105 results on '"Fiebiger, W."'
Search Results
2. Occurrence of a pulmonary carcinoid following allogeneic stem cell transplantation for chronic myelogenous leukemia: a case report
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Fiebiger, W., Kurtaran, A., Novotny, C., Kainberger, F., Dekan, G., and Raderer, M.
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- 2003
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3. Second-Line Treatment of Advanced Colorectal Cancer with a Biweekly Oxaliplatin plus Irinotecan Combination Regimen
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Schüll, B., Kornek, G. V., Schmid, K., Raderer, M., Ulrich-Pur, H., Fiebiger, W., Schneeweiss, B., Lenauer, A., Depisch, D., and Scheithauer, W.
- Published
- 2002
4. Docetaxel as rescue medication in anthracycline- and ifosfamide-resistant locally advanced or metastatic soft tissue sarcoma: Results of a phase II trial
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Köstler, W. J., Brodowicz, T., Attems, Y., Hejna, M., Tomek, S., Amann, G., Fiebiger, W. C.C., Wiltschke, Ch., Krainer, M., and Zielinski, Ch. C.
- Published
- 2001
5. Multicenter phase II trial of dose-fractionated irinotecan in patients with advanced colorectal cancer failing oxaliplatin-based first-line combination chemotherapy
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Ulrich-Pur, H., Kornek, G. V., Fiebiger, W., Gedlicka, C., Raderer, M., Lenauer, A., Depisch, D., Lang, F., Pidlich, J., and Scheithauer, W.
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- 2001
6. Impaired response of gastric MALT-lymphoma to Helicobacter pylori eradication in patients with autoimmune disease
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Raderer, M., Österreicher, C., Machold, K., Formanek, M., Fiebiger, W., Penz, M., Dragosics, B., and Chott, A.
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- 2001
7. Subcutaneous administration of amifostine: A promising therapeutic option in patients with oxaliplatin-related peripheral sensitive neuropathy
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Penz, M., Kornek, G. V., Raderer, M., Ulrich-Pur, H., Fiebiger, W., and Scheithauer, W.
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- 2001
8. Phase II trial of two-weekly gemcitabine in patients with advanced biliary tract cancer
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Penz, M., Kornek, G. V., Raderer, M., Ulrich-Pur, H., Fiebiger, W., Lenauer, A., Depisch, D., Krauss, G., Schneeweiss, B., and Scheithauer, W.
- Published
- 2001
9. China clays for the sanitaryware production from Portugal.
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Oliveira V., Fiebiger W., Oliveira V., and Fiebiger W.
- Abstract
The expansion is discussed of the sanitary-ware industry with reference to the availability of domestic raw materials. There are 11 kaolin deposits in the country, the source rocks being lower and upper Palaeozoic granites and Precambrian gneisses. Primary deposits of hydrothermal and/or in situ origin and secondary deposits of fluvial origin are found mainly in northwest Portugal in the areas of Viana do Castelo, Braga, Porto and Aveiro. The Alvaraes and Aveiro deposits have an estimated average kaolinite content of 20% and are characterised by low Fe and Ti contents. Total production of refined kaolin is 200 000 t/y. New washing plants have been installed at Alvaraes and Vialpo. Washing and screening is used to separate the oversize +25 to + 1mm silica sand fractions. The - 1 mm fraction passes through a three-stage hydrocyclone process and the +0.3 mm and 0.045 mm underflow is separated and passed through dewatering screens. The -0.045 micron overflow is passed through a thickener and pumped to storage tanks for primary and secondary kaolin products. Final product quality is achieved by blending. The technological properties of sanitary ware kaolin SAS 50 are described., The expansion is discussed of the sanitary-ware industry with reference to the availability of domestic raw materials. There are 11 kaolin deposits in the country, the source rocks being lower and upper Palaeozoic granites and Precambrian gneisses. Primary deposits of hydrothermal and/or in situ origin and secondary deposits of fluvial origin are found mainly in northwest Portugal in the areas of Viana do Castelo, Braga, Porto and Aveiro. The Alvaraes and Aveiro deposits have an estimated average kaolinite content of 20% and are characterised by low Fe and Ti contents. Total production of refined kaolin is 200 000 t/y. New washing plants have been installed at Alvaraes and Vialpo. Washing and screening is used to separate the oversize +25 to + 1mm silica sand fractions. The - 1 mm fraction passes through a three-stage hydrocyclone process and the +0.3 mm and 0.045 mm underflow is separated and passed through dewatering screens. The -0.045 micron overflow is passed through a thickener and pumped to storage tanks for primary and secondary kaolin products. Final product quality is achieved by blending. The technological properties of sanitary ware kaolin SAS 50 are described.
- Published
- 2007
10. Treatment of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type with cladribine: a phase II study.
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Jager, G.J., Neumeister, P., Brezinschek, R., Hinterleitner, T., Fiebiger, W., Penz, M., Neumann, H.J., Mlineritsch, B., Santis, M. de, Quehenberger, F., Chott, A., Beham-Schmid, C., Hofler, G., Linkesch, W., Raderer, M., Jager, G.J., Neumeister, P., Brezinschek, R., Hinterleitner, T., Fiebiger, W., Penz, M., Neumann, H.J., Mlineritsch, B., Santis, M. de, Quehenberger, F., Chott, A., Beham-Schmid, C., Hofler, G., Linkesch, W., and Raderer, M.
- Abstract
Item does not contain fulltext, PURPOSE: As chemotherapy has not been extensively studied in patients with lymphoma of the mucosa-associated lymphoid tissue (MALT), we initiated a prospective study to evaluate the activity of the nucleoside analog cladribine (2-chlorodeoxyadenosine [2-CdA]) in this disease. PATIENTS AND METHODS: Patients with histologically verified MALT-type lymphoma were enrolled. 2-CdA was administered at a dose of 0.12 mg/kg body weight on 5 consecutive days, as a 2-hour infusion. Cycles were repeated every 4 weeks for a maximum of six cycles. RESULTS: Nineteen patients with gastric and seven patients with extragastric MALT lymphoma were enrolled. All patients were chemotherapy-naive, and two had been locally irradiated before systemic relapse of the lymphoma. A total of 102 cycles was administered to our patients (median number of cycles per patient, four). All 25 assessable patients responded to treatment: 21 patients (84%) achieved complete remission (CR) and four patients achieved partial remission. All patients (100%) with gastric presentation, but only three patients (43%) with extragastric presentation, achieved CR. Toxicities were moderate and mainly hematologic and required dose reduction and/or premature discontinuation of therapy in only three cases. Two patients died from vascular events, one shortly after the first cycle because of myocardial infarction and the other from stroke 3 months after the second course. Three patients relapsed after 13, 18, and 22 months and one patient showed progressive disease after 15 months. At present, 24 patients are alive at a median follow-up time of 32 months. CONCLUSION: Our data demonstrate that 2-CdA is highly effective in inducing CR in 84% of patients with MALT-type lymphoma.
- Published
- 2002
11. Effective combination chemotherapy with paclitaxel and cisplatin with or without human granulocyte colony-stimulating factor and/or erythropoietin in patients with advanced gastric cancer
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Kornek, G V, primary, Raderer, M, additional, Schüll, B, additional, Fiebiger, W, additional, Gedlicka, C, additional, Lenauer, A, additional, Depisch, D, additional, Schneeweiss, B, additional, Lang, F, additional, and Scheithauer, W, additional
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- 2002
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12. Phase II Study with Docetaxel and Cisplatin in the Treatment of Recurrent and/or Metastatic Squamous Cell Carcinoma of the Head and Neck
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Gedlicka, C., primary, Formanek, M., additional, Selzer, E., additional, Burian, M., additional, Kornfehl, J., additional, Fiebiger, W., additional, Cartellieri, M., additional, Marks, B., additional, and Kornek, G.V., additional
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- 2002
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13. Absence of Therapeutic Efficacy of the Somatostatin Analogue Lanreotide in Advanced Primary Hepatic Cholangiocellular Cancer and Adenocarcinoma of the Gallbladder Despite In Vivo SomatostatinReceptor Expression
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Fiebiger, W. C. C., primary, Scheithauer, W., additional, Traub, T., additional, Kurtaran, A., additional, Gedlicka, C., additional, Kornek, G. V., additional, Virgolini, I., additional, and Raderer, M., additional
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- 2002
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14. Somatostatin-receptor scintigraphy for staging and follow-up of patients with extraintestinal marginal zone B-cell lymphoma of the mucosa associated lymphoid tissue (MALT)-type
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Raderer, M, primary, Traub, T, additional, Formanek, M, additional, Virgolini, I, additional, Österreicher, C, additional, Fiebiger, W, additional, Penz, M, additional, Jäger, U, additional, Pont, J, additional, Chott, A, additional, and Kurtaran, A, additional
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- 2001
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15. Tumormarker
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Fiebiger, W., primary and Wiltschke, CH., additional
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- 2001
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16. Does pantoprazole alleviate mouth dryness in patients with Sjogren's syndrome?
