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Biomedical subjects

A H Tierie

Publications and source records attributed to A H Tierie.

At least 19 recordsLinked to original sources
PubMed1989

Adenoid cystic carcinoma of the salivary glands: clinicopathological survey of 51 patients.

A clinicopathological study of 51 cases of adenoid cystic carcinoma in the head and neck region seen over a period of 20 years is presented. The correlation between various histological features and their impact on the results is attempted. Longterm results with respect to loco-regional recurrences, distant metastases and survival with various modalities of therapy are presented. Although this is a small series, radical surgery in keeping with the aim of avoiding undue mutilation, thus preserving the quality of life, followed by a full course of radiotherapy has been the mainstay of treatment and the results here presented justify this approach.

Adult↗
PubMed1988

Combined radiation therapy and daily low-dose cisplatin for inoperable, locally advanced non-small cell lung cancer: results of a phase II trial.

The Free University Hospital in Amsterdam conducted a phase II trial on inoperable patients with non-small cell lung cancer (NSCLC) to evaluate the role of cisplatin as a radiosensitizer. Forty patients were entered into the study. Thirty-three patients were evaluable for response and 37 for toxicity. The regimen consisted of the daily administration of cisplatin 6 mg/m2 administered within 30 minutes after each radiation therapy session. The radiation therapy modality was a regimen of 300 cGy four times per week for 4 weeks with a 2-week split in between, administering a total dose of 48 Gy. The overall response rate was 65%; median duration of control of local disease was 7 months, and overall survival was 10.5 months. Toxicity was considered to be mild. The results appear similar to data using radiation therapy alone; however, the optimum dosing and timing of this combination therapy has not been determined and deserves further clinical studies.

Carcinoma, Non-Small-Cell Lung↗
PubMed1987

Intravenous urography as a prognostic indicator in vesical carcinoma.

A retrospective analysis of 1378 cases of urinary bladder tumor, showed that unilateral or bilateral ureteric obstruction seen on an intravenous urogram at presentation, was significantly associated with both decreased overall survival and tumor-free interval. A tumor shadow shown on standard projections did not correlate with survival. At 24 months only 35% of the ureteric obstruction group were tumor-free as compared with 65% of the unobstructed group. Survival at 5 years was 27% in the obstructed ureter group and 73% in the non-obstructed group. This difference although less marked, persists at 9-year follow-up.

Adult↗
PubMed1987

Heterogeneity of stage II glottic carcinoma and its therapeutic implications.

The heterogeneity of glottic carcinoma results in variable loco-regional control probabilities from 40 to 80%. These widely different results may be due to two prognostic parameters of the tumor: the mobility of the vocal cord and the volume of the tumor. On the other hand radiation dose and technique may influence the treatment results. Stringent work-up has been prospectively undertaken in 156 patients with Stage II glottic carcinoma since 1974 through 1983 in the Academic Hospital of the Free University in Amsterdam. Several subgroups were defined from the beginning to indicate one or both of these prognostic factors. All were treated with a high quality accurate radiation therapy program delivering high dose to all patients with worse prognostic factors and even higher dosages to voluminous tumors with impaired mobility of a cord or slowly regressing tumors. The latter was individually judged for each patient towards the end of the treatment period. The loco-regional control probability of around 80% for all the subgroups irrespective of the prognostic factors indicate that the heterogeneity of Stage II glottic cancer may be influenced by high dosages of quality controlled radiotherapy. Thus results hitherto reported in literature may be further improved by the dose-schedules outlined here.

Adult↗
PubMed1987

Radiation therapy for advanced (T3T4N0-N3M0) laryngeal carcinoma: the need for a change of strategy: a radiotherapeutic viewpoint.

Since 1974 through 1984, 137 selected patients with loco-regionally advanced carcinoma of the larynx (T3T4 N0-N3) were treated primarily with quality controlled high dose megavoltage radiation therapy with salvage surgery in reserve. This policy of treatment has yielded 67% loco-regional control probability with primary radiotherapy and 85% with salvage surgery at 3 years. Fourteen patients (14/38) had moderate to severe complications after salvage surgery. The quality of life of the patients successfully treated by radiation therapy is obviously and unquestionably better. Primary radiotherapy with salvage surgery in reserve should be accepted as the strategy of choice in at least a selected group of patients with advanced laryngeal carcinoma.

Aged↗
PubMed1987

Phase II trial of combined radiotherapy and daily low-dose cisplatin for inoperable, locally advanced non-small cell lung cancer (NSCLC).

