Biomedical subjects

A C van den Bergh

Publications and source records attributed to A C van den Bergh.

5 recordsLinked to original sources

PubMed2001

The morbidity of treatment for patients with Stage I endometrial cancer: results from a randomized trial.

PURPOSE: To compare the treatment complications for patients with Stage I endometrial cancer treated with surgery and pelvic radiotherapy (RT) or surgery alone in a multicenter randomized trial. METHODS AND MATERIALS: The Postoperative Radiation Therapy in Endometrial Carcinoma (PORTEC) trial included patients with endometrial cancer confined to the uterine corpus, either Grade 1 or 2 with more than 50% myometrial invasion, or Grade 2 or 3 with less than 50% myometrial invasion. Surgery consisted of an abdominal hysterectomy and oophorectomy, without lymphadenectomy. After surgery, patients were randomized to receive pelvic RT (46 Gy), or no further treatment. A total of 715 patients were randomized. Treatment complications were graded using the French-Italian glossary. RESULTS: The analysis was done at a median follow-up duration of 60 months. 691 patients were evaluable. Five-year actuarial rates of late complications (Grades 1-4) were 26% in the RT group and 4% in the control group (p < 0.0001). Most were Grade 1 complications, with 5-year rates of 17% in the RT group and 4% in the control group. All severe (Grade 3-4) complications were observed in the RT group (3%). Most complications were of the gastrointestinal tract. The symptoms resolved after some years in 50% of the patients. Grade 1-2 genitourinary complications occurred in 8% of the RT patients, and 4% of the controls. Bone complications occurred in 4 RT patients (1%). Seven patients (2%) discontinued their RT due to acute RT-related symptoms. Patients with acute morbidity had an increased risk of late RT complications (p = 0.001). The 4-field box technique was associated with a lower risk of late complications (p = 0.06). CONCLUSION: Pelvic RT increases the morbidity of treatment in Stage I endometrial cancer. In the PORTEC trial, severe complications occurred in 3% of treated patients, and over 20% experienced mild (mostly Grade 1) symptoms. Patients with acute RT-related morbidity had an increased risk of late complications. As pelvic RT in Stage I endometrial carcinoma was shown to significantly reduce the rate of locoregional recurrence, but without a survival benefit, its use in the adjuvant setting requires careful patient selection (treating those at increased risk of relapse), and the use of treatment schemes with the lowest risk of morbidity.

Aged↗

PubMed2000

Surgery and postoperative radiotherapy versus surgery alone for patients with stage-1 endometrial carcinoma: multicentre randomised trial. PORTEC Study Group. Post Operative Radiation Therapy in Endometrial Carcinoma.

BACKGROUND: Postoperative radiotherapy for International Federation of Gynaecology and Obstetrics (FIGO) stage-1 endometrial carcinoma is a subject of controversy due to the low relapse rate and the lack of data from randomised trials. We did a multicentre prospective randomised trial to find whether postoperative pelvic radiotherapy improves locoregional control and survival for patients with stage-1 endometrial carcinoma. METHODS: Patients with stage-1 endometrial carcinoma (grade 1 with deep [> or =50%] myometrial invasion, grade 2 with any invasion, or grade 3 with superficial [<50%] invasion) were enrolled. After total abdominal hysterectomy and bilateral salpingo-oophorectomy, without lymphadenectomy, 715 patients from 19 radiation oncology centres were randomised to pelvic radiotherapy (46 Gy) or no further treatment. The primary study endpoints were locoregional recurrence and death, with treatment-related morbidity and survival after relapse as secondary endpoints. FINDINGS: Analysis was done according to the intention-to-treat principle. Of the 715 patients, 714 could be evaluated. The median duration of follow-up was 52 months. 5-year actuarial locoregional recurrence rates were 4% in the radiotherapy group and 14% in the control group (p<0.001). Actuarial 5-year overall survival rates were similar in the two groups: 81% (radiotherapy) and 85% (controls), p=0.31. Endometrial-cancer-related death rates were 9% in the radiotherapy group and 6% in the control group (p=0.37). Treatment-related complications occurred in 25% of radiotherapy patients, and in 6% of the controls (p<0.0001). Two-thirds of the complications were grade 1. Grade 3-4 complications were seen in eight patients, of which seven were in the radiotherapy group (2%). 2-year survival after vaginal recurrence was 79%, in contrast to 21% after pelvic recurrence or distant metastases. Survival after relapse was significantly (p=0.02) better for patients in the control group. Multivariate analysis showed that for locoregional recurrence, radiotherapy and age below 60 years were significant favourable prognostic factors. INTERPRETATION: Postoperative radiotherapy in stage-1 endometrial carcinoma reduces locoregional recurrence but has no impact on overall survival. Radiotherapy increases treatment-related morbidity. Postoperative radiotherapy is not indicated in patients with stage-1 endometrial carcinoma below 60 years and patients with grade-2 tumours with superficial invasion.

