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J J Battermann

Publications and source records attributed to J J Battermann.

At least 55 records · Page 3Linked to original sources
PubMed1987

Preliminary results with iodine-125 seeds for permanent implantation in patients with localized prostatic cancer.

Since August 1981, a permanent implantation with iodine-125 seeds has been performed in 41 patients with localized prostatic cancer. The seeds are implanted through a suprapubic incision. This gives the opportunity also to perform a diagnostic dissection of the regional lymph nodes. In five patients, the nodes were positive. In 4 out of these 5 patients bone metastases became manifest within one year. Two patients died of disseminated tumor, the first also had a local recurrence. Two other patients died shortly after treatment because of heart failure, while a third patient also died of heart failure, 2 years after implantation. Out of 31 patients with a follow-up period of 6 months or longer, distant metastases were found in four, in 2 followed by a local recurrence in the prostate. We can conclude that the preliminary results of this technique are encouraging with only three local recurrences in 41 patients. The prognostic value of positive lymph nodes was once again established.

Brachytherapy↗
PubMed1987

What degree of accuracy is required and can be achieved in photon and neutron therapy?

In this paper an attempt is made to formulate criteria for the accuracy in the delivery of absorbed dose to a patient during photon or neutron therapy. These requirements are mainly based on the relative steepness of dose-effect curves for local tumour control and normal tissue damage. A review of these dose-effect curves after photon irradiation shows a great variety in steepness; the curves for normal tissue complications in general may be steeper than those for local tumour control. From these data a standard requirement for the combined uncertainty of type A (random) and type B (systematic), given as one relative standard deviation, in the absorbed dose delivery of 3.5% is proposed, even though it is known that in many cases larger values are acceptable and in a few special cases an even smaller value should be aimed at. From the available radiobiological and clinical data it can be concluded that no statistically significant difference can be observed in the relative steepness of dose-effect curves after photon or neutron irradiation. Similar limits will thus be requested in neutron therapy. The uncertainties in the various steps involved in the delivery of an absorbed dose to a point in a patient have been analysed for a treatment with two parallel-opposed beams. The results of this analysis showed that even for these simple treatment conditions, the required accuracy in the delivery of the absorbed dose cannot completely be obtained in photon therapy, and not nearly in neutron therapy. The uncertainties in physical, radiobiological and clinical approaches for weighting of the biological effectiveness of neutron radiation have been compared. The uncertainty in the RBE ratio will replace the type B uncertainty in the absorbed dose during patient treatment if the same dosimetry protocol is applied during biological and clinical procedures.

Cell Survival↗
PubMed1986

The Amsterdam fast neutron therapy project: a final report.

In the period from February 1975 through September 1981 a total of 435 patients received radiotherapy with the 14 MeV d + T neutron generator, hospital based in the Netherlands Cancer Institute (the Antoni van Leeuwenhoek Hospital). Preliminary data on clinical results were published during the past few years. In this paper a final report is given of the program. The results can be summarized as follows: The neutron generator fulfilled the criteria for clinical use, that is it was reliable and had the required minimal output of 10(12) neutrons s-1. However, the dose distribution was more comparable with a 250 kV X-ray machine than with a modern accelerator. A number of physical parameters of importance for clinical neutron dosimetry have been determined for our therapy unit. These data, as well as the results of dosimetry intercomparisons in which our institute participated, contributed in the drafting of a European protocol for clinical neutron dosimetry. Pilot studies were carried out on different tumor sites, including head and neck, brain, pelvis, soft tissue and pulmonary metastases. In many patients local tumor control was seen, however, often concomitant with severe complications, especially in deep seated tumors. Randomized clinical trials were carried out for head and neck tumors (in collaboration with some other European centers) and for inoperable bladder and rectal tumors. No significant difference was observed in local tumor control or late morbidity between photon and neutron irradiation for the head and neck tumors. Also the results for pelvic tumors failed to demonstrate an advantage for neutron therapy. In this study two neutron arms were used with different dose schedules. As could be expected a higher local control rate was noticed for the higher neutron dose group, but concomitant with a higher complication rate. From our experience we have to conclude that treatment with our fast neutron treatment facility did not result in a benefit over photon irradiation. It seemed that the differential effect between tumor and normal tissues is smaller with fast neutrons than with photons.

Evaluation Studies as Topic↗
PubMed1986

Results of implantation for T1 and T2 bladder tumours.

In the period from January 1972 through December 1983 a total of 123 patients was treated for a bladder malignancy by preoperative external irradiation followed by interstitial therapy. Criteria for selection of patients are solitary lesion, tumour smaller than 5 cm in diameter, state T1 and T2. The majority of patients was in state T2 (89 patients). Persisting local control was achieved in 29 out of 34 T1 cases and in 69 out of 85 T2 cases. The actuarial 10 years survival was 72% for T1 and 34% for T2, with a total disease-free percentage at 10 years of 77% for T1 and 56% for T2. Although in many patients delayed wound healing was noticed, no serious late reactions were seen in skin, bladder or intestine. The causes of death are distant metastases in 13 patients and intercurrent diseases in another 21 patients.

