Biomedical subjects
C M Mansfield
Publications and source records attributed to C M Mansfield.
Head/neck carcinoma: the use of radiation therapy.
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Results of radiation therapy in the treatment of epithelial carcinoma of the ovary.
Between 1967 and 1976, 82 patients who had epithelial carcinoma of the ovary and were treated with surgery and postoperative radiation therapy, respectively, were studied. Of these patients, 35% had Stage I disease, 16% Stage II, 45% Stage III, and 4% Stage IV. Serous cystadenocarcinoma was the histologic cell type in 54% of the patients, and mucinous cystadenocarcinoma was involved in 24%. Of the tumors, 35% were Grade 1, 34% Grade 2, 18% Grade 3, and 13% were unspecified. Survival at five years was 96% for Stage I patients, 60% for Stage II, and 60% for Stage III. No stage IV patient survived past two years. Stage III patients with no palpable tumor prior to radiation therapy did well, with 80% alive at more than two years, while only 10% of Stage III patients with palpable tumors prior to radiation therapy are alive. Patients with Stage III disease treated by whole-abdominal irradiation with a pelvic boost did better than those who received 3,000 rad or less to the pelvis. Radiation therapy continues to be an important treatment modality in epithelial carcinoma of the ovary, particularly in patients with minimal tumor burden.
Evaluation of a new Fletcher Applicator using cesium-137.
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CT for intracavitary radiotherapy planning.
Twenty-two patients with malignant uterine tumors were examined with computed tomography (CT) for treatment planning after insertion of an afterloading Fletcher applicator. The CT findings maximized the individualization of treatment planning, including the number, dosage, and loading arrangement of radioactive sources. Artifacts were produced by the metal; but in most cases the scans accurately portrayed the three-dimensional anatomic relationship of the applicator, uterus, and neighboring vital structures. The CT information made it possible to calculate dose distribution more rapidly and accurately for both intracavitary therapy and combined intracavitary and external therapy. Unsuspected uterine perforation was detected by CT in one case.
The search for new hypoxic cell radiosensitizers.
A number of newly synthesized compounds whose chemical structure suggested possible or remotely possible ability to radiosensitize hypoxic mammalian cells were studied in an in-vitro system. Those compounds that were not excluded because of insolubility or extreme cytotoxicity were tested for radiosensitizing ability. The correlation between chemical structure and radiosensitizing ability will be used for the rational design of additional compounds with a high probability of being effective hypoxic cell radiosensitizers. It is hoped that this will contribute to attempts to improve the cure rate of patients with malignant tumors through the use of radiation therapy and hypoxic cell radiosensitizers.
Development and testing of new hypoxic cell radiosensitizers.
Several new electron-affinic compounds have been shown to possess radiosensitizing ability in hypoxic mammalian cells. The correlation between chemical structure and biological activity can aid in the design and synthesis of new agents with potentially greater hypoxic cell radiosensitizing ability.
Comparison of various radiation techniques in treatment of the breast and chest wall.
Radiation therapy will continue to play a major role in the curative management of patients with mammary carcinoma. For this reason, a comparison was made of the dose distributions and techniques used by several leading institutions in the treatment of the chest wall and internal mammary nodes. The dose distributions within the treatment volumes were similar. However, some unique differences within the treatment volume, as well as in the skin and superficial tissues were found.
Malignant salivary gland tumors: role of radiation therapy.
Malignant salivary gland tumors are rare. They represent less than one percent of all head and neck tumors. Approximately three fourths of all salivary gland tumors occur in the major salivary glands.Traditionally, the treatment of choice for these tumors is surgery. The majority of these tumors reoccur after curative surgical procedures. Local recurrence rate following surgery varies with the histology, grade, and extent of the disease.In spite of high local recurrence rate following curative surgical treatment of these tumors, radiotherapy has seldom been used as an adjuvant to surgery. The value of elective postoperative radiation therapy for subclinical microscopic disease was not recognized. Review of the literature supports the improved local control rate with the use of immediate postoperative radiotherapy. Radiation therapy proved to be effective as an adjuvant to surgery. A local control rate of better than 40 percent can be achieved by radiation therapy as a sole modality in inoperable and locally advanced cases. Radiation therapy provides an excellent palliation for locally advanced tumors or symptomatic metastases.
