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D I Hodson

Publications and source records attributed to D I Hodson.

25 records · Page 2Linked to original sources

Long-term results of a pilot study for the treatment of advanced unresectable head and neck tumors by combination chemotherapy and split course radiotherapy.

The results of treatment of 30 patients with advanced unresectable squamous cell carcinoma of the head and neck (stage III and IV) are presented. These patients were treated in a pilot study using kinetically based combination chemotherapy and split course radiotherapy from July 1977 until December 1979. Twenty-three patients (76%) achieved a local response (53% complete and 23% partial) and the median survival was 16 months. The two-year survival was 43%. Although no significant increase in acute radiation morbidity was seen, 43% of the patients developed chronic symptomatic complications. Seven patients (23%) developed second primary cancers, of which five were bronchogenic carcinomas and two were esophageal carcinomas. The regimen adopted produced a high local control rate with permanent local control in 50% of patients treated, but this was achieved at the expense of a high chronic toxicity rate. The incidence of second primary malignancies, presumably because of on-going environmental factors, remains a continuing concern.

Antineoplastic Combined Chemotherapy Protocols↗

Pilot studies of superfractionated radiotherapy and combination chemotherapy in limited oat cell carcinoma of the bronchus.

There are sound radiobiologic and suggestive clinical rationale for superfractionating the radiotherapeutic regimens employed for the therapy of rapidly growing malignancies. Oat cell carcinoma of the bronchus is such a tumor. We report our experience combining aggressive systemic combination chemotherapy with superfractionated radiotherapy for the treatment of "limited" oat cell carcinoma of the bronchus. Overall, patient tolerance was satisfactory and a complete remission rate of 74% was achieved. It remains to be proven, in a prospective randomized fashion, whether this approach is superior to current conventional management.

Adult↗

Once-monthly radiotherapy for the palliation of pelvic gynecological malignancy.

Twenty-seven patients with advanced pelvic gynecological malignancies were treated using a once-monthly fractionation scheme of 10 Gy to a total dose of 30 Gy to the whole pelvis. This course was well tolerated and provided effective palliation with a minimum of hospitalization. The results obtained suggest this course merits consideration for the palliation of other pelvic malignancies.

Aged↗

Chordoma: the results of megavoltage radiation therapy.

Twenty-four patients with chordoma who received one or more courses of megavoltage radiation therapy following biopsy or incomplete resection were reviewed. The uncorrected survival rate at five years was 62%, and at 10 years was 28%, but most patients had clinically detectable residual chordoma present at the time of death or last follow-up. The duration of symptomatic improvement following irradiation ranged from a few months to 18 years, median 3.5 years. Detailed dose-time and symptomatic response data for 56 patients from this series and from the literature who were treated by conventional daily fractionated megavoltage irradiation show no convincing evidence that symptomatic relief is more likely after high doses than after total doses of only 4000 to 5500 cGy. Patients are rarely cured of chordoma by partial tumor resection and conventional radiation. Four patients received multiple fractions of 100 cGy each day either as retreatment for recurrence, or as initial treatment. Symptomatic responses, and decreases in the size of tumor masses, were seen following total doses ranging from 2000 cGy/20 fractions/5 days/4 X 3 hourly fractions each day to 4000 cGy/40 fractions/12 days/4 X 3 hourly fractions each day. The short duration of follow-up in these patients prevents comparison with conventional fractionation. However, this technique presents one possible new approach for the treatment of chordoma.

Adult↗

Hypofractionated radiotherapy for the palliation of advanced pelvic malignancy.

Forty-two patients, with a variety of advanced pelvic malignancies, have been treated with a hypofractionated radiotherapy regimen. The most common schedule was 30 Gy in three fractions at monthly intervals. This has provided effective palliation with acceptable morbidity in the select patient group treated. The results in advanced rectal and ovarian tumors were particularly encouraging. The most effective dose/fraction and interfraction interval is, at present, under active investigation within our institution.

Adult↗

Comparison of the addition of T and N integer scores with TNM stage groups in head and neck cancer.

The 1987 TNM classification system modified T and N definitions for squamous cell carcinomas of the head and neck. It did not change stage groupings (I through IV). The primary purpose of clinical staging is to divide patients into prognostically meaningful groups. The 1987 changes to the TNM T and N descriptions may not have removed the previously established heterogeneity within stage groups III and IV which existed before 1987. The development of a stage grouping system called TANIS (the T And N Integer Score), which is formed by adding the integer values of the T and N classifications, is reported herein. We compared the prognostic performance of T, N, TNM stage group, and TANIS stage for radiotherapy response and survival using data from 86 patients with newly diagnosed, measurable TNM II (oral cavity), and localized TNM III-IV squamous cell carcinomas of the head and neck, excluding nasopharynx, who were randomized to test 5-fluorouracil-methotrexate sequencing. The sequencing of chemotherapy was shown to make no difference to prognosis. All patients received 60 Gy of radiotherapy in 6 weeks. As compared to T, N, and the TNM stage group system, TANIS was the single best predictor for a complete response to radiotherapy (p = 0.0005). TANIS was also the single best predictor for survival from randomization (p = 5 x 10(-6)). With the 86 patients divided into three groups (TANIS 2 to 3, 4, and 5 to 7), TANIS provided a better prognostic discrimination than did the TNM stage grouping method (TNM II, III, and IV).(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Squamous Cell↗