An innovative method for neuraxis radiotherapy using partial transmission block technique.
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Brain Neoplasms↗
Biomedical subjects
B Magee
Publications and source records attributed to B Magee.
Use of an electron beam for post-mastectomy radiotherapy: 5-year follow-up of 500 cases.
Since 1982, the standard method of postmastectomy regional radiotherapy at the Christie Hospital has been to use a single electron field of fixed energy (8 MeV) to irradiate the chest wall, matched to a single megavoltage field (4 or 8 MV) irradiating the nodal areas in the axilla and supraclavicular fossa. (A separate parasternal field was not used.) All 500 cases treated in 1982 and 1983 with this method were reviewed (median follow-up 59 months). Four hundred and twenty-two were referred directly post-mastectomy and 78 for local recurrence after previous mastectomy. Of these, 42 were treated palliatively, and 458 with radical intent. In radical cases the given dose in both fields was 40 Gy in 15 fractions in 3 weeks. The overall survival (n = 458) was 51% (actuarial) at 5 years. At 5 years the local recurrence rate by site and UICC stage were as follows: chest wall - all Stages 17%, Stage I 4%, Stage II 13%, Stage III 26%, recurrent cases 21%; axillary recurrence - all Stages 20%, Stage I 4%, Stage II 10%, Stage III 22%, recurrent cases 39%; supraclavicular recurrences - all Stages 9%. Only one patient of the 500 treated had a parasternal recurrence. Late effects included mild telangiectasia in the electron field and asymptomatic apical lung fibrosis in the photon field. There was no match line fibrosis.
Adolescent↗
The antiemetic effect of granisetron in lower hemibody radiotherapy.
Radiotherapy-induced emesis is poorly controlled with existing antiemetics. 5-Hydroxytryptamine (5HT3) receptor antagonists are a new class of antiemetics which have been demonstrated to be effective in controlling cytotoxic-induced emesis. We have prospectively studied the antiemetic efficacy of the 5HT3 receptor antagonist granisetron in an open non-randomized efficacy and toxicity study, at two dose levels, in patients receiving lower hemibody radiotherapy for multiple bone metastases. Of the 22 patients studied, 13 patients received 20 micrograms/kg and nine patients 40 micrograms/kg of granisetron, administered as an intravenous infusion 1 h before radiotherapy. Radiotherapy was administered as a single exposure to the lower half body to a midline dose of 8 Gy. A complete response (no nausea or vomiting) was observed in 9/13 patients at the lower dose level and 6/9 patients at the higher level. No major adverse events were recorded. We conclude that granisetron is a well-tolerated and effective antiemetic agent in radiotherapy-induced emesis. Formal comparison with conventional antiemetic agents in this situation is required.
Aged↗
The treatment of advanced seminoma with chemotherapy and radiotherapy.
Between 1979 and 1984 thirty-seven patients were treated with combination chemotherapy for metastatic seminoma; 27 of these had relapsed following initial radiotherapy for stage I and IIA disease and 10 patients with stage IIB-IV disease received chemotherapy de novo followed by radiotherapy to sites of bulk disease. Treatment consisted of either a cis-platinum containing combination (25 patients), or cyclophosphamide and etoposide (12 patients). The overall survival of all patients at 5 years was 49%, 34 patients were assessable for response; a CR was obtained in 8 (24%) and a GPR in 19 (56%), the 5 year survival of this group being 66% at 5 years. No difference in survival was seen in relation to age, previous irradiation, serum HCG or LDH; bulk disease however, was an adverse prognostic factor. Survival was similar for both chemotherapy schedules but neutropenia and life-threatening sepsis was less with the cyclophosphamide etoposide combination.
Adult↗
Inappropriate thyrotrophin secretion, increased dopaminergic tone and preservation of the diurnal rhythm in serum TSH.
A patient presented with mild hyperthyroidism, elevated serum T4 and T3, and an inappropriately raised serum thyrotrophin (TSH). There was no evidence of pituitary tumour (alpha-subunit secretion and CT scan of the pituitary were normal). The TSH response to TRH was greater than normal. The elevated TSH was suppressed by oral triiodothyronine (100 micrograms daily for 10 d). The normal diurnal variation of TSH was preserved. Intravenous injection of the dopamine receptor blocking agent domperidone led to a greater than normal elevation in TSH (maximum increments 18-20 mU/l). This increased dopaminergic tone was similar in studies carried out in the morning and late evening. The dopamine agonist bromocriptine (2.5 mg twice daily) failed to suppress serum TSH either acutely or over 6 weeks. The circadian rhythm was unaltered by this treatment. Basal serum prolactin levels were normal, and responded appropriately to TRH, domperidone and bromocriptine. These observations indicate that dopamine does not control the diurnal variation of TSH in nontumoral TSH-mediated hyperthyroidism. The increased dopaminergic tone demonstrated may be secondary to the primary failure of pituitary-thyroid feedback in the condition.
Adult↗