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Biomedical subjects

E E Mills

Publications and source records attributed to E E Mills.

At least 19 recordsLinked to original sources
PubMed1996

The neutron therapy clinical programme at the National Accelerator Centre (NAC).

A total of 721 patients were treated in the neutron therapy programme at NAC from February 1989-March 1995 with a p(66)/Be isocentric unit. The preliminary results showed: 3-year local control and survival probabilities of 57 and 79% respectively for advanced salivary gland tumours; increased local control for twice-daily neutron therapy for advanced head and neck cancer compared with photon therapy; local control rates of 68 and 83% for locally advanced breast cancer treated with 17 and 19 Gy respectively; complete response rates of 67% for macroscopic residual soft tissue sarcomas and those with irresectable disease of less than 10 cm; complete response rate of 56% for macroscopic residual uterine sarcoma with a median follow up of 38 months; 2-year local control rate and survival of 44 and 38% respectively for advanced squamous carcinoma of the maxillary antrum; complete response rate of 38% for advanced osteosarcomas and chondrosarcomas.

Breast Neoplasms↗
PubMed1992

Radiotherapy of aggressive fibromatosis.

The long term results of 24 patients treated with postoperative irradiation for aggressive fibromatosis are presented. Tumour sites were the pelvis (8), chest wall (5), shoulder (5), extremities (4) and head and neck (2). Macroscopic complete resection (R1) was performed in 3 cases. 17 patients presented postoperatively with gross disease (R2), 8 of which were recurrent tumours. 4 patients with inoperable disease had biopsies only. Radiation doses ranged from 28 to 64 Gy at a fractionation of 5 x 2 or 4 x 2.5 Gy/week. 4 patients had external irradiation in combination with 192Ir implants, 2 were irradiated with implants alone. In the combined treatment group, external doses ranged from 28 to 52 Gy and additional interstitial doses from 35 to 50 Gy. 192Ir treatment alone was given with 45 and 57 Gy to the contour of the target volume. The 10 year recurrence free survival rate is 75%. A dose response relationship has been established in the dose range of 30-60 Gy revealing an expected 80% persistent tumour control rate at 60 Gy. A dose volume relationship however, could not be derived from our data. Moderate fibrosis without functional impairment developed in 5 patients (21%). These data support a policy of postoperative radiotherapy with 60 Gy in patients with incompletely excised or gross residual tumour following surgery.

Adolescent↗
PubMed1989

The role of neutrons in the treatment of soft tissue sarcomas.

Two-hundred twenty-one patients with soft tissue sarcoma were treated from 1978 to 1983. Treatment was nonrandomized and consisted of neutron irradiation in 94 cases with gross tumor. Treatment was nonrandomized and consisted of neutron boost irradiation after photon-irradiation or electron-irradiation in 127 cases with no gross tumor after surgery. Patient distribution according to UICC (1978) criteria was 15, 100, and 106 of T1, T2, and T3 respectively. Distribution by pathologic grade was 54, 107, and 60 for Grade 1, Grade 2, and Grade 3 tumors. Distribution by tumor residuum after surgery was 23 cases without microscopic disease (R0), 104 with microscopic disease (R1), and 94 with gross residuum (R2) or nonoperative disease. Five-year follow-up reveals a significant difference (P = 0.024) in disease-free survival (DFS) for T1 (60%), T2 (71%), and T3 (29%, P = 0.016) tumors. Similarly, there are significant DFS differences among G 1 (74%), G 2 (48%, P = 0.035), and G 3 lesions (22%, P = 0.024). The impact of tumor bulk or residuum on DFS after operation is significant when comparing R0 (87%) and R1 (65%) disease (P = 0.042). The 5-year survival of patients who had gross residuum (R2) after surgery was significantly worse (26%, P = 0.003). Ninety percent of patients failed treatment locally and distally within 2 years. The late morbidity rate was 27% for neutron and 7% for neutron-boost irradiation. In our series and reported photon data, local control rates for tumors 5 to 10 cm with neutrons were 76% and 53%, respectively. Low energy (d(14) + Be) neutrons are considered beneficial in the postoperative treatment of well-differentiated soft tissue sarcomas where gross tumor remains. Neutron-boost irradiation is of potential benefit in the treatment after operation of T2-3, and G 1-2 tumors if there is microscopic residual tumor.

Adult↗
PubMed1987

Simultaneous radiation therapy and cisplatin chemotherapy in advanced cancer of the head and neck. A pilot study at Tygerberg Hospital, Parowvallei, South Africa.

