Biomedical subjects
Publications and source records attributed to H Gilbert.
Sixteen patients with intestinal and bladder injury secondary to external irradiation alone have been reviewed. Tolerance doses are shown to vary depending on the history of recent pelvic surgery, as compared to pelvic surgery in the past. A partial review of the literature and a discussion of the causative factors is presented.
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Deficiencies in zinc and vitamin A may play a role in the night blindness and hypogonadism of some chronic alcoholics; abstinence and zinc and vitamin A therapy may be of some benefit in these processes.
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The authors reviewed 181 patients who received local radiation therapy for the prevention or control of extramedullary disease resulting from acute leukemia. 126 had acute lymphocytic leukemia and 55 had acute granulocytic leukemia. They were treated over a 18-year period of time with different forms of chemotherapy. Most had not received prophylactic CNS radiation therapy. Patients were evaluated for local control until death or hematologic relapse intervened. More than 80% of patients with clinical ALL meningeal leukemia had a successful response to doses over 1000 rads. This same response was not apparent in AML. More than 80% of clinical non-CNS extra medullary leukemia was controlled with doses of 600 rads or greater. Only one patient with extra-medullary relapse is still alive. The authors feel that lower preventative doses of radiation to the CNS are compatible with similar control rates, based on their own data and other suggestive data.
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Forty-two patients with squamous cell carcinoma of the nasal vestibule were reviewed. The patients were treated at either the Southern California Permanente Medical Group or the UCLA Medical Center. Thirty-eight patients (90%) had early lesions and 4 (10%) had late disease (involving the nodes or bone). The following conclusions were formed from this study: (1) Patients without bone destruction or lymph node metastases will do well with either irradiation or surgery. Those with bone destruction or lymph node metastases will do poorly in spite of radical treatment. (2) Early lesions can often be cured with either partial rhinectomy or irradiation. (3) A surgical recurrence following partial rhinectomy can be salvaged with irradiation. (4) A radiation recurrence of an early lesion can be salvaged with surgery. (5) The routine use of total rhinectomy for early carcinoma or radiation failure is unwarranted. (6) Other primary cancers are not uncommon when followup is extended to the 5- to 10-year interval.
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