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Biomedical subjects

F Batley

Publications and source records attributed to F Batley.

At least 19 recordsLinked to original sources
PubMed1983

Preoperative reductive chemotherapy for locally advanced carcinoma of the oral cavity, oropharynx, and hypopharynx.

Recent reports have documented that five year survivals have not really improved as a result of combined therapy programs utilizing surgery and radiation therapy. The pattern of treatment failure seems to have changed in that such combined programs offer improved local and regional control but only to have patients develop distant metastases. The need for some form of systemic treatment was obvious. In 1977, a pilot study was initiated at the Ohio State University to evaluate a particular four drug combination and its effectiveness against squamous cell carcinoma of the head and neck. The initial results revealed an acceptable risk-benefit ratio to evaluate this regimen in a group of patients who had previously received no treatment. This report details the final results of the pilot study designed to evaluate response rates in previously untreated locally advanced squamous cell carcinoma of the oral cavity, oropharynx, and hypopharynx. During the 15 month duration of this study there were 58 patients who were evaluable. The overall response to a combination of cis-platinum, vincrinstine, methotrexate, and bleomycin was 66%. All toxicities occurred in less than 10% of the patients except for nausea and vomiting, which occurred to a mild to moderate degree in three quarters of the patient population. There was no increase in surgical or radiotherapeutic complications as a result of utilizing initial chemotherapy. This four-drug combination is now being evaluated to test its impact on survival as a Southwest Oncology Group study.

Antineoplastic Agents↗
PubMed1983

Comparison of chemotherapy alone versus chemotherapy and radiation therapy of extensive small cell carcinoma of the lung.

In a randomized study 145 patients with extensive small cell carcinoma of the lung were treated with chemotherapy alone (Cytoxan, CCNU, methotrexate) or with the same drug regimen and with radiation therapy to the brain, chest, and abdomen. One hundred eighteen of these patients were evaluable. Those patients receiving radiation had a better response rate (55% vs 31%, P = .016) but significantly greater toxicity. There was no significant difference in rates of complete response (7% vs 8%) or in survival (median 18.4 vs 15.3 weeks) between the two groups overall. The median survival of those patients with a partial response to therapy was 18 weeks; for those achieving a complete response it was 46 weeks. However, a clear difference in survival comparing responders with non-responders was evident only for patients who were assigned to chemotherapy alone. Partial regressions have little, if any, correlation with improvement in survival. Therapy in this disease must be oriented toward inducing complete response.

Aged↗
PubMed1982

Influence of chest radiotherapy in frequency and patterns of chest relapse in disseminated small cell lung carcinoma. A Southwest Oncology Group Study.

The value of radiotherapy to the chest (RC) in disseminated small cell lung carcinoma (SCLC) has been questioned. Two protocols for disseminated SCLC from the Southwest Oncology Group (SWOG) have been compared. They were developed four years apart. The first one included radiotherapy (RT), 3000 rad in two weeks, to the primary tumor, mediastinum and supraclavicular areas, while the second one deleted any RC. Multidrug chemotherapy (CT) and brain RT were used in both protocols. Nonresponders to CT were removed from the study. Our main findings are as follows: (1) Initial chest relapses (patients with no initial extrathoracic relapse) have increased from 24-55% when RC is not given (P = 0.0001). Overall chest relapse (adding those patients that relapsed simultaneously in the chest plus other sites) in the second protocol was 73%. (2) Amount of response to CT does not influence the chances for relapse. Even complete responders to CT have a high chance for chest relapse. (3) Sites of relapse without RC are mainly in the primary tumor, ipsilateral hilus and mediastinum. (4) With RC, relapses shift to the chest periphery, mostly to the lung outside the radiotherapy field and to the pleura. (5) The two very different CT regimens have produced similar percentages and duration of response. (6) CT schema with periodic reinductions prolongs duration of response and survival over schema with continuous maintenance. Hence, interruption of CT to allow RC does not seem to adversely influence CT efficacy. From our results and the review of the literature we conclude that: (1) patients with disseminated SCLC that respond to CT should be given RC to decrease chest relapses. (2) A dose of 3000 rad in two weeks seems to be enough to produce a low percentage of chest relapse in disseminated SCLC, as survival of these patients is short and many will die prior to developing chest relapse. However, according to the literature, 4000-4800 rad is probably a more effective dose. (3) More studies and guidelines are needed to outline proper boundaries of radiotherapy fields, to decrease chances of peripheral chest relapses. (4) Median survival might not be a good parameter to evaluate the impact of RC in disseminated SCLC. The study of long-term survivors seems to be more important.

Carcinoma, Small Cell↗
PubMed1980

Combination therapy protocol for stage III or IV carcinoma of the oral cavity, oropharynx and hypopharynx.

Combined therapy programs have improved recurrent and nodal metastatic rates but have not controlled distant metastases. A pilot study undertaken at Ohio State University evaluated the feasibility of adding chemotherapy to a combined modality regimen. The first phase determined that the toxicity of a four-drug combination chemotherapy yielded a favorable risk/benefit ratio and justified its inclusion in a protocol for untreated cancers. The second phase evaluated chemotherapy followed by surgery and postoperative irradiaation for untreated Stage III and IV epidermoid carcinoma of the oral cavity, oropharynx or hypopharynx. The overall chemotherapy response rate is 88% (22/25) with 6 complete and 16 partial responses. Evaluation of pathology specimens revealed 7 of 14 primary sites and 4 of 15 neck specimens had no histologic evidence of carcinoma. In the 10 patients who received all 3 modalities, 9 are free of disease (6 to 17 mo. follow-up).

Carcinoma, Squamous Cell↗
PubMed1979

An analysis of the dosimetry for mantle field therapy using 4 MV X-rays and its routine application.

There are several different methods in vogue at present in determining patient midplane doses in the "mantle" treatment for Hodgkin's disease and malignant lymphomas. A method of determining midplane doses in individual cases using thermoluminescent dosimetry is presented. It shows excellent agreement with the midplane doses measured in an Alderson-Rando phantom treated as a hypothetical "mantle" patient.

Hodgkin Disease↗