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Biomedical subjects

C Kim-Sing

Publications and source records attributed to C Kim-Sing.

7 recordsLinked to original sources
PubMed2004

The effect of smoking on outcome following external radiation for localized prostate cancer.

PURPOSE: We investigated whether a smoking habit affects biochemical and survival outcome after curative external beam radiation therapy (EBRT) for localized prostate cancer. MATERIALS AND METHODS: The study population comprised 601 men treated with curative EBRT between 1994 and 1997 who had a smoking history available. Pretreatment prognostic factors were examined and high risk was defined as any of prostate specific antigen greater than 20, Gleason greater than 7 or stages T3-4. Biochemical outcome (bNED) was assessed by American Society for Therapeutic Radiology and Oncology, and Houston criteria. Biochemical, clinical, prostate cancer and nonprostate cancer death rates were examined by univariate and multivariate statistics. RESULTS: Of the men 15% were current smokers, 55% were former smokers and 31% were nonsmokers. Current smokers were younger than former smokers or nonsmokers by a mean of 2.5 years (p <0.001). Current smokers had higher risk cancers than former smokers or nonsmokers (high risk 60%, 40% and 43%, respectively, p = 0.017). Five-year bNED rates for smokers were significantly worse than for former smokers or nonsmokers (55%, 69% and 73%, p = 0.01 and 0.0019, respectively). Median followup was 59 months. Multivariate analysis confirmed smoking as an independent adverse factor for bNED (p = 0.013) even when controlling for prostate specific antigen (p <0.0001), Gleason score (p <0.0001), stage (not significant), radiation dose (not significant) and neoadjuvant hormone use (p = 0.0014). Local and metastatic failure did not differ among the groups. Prostate cancer specific mortality was nonsignificantly worse in smokers but overall mortality was much greater. CONCLUSIONS: Smokers present with higher risk prostate cancers. Outcomes following EBRT are poorer, even when accounting for differences in known pretreatment factors.

Aged↗
PubMed2001

Measurement of upper extremity volume in women after axillary dissection for breast cancer.

OBJECTIVE: To determine if 2 methods of calculating upper extremity volume (using arm circumferences) can substitute for water displacement volumetry. DESIGN: Interrater and test-retest reliability and limits of agreement for volume measures. SETTING: University. PARTICIPANTS: Twenty-five women at risk for lymphedema who had undergone axillary lymph node dissection surgery for breast cancer. INTERVENTIONS: Circumference and volume measurements of both upper extremities were taken by 2 physical therapists at an initial visit and by 1 of the therapists 1 week later. MAIN OUTCOME MEASURES: Intraclass correlation coefficients (ICCs) were calculated to analyze measurement reliability. Pearson's product-moment correlation coefficient (r) was used to evaluate the relationship between volumetry and calculated truncated cone volumes. Limits of agreement were calculated to determine the level of agreement between the 2 measurement methods. RESULTS: Interrater and test-retest reliability ICCs for circumferential and volumetric data were .99 and .99, respectively. Pearson's r values were .93 and .97 for the single truncated cone and the summed truncated cone volume calculations, respectively. Limits of agreement (mean +/- 2 standard deviations) were -52 +/- 334mL and -40 +/- 234mL, respectively, between volumetry and the single truncated cone and summed truncated cone calculations. CONCLUSIONS: Calculated and volumetric measurements in this population are both reliable and closely related, but do not agree with each another, and thus should not be used interchangeably.

Adult↗
PubMed1998

Radiotherapy in the treatment of dermatologic malignancies.

Although advances in surgical techniques, particularly micrographic surgery, have considerably expanded its role in the management of dermatologic malignancies, radiotherapy remains of considerable value. Its use should be considered in particular for the appropriate solid tumors in older patients, for metastatic disease, and for the more radioresponsive tumors including Merkel cell carcinoma, Kaposi's sarcoma, and the cutaneous lymphomas.

Clinical Trials as Topic↗
PubMed1996

Late cosmetic results of short fractionation for breast conservation.

BACKGROUND AND PURPOSE: The number of fractions of radiation therapy (RT) used after breast conserving surgery varies widely and accounts for a significant proportion of the workload in a modern radiotherapy department. Internationally, 'standard' therapy ranges from 3 to 7 weeks of daily treatment with or without a boost. Short RT schedules have the attraction of reducing workload but raise concern about an increased risk of late effects and poorer cosmetic outcome. MATERIALS AND METHODS: In a randomized trial, 186 women with T1 or T2, pathologically node-negative breast cancer had cosmetic and various normal tissue effects data collected prospectively. The breast RT prescription was 44 Gy in 16 daily fractions to a tangent pair. RESULTS: Median follow-up is 6.7 years. Actuarial 5-year breast recurrence was 6%. Overall cosmetic results at 5 years were good or excellent in 89% and 96% as reported by physicians and patients, respectively, and were stable between 2 and 5 years. Breast discomfort, erythema, edema and induration were related to both surgery and RT. At 5 years, 20% had breast discomfort, 18% had induration, 6% had erythema and 3% had some degree of breast edema. Fewer patients had these effects at 5 years than immediately after primary surgery. The presence of induration prior to starting RT was associated with a greater likelihood of breast induration 3 or more years following RT (P = 0.02). Thirteen percent of patients, generally those with large breasts, developed mild inframammary telangiectasia by 5 years. CONCLUSIONS: Results are comparable to those reported from centers employing more conventional fractionation. Short fractionation produces acceptable cosmetic results for the majority of women if there are no contraindications to RT and in the absence of significant post-operative breast induration.

Aspirin↗
PubMed1996

Effect of acetylsalicylic acid on radiation and cosmetic results after conservative surgery for early breast cancer: a randomized trial.

BACKGROUND AND PURPOSE: Acetylsalicylic acid (ASA) can reduce the incidence of stroke and myocardial infarction by inhibiting platelet-fibrin thrombi in small blood vessels. To determine if ASA could reduce late effects of radiation therapy mediated by damage to small blood vessels, a prospective, placebo-controlled, double-blind trial was conducted in women with early breast cancer, receiving radiotherapy to the conserved breast. MATERIALS AND METHODS: Cosmetic outcome and late radiotherapy effects were recorded prospectively for 186 women with T1 or T2, pathologically node-negative breast cancer treated with breast conservation and randomized to receive ASA (325 mg daily) or placebo for 1 year from the start of radiation therapy. Radiation was a tangent pair to the breast alone delivering a modal dose of 44 Gy in 16 daily fractions in 22-25 days. RESULTS: Median follow-up is 6.5 years. The use of ASA has not had any effect on the acute (erythema, edema or discomfort) or late (induration, telangiectasia) effects of radiotherapy (all P > 0.10), the patients' or physicians' assessment of the cosmetic outcome (all P > 0.25) or rates of breast recurrence (P > 0.25). CONCLUSION: ASA cannot be recommended to improve the outcome of radiotherapy complementing breast conserving surgery.

Aspirin↗
PubMed1987

Postmastectomy lymphedema treated with the Wright linear pump.

Fifteen patients with postmastectomy lymphedema of the arm were treated with the Wright linear pump, a programmable, gradient pressure, sequential, intermittent compression pump. The group comprised volunteers in whom conservative measures had failed. This is a phase II trial to determine the efficacy of the pump. All patients had subjective improvement. Objectively, all showed a reduction in edema, but this was of variable degree and depended on the amount of pre-existing lymphedema in the arm. The Wright linear pump is easy to use and treatment was well tolerated. No fluid overload occurred due to treatment and no other medical problems were encountered. The Wright linear pump seems more effective than other pneumatic intermittent compression pumps available.

Adult↗