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Fiebiger, W., primary
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- 2001
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17. Randomized phase II study of CPT-11 plus mitomycin C versus oxaliplatin plus mitomycin C in previously treated patients with advanced colorectal cancer (ACC)
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Ulrich-Pur, H., primary, Brugger, S., additional, Kornek, G.V., additional, Fiebiger, W., additional, Haider, K., additional, Kwasny, W., additional, Depisch, D., additional, Kovats, E., additional, Lang, F., additional, and Scheithauer, W., additional
- Published
- 1999
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18. Phase II trial of high-dose gemcitabine in patients with metastatic pancreatic adenocarcinoma
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Scheithauer, W., primary, Kornek, G., additional, Ulrich-Pur, H., additional, Raderer, M., additional, Fiebiger, W., additional, Zickero, G., additional, Pidlich, J., additional, Greul, R., additional, Schneeweiss, B., additional, and Depisch, D., additional
- Published
- 1999
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19. 5-Methyltetrahydrofolate for biochemical modulation of fluorouracil (FU) in patients with advanced colorectal cancer: A randomized phase I–II study of two different FU administration schedules
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Hejna, M., primary, Kornek, G.V., additional, Raderer, M., additional, Valencak, J., additional, Weinländer, G., additional, Fiebiger, W., additional, Miholic, J., additional, and Scheithauer, W., additional
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- 1998
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20. Reinduction therapy with the same cytostatic regimen in patients with advanced colorectal cancer.
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Hejna, M, Kornek, GV, Raderer, M, Depisch, D, Brodowicz, T, Fiebiger, WCC, Scheithauer, W, Kornek, G V, and Fiebiger, W C
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- 1998
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21. Malignancy in Slow Motion: Diagnosis of Biochemically Apparent, but Otherwise Occult Persistent Disease 21 Years After Resection of a Carcinoid Tumour of the Terminal Ileum.
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Fiebiger, W., Penz, M., Längle, F., Kurtaran, A., Oberhuber, G., and Raderer, M.
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SOMATOSTATIN , *ILEUM diseases , *PHYSIOLOGY - Abstract
Carcinoid tumors may relapse after a long time span following initial diagnosis, and relapse might be clinically inapparent despite biochemical indications due to a low sensitivity of conventional methods. We present the case of a patient who had biochemical indication for hidden disease persistence for more than two decades. In 1978, a 39-year-old man underwent surgery for a carcinoid tumour of the ileum measuring 3.5 cm with multiple local lymph-node metastases. After surgery, however, serotonin- and urinary 5-hydroxy-indole-acetic-acid (5-HIAA) remained markedly elevated, and persisted over more than 20 years at levels between 600 and 950 ng/ml for serum serotonin (normal range 40-400 ng/ml) and 29-35 mg/24 h for 5-HIAA (normal range 2-9 mg/24 h). Despite this, regular radiological follow-up, including sonography and CT-scan, did not reveal the location of suspected malignancy until 1999, when the patient was re-admitted to our hospital for a hypertensive episode. CT-scanning of the abdomen showed a singular lesion within the liver, which was verified as recurrence of the carcinoid by fine needle biopsy. Somatostatin receptor scintigraphy using [sup 111]In-DTPA-D-Phe[sup 1]-Octreotide revealed a second lesion within the liver along with local recurrence at the anastomosis, which was verified by surgery. While the propensity for late relapse of ileal carcinoids has repeatedly been demonstrated, a case with biochemical signs of disease persistence over a time span of 21 years before final diagnosis is unusual. In addition, our case reflects the low sensitivity of conventional radiological evaluation for localization of carcinoid tumours as compared to somatostatin receptor scanning. [ABSTRACT FROM AUTHOR]
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- 2001
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22. Fatal liver failure after the administration of raltitrexed for cancer chemotherapy: a report of two cases.
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Raderer, Markus, Fiebiger, Wolfgang, Wrba, Friedrich, Scheithauer, Werner, Raderer, M, Fiebiger, W, Wrba, F, and Scheithauer, W
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- 2000
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23. Implantation des nouveaux interfaces specifiques des alimentations du PSB
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Baribaud, G, Benincasa, G P, Burla, P, Carter, C, Donnat, J, Fiebiger, W, Gailloud, R, Giudici, F, Labeye, J F, Metais, M, Royer, J P, and Völker, F
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Accelerators and Storage Rings - Published
- 1979
24. Made in Portugal: innovative sanitaryware clay blends for state-of-the-art production.
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Batista S., Fiebiger W., Rocha C.M., Stentiford M., Batista S., Fiebiger W., Rocha C.M., and Stentiford M.
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The Portuguese sanitaryware industry ranks third behind Turkey and Italy in European producers. The introduction of modern production methods has resulted in most raw materials being imported. An investigation was carried out into the suitability of ball clays from the Barracao-Pombal district in central Portugal, which are comparable with deposits in Devon and Dorset in England in relation to the disordered to ordered kaolinite, micaceous minerals and quartz contents. Studies were carried out of the chemical compositions and physical and rheological properties of the ball clays, with particular reference to their slip casting characteristics. Clay blends were formulated with other raw materials in the proportion ball clay 23%, kaolin 28%, feldspar 26% and silica sand 23% and used to prepare standard bodies. The results showed that the blends were suitable for sanitaryware production., The Portuguese sanitaryware industry ranks third behind Turkey and Italy in European producers. The introduction of modern production methods has resulted in most raw materials being imported. An investigation was carried out into the suitability of ball clays from the Barracao-Pombal district in central Portugal, which are comparable with deposits in Devon and Dorset in England in relation to the disordered to ordered kaolinite, micaceous minerals and quartz contents. Studies were carried out of the chemical compositions and physical and rheological properties of the ball clays, with particular reference to their slip casting characteristics. Clay blends were formulated with other raw materials in the proportion ball clay 23%, kaolin 28%, feldspar 26% and silica sand 23% and used to prepare standard bodies. The results showed that the blends were suitable for sanitaryware production.
25. Industrial minerals in soil sealants and waste dump linings.
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Fiebiger W., Schellhorn M., Fiebiger W., and Schellhorn M.
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German consumption for 1994 in waste disposal site construction projects is forecast at a minimum of 100 000 tonnes finely-ground clays, 100 000 t bentonite products and 1 000 000 t shredded clays. For base linings the concept has been established of multiple barriers, each with its own specific function. Typical raw materials for the first sealing element, which should be present in situ, are clayey soils and clays which include a limited amount of expandable smectic minerals with a good cation-exchange capacity. The hydro-geological barrier is constructed artificially if the site base does not meet its requirements, by blending local soil with high-quality smectic clays and materials. The base lining or technical barrier is the most critical element for guaranteeing the retention of toxic fluids within the waste body; because heavy-duty polyethylene foils tend to deteriorate with time, only chemical-resistant clays with over 20% in the -2 micron fraction are allowed, while only minor amounts of materials such as smectite that may swell or shrink are allowed. Requirements for surface linings are generally identical to those for bases, with the possible use of additives such as burnt lime or coagulant-building agents. Criteria for vertical sealing walls and injection systems are more complex because of the installation characteristics needed, such as good movement of suspensions and high supporting capacity; inert fillers such as kaolinite are of major importance for their quality., German consumption for 1994 in waste disposal site construction projects is forecast at a minimum of 100 000 tonnes finely-ground clays, 100 000 t bentonite products and 1 000 000 t shredded clays. For base linings the concept has been established of multiple barriers, each with its own specific function. Typical raw materials for the first sealing element, which should be present in situ, are clayey soils and clays which include a limited amount of expandable smectic minerals with a good cation-exchange capacity. The hydro-geological barrier is constructed artificially if the site base does not meet its requirements, by blending local soil with high-quality smectic clays and materials. The base lining or technical barrier is the most critical element for guaranteeing the retention of toxic fluids within the waste body; because heavy-duty polyethylene foils tend to deteriorate with time, only chemical-resistant clays with over 20% in the -2 micron fraction are allowed, while only minor amounts of materials such as smectite that may swell or shrink are allowed. Requirements for surface linings are generally identical to those for bases, with the possible use of additives such as burnt lime or coagulant-building agents. Criteria for vertical sealing walls and injection systems are more complex because of the installation characteristics needed, such as good movement of suspensions and high supporting capacity; inert fillers such as kaolinite are of major importance for their quality.