Adenocarcinoma↗

PubMed1999

[A strontium-89 injection: a simple treatment of painful bone metastases in patients with prostate cancer unresponsive to hormonal treatment].

Four patients (men aged 75, 67, 65 and 69 years) with painful osseous metastases from prostate cancer were treated by intravenous radionuclide therapy using Strontium-89. All had secondary progression after initially successful hormonal treatment. Three of these four had good responses lasting from 5 to 9 months. One patient with rapidly progressive disease did not respond. Second and third injections were successful in two patients. Mild bone marrow suppression was observed in all, but was not clinically significant. The 70-80% chance of long-lasting pain alleviation through a single injection of Strontium-89 is a valuable addition in the treatment of painful bone metastases from prostate cancer, and probably also in such metastases from breast cancer.

Aged↗

PubMed1994

The influence of respiration induced motion of the kidneys on the accuracy of radiotherapy treatment planning, a magnetic resonance imaging study.

An MRI study has been performed to determine the respiration induced motion of the kidneys. Under normal respiration conditions displacements of the left and right kidney varied from 2 to 24 mm and 4 to 35 mm, respectively. Under forced respiration conditions displacements were larger and ranged from 10 to 66 mm for the left kidney and 10 to 86 mm for the right kidney. The influence of kidney motion on the radiation dose was determined for patients irradiated on the total abdomen for ovarian cancer with shielding of the kidneys during part of the treatment. The kidney motion resulted in a larger fraction of the kidney volume receiving a dose between 20 and 22 Gy.

Adult↗

PubMedDate not supplied

Forced oscillation technique. Reference values for resistance and reactance over a frequency spectrum of 2-26 Hz in healthy children aged 2.3-12.5 years.

The forced pseudo-random noise oscillation technique is a method by which total respiratory resistance (Rrs) and reactance (Xrs) can be measured simultaneously at various frequencies by means of complex oscillations, superimposed at the mouth during spontaneous quiet breathing. Reference values were obtained in 255 healthy Caucasian children of Dutch descent aged 2.3-12.5 years. Rrs and Xrs vs frequency (f) curves are mainly determined by the child's sex, age, height and weight. Taking complete Rrs and Xrs-f curves into account, we found that Rrs values were significantly higher in young boys than in young girls. They were equal at about 8 years, but at about 12 years of age Rrs values were again significantly higher in boys than in girls. Frequency dependence of Rrs was found in healthy boys up to about 5 years of age, but not in girls of the same age or in older children. These data suggest differences in airway diameter between boys and girls. At all ages Xrs was significantly lower in boys than in girls. This suggests differences in bronchial patency of peripheral airways, boys being at a disadvantage. It is concluded that multiple frequency oscillometry is a method which is ideal for children from the age of about 3 years. The possibility of measuring Rrs as well as frequency dependence of Rrs and Xrs simultaneously is the major advantage over other oscillation devices.

Adolescent↗