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F L Ampil

Publications and source records attributed to F L Ampil.

At least 19 recordsLinked to original sources
PubMed2006

Definitive and palliative radiotherapy for cervix cancer in the elderly.

The elderly population is increasing in number. Aggressive therapeutic intervention in this patient group may not always be possible because of age, the presence of co-morbidity, and poor functional status. Hence, individualized management of cervix cancer (CC) in the elderly is often practiced. Because of the preceding consideration, the cases of 79 women 65 years of age and older with CC treated with radiation over the last 20 years were reviewed. The cases were classified into two groups--those who were aggressively irradiated (group 1: 43 patients) and those managed less intensively for palliation (group 2: 36 patients). Local tumor control, complications, and survival were assessed. There were fewer extremely aged (> or = 75 years of age) women (p = 0.006) with advanced stage disease (p = 0.012) in group 1 than in group 2. Also, group 1 women experienced fewer treatment failures (p < 0.0003) and more of them were alive and well at last follow-up (p < 0.005) than those from group 2. The median survival periods for groups 1 and 2 were 60 months and 11 months, respectively (p < 0.0001); the corresponding 5-year crude survival rates were 54% and 19%, respectively (p = 0.002). Two women required remedial surgery for bowel obstruction/perforation after irradiation, and one patient sustained chronic radiation cystitis.

Aged↗
PubMed2005

Thoracic metastases from breast cancer: a single-institution's experience.

OBJECTIVE: Thoracic metastasis from breast cancer (TMBC) is a relatively uncommon condition, and few reports of its therapeutic palliation and patient outcomes exist. We therefore reviewed retrospectively our radiotherapeutic experience of TMBC. METHODS: Between 1981 and 2003, 19 patients were treated with radiation (with doses raging from 10 Gy to 50 Gy) for palliation of TMBC. RESULTS: The mean age was 55.4 years. Mediastinal lymph node disease was the most common form of TMBC. TMBC developed within five years of breast cancer diagnoses in 11 patients (58%). Among the evaluable symptomatic individuals, subjective palliation was complete in 78% of the cases. The complete objective response (e.g., complete resolution of clinically manifested superior vena caval obstruction or imaging-demonstrated atelectasis) rate was 50%. There was no significant difference in survival between patients presenting with airway obstruction and women who were not in respiratory distress, asymptomatic and symptomatic patients, and women with and without concurrent extrathoracic metastases. CONCLUSION: Although the prognosis of women with TMBC was quite ominous, radiotherapy should be considered in very symptomatic patients because justifiable palliation can be effected in some individuals.

Adult↗
PubMed2004

Breast cancer metastasis to the medulla oblongata: a case report.

Breast cancer metastasis to the brain stem is uncommon. Because of the rarity of the condition, the clinical course of such patients is not known. The case of a 41-year-old woman with advanced-stage carcinoma of the breast involving the medulla oblongata is presented and the literature concerning management, including patient outcome, is reviewed.

Adult↗
PubMed2003

Supraclavicular nodal relapse of breast cancer: prevalence, palliation, and prognosis.

PURPOSE: To determine the frequency, palliative effects of radiotherapy (RT) and survival of patients developing supraclavicular nodal relapse (SNR) after definitive surgery for non-disseminated breast cancer (BCa). METHODS: A retrospective study of individuals treated by breast conserving surgery or modified radical mastectomy for Stage I to III BCa at a single institution during a 17-year period (1980-96) was undertaken. RESULTS: Of the 536 patients studied, 22 (4%) developed SNR. Among the seven symptomatic women, the complete subjective response rate after RT was 71%. Of the 18 evaluable patients with manifest SNRs, tumor regression was complete in 12 (66.6%), partial in one (5.6%), and absent in five (27.8%). The overall median survival was 11.5 months; five patients (23%) survived for at least two years. CONCLUSION: Supraclavicular nodal relapse in breast cancer patients occurs infrequently. The application of radiotherapy for palliation of SNR was fully justified by the perceived results even though long-term survival was not often observed.

