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Biomedical subjects

B H Feder

Publications and source records attributed to B H Feder.

13 recordsLinked to original sources
PubMed1977

Persistent carcinoma of the oropharynx and oral cavity re-treated by after-loading interstitial 192Ir implant.

After-loading implantation techniques apparently offer an effective alternative in the management of persistent (or recurrent) oropharynx and oral cavity carcinoma postirradiation. A total of 29 patients with such lesions was treated from February 1974, to July 1975, in the LAC/USC Radiation Medicine Section, using after-loading 192Ir implantation techniques. These patients all had extensive persistent cancer after "full tolerance" irradiation (with or without previous surgery) and were referred for palliation or for possible salvage. Additional doses administered ranged from 5000 to 7000 rads in three to five days. Eighteen of the 29 patients (63%) have had complete local control for 18 to 36 months. These patients have maintained a relatively satisfactory palliative status. Ten of the 29 are dead. Follow-up periods are short, but early indications are that problem patients with persistent cancer after "full tolerance irradiation" can be salvaged, or at least satisfactorily palliated, with after-loading interstitial implant techniques. Clinical details, sites of involvement, implantation techniques, dosimetry methodology, reactions and complications will be described.

Adult↗
PubMed1977

Afterloading interstitial implant in the treatment of oral cavity and oropharyngeal cancers.

(1) In all, 70 patients with carcinoma of the oral cavity and oropharynx have been treated utilizing one or more of several interstitial iridium-192 afterloading techniques. (2) After an 18-month minimum follow-up period, local control is still maintained in 9 of 10 patients with T1 and T2 lesions (UICC), in 17 of 22 patients with T3 lesions, and in 21 of 38 patients reirradiated for recurrent disease. The complication rate of 29% in the reirradiated patients, though high, is considered acceptable in these essentially hopeless cases. (3) This preliminary report is made to stimulate interest in the role of interstitial iridium-192 afterloading techniques. We feel they deserve evaluation in a controlled study of other head and neck cancer management techniques (including external irradiation, surgical resection and adjunctive chemotherapy).

Follow-Up Studies↗
PubMed1977

Technique of after-loading interstitial implants.

Interstitial implants are either removable or permanent (and occasionally a combination of both). Permanent implants are generally utilized where tumors are not accessible enough to permit easy removal of sources or where accurate source distribution is less critical. They are useful for cancers of the lung, pancreas, prostate, bladder, lymph nodes, etc. Radon and gold-198 have been largely replaced by iodine-125. Our major interests are in the removable after-loading iridium-192 implant techniques. Template (steel guide) and non-template (plastic tube) techniques are utilized. Templates are preferred where the tumor volume can only be approached from one side and where accurate positioning of sources would otherwise be difficult. They are useful for cancers of the cervix, vagina, urethra, and rectum. Non-template (plastic tube) techniques are preferred where the tumor volume can be approached from at least two sides and where templates are either not feasible or not essential for accurate positioning of sources. The single needle non-template approach is useful for cancers of lip, nodes, and breast (plastic button) and for cancers of the oral cavity and oropharynx (gold button). The paired needle non-template approach is useful for cancers of the gum, retromolar trigone, and base of tongue (loop technique) and for cancers of the palate (arch technique). Procedures for each technique are described in detail.

Carcinoma, Squamous Cell↗