melphalan and Adenocarcinoma--Mucinous

Topics: Adenocarcinoma, Mucinous; Altretamine; Antineoplastic Agents; Carcinoma, Squamous Cell; Cisplatin; Cyclophosphamide; Doxorubicin; Drug Therapy, Combination; Female; Humans; Melphalan; Neoplasm Staging; Ovarian Neoplasms; Prognosis

A multimodality treatment program has been applied to ovarian carcinoma at the Johns Hopkins Hospital since August 1975. Forty-nine patients were subdivided into 23 patients with maximally resected Stage III micrometastatic, and 26 patients with significant retained disease, 20 with Stage III macrometastatic and 6 with Stage IV. After initial pilot studies, those patients with minimally retained disease entered a randomized prospective study. Antiovarian antiserum was used in one arm of the study; in both study arms colloidal P-32, delayed split whole abdominal irradiation, and maintenance melphalan were used. For the 23 patients with micrometastatic disease the cumulative survival and survival without evidence of disease at four years is 78 and 34% respectively. Twenty-six patients with macrometastatic disease were treated with or without intraperitoneal antiserum and multiagent chemotherapy; their cumulative one year survival is 50%. The lack of significant toxicity of intraperitoneal antiovarian antiserum and the results of multimodality therapy indicate the feasibility of this therapeutic approach to further improve ovarian cancer therapy.

Topics: Adenocarcinoma, Mucinous; Altretamine; Antibodies, Neoplasm; Carcinoma; Cisplatin; Clinical Trials as Topic; Cyclophosphamide; Doxorubicin; Drug Therapy, Combination; Female; Humans; Melphalan; Ovarian Neoplasms; Ovary; Phosphorus Radioisotopes; Prospective Studies; Random Allocation

A prospective randomized trial for comparing the effects of chemotherapy and radiotherapy on survival in malignant epithelial ovarian tumours was carried out during the years 1975-1978 in 142 (90%) of a total material of 157 patients in Stage I and Stage II of this disease. Stratification was done according to the state of the tumour capsule and the type of histology found in Stages Ia and Ib. Two types of randomized treatment were given: A. Patients with no extracystic excrescences and intact tumour capsule with mucinous tumours in Stages Ia and Ib were given Melphalan or were not treated, while those with non mucinous tumours were given Melphalan or radiotherapy; B. All of the other patients with tumours in Stage I and Stage II were treated with radiotherapy alone, or were irradiated in combination with Melphalan treatment. Both of these treatment groups had about the same rates of 2- and 5-year survival. It was seen that the histological grade and the amount of residual tumour left at surgery are important prognostic factors. Postoperative treatment does not seem to improve cases of well differentiated, early mucinous tumours in Stage Ia. Acceptable results were obtained, however, irrespective of histological type, in early Stage I, moderately differentiated tumours treated with Melphalan or radiation therapy, and in well- or moderately differentiated tumours in Stage I or Stage IIa using irradiation alone or in combination with chemotherapy. Stages IIb and IIc, and all poorly differentiated tumours in Stages I and II, require more aggressive treatment.

Topics: Adenocarcinoma, Mucinous; Adult; Castration; Female; Humans; Melphalan; Middle Aged; Ovarian Neoplasms; Postoperative Care; Prospective Studies; Radiotherapy Dosage; Random Allocation

Topics: Adenocarcinoma, Mucinous; Breast Neoplasms; Carcinoma, Intraductal, Noninfiltrating; Clinical Trials as Topic; Drug Therapy, Combination; Female; Fluorouracil; Humans; Leukopenia; Lymphatic Metastasis; Mastectomy; Melphalan; Middle Aged; Neoplasm Metastasis; Neoplasm Recurrence, Local; Prospective Studies; Thrombocytopenia

Twenty-four fully staged, previously untreated patients with advanced ovarian carcinoma were prospectively randomized to either intensive intravenous cyclophosphamide or conventional oral Melphalan therapy. The median durations of initial remissions (5 and 6 mo) and the median durations of survival (15 and 14 mo) were similar for the two regimens but the toxicity of the intensive regimen was excessive. Followup indicates that long term disease free survivals are possible in those patients who achieve complete remissions on chemotherapy alone as three of the four patients achieving complete remission in the present study remain free of disease with a median survival in excess of 30 mo. High dose intensive alkylating agent therapy in the manner used in the present study fails to enhance the response to chemotherapy and produces unacceptable toxicity.

