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J M Quivey

Publications and source records attributed to J M Quivey.

49 records · Page 3Linked to original sources
PubMed1982

Clinical problems in radiotherapy of carcinoma of the pancreas.

Since 1975, 94 patients with localized unresectable carcinoma of the pancreas have been irradiated using helium and heavier particles at the University of California Lawrence Berkeley Laboratory. Despite surgical exploration and an extensive diagnostic workup including radiological, nuclear medicine, and computer-assisted tomographic studies, many patients proved to have occult liver metastases manifested within 9 months post treatment. In addition, local and regional control of the primary neoplasm (approximately 20%) has been difficult to obtain even with doses of 6000 equivalent rad in 7 1/2 weeks. Gastric and biliary obstruction have required surgical bypass procedures since irradiation has not been successful in relieving obstructive symptoms. Evidence of gastrointestinal injury has been present in postradiation therapy in approximately 10% of patients, a figure which might be higher if more patients had a longer survival (average 10 months). Some patients require pancreatic enzyme supplementation because of pancreatic deficiency either secondary to tumor or treatment. Further improvement in local control and survival requires better diagnostic methods for evaluation of local and metastatic spread, improved therapy for local and regional disease, as well as therapy directed at occult liver metastases that are frequently present.

Adenocarcinoma↗
PubMed1981

Treatment of carcinoma of the vocal cord. A review of 20 years experience.

At the University of California, San Francisco, 323 patients were treated for carcinoma of the vocal cord between January 1956 and December 1975. Patients with early T1 or T2 lesions were treated with radiotherapy or conservative surgery. Patients with T3 or T4 lesions were treated with total laryngectomy, radiation alone, or combined therapy. Of the 247 patients treated with definitive radiotherapy, initial control of the primary lesion was achieved in 100% of T1S, 80% of T1, 52% of T2, and 50% of T3 and T4 lesions. Surgical salvage of radiation failures was 86%, giving ultimate control rates in this group of 100% for T1S, 97% for T1, 91% for T2 and 64% for T3 and T4. Involvement of the anterior commissure did not significantly affect local control or survival rates of the irradiated patients. Voice quality was satisfactory in 95% of controlled patients. Surgery alone was used as the primary treatment modality in 63 patients, with ultimate local control achieved in 75% of T1S, 83% of T1, 85% of T2, 81% of T3 and T4 lesions. Planned combined therapy was successful in 9/13 patients in whom it was used. The overall 3 and 5 year actuarial survival rates were 84% and 77% respectively corresponding determinate survival rates were 90% and 86%.

Aged↗
PubMed1980

Current status of clinical particle radiotherapy at Lawrence Berkeley Laboratory.

Clinical experience with charged particle irradiation of human cancers has been underway at the University of California Lawrence Berkeley Laboratory. Over 150 patients have been irradiated with heavy charged particle beams including helium, carbon, neon, and argon ions. Pilot studies have included such tumor sites as glioma of the brain, carcinoma of the esophagus, carcinoma of the pancreas, carcinoma of the stomach, ocular melanoma, and carcinoma of the uterine cervix. Prospective studies are planned to investigate the improved dose localization potential (helium) and the enhanced biologic and physical dose potential (carbon, neon) in a controlled trial against the best available megavoltage irradiation techniques.

Argon↗
PubMed1980

Helium ion charged particle therapy for choroidal melanoma.

Nine patients with choroidal melanomas were treated with helium ion charged particle irradiation. No patient demonstrated tumor enlargement, and most lesions followed for more than five months have demonstrated tumor shrinkage. The most effective method of choroidal melanoma management is unclear. Heavy charged particle irradiation may be more applicable and have less ocular morbidity associated with it in either radioactive plaques or photocoagulation.

Adult↗
PubMed1980

CT of radiation-induced hepatic injury.