Fifty patients with advanced carcinoma of the head and neck were treated in a nonrandomized pilot study utilizing simultaneous cisplatin and radiotherapy. Treatment was delivered in two segments. The initial partial course (PC) consisted of 75-100 mg/m2 of cisplatin and concomitant radio-therapy to 20.00 Gy in 1 week, with 4-week split. Patients who tolerated therapy and experienced at least a partial response (PR) went on to complete the full course of therapy (FC), with the second phase consisting of 120 mg/m2 of cisplatin and 38.40 Gy of radiation. Total cisplatin delivered ranged between 195 and 220 mg/m2, and the total radiation dose was 58.40 Gy. Of 38 evaluable patients, 31 (82%) had at least a partial response (PR). However, at time of analysis 20 months after study, 27 (71%) patients were alive with disease or dead. Mean disease-free survival (DFS) for patients receiving FC therapy (10.05 months) was greater than that for patients who received only PC therapy (2.65 months), but the difference in overall survival (OS) was not statistically significant (11.95 FC versus 10.29 PC). Response rates and the minimal toxicity are within the range of other reported studies. Randomized studies should seek optimal time-dose schedule and establish advantages in terms of crude survival and disease-free survival.

Adolescent↗
PubMed1983

The role of vitamin A in cancer.

The differentiation and maintenance of epithelial tissues is a well-known function of vitamin A. The most dramatic expression of this is the antineoplastic effect. This biological activity of vitamin A is reviewed with regard to anticarcinogenesis, the reversal of transformation and a possible role in cancer therapy. A brief account is given of vitamin A absorption and transport in the body and the importance of varying levels of cellular binding proteins in normal and malignant tissues.

Animals↗
PubMed1982

Adjuvant chemotherapy of adult high-grade soft tissue sarcoma.

Of 12 adult patients with high-grade soft tissue sarcoma receiving adjuvant chemotherapy and at risk for 36-84 months, 9 (75%) remain metastasis free and 10 (83%) have adequate local disease control with limb preservation. This is significantly better (P greater than 0.015) than a comparable "historic" control of 48 previously treated patients. The results correlate well with the few similar studies reported.

Adult↗
PubMed1981

Combined pre-operative telecobalt therapy and supraglottic laryngectomy.

At Groote Schuur Hospital, Cape Town, over a 5-year period (1974 to 1978) 15 patients with squamous cell carcinoma of the larynx or hypopharynx have had planned 2,000 Rad Telecobalt therapy followed by supraglottic horizontal laryngectomy. Five patients following surgery had a further 3,600--4,000 Rad Telecobalt therapy. The peri-operative complications, in addition to those of whole organ resection, included debilitating laryngeal incompetence in three patients, two of whom underwent total laryngectomy. All 15 patients have remained free of recurrent disease for 2 years and 10 have been free for 3 or more years. One patient died 4 years after surgery from a primary bronchial carcinoma.

Adult↗
PubMed1981

Management of soft tissue tumours by limited surgery combined with tumour bed irradiation using brachytherapy and supplementary teletherapy.

Sixteen of 17 soft-tissue sarcomas were controlled by limited resection combined with high-dose radiation therapy using brachytherapy with or without supplementary cobalt teletherapy. Function was retained with preservation of the limb in all lesions in extremities. Adjuvant chemotherapy was used in four of five pathological Grade III cases.

Brachytherapy↗
PubMed1978

The use of hyperbaric oxygen as an adjunct in the treatment of radionecrosis.

The rationale leading to the use of hyperbaric oxygen (HBO) in the treatment of radionecrosis is described. Between January 1975 and February 1977, 13 patients received HBO at Groote Schuur Hospital for radionecrosis, and the response is evaluated in terms of pain relief and wound healing. The implications of these results are discussed.

Aged↗
PubMed1978

Osteosarcoma--the winds of change.

The occurrence of pulmonary metastases in patients suffering from primary classic osteogenic sarcoma is compared among two groups of patients treated according to different protocols at Groote Schuur Hospital. A group of 28 patients treated by radiation and delayed amputation (before the end of 1974) is compared with 12 patients managed by immediate ablation and adjuvant chemotherapy with vincristine, high-dose methotrexate and leucovorin rescue, and adriamycin (after 1974). The incidence of pulmonary metastases at 12 months was significantly lower in the latter group.

Adolescent↗
PubMed1976

Bone infarction complicated by sarcomatous change: a case report.

A patient with a sarcoma of the tibia associated with multiple bone infarcts and a history of alcoholism, is presented. This is a rare association. The possible aetiological role of bone infarcts in relation to the development of a sarcoma is discussed.

Fibrosarcoma↗