26. The changing German market for ceramics
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Fiebiger W., Fiederling-Kapteinat H.G., Fiebiger W., and Fiederling-Kapteinat H.G.
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The current situation of the ceramic industry in Germany after unification is analysed. The analysis focuses mainly on the raw materials aspect and covers the prospects of industry development to a lesser extent., The current situation of the ceramic industry in Germany after unification is analysed. The analysis focuses mainly on the raw materials aspect and covers the prospects of industry development to a lesser extent.
27. Optimising supplies to meet ceramic market trends.
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Fiederling-Kapteinat H.G., Fiebiger W., Fiederling-Kapteinat H.G., and Fiebiger W.
- Abstract
It is essential for the raw material supplier and clay producer to keep track of the technical and economic developments, in order to condition his products in accordance with the specific and increasingly demanding needs of the customer. On the other hand, raw materials resources are not infinite and the distribution of the various qualities is not static nor are the different raw materials available at the same time. These problems are discussed., It is essential for the raw material supplier and clay producer to keep track of the technical and economic developments, in order to condition his products in accordance with the specific and increasingly demanding needs of the customer. On the other hand, raw materials resources are not infinite and the distribution of the various qualities is not static nor are the different raw materials available at the same time. These problems are discussed.
28. Zur Bekämpfung der Taenia saginata. I.: Ein Beispiel für die notwendige Zusammenarbeit von Human- und Veterinärmedizin
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Fiebiger, W., primary
- Published
- 1939
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29. Treatment of Advanced Gastric Cancer with Oral Etoposide, Leucovorin and Tegafur: Experience with an Oral Modification of the Etoposide, Leucovorin and 5-Fluorouracil (ELF) Regimen
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Raderer, M., Kornek, G. V., Hejna, M. H. L., Miholic, J., Weinlaender, G., Brodowicz, T., Fiebiger, W. C. C., Valencak, J. B., and Scheithauer, W.
- Published
- 1998
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30. Gemcitabine plus Capecitabine: An Effective Drug Combination for Advanced Pancreatic Adenocarcinoma.
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Ulrich-Pur, H., Kornek, G. V., Raderer, M., Fiebiger, W., Gedlicka, C., Schüll, B., Depisch, D., Lang, F., Schneeweiss, B., and Scheithauer, W.
- Subjects
COMBINATION drug therapy ,DRUG interactions ,DRUG dosage ,PANCREATIC cancer ,ADENOCARCINOMA ,PHARMACOKINETICS ,ANALGESICS - Abstract
Background: Preclinical evidence of a positive interaction between gemcitabine and the oral 5-FU prodrug capecitabine has been confirmed in a recently reported phase II study by Hermann et al. (Proc.ASCO 2000:267a). The present trial was initiated to investigate the efficacy and tolerance of a modified dose schedule of this particular combination in patients with advanced pancreatic cancer. Methods: Between 09/99 and 10/00, thirty-two patients with metastatic pancreatic adenocarcinoma were entered in this trial. 27 pts (10 female, 17 male) are currently evaluable for response and toxicity assessment. Their median age is 63 (40-75) years, and their median WHO performance status 1 (0-2). Eighteen patients (67%) were symptomatic at the time of initiating therapy. Treatment consisted of gemcitabine 2200 mg/m² iv on day 1 plus capecitabine 2500 mg/m²/d given orally from days 1 to 7. Courses were repeated every 2 weeks. Results: A clinical benefit response (defined as a >50% eduction in pain intensity, >50% reduction in daily analgetic consumption, and/or >1 WHO score improvement in performance status that was sustained for >4 weeks) was achieved in 9/18 (50%) symptomatic patients. Objective tumor responses (as assessed by seria CT-scans) were noted in 4/27 patients (15%), and 16 (59%) had stable disease. Median time to progression is 5.8 (1.5-10) months, and median survival has not been reached yet (>7.6 months). Therapy was generally well tolerated with a low incidence of severe, i.e., >3 WHO grade hematologic (11%) or nonhematologic (4%) toxicities. Conclusions: Our findings suggest that gemcitabine + capecitabine is a tolerable and palliatively effective combination regimen for the treatment of patients with this otherwise chemorefractory and universally fatal disease. [ABSTRACT FROM AUTHOR]
- Published
- 2001
31. Multicenter Phase II Trial of Dose-Fractionated Irinotecan in Patients with Advanced Colorectal Cancer Failing Oxaliplatin-based First-Line Combination Chemotherapy.
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Fiebiger, W., Ulrich-Pur, H., Kornek, G. V., Raderer, M., Gedlicka, C., Sch¨, B., Depisch, D., Lang, F., Pidlich, J., and Scheithauer, W.
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DRUG efficacy , *ENZYME inhibitors , *DNA topoisomerase I , *CANCER chemotherapy , *COLON cancer , *COMBINATION drug therapy , *NEUTROPENIA , *DRUG side effects - Abstract
Irinotecan is a topoisomerase I inhibitor with established anticancer activity in advanced colorectal cancer. This trial was initiated to investigate the efficacy and tolerance of a dose fractionated administration schedule in patients with advanced colorectal cancer pre-treated with fluoropyrimidine/oxaliplatin-based first-line combination chemotherapy. Methods: Thirty-eight patients with metastatic colorectal cancer, who progressed while receiving or within 6 months after withholding systemic chemotherapy with oxaliplatin in combination with 5-FU/leucovorin or the specific thymidilate synthase inhibitor raltitrexed were enrolled in this study. Treatment consisted of irinotecan 175 mg/m² given on days 1 and 10. Courses were repeated every 3 weeks for a total of 6 courses unless prior evidence of progressive disease. Results: The overall objective response rate was 21% for all 38 patients (95% CI, 9.6 to 37.4%). Stable disease was noted in 19 patients (50%), whereas the tumor progressed in 11 (29%). The median progression-free survival was 4.8 months (range, 1.5 to 10.5). After a median follow-up time of 10 months, 21 patients (55%) are still alive. Treatment was fairly well tolerated with only 9/38 patients (24%) experiencing grade 3 or 4 neutropenia. Similarly, nonhaematologie adverse reactions were generally mild; grade 3 toxicities included late-onset diarrhea in 2 (5%), alopecia in 5 (13%), and infection in 1 case (3%), respectively. Conclusions: Our data suggest that this dose fractionated irinotecan monotherapy schedule has substantial antitumor activity in patients with progressive 5-FU/leucovorin/oxaliplatin or altitrexed/oxaliplatin pre-treated colorectal cancer. Because of its favourable toxicity profile when compared to previous experiences with the European standard schedule of 350 mg/m² every 3 weeks, further evaluation of this modified regimen seems warranted. [ABSTRACT FROM AUTHOR]
- Published
- 2001
32. Treatment of Advanced Breast Cancer (ABC) with Docetaxel and Gemcitabine + Human Granulocyte Colony-Stimulating Factor (G-CSF).
- Author
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Kornek, G. V., Fiebiger, W., Raderer, M., Gedlicka, C., Schüll, B., Haider, K., Kwasny, W., Depisch, D., and Scheithauer, W.
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- *
PHARMACODYNAMICS , *CANCER chemotherapy , *BREAST cancer , *DOCETAXEL , *ANTINEOPLASTIC agents , *GRANULOCYTE-macrophage colony-stimulating factor , *DRUG efficacy , *DRUG side effects - Abstract
Background: In order to investigate the efficacy and tolerance of docetaxel in combination with gemcitabine + G-CSF in ABC we initiated a multicenter phase II trial. Methods: Fifty-two patients received a combination regimen consisting of docetaxel (50 mg/m², days 1+15) and gemcitabine (1500 mg/m², days 1+15) + G-CSF (5 mcg/kg/d, s.c.) depending on the nadir granulocyte counts. Treatment courses were repeated every 4 weeks. Results: Patients and Methods: Forty-one pts are presently evaluable for response and toxicity assessment. Twelve were pre- and 29 pts were postmenopausal. Their median age was 61 (44-75) years, and the median WHO performance status 1 (0-2). Predominant sites were visceral in 29, bone in 6 and soft-tissue in 6 pts, respectively. Eleven pts were refractory to previous 1st-line chemotherapy, all others were previously untreated. After a median of 6 (2-6) treatment courses an overall response rate of 56% including 4 CR, and 19 PR was observed. Specifically, 19/30 (63%) previously untreated pts, and 4/11 (36%) chemotherapeutically pretreated pts responded. Eleven additional pts had SD (27%) and only 7 PD (17%). The median time to response was only 2.5 (2-4.5) months. The median duration of response (>6 months), time to progression (>8 months) and survival (>13 months) with 31 pts (76%) currently alive have not been reached yet. WHO grade 3 or 4 neutropenia occurred in 6 (17%) pts each, and was complicated by septicaemia in 3 (7%). Non-hematologic side effects were generally mild to moderate, and included alopecia (68%). nausea/vomiting (63%), peripheral neuropathy (34%). tearing (31%), fatigue (47%), stomatitis (32%), peripheral edema (36%). diarrhea (24%), skin/nail reactions (36%), constipation (15%) and pathologically raised liver enzymes (27%). Conclusions: We conclude that docetaxel and gemcitabine + G-CSF is an effective and fairly well tolerated regimen for the treatment of ABC. [ABSTRACT FROM AUTHOR]
