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Biomedical subjects

F N Rutledge

Publications and source records attributed to F N Rutledge.

At least 73 records · Page 4Linked to original sources
PubMed1977

Preirradiation celiotomy and extended field irradiation for invasive carcinoma of the cervix.

Epidermoid carcinoma of the cervix was treated in 120 patients by means of exploratory celiotomy (with semitherapeutic excision of involved lymph nodes) followed by irradiation. The size of the field used for irradiation was determined by the presence and site of lymph involvement. Of 64 patients, metastatic cancer in pelvic nodes was found in 40, and in common iliac or aortic nodes in 24. Of the 2 groups, 8 and 3 patients, respectively, survived for 2 years or more. Irradiation to extended fields (using 5500 rads at 850 rads per week) controlled the cancer satisfactorily within the treated area, but the incidence of bowel complications was high. Recurrent carcinoma usually appeared as distant metastases outside the treatment area which suggests that patients with bulky primary lesions and positive nodes actually already have systemic disease as treatment is started. A safe yet effective dosage level for radiation therapy to extended fields has not yet been established.

Carcinoma, Squamous Cell↗
PubMed1976

The significance of measurement of human placental lactogen, human chorionic gonadotropin, and carcinoembryonic antigen in patients with ovarian carcinoma.

Human placental lactogen (HPL or HCS), the beta subunit of human chorionic gonadotropin (beta-HCG), and carcinoembryonic antigen (CEA) were measured by a specific radioimmunoassay in plasma of 65 patients with ovarian cancer. Fifty-one patients had epithelial tumors, while 14 had germ cell tumors. It was found that 47 patients (72 per cent) had high levels of plasma HPL, 29 patients (45 per cent) had high levels of plasma beta-HCG, and 34 patients (52 per cent) had high levels of plasma CEA, but there was no correlation between these protein marker levels in different patients. Twenty of these patients were studied before and after operation and during chemotherapy and/or radiotherpy. There was no consistent correlation between these marker levels and the course of the disease. These data suggest that measurement of HPL, beta-HCG, and CEA in sera of patients with ovarian cancer is not of value in assessing the clinical status of the patients or in determining the effect of therapy.

Adenocarcinoma↗
PubMed1976

Clinical studies with adjunctive surgery and irradiation therapy in the treatment of carcinoma of the cervix.

The majority of patients with cancer of the cervix are treated adequately by irradiation alone, and surgery is not necessary. A role for operation developsin certain patients with Stage I-II cancer of the cervix, who are prone to develop central recurrence if treated by irradiation alone. In these patients the primary lesion is massive. The vasculature to the center of these bulky or barrel-shaped cancer is insufficient, and a population of the cancer cells, perhaps related to anoxia, is more resistant to irradiation. The postirradiation conservative hysterectomy was incorporated into the treatment plan for 212 selected patients and the number of local recurrences was reduced. Incomplete cure of the peripheral component of the disease is another mechanism of treatment failure. This may occur, even though the primary lesion is cured. Patients with cervical cancers greater than 5 cm diameter have a high incidence of node metastasis, regardless of clinical stage. In those patients with positive nodes, the standard portals for external irradiation were expanded to include nodes at higher levels. The site of metastases was established by pretreatment laparotomy and the irradiation portals were then extended to include the involved nodes. Survival rates were not improved, because recurrences were not prevented, and death from treatment complications were high.

Adenocarcinoma↗
PubMed1976

ARS Presidential Address: Estrogen therapy: a causal role in endometrial cancer?

Publicity associated with recent reports of a greater frequency of adenocarcinoma of the endometrium among women who take exogenous estrogens has created confusion among physicians and fear among patients. An objective review of available data on estrogen effects and current epidemiologic evidence suggests that estrogen may play an indirect role in the development of endometrial carcinoma. Until definitive data are available, physicians should exercise caution in prescribing estrogens, monitoring the status of the endometrium at regular intervals by sampling and pathologic analysis.

Estrogens↗
PubMed1975

Adenocarcinoma of the uterine cervix.

From January 1, 1947, through December 31, 1971, 219 patients with primary adenocarcinoma of the intact uterine cervix were treated at the M.D. Anderson Hospital and Tumor Institute. Two modes of therapy were primarily used, namely, irradiationtherapy alone and irradiation therapy plus operation. The 5 year survival resultsare 83.7 per cent for patients with Stage i disease, 48.0 per cent for patients with Stage ii disease, 29.2 per cent for patients with Stage iii disease, and 0.0 per cent for patients with Stage iv disease. The group with irradiation plus operation had a better over-all survival rate. In addition, the incidence of central and pelvic recurrent disease was remarkably lower (fourfold difference). The urologic and bowel complications are discussed. This review lends support for our practice of preoperative irradiation followed by simple (constructive) hysterectomy for selected patients eith adenocarcinoma of the uterine cervix.

Adenocarcinoma↗
PubMed1975

Treatment of clear cell adenocarcinoma in young females.