Topics: Adenocarcinoma; Adenocarcinoma, Mucinous; Administration, Oral; Cyclophosphamide; Cystadenocarcinoma; Dose-Response Relationship, Drug; Female; Humans; Injections, Intravenous; Laparoscopy; Melphalan; Ovarian Neoplasms; Remission, Spontaneous; United States

Melphalan is widely used in the chemotherapeutic treatment of an ovarian cancer. Bone marrow depression, nail change, hypersensitivity, chronic pulmonary fibrosis, and nausea and vomiting, are the side effects reported as a result of the toxicity of Melphalan. So far as we know, renal toxicity caused by Melphalan has not been reported in the past literature. A case of acute renal failure induced by Melphalan in a patient with 3rd stage ovarian cancer is presented in this paper. This therefore is the first report of renal toxicity caused by Melphalan.

Topics: Acute Kidney Injury; Adenocarcinoma, Mucinous; Aged; Female; Humans; Kidney; Melphalan; Ovarian Neoplasms

From 1980 to 1984 fifty-four patients with advanced ovarian carcinoma after operation and concluding chemotherapy with alkeran (n = 7) or cis-platin/alkeran +/- hexamethylmelamine (n = 47) as well as second-look laparotomy received follow-up radiotherapy either with the moving-strip technique (n = 35) or later the open-field technique (n = 19). 32 patients in CR received radiation therapy. 15 patients in CR are without relapse after undergoing open-field radiation therapy and a mean observation period of 25 months. At this point of time 5 of 17 patients had relapses under the moving-strip radiation treatment. The frequency of the relapses is apparently due to the very long periods of radiation and numerous interruptions in treatment. If residual tumors were present at the begin of ray therapy, a CR could only be achieved in cases where the previous monotherapy was with alkeran.

Topics: Adenocarcinoma; Adenocarcinoma, Mucinous; Adolescent; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Carcinoma; Cisplatin; Combined Modality Therapy; Endometriosis; Female; Humans; Melphalan; Middle Aged; Ovarian Neoplasms; Prognosis; Reoperation

The paper presents the results of intratumoral chemotherapy of 32 cases of single metastases of stage III-IV ovarian cancer into the Douglas pouch. The metastases were detected at different stages after primary treatment. Thiotepa, cyclophosphamide, sarcolysin and methotrexate were administered in 81.2, 9.4, 6.2 and 3.1% of cases, respectively. A clinically-significant effect was recorded in 14 out of 32 cases (43.7%); tumor process was arrested in 15 cases (46.9%); treatment failed in 3 cases (9.4%). Toxic side-effects were less frequent and pronounced than in patients given standard systemic monochemotherapy.

Topics: Adenocarcinoma; Adenocarcinoma, Mucinous; Adult; Aged; Antineoplastic Agents; Cyclophosphamide; Cystadenocarcinoma; Douglas' Pouch; Endometriosis; Female; Humans; Melphalan; Methotrexate; Middle Aged; Ovarian Neoplasms; Peritoneal Neoplasms; Thiotepa

Between 1958 and 1973, 2412 women with epithelial ovarian carcinoma were treated at Radiumhemmet. Of these tumors, 14.5 per cent were of borderline malignancy. The 5-year relative survival rate was 34 per cent among the patients with true malignant tumor and 93 per cent in the borderline cases. Even in advanced stages (IIb-IV) the 5-year survival rate was 78 per cent in the borderline cases. Advanced stage and high age at diagnosis, true malignancy and tumors of serous, clear cell or anaplastic type were associated with poor prognosis. The 5-year relative survival rate of patients with epithelial ovarian carcinoma in an early stage improved during the period, from 67 to 81 per cent.