- Published
- 2001
33. In vitro cytotoxicity of novel platinum-based drugs and dichloroacetate against lung carcinoid cell lines.
- Author
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Fiebiger W, Olszewski U, Ulsperger E, Geissler K, and Hamilton G
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- Antineoplastic Combined Chemotherapy Protocols pharmacology, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Carcinoid Tumor drug therapy, Cell Cycle drug effects, Cell Cycle physiology, Cell Line, Tumor, Cell Proliferation drug effects, Cytotoxins administration & dosage, Cytotoxins pharmacology, Dichloroacetic Acid administration & dosage, Drug Evaluation, Preclinical, Drug Resistance, Neoplasm drug effects, Humans, Lung Neoplasms drug therapy, Organoplatinum Compounds administration & dosage, Organoplatinum Compounds pharmacology, Platinum Compounds administration & dosage, Carcinoid Tumor pathology, Dichloroacetic Acid pharmacology, Lung Neoplasms pathology, Platinum Compounds pharmacology
- Abstract
Introduction: Chemotherapy for advanced well-differentiated carcinoids is characterised by low response rates and short duration of responses. The present study aimed to assess the in vitro activity of novel platinum-based chemotherapeutic drugs in combination with dichloroacetate (DCA), a sensitiser to apoptosis, against lung carcinoid cell lines., Methods: Three permanent cell lines (UMC-11, H727 and H835) were exposed to 14 different established cytotoxic drugs and the novel platinum-based compounds as satraplatin, JM118 and picoplatin in combination with DCA, and viability of the cells was measured using a tetrazoliumbased dye assay., Results: With exception of the highly chemoresistant UMC- 11 line, the carcinoid cell lines (H727, H835) were sensitive to the majority of chemotherapeutics in vitro. Among the platinum-based drugs, carboplatin and oxaliplatin showed highest efficacy. H835 cells growing as multicellular spheroids were 2.7-8.7-fold more resistant to picoplatin, satraplatin and its metabolite compared to single cell suspensions. DCA (10 mM) inhibited the growth of UMC- 11 cells by 22% and sensitised these highly resistant cells to carboplatin, satraplatin and JM118 1.4-2.4-fold., Conclusion: The highly resistant UMC-11 lung carcinoid cells are sensitive to carboplatin, oxaliplatin and the satraplatin metabolite JM118, but multicellular spheroidal growth, as observed in the H835 cell line and pulmonary tumourlets, seems to increase chemoresistance markedly. The activity of carboplatin and JM118 is significantly and specifically increased in combination with the apoptosis sensitiser DCA that promotes mitochondrial respiration over aerobic glycolysis. In summary, among the novel platinum drugs satraplatin has the potential for treatment of lung carcinoids and DCA potentiates the cytotoxicity of selected platinum drugs.
- Published
- 2011
- Full Text
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34. Neuroendocrine carcinomas arising in solid-organ transplant recipients: rare but aggressive malignancies.
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Fiebiger W, Kaserer K, Rodler S, Oberbauer R, Bauer C, and Raderer M
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- Carcinoma, Neuroendocrine drug therapy, Carcinoma, Neuroendocrine mortality, Female, Humans, Male, Middle Aged, Retrospective Studies, Carcinoma, Neuroendocrine etiology, Heart Transplantation adverse effects, Kidney Transplantation adverse effects
- Abstract
Organ transplant recipients are at an increased risk of developing malignancies due to prolonged immunosuppression. However, the rate and clinical course of neuroendocrine tumors (NETs) following organ transplantation has not been assessed so far. We have retrospectively analyzed patients undergoing organ transplantation between 1985 and 2001 in order to assess the frequency and clinical course of NETs in organ transplant recipients. 3,190 organ transplant recipients with sufficient clinical data were identified (2,521 kidney and 669 heart transplants). In total, 161/3,190 patients (5%) developed malignancies, with 6 of them being classified as NETs (0.18%). Interestingly, all 6 patients were diagnosed with undifferentiated neuroendocrine carcinomas, while no indolent NETs were seen. Four of these patients had undergone renal, 1 patient heart and 1 patient both heart and renal transplantation. All 6 patients were given chemotherapy, but none of them responded, as all patients showed disease progression after a median of 3 cycles of chemotherapy (range 1-4) with the median survival being 4.8 months (range 2-11). The occurrence of NETs/undifferentiated neuroendocrine carcinomas following organ transplantation appears to be rare, with an incidence comparable with the normal population. Our data suggest a highly aggressive course with a dismal prognosis and unresponsiveness to chemotherapy., (Copyright 2009 S. Karger AG, Basel.)
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- 2009
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35. Closed suctioning system reduces cross-contamination between bronchial system and gastric juices.
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Rabitsch W, Köstler WJ, Fiebiger W, Dielacher C, Losert H, Sherif C, Staudinger T, Seper E, Koller W, Daxböck F, Schuster E, Knöbl P, Burgmann H, and Frass M
- Subjects
- Aged, Female, Humans, Male, Middle Aged, Pneumonia, Bacterial etiology, Prospective Studies, Bronchi microbiology, Equipment Contamination prevention & control, Gastric Juice microbiology, Suction instrumentation, Ventilators, Mechanical microbiology
- Abstract
In this prospective, randomized study, we evaluated whether a closed suctioning (CS) system (TrachCare) influences crossover contamination between bronchial system and gastric juices when compared with an open suctioning system (OS). The secondary aims were an analysis of the frequency of ventilator-associated pneumonia (VAP) and an analysis of alteration in gas exchange. Antibiograms were performed from tracheal secretions and gastric juice aspirates on Days 1 and 3 of intubation in 24 patients in a medical intensive care unit. Five cross-contaminations were observed in the OS group on Day 3 versus Day 1; the 5 strains shared common genotypes as determined by random amplification of polymorphic DNA. No cross-contaminations were seen in the CS group (P = 0.037). VAP occurred in 5 patients of the OS group but in none of the CS group patients (P = 0.037). Spao(2) decreased significantly in the OS group compared with presuctioning values--the opposite of the CS group. Whereas presuctioning values were comparable between groups, postsuctioning Spao(2) was significantly higher in the CS group. CS significantly reduced cross-contamination between bronchial system and gastric juices and reduced the incidence of VAP when compared with OS. Hypoxic phases can be reduced by the help of CS.
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- 2004
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36. Inhibition of platelet function by hydroxyethyl starch solutions in chronic pain patients undergoing peridural anesthesia.
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Rabitsch W, Köstler WJ, Fiebiger W, Dielacher C, Losert H, Sherif C, Staudinger T, Seper E, Koller W, Daxböck F, Schuster E, Knöbl P, Burgmann H, and Frass M
- Subjects
- Adult, Aged, Blood Platelets drug effects, Blood Platelets physiology, Chronic Disease, Colloids, Cross-Over Studies, Crystalloid Solutions, Double-Blind Method, Hemodilution, Humans, Isotonic Solutions, Middle Aged, Pain blood, Plasma Substitutes, Prospective Studies, Anesthesia, Epidural, Hydroxyethyl Starch Derivatives pharmacology, Pain Management, Platelet Aggregation Inhibitors pharmacology
- Abstract
The use of hydroxyethyl starch (HES) solutions as a fluid replacement before peridural blockade may compromise blood coagulation, thus increasing the risk of neuraxial bleeding. In this prospective, double-blind, placebo-controlled, crossover study, we compared the influence of HES 130 (molecular weight in kilodalton), HES 200, and lactated Ringer's solution on platelet function and hemodynamics in chronic low back pain patients scheduled for peridural blockades. Patients received 3 test infusions of 10 mL/kg each administered IV for 30 min. Collagen/epinephrine and collagen/adenosine diphosphate were used as agonists for assessment of platelet function analyzer-closure times. Arterial blood pressure, heart rate, platelet counts, and hemoglobin levels were documented. Platelet function analyzer-closure times remained stable after lactated Ringer's solution but were significantly prolonged after HES. The platelet-inhibiting effect of HES 200 was more than that of HES 130. Hemodynamic stability was sufficiently maintained by all test infusions. In contrast to previous observations, a relevant antiplatelet effect of both low and medium molecular weight HES solutions was found in this study in chronic pain patients undergoing peridural anesthesia. Because hemostasiological competence is a prerequisite for safe neuraxial blockade, the decision of HES for intravascular fluid administration before blockade should be critically made.
