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Biomedical subjects

K W James

Publications and source records attributed to K W James.

At least 19 recordsLinked to original sources
PubMed1986

Length of follow-up in teratomas--results of a modification of Einhorn's regime in testicular teratomas.

A modification of Einhorn's original chemotherapy schedule was used to treat 40 patients with metastatic testicular teratomas. Each cycle of chemotherapy consisted of cisplatin (100 mg/m2), bleomycin (30 mg X 3) and vinblastine (5 mg/m2 X 2). Four patients failed to achieve a complete response and died with advanced disease. There was one treatment death. Only two of 14 patients who had residual masses resected still had active tumour. The 2-year actuarial disease free survival for patients in first remission was 85%, but this fell to 77% at 5 years as 3 patients relapsed (34, 36, 37 months). The results are comparable with other series but are associated with less toxicity. The need for continued follow-up is demonstrated in view of relapses occurring after 2 years.

Aged↗
PubMed1985

Cisplatin and etoposide alternating with vincristine, doxorubicin and cyclophosphamide in patients with small cell lung cancer.

Fifty-seven patients with small cell lung cancer were treated with cisplatin and etoposide alternating with vincristine, doxorubicin and cyclophosphamide. Seven patients were withdrawn because of drug toxicity. Of 50 evaluable patients 21 had limited and 29 extensive disease of whom 19 and 21 respectively achieved an objective response. Seven patients survived for longer than 2 years of whom 5 remained alive and tumour free 121-167 weeks from the start of treatment. Patients with limited disease and a complete response had a median survival of 72 weeks and the median survival of the whole group was 43 weeks. Seven out of 22 (32%) of patients who obtained a complete response relapsed and died with solitary evidence of cerebral metastases. This indicates the need for reassessment of the role of prophylactic cranial irradiation in patients achieving a complete response with effective systemic chemotherapy.

Adult↗
PubMed1984

Resolution after radiotherapy of severe pulmonary damage due to paraquat poisoning.

A 29 year old man was admitted 36 hours after ingesting about 5 g paraquat. His arterial oxygen pressure fell progressively to 3.4 kPa (34 mm Hg), and pulmonary damage induced by paraquat was diagnosed. His condition did not improve after treatment with prednisolone and cyclophosphamide, but after irradiation both lungs cleared and arterial oxygen pressure started to improve. Irradiation of the lungs should be considered in patients who, after surviving the acute phase of poisoning with paraquat, show progressive deterioration of respiratory function.

Adult↗
PubMed1983

Treatment of cancer of the cervix with a high-dose-rate afterloading machine (the Cathetron).

Two hundred and ninety-one patients with invasive carcinoma of the cervix uteri were treated by a combination of external beam therapy (telecobalt or 4 Mv Linear accelerator) and a high dose-rate afterloading intracavitary apparatus (the Cathetron). All patients have been followed for a minimum of 3 1/2 years. The five year survival rates are: all patients 55%; Stage I, 81%; Stage IIA, 74%; Stage IIB, 40%; Stage III, 27%. Death was directly attributed to treatment in five patients. We found a serious complication rate of 3% for all patients treated, the major problem being radiation ileitis. It is concluded that high dose-rate treatment offers comparable results to conventional radium therapy; the choice between high and lose dose-rate afterloading systems depends on the number of patients needing treatment and associated economic factors rather than any intrinsic radiobiological advantage of either system.

Adenocarcinoma↗
PubMed1982

A controlled clinical trial in advanced ovarian cancer.

Thirty-eight patients with an advanced ovarian cancer (FIGO stage III and IV) were randomly allocated to treatment, either with melphalan (M) or a combination of adriamycin, 5-fluorouracil and cyclophosphamide (CAF) to determine the effect on survival. Actuarial survival of the two treatment groups was the same but the combination was more toxic.

Antineoplastic Agents↗
PubMed1981

The investigation and treatment of germ cell tumours of the testis.

Fifty-five per cent of patients presenting with testicular tumours in 1973--78 had teratomata. A history of undescended testis was only found in patients with seminoma. The right testis was the more frequent site of the primary. Radiation doses of 3400 cGy (rad) in 20 fractions for seminoma and 4500 cGy in 25 fractions for teratoma were well tolerated and sterilised microscopic disease in the majority of patients. Forty-two of 44 seminoma patients are alive and free from disease at a median follow-up of three years. Only 15 of 22 Stage I teratoma patients remain disease free, however. A combination of vinblastine and bleomycin produced 12 complete remissions in 30 patients with metastatic teratoma. Survival was significantly longer for patients achieving complete remission. Although six of the complete responders remain alive, only three are in their initial complete remission. Alpha-foeto-protein and/or beta-subunit human chorionic gonadotrophin levels were elevated in almost all cases of advanced teratoma. The biological half-life of alpha-foeto-protein in the serum is less than six days. The value of these markers in predicting relapse was limited in this series. The doubling of complete response rate in metastatic teratomata that can be achieved by adding cis-platinum to the vinblastine/bleomycin combination, together with the propensity for extranodal metastasis shown by testicular teratomata, suggest that adjuvant chemotherapy should be explored in early disease.

Adult↗
PubMed1978

Cancer-specific density changes in lymphocytes after stimulation with phytohaemagglutinin.

A fluorescence polarisation technique ("S.C.M. test") for detecting responses to phytohaemagglutinin revealed that the responsive lymphocytes from patients with malignant disease had an abnormal distribution after centrifugation through lymphocyte separation medium. In a small blind series the technique accurately distinguished patients with histologically proven malignancies from those with nonmalignant disease and normal people.

Adenocarcinoma↗
PubMed1978

Comparative trial of large and small fractions in the radiotherapy of head and neck cancer.

A random controlled trial was performed to compare long and short fractionation of radiotherapy in patients with head and neck cancer with a poor prognosis. Ninety-eight matched pairs were treated, one member of each pair received 10 fractions in 22 days, the other 30 fractions in 42 days. The same nominal standard dosages were used in each arm of the trial. Mucosal reactions were more severe with 10 fractions, skin reactions more severe with 30 fractions. No difference in survival, local tumour control rates or late normal tissue effects could be demonstrated. It is suggested that any possible therapeutic advantage of prolonged fractionation is minimal and that it is justified to use a small number of large fractions in clinical trials involving hyperbaric oxygen or electron-affinic sensitizers.

Aged↗
PubMed1978

Hepatic oil embolism following lymphography.

Lymphograms of 1,000 patients were reviewed with special reference to the occurrence of hepatic oil embolism following the procedure. Oily contrast medium ("Lipiodol" ultra-fluid) was found in the liver in seven cases, five of whom had carcinoma of the cervix uteri. Hepatic oil embolism was not encountered in patients with lymphomas in this series. Complete or partial lymphatic obstruction was present in all seven cases and one patient had almost complete obstruction of the inferior vena cava. Malignant disease need not always be the predisposing factor since hepatic oil embolism occurred in one patient with retroperitoneal fibrosis. The routes through which the contrast medium may reach the liver are discussed and lymphaticoportal communications in the mesentery are thought to play an important role. Contrast was invariably seen in the liver within two hours of commencement of the injection and was still faintly visible in one case three and a half months later. The way in which the contrast-pattern in the liver changes with time is described. An attempt is made to correlate the radiological appearances with the fate of the contrast medium in the liver.

Contrast Media↗