vincristine (PACCO) in the treatment of non-small cell bronchogenic carcinoma.

A total of 43 patients with non-small cell carcinoma from a small preliminary trial and a larger in-house study were evaluated after treatment with cisplatin (50 mg/m2), doxorubicin (50 mg/m2), cyclophosphamide (300 mg/m2), and vincristine (1.4 mg/m2), all given iv on Day 1, and lomustine (50 mg/m2) given orally on Day 1. The response rate in the larger trial was 9%, with a 95% confidence interval of 2%-24%.

Aggressive combined modality therapy for advanced local-regional breast carcinoma.

Thirty-two women with advanced local regional breast carcinoma, including nine patients with histologically diagnosed inflammatory cancer, were entered on a prospective pilot study. They were treated aggressively with initial surgery, two courses of induction chemotherapy with cyclophosphamide, methotrexate, 5-fluorouracil, +/- prednisone, +/- tamoxifen (CMF [P] [T]), local-regional radiotherapy, and then maintenance chemotherapy with CMF(P) (T) alternating with doxorubicin, vincristine, +/- tamoxifen (AV[T]). The patients have been followed for 19-70 months from the time of mastectomy and their actuarial three-year survival is 65% with a median survival that has not yet been reached.

The present dilemma of adjuvant chemotherapy: acceptance and risks versus benefits.

The acceptance of ACT has been very rapid since 1974 although earlier studies by Nissen-Meyer and the NSABP in the 1960's originally suggested the effectiveness of modest short-term chemotherapy [16, 17]. The current practice is to administer combination chemotherapy for at least 6 months in all node-positive women. The survival benefits are clearly established only for women who are premenopausal and who have fewer than three positive nodes.

[2,3-diphosphoglycerate and glycosylated hemoglobin in diabetes mellitus].

Large amounts of intraerythrocyte 2-3 diphosphoglycerate (2-3 DPG) increase red cell oxygen-releasing capacity. Since glycosylated hemoglobins, found in higher percentages in diabetics, have an increased oxygen affinity, 2-3 DPG concentration was assayed in 12 diabetics (4 I.D.

[Function of the psychiatrist in a hematology ward. Notes on consultation-liaison psychiatry].

Collaboration between Haematology and Mental Hygiene Departments of the University of Rome aims at clinical assistance, scientific research and staff training. It takes place through meetings of psychiatric consultants with haematologic patients and, above all, with doctors and paramedical staff. The psychiatrist's role takes place inside the framework of modern CLP (consultation-liaison psychiatry), whose psychosomatic approach to illness it shares, taking into consideration the complex network of interactions and feedbacks in which the relationships between doctor, patient and illness develop.

[Strain-gauge plethysmographic measurement of the systemic bioavailability of oral nitroglycerin in liver cirrhosis].

7 cirrhotic (M = 3, F = 4, mean age 55, range 35-74) and 7 healthy subjects (M = 6, F = 1, mean age 24, range 23-40) were studied. 2.5mg% nitroglycerin were administered per os.

Clinical trials and drug toxicity in the elderly. The experience of the Eastern Cooperative Oncology Group.

Nineteen studies of advanced cancer in 8 disease sites have been examined using data from the Eastern Cooperative Oncology Group. The purpose of the investigation was to determine susceptibility of elderly patients (greater than or equal to 70 years of age) to cancer chemotherapy and to compare the results with corresponding figures in control patients (less than 70 years of age). The results indicate that in general, the elderly patients have identical rates of severe toxicity as their younger counterparts.

Cooperative groups and community hospitals. Measurement of impact in the community hospitals.

The Eastern Cooperative Oncology Group, composed of major cancer treatment centers, has an outreach program which involves community hospitals in ongoing cancer clinical trials. A prevalence survey was carried out in February 1981 among 104 community hospitals and 21 member institutions to determine the characteristics of patients being treated, their staffing, and reasons why patients were not on protocol studies. The survey sampled 25 (50) consecutive patients from community hospitals (member institutions).

Experience with an automated cancer protocol surveillance system.

At an active cancer center, patients may be on a large number of different treatment protocols. Each of these protocols has its own examination, test, and treatment modification requirements. It is often difficult for the clinician to keep track of the protocol requirements on all of his patients, so elements of the protocol may be inadvertently omitted.

Combined modality treatment of regional small cell undifferentiated carcinoma of the lung: a cooperative study of the RTOG and ECOG.

Between 1975 and 1979, 271 patients with regional small cell undifferentiated (including oat cell) carcinoma of the lung were entered into a study involving treatment by radiation therapy (4500 cGy (rad) in five weeks) to the primary tumor, mediastinum and supraclavicular lymph nodes, and a randomization to receive or not receive prophylactic treatment of the brain (3000 cGy in two weeks) and a randomization to prophylactic or delayed chemotherapy (cyclophosphamide and CCNU). Analysis of the data indicates that the median survival for responders (53 weeks) was significantly longer than that of the non-responders and partial responders (37 and 34 weeks). Median survival by treatment arm was 48 weeks for thoracic irradiation (TI), brain irradiation (BI), and early chemotherapy (CT), 44 weeks for TI alone, 41 weeks for TI and CT, 38 weeks for TI and BI.

Prognostic factors in invasive gallbladder carcinoma.

The medical records of 52 patients from the University of Wisconsin Hospital and Clinics with carcinoma of the gallbladder were examined retrospectively. The cases were reviewed for factors in their medical history, presenting physical examination, laboratory data, therapy, pathological grade, and histology that might effect median survival. Only a prior complaint of anorexia, an elevated lactic dehydrogenase (LDH), or advanced pathologic stage at time of diagnosis provided significant prognostic information.

Multiple trials of adjuvant chemohormonal therapy in the treatment of breast cancer: preliminary results--the ECOG experience.

Adjuvant therapy trials in breast cancer have grown steadily more complex since 1971, when the first long-term adjuvant trial in the United States was initiated. From L-PAM alone or in combination with a few other cytotoxic agents, ECOG protocols have expanded to consider different multidrug combinations with tamoxifen and other endocrine agents, administered for various lengths of time, sometimes alternating between two combinations. Nevertheless, we are still in the gestational stages of adjuvant studies, with many critical questions yet to be answered.