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- 2004
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37. Detection of extranodal lymphoma of mucosa-associated lymphoid tissue-type in the thyroid gland using combined x ray computed tomography/single-photon emission computed tomography technology: a case report.
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Fiebiger W, Kienast O, Dobrozemsky G, Dudczak R, Raderer M, and Kurtaran A
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- Aged, Aged, 80 and over, Female, Humans, Lymphoma, B-Cell, Marginal Zone diagnosis, Thyroid Neoplasms diagnosis, Tomography, Emission-Computed, Single-Photon instrumentation, Tomography, X-Ray Computed instrumentation
- Published
- 2004
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38. Health-related quality of life outcomes after kidney transplantation.
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Fiebiger W, Mitterbauer C, and Oberbauer R
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- Humans, Immunosuppressive Agents therapeutic use, Kidney Failure, Chronic therapy, Psychometrics instrumentation, Renal Dialysis, Sirolimus therapeutic use, Surveys and Questionnaires, Tacrolimus therapeutic use, Kidney Failure, Chronic surgery, Kidney Transplantation immunology, Outcome Assessment, Health Care methods, Quality of Life, Sickness Impact Profile
- Abstract
With the improvements in short and long term graft and patient survival after renal transplantation over the last two decades Health-Related Quality of Life (HRQL) is becoming an important additional outcome parameter. Global and disease specific instruments are available to evaluate objective and subjective QOL. Among the most popular global tools is the SF-36, examples of disease specific instruments are the Kidney Transplant Questionnaire (KTQ), the Kidney Disease Questionnaire (KDQ) and the Kidney Disease-Quality of Life (KDQOL). It is generally accepted that HRQL improves dramatically after successful renal transplantation compared to patients maintained on dialysis treatment but listed for a transplant. It is less clear however which immunosuppressive regimen confers the best QOL. Only few studies compared the different regimens in terms of QOL outcomes. Although limited in number, these studies seem to favour non-cyclosporine based protocols. The main differences that could be observed between patients on cyclosporine versus tacrolimus or sirolimus therapy concern the domains of appearance and fatigue. This may be explained by two common adverse effects occurring under cyclosporine therapy, gingival hyperplasia and hair growth. Another more frequently occurring side effect under calcineurin inhibitor therapy is tremor, which may favour CNI free protocols. This hypothesis, however, has not been formally evaluated in a randomised trial using HRQL measurements.In summary HRQL is becoming more of an issue after renal transplantation. Whether a specific immunosuppressive protocol is superior to others in terms of HRQL remains to be determined.
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- 2004
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39. Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue of the head and neck area: high rate of disease recurrence following local therapy.
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Wenzel C, Fiebiger W, Dieckmann K, Formanek M, Chott A, and Raderer M
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- Adult, Aged, Aged, 80 and over, Antineoplastic Agents therapeutic use, Combined Modality Therapy, Female, Head and Neck Neoplasms pathology, Humans, Lymph Nodes pathology, Lymphoma, B-Cell, Marginal Zone pathology, Male, Middle Aged, Radiotherapy Dosage, Remission Induction, Retrospective Studies, Treatment Outcome, Head and Neck Neoplasms therapy, Lymphoma, B-Cell, Marginal Zone therapy, Neoplasm Recurrence, Local
- Abstract
Background: Mucosa-associated lymphoid tissue (MALT) lymphoma is a distinct entity with specific clinical and pathologic features that may affect diverse organs. MALT-lymphomas remain localized within their original environment for a long period of time. As recent data have demonstrated a relatively high rate of multiorgan involvement at diagnosis, the authors have retrospectively evaluated 36 patients presenting with MALT-lymphoma in the head and neck area. The authors focused on patients' disease localization, initial treatment, clinical course, and follow-up., Methods: Thirty-six patients with a histologically verified diagnosis of an extranodal marginal zone B-cell MALT-lymphoma arising in the head and neck area were included in this retrospective analysis., Results: Treatment consisted of surgical resection as the sole treatment in 4 patients (11%), surgical resection with consecutive radiotherapy in 13 patients (36%), radiotherapy alone in 11 patients (31%), chemotherapy in 2 patients (6%), surgical resection plus radiotherapy and chemotherapy in 4 patients (11%), and combined radiation and chemotherapy in 1 patient (3%). Complete and partial disease remissions after initial treatment were achieved in 22 (61%) and 13 patients (36%), respectively, whereas one patient refused any therapy. Four patients (11%) were lost to follow-up and 15 patients (43%) have had disease recurrence after a median time of 11 months (range, 3-80 months)., Conclusions: These data suggest that MALT-lymphomas of the head and neck area are preferentially treated using local modalities such as radiation and/or resection. This practice, however, is associated with an unexpectedly high rate of dissemination or disease recurrence. Obtaining an initial complete response is crucial in these patients. According to previous data, the possibility of understaging in such patients cannot be ruled out. Clinical trials with application of systemic treatment are warranted for these patients., (Copyright 2003 American Cancer Society.DOI 10.1002/cncr.11317)
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- 2003
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40. Rituximab for treatment of advanced extranodal marginal zone B cell lymphoma of the mucosa-associated lymphoid tissue lymphoma.
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Raderer M, Jäger G, Brugger S, Püspök A, Fiebiger W, Drach J, Wotherspoon A, and Chott A
- Subjects
- Antibodies, Monoclonal immunology, Antibodies, Monoclonal, Murine-Derived, Antigens, CD20 immunology, Antineoplastic Agents immunology, Epitopes, B-Lymphocyte immunology, Female, Humans, Lymphoma, B-Cell, Marginal Zone pathology, Male, Retrospective Studies, Rituximab, Antibodies, Monoclonal therapeutic use, Antigens, CD20 drug effects, Antineoplastic Agents therapeutic use, Epitopes, B-Lymphocyte drug effects, Immunotherapy methods, Lymphoma, B-Cell, Marginal Zone drug therapy, Lymphoma, B-Cell, Marginal Zone immunology
- Abstract
Background: Extranodal marginal zone B cell lymphoma of the mucosa-associated lymphoid tissue (MALT) is a relatively common type of lymphoma. Owing to its B cell lineage, it appears to be a potential target for treatment with the CD20 antibody rituximab. We present an analysis of our experience with rituximab for treatment of patients with advanced MALT lymphoma., Patients and Methods: A retrospective analysis of patients with histologically verified MALT lymphoma undergoing treatment with rituximab was done. After reassessment of histological samples for the presence of MALT lymphoma, patients were evaluated as regards date of diagnosis, prior therapy for MALT lymphoma, sites of involvement upon treatment with rituximab, clinical response in terms of complete remission (CR), partial response (PR), stable disease (SD) and progressive disease as well as symptomatic response, duration of response and survival., Results: A total of 9 patients with advanced MALT lymphoma undergoing therapy with single-agent rituximab were identified. All patients received treatment at a dose of 375 mg/m(2) once weekly x4. One patient each had relapsed after chemotherapy and radiation, respectively, while none of the other 7 patients had received prior cytotoxic treatment or radiation. Three patients achieved a CR, 2 patients had PR for 6 and 14 months, while the remaining patients had SD between 8 and 18+ months. One patient died of progressive disease in spite of the initiation of chemotherapy and 1 patient succumbed to a cardiovascular event while having been in ongoing PR for 11 months. The other 7 patients are currently alive with disease 10-27 months after initiation of therapy. Follow-up biopsies for histological assessment were available in 5 patients with gastric lymphoma. In 1 patient with SD, however, persistence of CD20-positive cells within lymphoepithelial lesions was noted in spite of almost complete depletion of B lymphocytes from the normal gastric mucosa, suggesting either recirculation of MALT lymphoma cells to these lesions or defining lymphoepithelial lesions as a sanctuary site from rituximab penetration., Conclusion: Rituximab had only moderate activity in terms of inducing objective responses in our unselected and heterogeneous cohort of patients with disseminated MALT lymphoma. Long-term disease stabilization, however, along with a symptomatic benefit was seen in all patients. Our data nevertheless indicate that rituximab might not optimally penetrate into the gastric mucosa in all patients., (Copyright 2003 S. Karger AG, Basel)
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- 2003
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41. Treatment of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type with cladribine: a phase II study.
