Thomas R. Buroker

Estrogen receptor and natural course of breast cancer.

The tumors from approximately 50% of patients with breast cancer contained estrogen receptor (ER). ER appeared more often and at higher levels in the tumors of postmenopausal women. Eleven out of 12 patients who had multiple ER assays from various metastatic sites showed no significant discrepancies in ER values. ER level appears to decrease as the duration of metastatic cancer increase. Patients with ER in the tumor more frequently have bone metastases than those without ER. Visceral metastases occurred more often with ER negative patients and appeared to have a more malignant course with significant shorter survival.

5 FU infusion with mitomycin‐C vs. 5 FU infusion with methyl‐CCNU in the treatment of advanced upper gastrointestinal cancer. A Southwest oncology group study

A randomized trial was conducted by the Southwest Oncology Group (SWOG) in advanced carcinoma of the stomach and pancreas. Patients were assigned to receive monthly 5‐fluorouracil 96‐hour continuous infusions with either bolus mitomycin‐C or oral methyl‐CCNU. Mitomycin‐C and methyl‐CCNU were administered every eight weeks. The 5 FU‐mitomycin combination produced a 14% and 22% response rate in disseminated stomach and pancreatic carcinoma, respectively. The combination of infusion 5 FU and methyl‐CCNU achieved responses in 9% and 5% of stomach and pancreatic tumors, respectively. There was ho significant difference in survival between limbs for either tumor. Median survival in gastric carcinoma on the 5 FU‐mitomycin regimen was 25 weeks vs. 18 weeks on the 5 FU‐methyl‐CCNU arm. In pancreatic carcinoma median survival on the mitomycin limb was 19 weeks as compared to 17 weeks on the methyl‐CCNU program. Leukopenia was greater for the first course on the mitomycin limb. Regression analysis demonstrated that performance status was the most important pretreatment characteristic for predicting survival in both tumors. Neither 5 FU infusion combination appears to significantly alter the dismal prognosis of advanced upper gastrointestinal neoplasms.

5FU infusion with mitomycin‐C versus 5FU infusion with methyl‐CCNU in the treatment of advanced colon cancer. A southwest oncology group study

The Southwest Oncology Group (SWOG) in a randomized trial evaluated 5FU infusions in combination with either Mitomycin‐C or Methyl‐CCNU in patients with disseminated large bowel cancer. A response rate of 18% was noted on the 5FU‐Mitomycin limb as compared to 16% on the Methyl‐CCNU arm (p = .39). Median survival for all treated patients was 43 weeks on both arms. Myelosuppression was found to be more significant on the Mitomycin‐C arm. Regression analysis demonstrated that performance status, sex, and primary site were significant pretreatment characteristics for predicting survival. The response rates associated with this burdensome method of 5FU administration in combination with either Mitomycin‐C or Methyl‐CCNU appear to offer little advantage over bolus 5FU alone.

Acquired hypertrichosis lanuginosa. Report of two new cases and a review of the literature

Hypertrichosis lanuginosa is a pathologic state characterized by an excessive, new growth of fine, fetal hair. Two cases of hypertrichosis lanuginosa with malignancy (lymphoma and uterine cancer) are presented and added to the 9 in the literature. Lymphoma and uterine cancer are previously unreported as associated with hypertrichosis lanuginosa. Review of the 11 cases of hypertrichosis lanuginosa revealed the following characteristics: females were predominant; none was below the 4th decade; all had advanced neoplastic disease; all malignancies except one were of epithelial origin; and there were no demonstrable endocrine abnormalities. Despite an attempt to find etiologic factors in our patients and in the literature, none could be elicited.

Phase ii evaluation of ftorafur in previously untreated colorectal cancer: A southwest oncology group study

Eighty‐four previously untreated patients with metastatic adenocarcinoma of the large intestine received intravenous ftorafur at a dosage of 2.25 g/m2/day for 5 consecutive days. Courses were repeated every three weeks. Regressions were noted in 9 of 84 treated patients (11%). Median survival for all patients was 32 weeks. Responders survived only 5 weeks longer than nonresponders; 36 vs. 31 weeks. Central nervous system toxicity was a limiting factor occurring in one‐third of patients. Ftorafur in a daily ×5 schedule appears not to make a significant contribution to the management of disseminated colorectal cancer.