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Biomedical subjects

K Prem

Publications and source records attributed to K Prem.

9 recordsLinked to original sources
PubMed1983

The morbidity and utility of periaortic radiotherapy in cervical carcinoma.

From 1971 through 1981, 81 women received 4350 to 5075 rad to the periaortic lymph nodes as part of their primary management for carcinoma of the uterine cervix. While two patients developed chronic small bowel damage, only one required surgical intervention. Five-year disease-free survival was 40%. Approximately one-third of the first recurrences were within the pelvic and periaortic radiation portals, with the remainder in the lungs, liver, bones, abdomen, and supraclavicular lymph nodes. Radiation dose and volume guidelines are presented in order to minimize enteric morbidity.

Adenocarcinoma↗
PubMed1980

Sequential surgery, radiation therapy, and Alkeran in the management of epithelial carcinoma of the ovary.

In 1970, a prospective multidisciplinary protocol was initiated for Stages I through III obviously malignant ovarian epithelial carcinomas. The planned sequential therapy included 1) surgery, 2) radiotherapy (2000 rads to whole abdomen, 3000 rad boost to pelvis), 3) chemotherapy (ten cycles of Alkeran), and 4) a "second-look" surgical procedure. Ninety-six patients were enrolled in this program through 1976. Median follow-up of the survivors was greater than 44 months. Adjusted disease-free survival was 90 percent for Stage I, 64 percent for Stages IIB--IIC, and 16 percent for Stage III. Stage III patients with no palpable tumor at time of initiation of radiation therapy had a survival of 37 percent. No Stage III patient with palpable tumor at time of initiation of radiation therapy was cured. Eight percent of patients developed small bowel obstruction requiring surgical intervention. Three percent of all patients died of hematologic causes; of the 30-month-plus survivors, 5 percent (2 of 37) developed acute myelogenous leukemia. Cure and toxicity will be examined in detail and compared with the literature.

Adenocarcinoma↗
PubMed1979

A comparison of medroxyprogesterone serum concentrations by the oral or intramuscular route in patients with persistent or recurrent endometrial carcinoma.

A randomized study, comparing serum medroxyprogesterone concentrations by the oral and intramuscular routes, was performed on 22 patients with persistent or recurrent endometrial adenocarcinoma by six institutions of the Gynecologic Oncology Group. The oral group (11 patients) received cutaneous Provera (medroxyprogesterone), 50 mg three times a day, and the intramuscular group (11 patients) received 300 mg of Depo-Provera (medroxyprogesterone) weekly for at least 2 months. Serum levels were evaluated at 0, 2, 4, 6, 8, 10, and 12 hours after administration and every day for the first week and weekly thereafter for 8 weeks. The mean serum levels (nanograms per milliliter) of medroxyprogesterone in the oral group were consistently higher than the corresponding mean levels of the intramuscular group. In addition, from the first through eighth weeks, the measurements (medians) for the oral group were statistically higher than those for the intramuscular group. Although the study indicates a significant increase in serum levels achieved by the oral route, the follow-up period of patients under study is too early to evaluate its clinical effectiveness as compared to the intramuscular route.

Adenocarcinoma↗
PubMed1977

Postpubertal evaluation of gonadal function following cyclophosphamide therapy before and during puberty.

Evaluation of pituitary gonadotropins, gonadal steroids, spermatogenesis, and menstrual function was undertaken in 32 patients (19 males and 13 females) treated with cyclophosphamide because of nephrotic syndrome. Patients were treated before, during, or after puberty. Evaluations took place after or in very late puberty. Spermatogenic dysfunction occurred in six of 15 boys who received the entire course before and during puberty and was probably dose related. Menstrual dysfunction did not occur following treatment of six prepubertal or pubertal girls, though only low total doses were used. Therapy after puberty was associated with spermatogenic dysfunction in all four boys, but did not cause menstrual dysfunction in any of seven women. Tentative guidelines are suggested that many minimize gonadal toxicity when cyclophosphamide is used in children with nephrotic syndrome. Factors of particular importance in the interpretation of gonadotropin determinations and of sperm counts in young cyclophosphamide-treated patients are discussed.

Cyclophosphamide↗