Eight cases of clear cell adenocarcinoma treated at The M. D. Anderson Hospital are reviewed. Six such lesions were primarily vaginal carcinomas and 2 involved the cervix. Five patients with early carcinomas were treated entirely with a transvaginal cone or interstitial irradiation and 4 are living and well, 2 to 8 years after completion of therapy. We believe that this experience justifies further treatment of early clear cell carcinomas with conservative radiation. This form of therapy is particularly important since the DEX-exposed patients represent an identifiable high-risk group which should augment the chances for early diagnosis.

Adenocarcinoma↗
PubMed1975

Postoperative treatment of early cancer of the ovary: a random trial between postoperative irradiation and chemotherapy.

One hundred and forty-nine patients with early cancer of the ovary who were suitable for postoperative radiotherapy were treated in a random study in which the efficacy of whole abdominal irradiation with additional irradiation to the pelvis was compared to that of chemotherapy with melphalan. The number of patients without evidence of disease at 2 years indicates that both treatments give similar results. However, the survivals among patients with stage I ovarian cancer showed an improvement for women treated with irradiation, survivals among patients with stage II ovarian cancer showed only a minor difference between women treated with irradiation and those treated with chemotherapy, and survivals among patients with stage III ovarian cancer improved for women treated with chemotherapy. The complications resulting from both treatments differed greatly. Melphalan was well tolerated; it caused serious bone marrow depression in only one patient. The blood counts of all patients after completing their prescribed chemotherapy promptly returned to normal levels. Seven patients treated with irradiation developed small bowel injury requiring surgery. Six of these patients, however, were treated with irradiation to the pelvis followed by strip irradiation to the entire abdomen. Since this treatment plan probably gives excessive doses of irradiation to the pelvis, it has been discontinued.

Adolescent↗
PubMed1975

Epithelial carcinoma of the ovary:prognostic importance of histologic grade.

Although this report contains only a few cases of epithelial carcinoma of the ovary and is not complete, it does suggest several new points and confirms other points reported in the literature: 1) increasing stage of cancer correlates well with decreased survival; 2) higher histologic grade of cancer correlates with decreases survival; 3) patients with a given stage of ovarian cancer having higher grades of malignancy have poorer survival; and 4) lower grade tumors are most frequently associated with lower stages of cancer, and higher grade tumors are most frequently associated with advanced stages.

Adolescent↗
PubMed1975

Results of chemotherapy as an adjunct to surgery in patients with localized ovarian cancer.

One hundred and forty-nine patients with early cancer of the ovary who were suitable for postoperative radiotherapy were treated in a random study in which whole abdominal irradiation with additional treatment to the pelvis was compared to chemotherapy with Melphalan. The number of patients without evidence of disease at 2 yr seems to show that the results of treatment are similar. When the Berkson-Gage method of projection is used, however, the survival rate in stage I is apparently improved with irradiation; there is only a minor difference in the results of the two methods in stage II, and survival rates are improved for patients with stage III disease who were treated with chemotherapy. The complications of treatment in this study were quite different. Melphalan was well tolerated, and only one patient had serious bone marrow depression as a result of this treatment. All had prompt recovery of blood counts to normal after completing the prescribed chemotherapy. Seven patients treated by radiotherapy developed a small bowel injury which required surgery. Six of these were treated with irradiation to the pelvis followed by strip irradiation to the entire abdomen. This treatment plan probably gives excessive doses of irradiation to the pelvis and has been discontinued. This type of complication is much less frequent with the other sequence of treatment--strip irradiation to the whole abdomen and subsequent treatment to the pelvis. The cost to the patient of the two treatment programs varied considerably. Patients who received irradiation had the added expense of living in Houston for the duration of treatment. Patients treated with chemotherapy were often seen a 2- or 3-mo intervals and had their chemotherapy supervised by their personal physician.

Antineoplastic Agents↗
PubMed1975

Chemotherapy in advanced ovarian cancer.

Most patients with epithelial cancer of the ovary are not cured by surgery, since their cancer has spread beyond the ovaries. The majority of these patients are not suitable for postoperative irradiation therapy, since the residual tumors are too large to be effectively treated with irradiation or they have metastasized to areas that cannot be effectively irradiated. Approximately 50% of the patients with advanced ovarian cancer who are treated postoperatively with melphalan will benefit from this chemotherapy. Approximately 40% of the patients who do not respond to chemotherapy with melphalan will benefit from treatment with a combination of actinomycin D, 5-fluorouracil, and cyclophosphamide. A second-look operation after 12 or more cycles of chemotherapy is often helpful in planning future treatment of patients, and it may be curative in a few patients if all the remaining tumor can be excised.

Altretamine↗
PubMed1975

Random study of hexamethylmelamine, 5-fluorouracil, and melphalan in treatment of advanced carcinoma of the ovary.

The effectiveness of melphalan, hexamethylmelamine, and 5-fluorouracil was compared in the treatment of patients with advanced ovarian cancer. Patients responded the best to hexamethylmelamine, which, however, was associated with considerable neurotoxicity. Patients responded the worst to 5-fluorouracil, which occasionally induced severe gastrointestinal toxicity. Patients treated with melphalan continued to demonstrate the response rate reported for several years in the literature. Melphalan seemed the best choice as a second-line drug. It induced not only the longest survival rate among patients, but also the only two complete responses as a second-line drug. Hexamethylmelamine has shown no activity as a third-line drug to date.

Adult↗