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Jäger G, Neumeister P, Brezinschek R, Hinterleitner T, Fiebiger W, Penz M, Neumann HJ, Mlineritsch B, DeSantis M, Quehenberger F, Chott A, Beham-Schmid C, Höfler G, Linkesch W, and Raderer M
- Subjects
- Adult, Aged, Aged, 80 and over, Antineoplastic Agents adverse effects, B-Lymphocytes, Cladribine adverse effects, Disease-Free Survival, Female, Follow-Up Studies, Humans, Lacrimal Apparatus pathology, Liver pathology, Lymphoid Tissue pathology, Lymphoma, B-Cell, Marginal Zone pathology, Male, Middle Aged, Neoplasm Staging, Parotid Gland pathology, Prospective Studies, Remission Induction, Stomach Neoplasms pathology, Survival Rate, Antineoplastic Agents therapeutic use, Cladribine therapeutic use, Lymphoid Tissue drug effects, Lymphoma, B-Cell, Marginal Zone drug therapy, Stomach Neoplasms drug therapy
- Abstract
Purpose: As chemotherapy has not been extensively studied in patients with lymphoma of the mucosa-associated lymphoid tissue (MALT), we initiated a prospective study to evaluate the activity of the nucleoside analog cladribine (2-chlorodeoxyadenosine [2-CdA]) in this disease., Patients and Methods: Patients with histologically verified MALT-type lymphoma were enrolled. 2-CdA was administered at a dose of 0.12 mg/kg body weight on 5 consecutive days, as a 2-hour infusion. Cycles were repeated every 4 weeks for a maximum of six cycles., Results: Nineteen patients with gastric and seven patients with extragastric MALT lymphoma were enrolled. All patients were chemotherapy-naive, and two had been locally irradiated before systemic relapse of the lymphoma. A total of 102 cycles was administered to our patients (median number of cycles per patient, four). All 25 assessable patients responded to treatment: 21 patients (84%) achieved complete remission (CR) and four patients achieved partial remission. All patients (100%) with gastric presentation, but only three patients (43%) with extragastric presentation, achieved CR. Toxicities were moderate and mainly hematologic and required dose reduction and/or premature discontinuation of therapy in only three cases. Two patients died from vascular events, one shortly after the first cycle because of myocardial infarction and the other from stroke 3 months after the second course. Three patients relapsed after 13, 18, and 22 months and one patient showed progressive disease after 15 months. At present, 24 patients are alive at a median follow-up time of 32 months., Conclusion: Our data demonstrate that 2-CdA is highly effective in inducing CR in 84% of patients with MALT-type lymphoma.
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- 2002
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42. Absence of therapeutic efficacy of the somatostatin analogue lanreotide in advanced primary hepatic cholangiocellular cancer and adenocarcinoma of the gallbladder despite in vivo somatostatin-receptor expression.
- Author
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Fiebiger WC, Scheithauer W, Traub T, Kurtaran A, Gedlicka C, Kornek GV, Virgolini I, and Raderer M
- Subjects
- Aged, Bile Duct Neoplasms diagnostic imaging, Cholangiocarcinoma diagnostic imaging, Female, Gallbladder Neoplasms diagnostic imaging, Gallbladder Neoplasms drug therapy, Heterocyclic Compounds, Humans, Male, Prospective Studies, Radionuclide Imaging, Radiopharmaceuticals, Somatostatin analogs & derivatives, Antineoplastic Agents therapeutic use, Bile Duct Neoplasms drug therapy, Bile Ducts, Intrahepatic diagnostic imaging, Cholangiocarcinoma drug therapy, Peptides, Cyclic therapeutic use, Receptors, Somatostatin metabolism, Somatostatin therapeutic use
- Abstract
Background: Carcinoma of the biliary system is a rare tumour entity, and patients with advanced disease face a dismal prognosis. Because of the absence of standard chemotherapy for advanced biliary carcinoma and reports of expression of receptors for somatostatin (SST), we performed a phase II study to evaluate the clinical potential of the long-acting SST analogue lanreotide (LAN) for treatment of this disease., Methods: Twenty consecutive patients with histologically verified primary hepatic cholangiocellular cancer or primary adenocarcinoma of the gallbladder were enrolled in the study. Before initiation of therapy, SST-receptor scintigraphy using 111In-DOTA-LAN was carried out in eight patients to check for in vivo expression of SST receptors. Thirty milligrams of a slow-release formulation of LAN was administered by deep intramuscular injection every 2 weeks until progression or patients wished to withdraw. Restaging by means of computed tomography was performed every 8 weeks, and response was assessed according to World Health Organisation standard criteria. In addition, weight, performance status, analgesic intake and subjective pain perception were recorded every 4 weeks, along with evaluation of tumour markers CEA and Ca 19-9., Results: Tumour sites were visualized by means of 111In-DOTA-LAN in all 8 patients. A total of 161 injections were administered, the median number per patient being 5 (range 2-36). Side effects were generally mild, only two patients complained of mild nausea and one patient had meteorism attributed to therapy. Therapeutic results, however, were disappointing, with only one patient demonstrating complete remission (CR), which lasted for 18 months before diagnosis of recurrence. Four patients had stable disease (SD) lasting between 3.5 and 9+ months accompanied by weight gain and improvement in performance status in 2 cases, while the remaining 15 patients progressed during therapy. The median time to progression was 2.5 months (range 1-18), and the median survival was 4.5 months (range 1.5-18+ months). No clear-cut correlation between scan result and therapeutic outcome could be demonstrated, as not only the patient with CR and two with SD, but also five patients with progressive disease had a positive scan result., Conclusion: Our data show that adenocarcinomas of the gallbladder and hepatic cholangiocellular carcinomas express SST receptors in vivo as judged by 111In-DOTA-LAN scintigraphy. Despite this fact, LAN did not display therapeutic activity in this study.
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- 2002
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43. Comparison of spiral-computed tomography with water-filling of the stomach and endosonography for gastric lymphoma of mucosa-associated lymphoid tissue-type.
- Author
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Vorbeck F, Osterreicher C, Püspök A, Dragosics B, Fiebiger W, Chott A, and Raderer M
- Subjects
- Adult, Aged, Endosonography, Female, Humans, Lymphoma, B-Cell, Marginal Zone pathology, Male, Middle Aged, Neoplasm Staging, Prospective Studies, Stomach diagnostic imaging, Stomach pathology, Stomach ultrastructure, Stomach Neoplasms pathology, Tomography, Spiral Computed, Lymphoma, B-Cell, Marginal Zone diagnostic imaging, Stomach Neoplasms diagnostic imaging
- Abstract
Background: Endosonography has been reported as the method of choice for local staging of patients with gastric lymphoma of mucosa-associated lymphoid tissue (MALT)-type. As endosonography is still restricted to specialized centers, we have investigated the use of spiral computed tomography of the abdomen with water-filling of the stomach (hydro-spiral CT) for enhanced contrast in patients with gastric lymphoma., Patients and Methods: Patients with a histological verified diagnosis of gastric lymphoma of MALT-type were included in this prospective series. All patients underwent routine staging procedures including endosonography of the upper GI-tract carried out by a single individual. In addition, patients were subjected to hydro-spiral CT either before or after endosonography within a maximal time span of 4 weeks. Results of hydro-spiral CT were compared to those of the endosonographic evaluation and histological work-up of biopsy specimens., Results: A total of 14 patients with primary gastric lymphoma of MALT-type (3 with a high-grade component) were studied prospectively. All patients underwent hydro-spiral CT before initiation of treatment, and 2 patients were also studied following chemotherapy. In the pretherapeutic setting, hydro-spiral CT identified gastric lymphoma in 8 patients, while a false negative result was seen in 6 patients. In addition, the localization of the lymphoma within the stomach was divergent between CT and endosonography in 1 patient. In the 2 patients who were also studied after therapy, CT showed unchanged thickening of the stomach wall in spite of normalization in the endosonographic assessment as well as the histologic evaluation., Conclusion: Our results demonstrate the superiority of endosonography over hydro-spiral CT for the staging and follow-up of patients with gastric lymphoma, who should therefore be managed at centers where endosonography is available., (Copyright 2002 S. Karger AG, Basel)
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- 2002
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44. Randomized phase II study of irinotecan plus mitomycin C vs. oxaliplatin plus mitomycin C in patients with advanced fluoropyrimidine/leucovorin-pretreated colorectal cancer.
