PubMed Health⌕ Search

Biomedical subjects

J Fernández García

Publications and source records attributed to J Fernández García.

13 recordsLinked to original sources
PubMed1998

[Treatment results with external radiotherapy in prostate cancer].

OBJECTIVE: External irradiation is an accepted curative treatment modality for patients with localized prostatic tumor. The 15-year results in patients treated by radical irradiation alone are presented. The determinant prognostic factors for local tumor control and disease free survival are analyzed. METHODS: 135 patients with a histologically confirmed localized carcinoma of the prostate were treated at our department from May 1972 to January 1998. Fifty patients received Co-60 therapy; the linear accelerator and high energy photons were utilized in the remaining 80 patients. By tumor stage, 53 patients were B1, 49 B2 and 33 C. The mean follow-up was 61 months (range 1-180). Most patients were exposed to localized fields of irradiation; dose ranged from 50-74 Gy, fractionated at a dose of 180-200 cGy/day. RESULTS: Overall local tumor control was 77% at 5 years and 73% at 15 years, with a disease free survival of 63% and 45% at 5 and 15 years, respectively. Local tumor control at 13 years was 71% for stage B1, 82% for B2 and 70% for C. The disease free survival at 13 years for stages B1, B2 and C were 46%, 49% and 36%, respectively. The BD and MD tumors had a 15-year disease free survival of 48% vs 32% for the PD tumors (p = 0.005). Patients with PSA < or = 20 ng/ml before treatment showed a disease free survival of 87% vs 48% for those with PSA > 20 ng/ml ((p = 0.011). Multivariate analysis showed dose to be a determinant prognostic factor for local tumor control (0.0432); dose and histological grade were determinants for disease free survival (p = 0.029 and 0.033). CONCLUSIONS: This retrospective study found dose to be a determinant prognostic factor for local tumor control and both dose and histological grade were determinants for disease free survival. Radiotherapy is a therapeutic option for these patients. The results can be enhanced if the dose delivered to the prostate can be increased while maintaining the complication rate within the same ranges.

Aged↗
PubMed1993

[Testicular germinal cell tumors. Authors' case load. Treatment review].

This article reports our case series of testicle germinal cell tumours, consisting of 14 cases, between 1974-1991. 42.85% (6 cases) were seminomas, 4 (66.6%) in Stage I. There was one case (16.6%) in Stage III and another one in Stage IV. 14.29% (2 cases) were embryonic carcinomas, one in Stage I and one in Stage II. Teratomas represented 14.29% (2 cases), in Stages I and IV respectively. There were 4 cases of mixed tumours (2 cases) in which teratomatous components (3 out of 4) were predominant. 50% were in Stage I and 50% in Stage III. Inguinal orchiectomy was performed in all cases, and three received radiotherapy (seminomas in Stages I (2 cases) and III), with survival ranging from 1 to 7 years. Two cases (seminoma and embryonic carcinoma) received chemotherapy under different regimes depending on the time of diagnosis. One patient has survived 11 years following rescue lymphadenectomy while the other one died 14 months later from pulmonary metastasis. Among the mixed tumours, 50% (2 cases in Stages II and III) died 5 and 11 months afterwards without further treatment due to overall affectation at diagnosis. An abstentionist approach in Stage I (seminomas and non-seminomas), which was "strictly" applied in 5 cases showing disease-free survival ranging from 1 to 5 years, is defended. Follow-up was not feasible in 2 cases (14.2%). Both the diagnostic means and a review of treatment by Stages, reflecting the evolution of chemotherapy and the results obtained, are analyzed. Also the most widely accepted approaches in the management of these tumours.

Combined Modality Therapy↗
PubMed1992

[The complete testicular feminization syndrome: apropos 2 new cases].

Two additional cases of complete testicular feminization syndrome or Morris syndrome are described. The patients had consulted for primary amenorrhea. Patient work up revealed a female phenotype, hormone profile and 46,XY karyotype. They were submitted to abdominal surgical exploration and orchidectomy of the cryptorchid male gonads. The potential etiologic factors, pathogenesis, incidence and clinical features of this syndrome are discussed. Furthermore, the surgical treatment and outcome are described, highlighting the incidence of gonadal malignancy if these are not removed early.

Adult↗
PubMed1990

[Incidence of epidermoid cancer of the esophagus in Asturias (1975-85)].

We present the incidence the esophageal squamous cell carcinoma in Asturias, based on the review of the clinical histories of eleven years (1975-85). Of 356 total cases, 92.4% were male patients and the remaining 7.6% females; the relation M:F was 12.2:1. Mean age at the time of diagnosis was 59.4 +/- 9.6 for males and 70 +/- for females. Total annual incidence was 2.8 +/- 0.8 cases/10(5) + population/year. Maximal annual incidence was registered in 1981: 1.1 cases/10(5) population/year. Asturias has eight health districts; those with highest incidence were mining areas: Mieres, Cangas de Narcea and Riaño. Compared to that of some developing countries, the incidence of esophageal cancer in Asturias is low, similar to that in European countries (except France) and white population of the USA; there is an aggregation of cases in males living in mining areas.

Adolescent↗
PubMed1989

[Combination of interstitial implants of Au-198 seeds and external irradiation in the treatment of prostatic carcinoma. Preliminary communication].

The usefulness of external and interstitial radiotherapy in the treatment of prostatic carcinoma is well-documented. We report on our experience in 23 cases using interstitial Au-198 seed implants in combination with external radiation. The diagnostic protocol and therapeutic approach are described. Local control was achieved in 73% and the disease-free survival at 36 months was 49%. The mean follow-up was 44 months. The problems resulting from TUR and the different factors that might be responsible for the failure of local treatment are discussed.

Aged↗
PubMed1989

[Radiotherapy as the definitive treatment of patients with carcinoma of the bladder].

Sixty-one patients, who refused surgery or whose overall medical status advised against radical cystectomy, were submitted to radical radiotherapy at the Oncology Radiotherapy Service of the General Hospital of Asturias. Irradiation was performed in a cobalt therapy unit. Radiation dose ranged from 50-70 Gy, with a daily dose of 190-200 cGy. Local control was achieved in 71% for stage A, 68% for B1. 17% for B2, and 0% for stage C. Disease-free survival was 63% for stage A, 48% for B1, 14% for B2, 0% for C, and 17% for D1. Overall disease-free survival was 20%, and the morbidity and mortality rates were 11.4% and 3.2%, respectively. In view of the poor results achieved in our setting, we have considered using combined external and interstitial radiation for tumors localized in the muscle layer, and adjuvant chemotherapy for stage C tumors (or those infiltrating perivesical fat).

Aged↗