Bladder cancer: the role of radiation therapy.
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A review of the role of radiation therapy in the treatment of non-hodgkin lymphomas.
Until recently, non-Hodgkin lymphoma has been difficult to understand. This was due to a lack of appreciation for histologic types, their sub-classifications, modes of spread, and sites of recurrence.The treatment of choice for stage I-II disease is radiation therapy. The value of irradiating adjacent uninvolved node areas or the more extensive Hodgkin-type mantle or inverted "Y" fields is uncertain.Most patients already have reached stage III or IV when first seen. Stage III cases should be treated by a combination of radiation therapy and chemotherapy. There are protocol studies evaluating the role of chemotherapy alone in stage III disease. The primary treatment of stage IV disease probably should be chemotherapy followed by radiation therapy to involved areas or to residual bulky disease.
Carcinoma of the rectum and rectosigmoid colon: role of radiation therapy.
Surgery is the modality of choice in curative treatment for cancer of the colon and rectum. Since a majority of the patients present advanced disease where the surgical outlook is poor, adjuvant therapy may be warranted. Clinical and experimental data demonstrate the benefits from preoperative radiation therapy and some clinical reports indicate the beneficial effects of postoperative radiotherapy. Two national studies are underway to determine the effectiveness of preoperative radiation therapy in moderate doses. A similar study is suggested to establish the effectiveness of postoperative radiation therapy.For patients who are poor surgical risks, or for a tumor which is considered to be inoperable, and in a selected group, radiation therapy can be used as a curative procedure. Advantages include eliminating the need for a permanent colostomy. In case of failure, electrocoagulation and abdominal perineal resection are still available alternatives.A modest amount of radiation therapy can afford maximum palliation with minimum discomfort to the patient. About 80-90 percent of patients with pain and bleeding and 50 percent of patients with symptomatic liver metastasis respond favorably.
Radiation therapy as initial treatment for early stage cancer of the breast without mastectomy.
This report describes 150 patients with clinical stage I and II carcinoma of the breast treated at four institutions--Yale University School of Medicine, Harvard Medical School-Joint Center for Radiation Therapy, Hahnemann Medical College, Jefferson Medical College--with radiotherapy only following excisional biopsy. Closely similar treatment policies were followed at all four centers, 4500-5000 rads minimum tumor dose being delivered to the entire breast and axillary, supraclavicular and internal mammary nodes. Forty-six of 49 stage I patients treated are alive without disease, the actuarial relapse-free survival being 91% at 5 years. Of the 101 stage II patients, 75 are alive without disease with a relapse-free actuarial survival of 60% at 5 years. Local failure has occurred in 10 patients (9 stage II and 1 stage I, 6.6%) 5 of whom are disease-free following mastectomy. The results obtained in this study are comparable to those of conventional surgery. It is our conclusion that mastectomy is not a necessary part of the treatment of small breast cancers, that radiation without mastectomy is an acceptable alternative with far superior cosmetic and functional results. Adjuvant chemotherapy should be considered particularly in stage II patients in view of their 40% relapse rate.
Gallium scanning in sarcoidosis.
This study of 36 patients, 27 with sarcoidosis, confirms the avidity of mediastinal and pulmonary sarcoidosis for gallium-67. This procedure may prove useful in distinguishing enlarged hilar vessels from lymph nodes. Gallium scanning proved unsuccessful, however, in detection of clinically important extrathoracic sarcoidosis and appears to have limited applicability in the diagnosis of thoracic sarcoidosis.
Clinical and dosimetric considerations in the radiation treatment of breast cancer.
Preliminary results indicate that film dosimetry is a simple and precise method of determining volume dose distributions. Calculated dose distributions using computers or estimations of surface dose using TLD dosimeters are within 5% of the measured dose. Initial attempts to find suitable alternate techniques tailored to each clinical situation are encouraging.
Early breast cancer its history and results of treatment.
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The management of "early" breast cancer. A review of present philosophies.
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Pseudodefect in 99m-Tc sulfur colloid liver scan caused by hepatodiaphragmatic interposition.
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