- Author
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Scheithauer W, Kornek GV, Brugger S, Ullrich-Pur H, Valencak J, Raderer M, Fiebiger W, Kovats E, Lang F, and Depisch D
- Subjects
- Adenocarcinoma secondary, Adult, Aged, Camptothecin administration & dosage, Colorectal Neoplasms pathology, Disease Progression, Disease-Free Survival, Female, Humans, Irinotecan, Leucovorin administration & dosage, Male, Middle Aged, Mitomycin administration & dosage, Neoplasm Metastasis, Neoplasm Staging, Organoplatinum Compounds administration & dosage, Oxaliplatin, Prospective Studies, Salvage Therapy, Treatment Outcome, Adenocarcinoma drug therapy, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Camptothecin analogs & derivatives, Colorectal Neoplasms drug therapy
- Abstract
Introduction: Irinotecan and oxaliplatin are two new agents with promising activity in advanced colorectal cancer. Based on preclinical and clinical evidence that both drugs might act synergistically with mitomycin C, a randomized study using a 'pick the winner' design was undertaken to determine the effectiveness and tolerance of these two combination schedules in patients with fluoropyrimidine/leucovorin-pretreated advanced colorectal cancer., Patients and Methods: Sixty-four patients with metastatic colorectal cancer, who progressed while receiving or within 6 months after discontinuing palliative chemotherapy with fluoropyrimidines/leucovorin were enrolled onto this study. They were randomly assigned to treatment with irinotecan 120 mg/m2 on days 1 + 15 plus mitomycin C 8 mg/m2 on day 1 (arm A) or oxaliplatin 85 mg/M2 on days 1 + 15 plus mitomycin C 8 mg/m2 on day 1 (arm B). In both treatment arms, courses were repeated every 4 weeks., Results: The objective response rate in arm A is 7/33 (21.2%; 95% confidence interval, 9.0-38.9%) as compared to 5/31 in arm B (16.1%; 95% CI, 5.5-34.7%). Stable disease was noted in 48.5 vs. 45.2%, whereas the tumor progressed in 30.3 vs. 38.7%, respectively. Similar to the recorded response activities, the difference of the two combination regimens in terms of median time to progression (7.0 vs. 5.2 months) and overall survival (12.0 vs. 11.2 months) was only minor and clincally insignificant. The tolerance of treatment was acceptable in both arms, though severe adverse reactions requiring dose reductions (30 vs. 16%) and treatment delays (22 vs. 13% of courses) were more commonly noted with irinotecan/mitomycin C. The most common toxicities in arm A were neutropenia (85%; WHO grade 3/4 in 33%), thrombocytopenia (52%), diarrhea (45%), emesis (52%) and alopecia (92%). In arm B, common toxicities included neutropenia (68%; grade 3/4 in 13%), thrombocytopenia (81%), emesis (52%), and peripheral neutropathy (48%)., Conclusions: Both mitomycin C combination regimens seem to provide an acceptable therapeutic index in patients with fluoropyrimidine/leucovorin-pretreated metastatic colorectal cancer. In view of the increasing need for a broader chemotherapeutic armentarium for second-line therapy of this common malignant disease, both regimens may be worthwhile to undergo further clinical investigation.
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- 2002
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45. Randomized multicenter phase II trial of oxaliplatin plus irinotecan versus raltitrexed as first-line treatment in advanced colorectal cancer.
- Author
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Scheithauer W, Kornek GV, Raderer M, Ulrich-Pur H, Fiebiger W, Gedlicka C, Schüll B, Brugger S, Schneeweiss B, Lang F, Lenauer A, and Depisch D
- Subjects
- Adenocarcinoma mortality, Adenocarcinoma secondary, Adult, Aged, Antimetabolites, Antineoplastic therapeutic use, Antineoplastic Combined Chemotherapy Protocols adverse effects, Camptothecin administration & dosage, Colorectal Neoplasms mortality, Cross-Over Studies, Disease-Free Survival, Dose-Response Relationship, Drug, Drug Synergism, Female, Humans, Irinotecan, Male, Middle Aged, Organoplatinum Compounds administration & dosage, Oxaliplatin, Palliative Care, Quinazolines therapeutic use, Survival Rate, Thiophenes therapeutic use, Adenocarcinoma drug therapy, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Camptothecin analogs & derivatives, Colorectal Neoplasms drug therapy
- Abstract
Purpose: Irinotecan and oxaliplatin are two new agents with promising activity in advanced colorectal cancer. Based on preclinical and clinical evidence that both drugs act synergistically, a randomized phase II study was initiated to investigate the therapeutic potential and tolerance of this combination in the front-line setting., Patients and Methods: Ninety-two patients with previously untreated, measurable disease were randomized to receive biweekly oxaliplatin 85 mg/m(2) plus irinotecan 175 mg/m(2) or raltitrexed 3 mg/m(2) given on day 1 every 3 weeks. Upon development of progressive disease, second-line treatment with the opposite arm was effected., Results: Patients allocated to oxaliplatin/irinotecan had a significantly better radiologically confirmed response rate (43.5% v 19.6%; P =.0025) and longer progression-free survival (median, 7.1 v 5.0 months; P =.0033). Improvement in overall survival, however, did not reach the level of significance (median, 16.0 v 16.5 months; P =.3943). The response rate after cross-over was 33.3% (eight of 24) for assessable patients treated with oxaliplatin/irinotecan compared with 14.2% (three of 21) for those treated with second-line raltitrexed. Oxaliplatin/irinotecan caused more hematologic and gastrointestinal toxicities, necessitating dose reductions in 10 of the first 20 patients. After adjustment of the irinotecan starting dose from 175 to 150 mg/m(2), tolerance of treatment was acceptable; the most commonly encountered events (all grades) were neutropenia (81%), alopecia (65%), nausea/emesis (62%), peripheral sensory neuropathy (62%), and diarrhea (46%)., Conclusion: Oxaliplatin/irinotecan seems beneficial as first-line therapy in advanced colorectal cancer, with an acceptable toxicity profile at the reduced irinotecan dose level. Its promising therapeutic potential is supported by the high response activity noted in the raltitrexed control arm after cross-over, which may also explain the lack of a difference in overall survival.
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- 2002
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46. CD5 expression in a lymphoma of the mucosa-associated lymphoid tissue (MALT)-type as a marker for early dissemination and aggressive clinical behaviour.
- Author
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Wenzel C, Dieckmann K, Fiebiger W, Mannhalter C, Chott A, and Raderer M
- Subjects
- Aged, Antigens, Neoplasm analysis, CD5 Antigens analysis, Conjunctival Neoplasms immunology, Conjunctival Neoplasms pathology, Humans, Hypopharyngeal Neoplasms immunology, Hypopharyngeal Neoplasms pathology, Immunophenotyping, Lymphoma, B-Cell, Marginal Zone etiology, Lymphoma, B-Cell, Marginal Zone immunology, Male, Prognosis, CD5 Antigens metabolism, Lymphoma, B-Cell, Marginal Zone pathology
- Abstract
Mucosa associated lymphoid tissue (MALT) developing in response to chronic infection or autoimmune stimuli has been recognized as a possible site of origin for a distinct type of B-cell lymphoma. While preferentially occurring in the stomach, MALT-type lymphomas can be found in virtually all organs. MALT-type lymphomas normally follow an indolent course, with a tendency to remain localized at their site of origin for a prolonged period of time. Histologically, MALT-type lymphomas are heterogeneous covering a cytological spectrum ranging from centrocyte-like cells to smaller lymphoid cells or monocytoid B-cells. Usually a small number of transformed blasts are also present. Immunohistochemically, the malignant cells express markers of B-cell lineage, but are distinct from follicular lymphomas (which express CD10), mantle cell lymphomas (expressing cyclin D1 and CD5) and small lymphocytic lymphoma, which express CD5 and CD23. In contrast to the usual phenotype CD20+CD10-CD5-Cyclin D1-, scattered reports in the literature have documented expression of CD5 in marginal zone B-cell lymphomas of MALT-type. However, these cases are rare, and aberrant CD5-expression has been thought to be a marker for early dissemination and aggressive behavior in some patients, while other reports have also found CD5 expression in localized indolent MALT-type lymphomas. We report a patient with a CD5+ MALT-type lymphoma following an aggressive clinical course without histological progression who relapsed only 18 months after local radiotherapy at the initial localizations (conjunctiva of the right upper eye lid and hypopharynx), and showed a rapid generalization to the contralateral conjunctiva, mediastinal lymph nodes and the esophagogastric junction. Our case lends further support to the notion that CD5+ MALT-lymphomas arising in the head-and-neck area and/or the ocular adnexa might be characterised by an aggressive clinical course.
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- 2001
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47. Beta-2-microglobulin levels in patients with extranodal B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT)-type: a retrospective analysis.
