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Biomedical subjects

B H van der Werf-Messing

Publications and source records attributed to B H van der Werf-Messing.

At least 19 recordsLinked to original sources
PubMed1990

Late radiation damage in prostate cancer patients treated by high dose external radiotherapy in relation to rectal dose.

A retrospective analysis of the incidence of radiation proctitis was performed in 154 patients with carcinoma of the prostate treated with external radiotherapy assisted by CT-scan planning from 1983 to 1985. An attempt was made to assess a dose-response relationship for proctitis. Multivariate Cox regression analysis showed that previous bowel disease or surgery, anterior rectal dose, and average rectal dose contributed to a higher risk of proctitis. The anterior rectal dose was the most important indicator. No statistically significant correlation was found for the posterior rectal dose. The actuarial 2-year incidence of moderate or severe proctitis was 22% for anterior rectal doses less than 70 Gy and 20% for anterior rectal doses between 70 and 75 Gy, but increased to 60% when the dose was more than 75 Gy. A dose effect relation was evident, with a sharp dose-response gradient around 75 Gy at the anterior rectal wall.

Aged↗
PubMed1989

Carcinoma of the urinary bladder category T2,3NXM0 treated by 40 Gy external irradiation followed by cesium137 implant at reduced dose (50%).

Forty-eight bladder cancers T2NXM0 with bad prognostic factors and 42 T3NXM0 growths, suitable for interstitial treatment, were submitted to 40 Gy external irradiation immediately followed by Cae137 Implant at "reduced dose". Intercurrent death corrected 5-year survival for both groups was about 80%. The influence of previously identified bad prognosticators (more than one TUR, WHO grade 3, 4, vascular invasion in the biopsy specimen, pathological IVP) was nearly eradicated.

Brachytherapy↗
PubMed1986

Factors influencing the prognosis in bladder cancer.

In the categories T1, T2 and T3NxM0 bladder cancer, diameter not exceeding 5 cm, the treatment in the Rotterdam Radio-Therapy Institute consists of interstitial irradiation with needles containing radioactive material. The results of treatment and the role of additional external irradiation are discussed. Category T3NxM0 tumors diameter exceeding 5 cm are treated by external irradiation followed by cystectomy; the results are presented here. Factors influencing prognosis appeared to be degree of differentiation, number of transurethral resections (TURs) prior to definitive treatment, intravenous pyelography (IVP), vascular invasion, T category after preoperative irradiation, and postsurgical histopathologically-assessed T category (pT).

Aged↗
PubMed1984

Non-seminoma testis treated by irradiation at the Rotterdamsch Radio-Therapeutisch Instituut: the risk of metastasis.

One hundred and thirteen patients with non-seminoma testis and without clinical evidence of distant metastasis (category M0) have been analyzed with regard to the risk of subsequent metastasis after subdiaphragmatic irradiation. Important prognostic factors were: histology (malignant teratoma intermediate (MTI), malignant teratoma undifferentiated (MTU), T-category (T4, T less than 4), clinical regional and juxta-regional subdiaphragmatic lymph node involvement (N0, N1,2, N3,4) and vascular invasion in the orchidectomy specimen (V-, V+). If vascular invasion was considered, the histological type MTI or MTU lost its prognostic impact. Categories T4 and N greater than or equal to 1 worsen prognosis and if vascular invasion could be observed metastasis-risk would be additionally increased. Watch-and-wait policy is probably most justified in categories T less than 4, N0, V-. Elective chemotherapy might be most justified in categories T4N0V+ and T less than 4N greater than or equal to 1V+.

Humans↗
PubMed1984

Carcinoma of the urinary bladder treated by interstitial radiotherapy.

Bladder cancers are usually only poorly radiosensitive and require a very high dose of radiation in order to become completely eradicated. Radioactive material inserted interstitially, however, can deliver an extremely high dose to the bladder malignancy and still spare vulnerable adjacent tissues and organs. Indications for implantation, treatment results, and prognosis are presented.

Brachytherapy↗
PubMed1984

Prostatic cancer treated by external irradiation at the Rotterdam Radiotherapy Institute.

Two-hundred-seventy-nine patients, mainly with prostatic cancer category T3NXM0 and T4NXM0 , have been treated by a full-course of external irradiation. Five- and 10-year survivals and relapse-free survivals are comparable to reports in literature. Complications in about 24% of all cases are acceptable but might be reduced in future by more sophisticated techniques. Important prognostic factors were the T-category of the primary, the histological grade according to WHO and according to Gleason, and to a lesser extent vascular invasion in the biopsy specimen and the diagnostic procedure: either transurethral resection or needle biopsy. Combinations of WHO-grade, Gleason-grade and T-category are possibly the best prognosticators . Persisting, positive transrectal cytology after the irradiation is probably an indicator of a slightly increased risk of metastasis. In spite of hormone therapy after evidence of metastasis, prognosis is poor and not significantly influenced by any pre-irradiation prognosticator.

Follow-Up Studies↗
PubMed1982

Carcinoma of the urinary bladder T3NxMo treated by preoperative irradiation followed by simple cystectomy.

One hundred eighty-three patients with bladder cancer category T3NxMo (the diameter of the primary exceeding 5 cm), were treated by preoperative 40 Gy and simple cystectomy. Using only pretreatment information, the group with the best prognosis was characterized by a T3A-growth with a normal intravenous pyelography, with about a 75% cure rate. Before cystectomy, after irradiation the combination of a clinically assessed radiation-downstaged growth (T40GY less than 3) with normal urography, predicted the best chance of cure at about 80%. After cystectomy was performed, the best prognostic group could be most correctly identified: those patients with both microscopic downstaging of the primary ("P" less than 3) and no vascular invasion in the cystectomy specimen (CV-) combined with normal urography had an 81% chance of cure. This most favorable group constitutes 45% of all patients.

Aged↗
PubMed1975

Carcinoma of the bladder T3NxMo treated by preoperative irradiation followed by cystectomy.

Eighty-nine patients with bladder cancer T3NxMo have been treated by preoperative external irradiation (4000 rads in 4 weeks) followed by cystectomy. Five-year survival is 50%. Of patients with T-reduction (T3 becomes P0, P1, or P2) the 5-year survival is 70%. Treatment mortality has been reduced to 3% during the last 2 years. T-reduction cannot be predicted by histologic grade. A second staging by palpation under general anesthesia ("T" 4000) is reliable when T-reduction is felt; however, fibrosis can simulate a persisting T3 mass.

Adult↗