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Fergus Macbeth

Publications and source records attributed to Fergus Macbeth.

7 recordsLinked to original sources
PubMed2004

Palliative treatment for advanced non-small cell lung cancer.

It should go without saying that all patients with advanced NSCLC are entitled to the treatment and care described in this article. It is probably also true that in many countries where these patients are often elderly and socially disadvantaged, they may have very variable access to this treatment and care. There is reasonable research evidence that both chemotherapy and palliative radiotherapy are modestly effective in controlling symptoms and prolonging life for some patients, but with significant risks of unpleasant and sometimes life-threatening toxicity. For this large and important group of patients, however, there are a large number of unanswered questions about the best regimens to use, how best to select patients so that they get the greatest benefit, how to mitigate side effects, and how best to integrate all the available treatment options. There have been significantly more trials in chemotherapy, but we must not overlook the need for research into palliative radiotherapy and other supportive care measures. There is still plenty of scope for intelligent and coordinated research.

Carcinoma, Non-Small-Cell Lung↗
PubMed2003

Palliative thoracic radiotherapy for non-small-cell lung cancer: a systematic review.

Non-small-cell lung cancer is one of the most common malignant tumors worldwide. The majority of patients are not treatable with curative intent because of the extent of disease or patient comorbidity. Radiotherapy to the primary intrathoracic tumor is used with the aim of palliating troublesome local symptoms in approximately 25% of patients. The dose/fractionation regimens used evolved empirically, and surveys have shown widespread variation. It has not yet been clearly established which regimens give the most benefit and least toxicity. This systematic review identified 12 randomized controlled trials comparing palliative external beam radiotherapy regimens. Narrative synthesis has been performed. Palliative radiotherapy is effective in controlling symptoms. There is no strong evidence that better palliation is obtained with higher radiation doses but good evidence that toxicity is greater. There is evidence of a modest survival benefit with higher dose schedules in patients with good performance status. The majority of patients should receive short courses (one or two fractions) of hypofractionated radiotherapy, Selected patients with good performance status should be considered for higher dose regimens if the chance of modest improvement in survival and palliation is considered worth the additional inconvenience and toxicity.

Carcinoma, Non-Small-Cell Lung↗
PubMed2002

Pulmonary blastoma: medium-term results from a regional center.

BACKGROUND: Pulmonary blastomas are rare lung tumors that morphologically resemble fetal pulmonary structure and can exist in two forms, biphasic and monophasic. We reviewed our experience over a 12-year period with emphasis on the clinical features, management, and outcome. METHODS: Patients with a diagnosis of pulmonary blastoma from January 1988 to July 1999 were identified from the database of the Department of Histopathology, Llandough Hospital, Cardiff. Specimens had been obtained from bronchoscopy, fine-needle aspiration, trucut biopsy, and thoracotomy. RESULTS: Six patients were identified from 2,720 histologically proven lung cancers (0.2%). Median age was 35.5 years and sex ratio was equal. Overall, 4 patients underwent resection and are all alive (median, 43.5 months). Three of these had advanced tumors at presentation (stage IIIb or IV), two of which were successfully downstaged with neoadjuvant chemotherapy, and the third treated with postoperative radiotherapy. Nonresected cases succumbed at a median of 5.5 months. CONCLUSIONS: Although pulmonary blastomas are rare, those affected represent a group of patients with advanced tumors for whom a coordinated approach from both oncologists and surgeons can achieve excellent medium-term results.

Adult↗