- Author
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Penz MZ, Fiebiger WC, Valencak JB, Osterreicher C, Ba-Ssalamah A, Formanek M, Brodowic T, Chott A, and Raderer M
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Humans, Lymphoma, B-Cell, Marginal Zone pathology, Lymphoma, B-Cell, Marginal Zone therapy, Male, Middle Aged, Neoplasm Staging, Prognosis, Retrospective Studies, Treatment Outcome, Biomarkers, Tumor blood, Lymphoma, B-Cell, Marginal Zone blood, Neoplasm Proteins blood, beta 2-Microglobulin analysis
- Abstract
Background: Serum levels of beta-2 microglobulin (B2M) have been reported as a predictor of clinical outcome, prognosis and tumor burden in patients with various types of lymphomas. In case of lymphoma of the mucosa-associated lymphoid tissue (MALT)-type, no clear data exist to define the role of B2M in terms of staging or prognosis. In a retrospective analysis we investigated the serum B2M-levels in patients suffering from histologically verified MALT-type lymphoma in correlation to stage and response to treatment., Patients and Methods: All patients admitted to our institution since 1996 with a diagnosis of MALT-type lymphoma were retrospectively evaluated for staging procedures and measurements of serum B2M levels. Patients with a staging work-up including otorhinolaryngologic evaluation, gastroscopy with multiple biopsies, endosonography of the upper GI-tract, enteroclysis, colonoscopy, CT of thorax and abdomen and bone marrow biopsy were analysed, while staging was performed according to the Ann Arbor system as modified by Musshoff. In addition, only patients with histologic samples amenable to re-assessment by a reference pathologist were included., Results: A total of 68 patients with a diagnosis of MALT-type lymphoma were identified from our records. However, only in 32 patients exact staging according to our inclusion criteria had been performed and serum B2M-levels prior to the initiation of therapy were available in all these patients. Twenty-five patients; suffered from gastric lymphoma, while the remaining 7 patients had extragastric manifestations. In total, 13 out of 32 patients presented with stage I disease, 17 patients were rated as stage II and 2 patients suffered from stage III disease. Nineteen patients had elevated B2M-levels prior to therapy: 6 patients were rated as stage 1, II had stage II and two had stage III disease. Five patients still had elevated B2M-levels following treatment despite radiologically and histologically verified complete remission., Conclusion: In this series, no correlation between serum B2M levels, tumor burden and clinical outcome was apparent in patients with MALT-type lymphomas. While the number of patients with disseminated disease was small we could not demonstrate a difference for B2M-levels between stage I and stage II. While we cannot rule out that B2M might be different in patients with stage I/II disease as compared to more advanced disease, further investigations are necessary to determine the role of this marker in patients with MALT-type lymphoma.
- Published
- 2001
48. [Acceptance of and satisfaction with medical information provided to cancer patients].
- Author
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Hejna M, Köstler WJ, Tomek S, Fiebiger WC, Raderer M, Wiltschke C, and Zielinski CC
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Austria, Female, Humans, Male, Middle Aged, Neoplasms therapy, Outpatients psychology, Outpatients statistics & numerical data, Physician-Patient Relations, Surveys and Questionnaires, Neoplasms psychology, Patient Acceptance of Health Care psychology, Patient Education as Topic standards, Patient Satisfaction statistics & numerical data
- Abstract
Background: Medical information to oncologic patients about their disease as well as regularly updated information about the course of their disease and the therapeutic success are essential components of a comprehensive treatment in cancer patients., Study Goal: The quality of the patient-doctor-interaction as well as the hospital preference of oncologic patients were evaluated by a questionnaire at the Oncologic Out-Patient Clinic of the University Hospital of Vienna., Methods: 350 questionnaires containing 12 questions about medical information, anti-cancer therapy, suggestions for improvement and hospital preference were distributed. The questions were correlated with the patients' demographic and medical data., Results: Out of 350 questionnaires, 234 (67%)--160 (68%) by women and 74 (32%) by men--were returned. 75% of the patients were satisfied with the provided medical information. In contrast, 12% of patients felt incompletely informed about their particular cancer and 19% were unsatisfied with their state of information about the actual status of their disease. Our institution was mostly visited for quality-associated reasons and only in 3% for pragmatic reasons. 58% of the patients had no suggestions for improvement of medical care, although 28% of the patients wanted to spend more time with their doctors, 10% asked for more psychological care and 8% for additional alternative therapeutic modalities., Conclusion: The Oncologic Out-Patient Clinic is frequented mainly for quality-associated reasons. Although satisfaction with medical management is very high, there remains space for improvement of information about the underlying disease and its current status.
- Published
- 2001
49. Serum levels of vasoactive intestinal peptide (VIP) in patients with adenocarcinomas of the gastrointestinal tract.
- Author
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Hejna M, Hamilton G, Brodowicz T, Haberl I, Fiebiger WC, Scheithauer W, Virgolini I, Köstler WJ, Oberhuber G, and Raderer M
- Subjects
- Aged, Female, HT29 Cells, Humans, Male, Middle Aged, Tumor Cells, Cultured, Adenocarcinoma blood, Colonic Neoplasms blood, Pancreatic Neoplasms blood, Vasoactive Intestinal Peptide blood
- Abstract
Background: VIP acts as a neuroendocrine mediator under physiological conditions, with an important role in water and electrolyte secretion in the gut. Recent findings suggest that VIP also promotes growth and proliferation of normal as well as malignant cells. We have investigated the VIP-serum levels in patients with pancreatic cancer and colonic adenocarcinoma as compared to healthy controls. This was accompanied by immunohistochemical investigations and in vitro experiments to further define the role of the peptide in pancreatic and colorectal cancer., Materials and Methods: Serum levels of VIP were evaluated under standardized conditions in a total of 135 patients; 45 patients had metastatic colorectal cancer, 45 suffered from metastatic pancreatic cancer, and 45 healthy volunteers served as controls. Human pancreatic and colorectal carcinoma cell lines were incubated over 5 days with VIP in increasing concentrations., Results: In healthy controls, a median VIP-serum level of 42.44 +/- 2.540 pg/ml (range, 12.9-98.5 pg/ml) was found, while patients with pancreatic cancer had a median level of 40.58 +/- 3.013 pg/ml (range, 6.9-102.4 pg/ml). In patients with cancer originating in the colon, however, a median serum level of 116 +/- 10.14 pg/ml (range, 51.6-487 pg/ml) was found. While no difference between healthy controls and patients with pancreatic cancer could be detected (p = 0.6381), a significant difference between patients with colorectal cancer and healthy controls (p < 0.0001) and patients with pancreatic cancer (p < 0.0001) was demonstrated. The median VIP-concentrations found in the patients sera for pancreatic and colonic tumor patient groups, 40 pg/ml and 115 pg/ml respectively, had no significant effect on the proliferation of PANC-1 and HT29, inhibited ASPC-1, BxPC3, COLO201 and HCT-15 cells, and stimulated the growth of one pancreatic (CAPAN-1) and one colonic (COLO320DM) cell line under these conditions., Conclusions: As opposed to pancreatic cancer and healthy controls, patients in our series had elevated serum VIP-levels. Further studies are warranted to evaluate whether VIP can be used as a tumor marker in this disease.
- Published
- 2001
50. Spontaneous erections in a patient with erectile dysfunction after palliative chemotherapy for non-small cell lung cancer.
- Author
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Hejna M, Fiebiger WC, Reiter WJ, and Raderer M
- Subjects
- Carcinoma, Non-Small-Cell Lung complications, Erectile Dysfunction complications, Female, Humans, Lung Neoplasms complications, Male, Middle Aged, Palliative Care, Vinblastine administration & dosage, Vinorelbine, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Carcinoma, Non-Small-Cell Lung drug therapy, Cisplatin administration & dosage, Erectile Dysfunction drug therapy, Lung Neoplasms drug therapy, Vinblastine analogs & derivatives
- Abstract
Erectile dysfunction is a common problem, especially among older men. It is often caused by psychological problems, and is also the reason for pronounced impairment of psychosocial well-being. Many systemic diseases, genitourinary surgery, drugs, particularly antihypertensive and psychotropic drugs, and also chemotherapeutic agents and dexamethasone are attributed as being causes of erectile dysfunction. In our case, severe erectile dysfunction was present for 8 months before non-small cell lung cancer was diagnosed. Normal sexual function, observed for a short period immediately following chemotherapy, is a highly unusual finding and has not been published before. Chemotherapeutic agents have repeatedly been shown to result in cessation of sexual function including erection. While we cannot offer a definite explanation for our findings, undefined paraneoplastic processes leading to erectile dysfunction amenable to successful cytotoxic intervention could be a possible explanation for our observation., (Copyright 2001 S. Karger AG, Basel.)
- Published
- 2001
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