Aged↗
PubMed2003

Cancer of the cervix with endometrial extension treated by radiotherapy: a retrospective case-control study.

BACKGROUND: Studies determining prognosis of cancer of the cervix with endometrial extension (CCEE) in a case-control fashion are scant. METHODS: A case-control retrospective study of 20 women with CCEE and 16 patients with cervical cancer not extending to the endometrium (CCNEE) treated by radiation was undertaken. The patient groups were matched for age, disease stage, the presence of bulky/barrel-shaped tumor in the cervix, intercurrent illness, total radiation dose, and hemoglobin level. The overall mean follow-up was 54 months (range 8 to 218 months). RESULTS: The numerical rates of local and systemic failure as well as 5-year survival were worse for patients with CCEE versus CCNEE. However, the observed differences were not statistically significant. CONCLUSION: Involvement of the endometrium by cancer of the cervix seems to confer a worse outcome among cervical cancer patients treated by radiation alone.

Adult↗
PubMed2002

Synchronous and metachronous extrapelvic metastases of cancer of the cervix: a study of prognosis and palliation.

Thirty-eight women with cancer of the cervix and extrapelvic metastases (EPM) were retrospectively reviewed with respect to prognosis and responses to palliative radiotherapy. Seventeen patients had synchronous EPM and 21 individuals displayed metachronous metastatic disease outside of the pelvic cavity. A meaningful difference was not revealed (p = 0.11) in the comparison of the two groups' 2-year survival rates. However, this small retrospective review highlighted the efficacy of radiotherapy administered for palliation to this cohort of patients.

Adult↗
PubMed2001

Palliative radiotherapy for synchronous bilateral lung cancers.

Scant information is available about the outcomes of patients with synchronous bilateral lung cancers (SBLC) treated with radiation. We report on 32 patients with SBLC who were treated for palliation by external beam irradiation during a 19-year period. The overall median survival was 7 months; 20 individuals (63%) survived at least 6 months. Among the evaluable patients, the complete/partial subjective and objective response rates were 100% and 60%, respectively. Survival was not significantly influenced by the total dose applied. Radiotherapy is effective for palliation of symptoms associated with SBLC. However, the dismal prognosis of SBLC managed by nonradical radiotherapy alone warrants investigation of treatment using curative doses of radiotherapy or chemotherapy with radiotherapy.

Adult↗
PubMed2001

Prophylactic and therapeutic fixation of weight-bearing long bones with metastatic cancer.

BACKGROUND: We retrospectively studied the duration of operations and the hospitalizations for impending and manifest fractures of weight-bearing long bones with metastatic disease, which has rarely been done. METHODS: The duration of operative fixation and the hospital stay in patients with an impending (n = 7) or actual (n = 15) fracture in a weight-bearing long bone with metastatic tumor were assessed, including symptomatic response, posttreatment mobility, and survival rate. RESULTS: Most patients had significant relief of pain. More than half of patients with impending fracture and 80% with actual fracture were ambulatory after therapy; 3-year survival rates were 29% and 13%, respectively. Corresponding mean durations for the operations were 175 minutes and 185 minutes, respectively; mean durations of hospitalization were 22 days and 16 days, respectively. CONCLUSION: Surgical fixation of fractures in weight-bearing long bones with metastatic cancer does not require excessive operative time as compared with that of impending fractures, does not extend hospitalization, and has an acceptable risk-reward ratio.

Activities of Daily Living↗
PubMed2001

Cauda equina compression in breast cancer--incidence and treatment outcome.

PURPOSE: To determine the incidence and treatment outcome of compression of the cauda equina by metastatic disease in patients with breast cancer. METHODS: A retrospective study of individuals diagnosed with breast cancer at a single institution during a 16-year period was undertaken. RESULTS: Of the 1,283 patients studied, 15 (1.2%) developed cauda equina syndrome from metastatic disease. The median survival was eight months; ten (67%) survived for at least six months. Among the evaluable patients, pain was completely relieved in eight of ten women; complete resolution of neurologic deficits was observed in five of nine patients. CONCLUSION: Metastatic breast cancer compression of the cauda equina and long-term survival of patients are infrequent occurrences. Beneficial responses can be mediated by radiotherapy.