With the use of cis-diamminedichloroplatinum(II), cisplatin, to enhance the effect of radiation a combined modality approach was designed to treat patients with inoperable, locally advanced NSCLC. The regimen consisted of radiation doses of 300 cGy for 4 days every week for 4 weeks with a 2 week split in between. Each radiation dose was followed by an i.v. injection of cisplatin 6 mg/m2 within 30 min. Hydration consisted on an oral fluid intake of 2 L only, enabling the patient to receive the treatment on an outpatient basis. Of 40 patients entered into the study, 37 were evaluable for toxicity and 33 for response. Overall response rate was 65% and complete response rate 22%. Median duration of local control was 7 months. The majority of all patients (76%) eventually progressed at the primary tumor site, while in 16 patients relapse occurred in distant sites first. Median duration of overall survival was 10.5 months, whereas that of complete responders was 29.5 months. Generally, acute side effects were transient and did not require discontinuation of treatment. One patient presented with thrombocytopenia 4 weeks after treatment had been finished. His death of cerebral bleeding was likely to be related with his therapy-resistant malignancy. Of late side effects three patients showed disabling symptoms consisting of uncontrollable pulmonary infections in the presence of tumor in two patients, one patient had radiation myelopathy and another experienced vertebral collapse with distal paresis. The combination of radiation and daily low-dose cisplatin is a tolerable treatment modality with most benefit for patients reaching a complete remission. Intensification of the regimen is being planned in those patients with inoperable, locally advanced squamous cell lung cancer to reach a complete remission.

Adenocarcinoma↗
PubMed1986

Results of implantation for T1 and T2 bladder tumours.

In the period from January 1972 through December 1983 a total of 123 patients was treated for a bladder malignancy by preoperative external irradiation followed by interstitial therapy. Criteria for selection of patients are solitary lesion, tumour smaller than 5 cm in diameter, state T1 and T2. The majority of patients was in state T2 (89 patients). Persisting local control was achieved in 29 out of 34 T1 cases and in 69 out of 85 T2 cases. The actuarial 10 years survival was 72% for T1 and 34% for T2, with a total disease-free percentage at 10 years of 77% for T1 and 56% for T2. Although in many patients delayed wound healing was noticed, no serious late reactions were seen in skin, bladder or intestine. The causes of death are distant metastases in 13 patients and intercurrent diseases in another 21 patients.

Adenocarcinoma↗
PubMed1984

Feasibility study on daily administration of cis-diamminedichloroplatinum(II) in combination with radiotherapy.

In experimental models cis-diamminedichloroplatinum(II) (cis-platinum) showed to have a radioenhancing effect. The feasibility of daily administration of cis-platinum in combination with radiotherapy was studied in 21 patients with locally advanced inoperable cancers (head and neck 7, esophagus 5, bronchus 3 and others 6). The tumours were squamous cell (15), or adenocarcinoma (6). Radiotherapy was delivered in one (180 cGy; 5 patients) or two (each of 125 cGy; 16 patients) fractions per day to a cumulative dose of 3000-6800 cGy, while cis-platinum was administered at a total daily dose of 8 mg/m2 (14 patients) or 6 mg/m2 (7 patients), in one single or two divided injections (total dose 168-352 mg cis-platinum). Fourteen patients received a total daily cis-platinum dose of 8 mg/m2 with 4 l of i.v. hydration. Severe myelosuppression occurred in 10/14 patients (range white blood cell count nadirs 0.6-2.1 X 10(9)/l) after 3-5 weeks of treatment, while seven developed severe thrombocytopenia (less than 75 X 10(9)/l). All patients became anaemic. Due to this myelosuppression, radiation treatment had to be postponed in four patients for 18-35 days. Eight patients developed bronchopneumonia, two of them had a septicaemia and one died. One patient with a bronchial carcinoma developed necrotizing pneumonitis with a cavity outside the tumour area and subsequent severe pulmonary fibrosis within the radiation field. Seven patients received cis-platinum at 6 mg/m2 per day without i.v. hydration. A moderate leukopenia (white blood cell count nadirs 1.8-2.1 X 10(9)/l) was observed in three patients requiring postponement of treatment in one of them.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1978

Radiotherapy in marginal resectable and non-resectable rectum cancer.

66 patients with inoperable rectum cancer were treated with megavoltage irradiation. These patients were studied in order to see if high dose radiotherapy could cure inoperable patients. No patients were cured. The palliative effect was important, because in most patients a colostomy was avoided. 21 patients with marginal resectable rectum cancer received preoperative irradiation. The effect of combined therapy in this highly selected group of patients gives an indication for a 50% 5-year cure rate.

Aged↗
PubMed1976

Clinical significance of urinary carcino-embryonic antigen estimations during the follow-up of patients with bladder carcinoma or previous bladder carcinoma. Clinical evaluation of carcino-embryonic antigen, III.

Urinary carcino-embryonic antigen (CEA) was measured in a follow-up study of 101 bladder carcinoma patients. Urinary CEA estimation during follow-up appears to be of clinical value. Negative results can be interpreted only in relation to previously increased values. Positive results are of value in retrospect when combined with negative data, e.g. in evaluation of suspicious bladder changes and as an early indication of renewed tumour growth. Increased CEA levels in urines from patients with urinary infection rapidly decline once the infection is cured.

Adult↗