The CT findings in three patients with radiation-induced hepatic injury are discussed. In each patient a sharply defined band of low density was identified within the liver in an area of prior radiation. The low density bands resolved on follow-up examination. Computed tomography is useful in the diagnosis and follow-up of patients with suspected radiation hepatitis and in differentiating radiation change from metastatic disease.

Adult↗
PubMed1980

Radiotherapy with heavy charged particles at Lawrence Berkeley Laboratory.

Since July 1975, 157 patients have been irradiated with heavy charged particles at the Lawrence Berkeley Laboratory in a Phase I-II clinical trial to study the usefulness of these particles in the irradiation of human cancers. The particles utilized have included helium, primarily of interest because of improved dose distributions with reduction of dose to adjacent normal tissues, and heavier particles such as carbon, neon and argon ions which have the additional potential of increased biologic effectiveness against the tumor, especially hypoxic tumor cells. Initial results with helium particles have been sufficiently good to warrant a Phase III randomized trial in carcinoma of the pancreas; in other tumor sites, and with other particles, Phase I -- Phase II studies are in progress. Although follow-up is short, control within the irradiated area in this heterogeneous group of patients appears at least as good as with current megavoltage irradiation and complications to date are acceptably low, warranting further studies with heavy charged particles.

Argon↗
PubMed1980

Computerized tomography in the quantitative assessment of tumour response.

While Computerized Tomographic (CT) scans have been a valuable asset to radiotherapy treatment planning, their role in the critical assessment of tumour response has been less well defined. Recent refinements in radiotherapy treatment techniques have intensified the need for non-invasive methods to evaluate the local control of inaccessible neoplasms. In this study, 20 cases in which both pre- and post-treatment CT scans were available up to 27 months post-therapy were reviewed. The majority of the patients had pancreatic carcinoma. In both pre- and post-therapy scans, the tumour volume was calculated from contours outlined on sequential CT slices. These interpretations were compared with surgical findings, clinical course and patient survival. The rate of the primary tumour regression had little bearing on the clinical outcome. However, there was CT scan evidence of initial local tumour stabilization or regression in > 80% of the cases. In addition, CT scan evidence of tumour progression was correlated with clinical progression in > 90% of the patients. This suggests that a growth delay analysis might be possible with the use of CT scans, at least for the evaluation of pancreatic carcinoma.

Humans↗
PubMed1977

Malignant tumors of the testis: analysis of treatment results and sites and causes of failure.

A total of 150 patients with germinal testicular neoplasms treated at the University of California, San Francisco, were reviewed. The 5-year actuarial survival rate was 95% for 57 patients with seminoma and 56% for 75 patients with carcinoma. Treatment modalities were compared with respect to sites and causes of failure and complications. The most common sites of failure in the carcinoma patients were lung, and supraclavicular or mediastinal lymph nodes. Scrotal orchiectomy, elevated gonadotropins, elements of choriocarcinoma, and bulky abdominal disease were all correlated with high treatment failure rate.

Carcinoma↗
PubMedDate not supplied

Dermatofibrosarcoma protuberans.

The consultants agreed that dermatofibrosarcoma protuberans is characterized by its persistent growth and locally aggressive behavior. However, they did not all agree on the mode of treatment. Drs. Schuller and Snyderman favored surgical resection of the involved areas including the right cheek, lower eyelid, and any necessary portions of the nasal ala and upper lip. They encouraged the use of Moh's chemosurgery to detect microscopic disease. They were also in agreement regarding reconstruction, suggesting a cervical-facial or bi-lobed flap for the cheek. A full-thickness skin graft was recommended for the lower eyelid with primary closure planned for the lip defect. They disagreed on the use of postoperative radiation therapy. Dr. Schuller elected not to irradiate; Dr. Snyderman favored 60 to 65 Gy post-operatively. Dr. Quivey expressed concern regarding the morbidity from such a large resection and extensive reconstruction and suggested primary radiation therapy with external beam. All three consultants felt that good follow-up would include thorough head and neck examinations with MRI and/or CT scans if there were any concern about tumor recurrence.

Adult↗