Biomedical subjects

L E Blank

Publications and source records attributed to L E Blank.

23 records · Page 2Linked to original sources

PubMed1986

Radiotherapy with multiple fractions per day in pancreatic and bile duct cancer.

Twenty patients with pancreatic and bile duct cancer have been treated with external radiotherapy with multiple fractions per day (MFD). All patients had localized disease only. Sixteen patients have been treated with a split-course technique, to a dose of 60 to 70 Gy in 7-8 weeks, four patients had a continuous series of 44 Gy in 19 days. The mean survival was 7.9 months for patients with a pancreatic cancer. Four out of nine patients with pancreatic cancer in whom the tumour was evaluable showed a tumour regression, one out of nine reached a partial remission. The mean survival in the responders was 9.5 months. All patients with pancreatic cancer died of their tumour. Four out of eight patients with bile duct cancer died of their tumour, the mean survival was 10 months. Four patients with bile duct cancer are still alive (10+, 10+, 10+, 11+ months). No serious acute toxicity was seen. Six patients showed gastrointestinal toxicity at 1.5 to 9 months after the end of treatment. All of them could be treated in a conservative way. From the results obtained in this feasibility study, radiotherapy with MFD in pancreatic and bile duct cancer appears to achieve similar tumour response as conventionally fractionated radiotherapy and the observed toxicity of MFD can be considered as acceptable. MFD might be a more appropriate treatment scheme for combination with chemotherapy and radiosensitizers.

Adenocarcinoma↗

PubMed1979

Minimized irradiation volume in treatment of carcinomas of the oropharynx and hypopharynx.

Twenty-two patients with advanced squamous cell carcinoma of the oropharynx and hypopharynx (T3T4-N2N3) were irradiated with curative intention. The treatment volume was minimized as much as possible with the aim to increase tumour control and decrease morbidity. Planning and results as well as the complications during and after the irradiation are discussed.

Aged↗

PubMedDate not supplied

Radiotherapy and hyperthermia.

72 patients with either unresectable or pelvic recurrence of colorectal cancer were treated with combined radiotherapy and locoregional hyperthermia. Radiation doses were 50 Gy or more in patients not previously treated with radiotherapy, and 32 Gy (8 x 4 Gy) in patients who had previously received radiotherapy. Hyperthermia was administered within 30 min of irradiation, and the aim was to give four to six sessions once or twice a week, intending to reach temperatures of at least 41 degrees C over 30 min. The mean of all the minimum (TMIN), maximum (TMAX) and median (TMED) intratumoral temperatures were 39.6, 41.1 and 40.2 degrees C, respectively. Toxicity during hyperthermia treatment consisted mainly of local pain within the heated field (33%) and general discomfort (17%). In 17% of the patients, the hyperthermic treatment was prematurely stopped. Palliation was achieved in 75% of patients with a mean duration of 12 months. The percentage of palliated patients was higher when higher radiation doses were administered. No correlation between palliative effect and thermal parameters was found. A computed tomography scan proved objective remission was obtained in 11 patients (15%). Median survival was 11 months, and 17% of the patients were alive at 3 years. The literature on combined radiotherapy and hyperthermia in colorectal cancer is reviewed. From this review and our own data, it is concluded that thermoradiotherapy is feasible. Acute and late toxicity are not major problems, although pain and general discomfort hamper hyperthermic treatment. The most disappointing fact is that, with the available hyperthermia equipment, the increase in intratumoral temperature does not reach, in general, the therapeutic range.

Colorectal Neoplasms↗

PubMedDate not supplied

Staging and prognosis using endosonography in patients with inoperable esophageal carcinoma treated with combined intraluminal and external irradiation.

Brachytherapy and external irradiation combined are an alternative to surgery in the treatment of advanced esophageal cancer. Endosonography has proved to be an accurate method of staging the depth of tumor invasion of esophageal cancer. Sixty-three patients with inoperable esophageal cancer underwent endosonography followed by combined brachytherapy and external irradiation. Staging was incomplete in 31 of 63 patients because of tight stenosis or difficulty in imaging celiac lymph nodes. During follow-up of 23 patients, reduction of tumor thickness and lymph node abnormalities was observed in 16. The median survival was 10.4 months. Survival time was correlated with initial number of metastatic lymph nodes found by endosonography. Paradoxically, the survival of patients with more extensive intra-luminal tumor growth was significantly better than survival of those with less tumor growth. In summary, the response to combined brachytherapy and external irradiation could accurately be assessed with endosonography. Lymph node abnormalities and tumor thickness were closely related to survival rate.

Adenocarcinoma↗

PubMedDate not supplied

[Brachytherapy for urinary bladder cancer].

OBJECTIVE: To present the results achieved by brachytherapy in the treatment of bladder cancer and to review the literature on this subject. METHODS: 120 patients with bladder cancer were treated with brachytherapy at two Dutch Centres. Selection criteria were good general condition allowing anesthesia, good bladder function (capacity of 300 ml), solitary tumor maximum 5 cm diameter, T1G3, T2, T3a. Before the implant an extensive transurethral resection was performed. The urologist carried out a cystostomy and the radiation oncologist did the implant using iridium-192 wires. The administered tumor dose was 60 Gy at a dose rate of 60-90 cGy/hour. RESULTS: The 5-year overall survival and disease-free survival was 67% and 73%, respectively. By stage, the 5-year disease-free survival was 100% in T1, 80% in T2 and 67% in T3. Local failure was observed in 15 patients (13%). Six of these relapses were salvaged by cystectomy. Ten patients had a superficial tumor Ta-T1 in bladder sites other than the original tumor site. Acute and late complications were unusual. The results compare quite well with those of other series published in the literature. CONCLUSION: Brachytherapy achieves excellent results in selected patients with solitary bladder cancer maintaining a fully functional bladder. Acute and late complications of this treatment modality are relatively infrequent.

Adult↗