The role of radiation therapy in the treatment of small cell undifferentiated bronchogenic cancer.
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Antineoplastic Agents↗
Biomedical subjects
H T Barkley
Publications and source records attributed to H T Barkley.
Combination chemotherapy and radiation therapy for small cell carcinoma.
A three-drug combination of the chemotherapeutic agents cyclophosphamide, vincristine sulfate, and doxorubicin hydrochloride was given to 45 patients with small cell bronchogenic carcinoma. In addition, patients with limited disease received radiation therapy to the primary tumor. The complete response rate was 44%, with a median survival of 50 weeks. The partial response rate was 29%, with a median survival of 35 weeks. Patients who did not respond to therapy showed a median survival of only 12 weeks. Twenty percent of the patients had their first recurrence in the brain, and the median survival from the time of disease recurrence was ten weeks. Bone marrow metastasis was encountered in 24% of the patient population, but this did not adversely affect survival.
Brain Neoplasms↗
The significance of residual disease after external irradiation of squamous-cell carcinoma of the oropharynx.
366 patients with squamous-cell carcinoma of the oropharynx treated by external irradiation were studied to see whether residual disease at the end of treatment influences control. The frequency of recurrence was found to be significantly greater when residual disease was present. When the total dose was determined by the degree of regression of the primary lesion during treatment rather than the initial tumor volume, recurrence was significantly more frequent. Forcing the dose beyond a level suitable for the original volume of disease failed to prevent recurrence in patients with residual disease, most likely due to the hypoxic state of the remaining tumor cells.
Carcinoma, Squamous Cell↗
Volume and time factors in interstitial gamma-ray therapy.
The two suppositions which have dictated time-dose and volume relationships in interstitial gamma ray implantation have been examined in the light of recent publications. The first of these assumptions, that total dose reduction is required when the dose rate exceeds 6,000-7,000 rads in seven days, does not appear to be substantiated by clinical experiences. It appears that total dose is the critical treatment parameter and that dose rate may be increased by a factor of two or three without requiring alteration of the total dose. Although the second classical assumption, "volume increase requires dose decrease," has been shown throughout radiation therapy experience to be generally correct, it should not be applied rigidly to interstitial gamma-ray therapy. In fact, recent experiences seem to indicate that compensation with respect to volume is not an absolute necessity. Larger lesions require, if anything, higher doses than small ones. To obtain a high percentage of controlled, lesions there must be no dose reduction, regardless of increased volume treated.
Animals↗
Total-lung irradiation in the treatment of pulmonary metastases.
Sixty-two patients with pulmonary metastases from a variety of primary malignant neoplasms were treated with total-lung irradiation. The incidence of radiation pneumonitis was 21%(13/62) overall, rising to 23% (9/39) in those receiving a tumor dose of 1,500 rads or more. Nine patients with radiation pneumonitis were given chemotherapy (actinomycin D) together with irradiation, and in this group the incidence of radiation pneumonitis was 25%. Five survivors, including 4 treated for metastatic Wilms' tumor, were treated more than 13 months prior to analysis without evidence of disease thus far. Total-lung irradiation for primary malignant neoplasms other than Wilms' tumor does not presently appear to be indicated. A dose of 1,500 rads in 2 weeks in conjunction with actinomycin D is recommended for metastatic Wilms' tumor.
Adolescent↗
Combination chemotherapy with bleomycin (NSC-125066), vincristine (NSC-67574), and methotrexate (NSC-740) plus split-course radiotherapy in the treatment of non-oat-cell bronchogenic carcinoma.
Twenty-seven unselected patients with limited disease non-oat-cell bronchogenic carcinoma were treated with a chemotherapy- radiotherapy protocol which consisted of bleomycin, vincristine, and methotrexate followed by split-course radiation. There were 15 objective responders with a median survival time in excess of 70+ weeks in contrast to a median survival time of 26 weeks for nonresponders (P less than 0.01). Objective benefit was limited to the epidermoid carcinoma group since none of the adenocarcinoma group achieved a greater than 50% reduction in maximum tumor diameter. The median survival time for the entire groups was 42 weeks in contrast to a recent split-course radiotherapy historical control group whose median survival time was 38 weeks. Toxic effects were predominantly gastrointestinal.
Administration, Oral↗