Topics: Adenocarcinoma; Adenocarcinoma, Mucinous; Carcinoma; Endometriosis; Female; Follow-Up Studies; Humans; Melphalan; Middle Aged; Ovarian Neoplasms; Prognosis; Radiotherapy Dosage; Statistics as Topic; Time Factors

In 1970, a prospective multidisciplinary protocol was initiated for Stages I through III obviously malignant ovarian epithelial carcinomas. The planned sequential therapy included 1) surgery, 2) radiotherapy (2000 rads to whole abdomen, 3000 rad boost to pelvis), 3) chemotherapy (ten cycles of Alkeran), and 4) a "second-look" surgical procedure. Ninety-six patients were enrolled in this program through 1976. Median follow-up of the survivors was greater than 44 months. Adjusted disease-free survival was 90 percent for Stage I, 64 percent for Stages IIB--IIC, and 16 percent for Stage III. Stage III patients with no palpable tumor at time of initiation of radiation therapy had a survival of 37 percent. No Stage III patient with palpable tumor at time of initiation of radiation therapy was cured. Eight percent of patients developed small bowel obstruction requiring surgical intervention. Three percent of all patients died of hematologic causes; of the 30-month-plus survivors, 5 percent (2 of 37) developed acute myelogenous leukemia. Cure and toxicity will be examined in detail and compared with the literature.

Topics: Adenocarcinoma; Adenocarcinoma, Mucinous; Female; Humans; Intestinal Obstruction; Melphalan; Mesonephroma; Neoplasm Recurrence, Local; Neoplasm Staging; Ovarian Neoplasms; Pilot Projects; Prospective Studies; Radiotherapy; Time Factors

Topics: Adenocarcinoma, Mucinous; Cyclophosphamide; Cystadenocarcinoma; Dactinomycin; Drug Combinations; Female; Fluorouracil; Humans; Melphalan; Neoplasm Metastasis; Ovarian Neoplasms

Topics: Adenocarcinoma; Adenocarcinoma, Mucinous; Ascites; Chlorambucil; Cobalt Isotopes; Cyclophosphamide; Cystadenocarcinoma; Dactinomycin; Endometriosis; Female; Fluorouracil; Humans; Melphalan; Ovarian Neoplasms; Radiotherapy, High-Energy; Thiotepa; Vinblastine; Vincristine

Topics: Adenocarcinoma; Adenocarcinoma, Mucinous; Antineoplastic Agents; Cyclophosphamide; Cystadenocarcinoma; Dactinomycin; Female; Fluorouracil; Humans; Melphalan; Ovarian Neoplasms

Topics: Adenocarcinoma; Adenocarcinoma, Mucinous; Cyclophosphamide; Cystadenocarcinoma; Dactinomycin; Female; Fluorouracil; Humans; Mechlorethamine; Melphalan; Ovarian Neoplasms; Thiotepa; Vinblastine

Topics: Adenocarcinoma; Adenocarcinoma, Mucinous; Adenocarcinoma, Scirrhous; Antibiotics, Antineoplastic; Antineoplastic Agents; Breast Neoplasms; Carcinoma, Squamous Cell; Culture Techniques; Flavonoids; Fluorouracil; HeLa Cells; Humans; Lung Neoplasms; Melphalan; Mercaptopurine; Methods; Mitomycins; Neoplasms; Rectal Neoplasms; Stomach Neoplasms

Topics: Adenocarcinoma; Adenocarcinoma, Mucinous; Adenocarcinoma, Papillary; Adult; Female; Humans; Melphalan; Middle Aged; Ovarian Neoplasms; Palliative Care

Topics: Adenocarcinoma; Adenocarcinoma, Mucinous; Carcinoma; Drug Therapy; Humans; Kidney Neoplasms; Kidney Pelvis; Melphalan; Neoplasms; Nephrectomy