Adenocarcinoma↗
PubMed1985

A neutron-photon treatment planning intercomparison.

In order to assess different treatment philosophies in different neutron therapy centres as well as to gauge the quality of neutron dose distributions relative to corresponding photon plans, a neutron-photon treatment planning intercomparison has been organized amongst the neutron therapy centres in Europe and the U.S.A. Treatment plans were compared for patients with a tumour in the floor of the mouth, a carcinoma of the base of the tongue and a large bladder carcinoma. A wide variety in treatment plans was received. This was mainly caused by the different assumptions on the treatment margin around the tumour and whether or not the lymph nodes should be irradiated electively. Within the same institute, however, similar types of plans were used for both the neutron and the photon irradiations. The homogeneity of the adsorbed dose over the target volume can be made almost the same for photon and neutron irradiations, although this may require a more complicated technique for neutron treatment. The relative absorbed dose to normal tissues was somewhat higher for the neutron treatment. There is an increased chance of the occurrence of a hot spot with the relatively low energy neutron beams compared to the photon beams.

Aged↗
PubMed1985

Review and evolution of clinical results in the EORTC Heavy-Particle Therapy Group.

Part of the clinical results from the "EORTC Heavy-Particle Therapy Group" are reviewed (September 1984). Fast neutrons can bring a significant benefit, compared to conventional photon (or electron) techniques, in well defined patient series. A benefit for neutrons is observed, in Hammersmith and in Amsterdam, for locally extended salivary gland tumours. Soft tissue sarcomas can also be considered as a good indication for neutron therapy, especially when they are slowly growing and well differentiated, as shown in Essen, Hammersmith and Louvain-la-Neuve. Neutrons can bring an advantage in the treatment of some melanoma patients as shown in Hammersmith. For locally advanced prostatic carcinoma, better results for neutrons are shown in Hamburg and Louvain-la-Neuve. These data are similar to those observed in the United States from the RTOG studies. Due to a reduced differential effect between tissues after neutron treatment, irradiation of large volumes of normal tissues, at high neutron dose, should be avoided. Different possible combinations between neutrons and photons (boost, mixed schedule) are discussed.

Adenocarcinoma↗
PubMed1984

Fast neutrons in the treatment of head and neck cancers: the results of a multi-centre randomly controlled trial.

The results are presented of a multi-centre randomly controlled trial of fast neutron irradiation and mega-voltage X-rays in the treatment of patients with locally advanced squamous cell carcinoma of the head and neck region. No significant difference was observed in local tumour control rates. Salvage surgery was performed in a similar number of patients in the two groups. Late morbidity was also similar in the two treatment groups. Patients in a subgroup with cancer of the larynx treated by photons had a significantly better survival than those in the neutron treated group.

Aged↗
PubMed1982

Results of d + T fast neutron irradiation on advanced tumors of bladder and rectum.

From November, 1975 to November, 1981, around 400 patients were irradiated with 14 MeV d + T fast neutrons at the Antoni van Leeuwenhoek Hospital in Amsterdam. Special interest was focused on inoperable tumors of bladder and rectum. During the pilot phase of the study 47 patients were treated, mostly via two parallel opposed ports with dosages that ranged from 18 to more than 22 Gy. Although persistent local control was achieved in 23 patients (48%), 14 patients (29%) died of severe complications. By the introduction of a six field technique, the fatal complication rate could be reduced significantly. Since May 1978 patients were randomized in a three arm trial, using two dose levels on the neutron site. The preliminary results of a group of 91 patients show a similar survival in the three treatment arms with a somewhat better local control rate for high dose neutrons. An attempt was made to estimate RBE values for tumor control and normal tissue reactions by comparing the data for neutron irradiation with the data obtained with photons on a similar group of patients. From the values derived it must be concluded that the gain for neutron irradiation on these tumors in the pelvis will be negligible.

Clinical Trials as Topic↗
PubMed1981

Dose-effect relations for tumour control and complication rate after fast neutron therapy for pelvic-tumours.

The effects of fast neutrons and high-energy photons were analysed for tumour control and skin and bowel damage after treatment of bladder and rectal cancers. A combination of statistical models was used for this analysis. A steep dose-effect curve was found for local tumour control as well as for the risk of complications. Some estimates were made of RBE values for control of bladder tumour and for normal-tissue damage. The implication of these data for neutron therapy is discussed.

Dose-Response Relationship, Radiation↗