Adult↗
PubMed2001

Can intermediate-risk node-negative patients with stage I corpus cancer do without posthysterectomy radiotherapy? Review of a 13-year experience.

A retrospective comparative study of 41 patients with stage I corpus cancer, negative surgical staging, and adverse pathological features either treated or untreated by posthysterectomy radiotherapy (PHR) during a 13-year period was undertaken. The patients were matched for age, intermediate-risk classification, number of sampled nodes and the presence of coexisting illness. After complete follow-up, there was no significant difference in outcome between the patient groups. Unless it can be shown definitely that PHR is beneficial, its use in intermediate-risk node-negative stage I corpus cancer patients must be seriously questioned.

Adult↗
PubMed2000

Involvement of the cavernous sinus by malignant (extracranial) tumour: palliation in six cases without surgery.

Involvement of the cavernous sinus region due to haematogenous spread or by local extension of a malignant head and neck tumour does not occur frequently. Six patients were treated by external beam radiation with (n=3) or without neoadjuvant chemotherapy between December 1989 and February 1996. Manifestations of the condition mainly consisted of fifth and sixth cranial nerve deficits (n=4). Complete resolution of cranial nerve deficits after therapy occurred in two of the four patients with only three individuals having been evaluable. Three of the six patients survived for more than 3 years. Thus, palliation can be achieved by chemoradiation or radiotherapy alone, and long term survival is not precluded.

Adult↗
PubMed2000

Patient compliance is critical for equivalent clinical outcomes for breast cancer treated by breast-conservation therapy.

OBJECTIVE: To determine the compliance with a standard breast-conservation therapy (BCT) program in a predominantly indigent, minority population of patients with early breast cancer (stage I and II) served by a rural state institution in the South; to compare the clinical outcomes of this group with those reported in clinical trials; and to examine the socioeconomic factors that may have contributed to the rate of compliance. SUMMARY BACKGROUND DATA: Disease-free survival and overall survival in early breast cancer treated by BCT versus modified radical mastectomy are reported to be equivalent in prospective randomized trials. However, patients enrolled in clinical trials may not be representative of patients living in the various diverse communities that make up the United States. The authors' hypothesis is that patients enrolled in clinical trials at the national level may not be representative of indigent patients in the rural South and that clinical trial results may not be directly applicable. METHODS: A retrospective review of 55 women with early-stage breast cancer treated from 1990 to 1995 was performed. Clinical data, compliance with treatment and clinical follow-up, and recurrence rates were examined. Statistical analysis performed include the Fisher exact test, Kaplan-Meier survival analysis, and log-rank test. RESULTS: Full compliance (defined as completion of the entire course of radiation therapy and clinical follow-up) with the BCT program was observed in only 36% of patients. Fifteen of the 35 noncompliant patients did not complete radiation therapy. A significantly higher local failure rate was observed: 8 of these 15 patients (53%) have had local failure. In contrast, patients who were either in full compliance with the BCT program or were deficient only in that they missed part of their clinical follow-up had local failure rates of 5% (1/20) and 10% (2/20), respectively. Age, race, stage of cancer, economic status (measured by availability of medical insurance), distance of patient's residence from the hospital, and education level were evaluated as potential predictors of compliance. None predicted patient compliance, although a trend toward higher compliance was noted in patients with a higher education level, as determined by literacy testing. CONCLUSIONS: Compliance with the BCT protocol at the authors' institution was worse than reported in clinical trials, and noncompliance translated into a significant increase in the local failure rate. Factors examined suggest that literacy may play a role in predicting compliance. Although BCT should be discussed with all breast cancer patients, the judicious application of clinical trial data to an institution's local population is warranted.

Breast Neoplasms↗