Adjuvant radiotherapy and chemotherapy in node-positive premenopausal women with breast cancer.

Background: Radiotherapy after mastectomy to treat early breast cancer has been known since the 1940s to reduce rates of local relapse. However, the routine use of postoperative radiotherapy began to decline in the 1980s because it failed to improve overall survival. We prospectively tested the efficacy of combining radiotherapy with chemotherapy.

Phase I/II trial of biweekly paclitaxel and cisplatin in the treatment of metastatic breast cancer.

Purpose: To determine the maximum-tolerated dose of escalating doses of paclitaxel (Taxol; Bristol-Myers Squibb, Princeton, NJ) administered biweekly with a fixed dose of cisplatin, to assess the toxicity, and to evaluate the activity of this combination in a phase I/II trial in metastatic breast cancer.

Patients And Methods: Twenty-nine women with metastatic breast cancer were enrolled; 27 were assessable for response and 29 for toxicity. All but two of the women had received prior adjuvant chemotherapy, with 23 receiving anthracyclines and six previous cisplatin.

Metastatic extraskeletal myxoid chondrosarcoma. Successful therapy with interferon alfa-2b.

A patient with pulmonary metastatic extraskeletal myxoid chondrosarcoma (EMC), of unknown cause, responded dramatically to 16 months of therapy with interferon alfa-2b. This is the first report of a significant response of a patient with EMC to this novel treatment approach.

Adjuvant systemic therapy and survival after breast cancer.

Background And Methods: We examined the effect of adjuvant systemic therapy on survival after breast cancer among the residents of the Canadian province of British Columbia. Data on survival were collected for all women in whom breast cancer was diagnosed in British Columbia during each of three calendar years chosen to represent different province-wide treatment recommendations: 1974, when no adjuvant systemic therapy was recommended; 1980, when adjuvant chemotherapy was recommended only for premenopausal women with node-positive disease; and 1984, when adjuvant chemotherapy was also recommended for premenopausal women with node-negative disease and lymphatic, vascular, or neural invasion and tamoxifen was recommended for postmenopausal women with involved lymph nodes or lymphatic, vascular, or neural invasion unless their tumors were negative for estrogen receptors.

Results: For women less than 50 years of age, disease-specific survival at seven years (i.

Phase I trial of recombinant human granulocyte-macrophage colony-stimulating factor derived from yeast in patients with breast cancer receiving cyclophosphamide, doxorubicin, and fluorouracil.

Purpose: To establish the optimum biologic dose and maximal-tolerated dose (MTD) of once-daily, subcutaneous recombinant human granulocyte-macrophage colony-stimulating factor derived from yeast (RhuGM-CSF) in patients with breast cancer.

Patients And Methods: Seventeen patients with either newly diagnosed breast cancer with more than four involved axillary nodes (five patients) or metastatic breast cancer (12 patients) were treated with cyclophosphamide 1 g/m2, doxorubicin 50 mg/m2, and fluorouracil 500 mg/m2 (CAF) intravenously (IV) once every 3 weeks. RhuGM-CSF was administered subcutaneously once daily for 14 days after the second and third CAF cycles, at one of three dose levels.

Treating the treatment: toxicity of cancer chemotherapy.

Many cancer chemotherapeutic agents can produce toxicity, even at the usual therapeutic doses. Family physicians are often called upon to treat symptoms of these toxicities and to advise patients about them. This brief discussion may help family physicians to anticipate some of the problems, to avoid some, and to manage others more effectively.

Klebsiella infection in a neonatal intensive care unit.

Fourteen infants in a Neonatal Intensive Care Unit became colonized with Klebsiella pneumoniae. Ten developed septicaemia. All infants survived the acute infection.

Bacille Calmette-Guérin as maintenance therapy for non-Hodgkin's lymphoma.

Following complete remission of non-Hodgkin's lymphoma by chemotherapy, irradiation or both, 44 patients were studied to assess the value of bacille Calmette-Guérin (BCG) as maintenance therapy. Patients with stage LI, EI or EII disease were allocated at random to receive BCG or no further maintenance therapy, and those with stage LII, LIII, EIII or IV disease received BCG therapy or orally administered cyclophosphamide. BCG had no effect on the duration of remission or the overall survival from the time of randomization.

Observations in immunotherapy of lymphoma and melanoma patients.

Maintenance of remission solely by repeated BCG vaccinations in seven patients with non-Hodgkin's lymphoma who had achieved a complete clinical remission with initial standard therapy has provided sufficient encouragement to begin a randomized clinical trial. In vitro lymphocyte responses to mitogens and PPD used as parameters of cell-mediated immunity have not proved to be of value in predicting early or late recurrence in six pre-trial and trial patients. Eight out of twenty-one patients with malignant melanoma have shown a satisfactory clinical response (10-34 months) to immunotherapy.

Hairy cell leukemia.

The clinical findings in 12 patients with an unusual type of leukemia have been reviewed. The leukemic cell cannot be identified with any of the normal hematopoietic cells or with any of the lymphomas and may best be referred to by the descriptive term "hairy cell", which describes its appearance, most clearly seen on phase contrast microscopy. The patients were all males and the major clinical features were enlargement of the liver and spleen, with little lymph node enlargement.