Biomedical subjects

L M Frick

Publications and source records attributed to L M Frick.

3 recordsLinked to original sources

PubMed1994

Radiotherapy for isolated increases in serum prostate-specific antigen levels after radical prostatectomy.

OBJECTIVE: To assess the outcome of radiotherapy in patients with increased serum prostate-specific antigen (PSA) levels 6 months or more after radical prostatectomy. DESIGN: In 27 Mayo Clinic patients, we examined the results of radiotherapy relative to various potentially prognostic factors during a median follow-up of 25 months. MATERIAL AND METHODS: All 27 patients had no nodal involvement at the time of prostatectomy and no clinical evidence of disease, as determined by history, physical examination, a radionuclide bone scan, computed tomography of the abdomen and pelvis, chest roentgenography, complete blood cell counts, and serum chemistry profiles. With use of 10-MV photons and a four-field approach, these patients received irradiation to the prostatic bed (60 to 67 Gy in 1.8- to 2.0-Gy fractions). RESULTS: Levels of PSA initially decreased in 24 of the 27 patients (89%). In 16 of the 27 patients (59%), the PSA level decreased to 0.3 ng/mL or less without hormonal intervention. "Freedom from failure" (defined as the actuarial chance of maintaining a PSA level of 0.3 ng/mL or less) was 58% at 2 years and 48% at 3 years. The response to salvage radiotherapy was more favorable in patients with no tumor spread into the seminal vesicles and those with serum PSA levels of less than 1.1 ng/mL at the beginning of radiotherapy than in those with seminal vesicle involvement or higher PSA levels. In addition, patients who received radiation doses of 64 Gy or more had more favorable responses than did those who received lesser doses. Radiotherapy resulted in no severe toxicity. No patient had clinical evidence of disease at the time of this report. CONCLUSION: Isolated increases in serum PSA after prostatectomy indicate the presence of residual or recurrent disease, and radiotherapy effectively decreases the PSA in approximately half the cases. This result is achieved by eradicating residual or recurrent cancer in the postoperative tumor bed.

Aged↗

PubMed1992

The results of radiotherapy for isolated elevation of serum PSA levels following radical prostatectomy.

Eleven patients were initially treated for localized prostate cancer with radical retropubic prostatectomy following negative pelvic lymph node dissection. Six or more months after surgery, these patients had elevated serum prostate specific antigen (PSA) levels. No patient had other clinical evidence of disease as determined by history, physical examination, bone scan, computed tomographic scan of the abdomen and pelvis, chest radiograph, complete blood cell count, and serum chemistry profile. These patients received prostate bed irradiation using 10-MV photons and a four-field technique. Doses ranged from 60.0 to 65.8 Gy in 1.8 to 2.0 Gy fractions. Levels of serum PSA were monitored and decreased initially in all treated patients. In two patients, levels of PSA increased after this initial decrease. In 7 of the 11 patients (64%), PSA levels decreased to less than or equal to 0.3 ng/mL at last measurement. Radiotherapy resulted in no severe toxicity. None of the patients had developed clinical evidence of disease at the time of this report. Isolated elevations of serum PSA after prostatectomy reflect residual disease, and radiotherapy appears to effectively decrease the PSA levels in most cases. This effect appears to be accomplished by killing locally residual or recurrent cancer in the postoperative tumor bed.

Aged↗

PubMed1991

Radiotherapy for large symptomatic hemangiomas.

Between 1974 and 1988, 13 patients presented with large (3 to greater than 20 cm) symptomatic unresectable or partially resected hemangiomas. Tumor sites were extremities (five cases), vertebral bodies (three cases), face (two cases), pituitary fossa (one case), pelvic bones (one case), and bladder (one case). Symptoms included severe pain in eight patients, inability to use an extremity in five, vision problems in three, weakness in two, and hematuria with decreased urinary stream in one. Many patients had more than one symptom. Two of the cases were associated with life-threatening consumptive coagulopathies (Kasabach-Merritt syndrome). Therapy was delivered with both orthovoltage and megavoltage photons. Doses ranged from 6.25 to 40.0 Gy in 1.6- to 2.5-Gy fractions. Follow-up ranged from 2 to 15 years (median, 13 years). Tumor shrinkage was noted in 9 (82%) of the 11 cases in which tumor size data were collected before and after therapy. Complete response of tumor mass occurred in 4 (36%) of 11, partial response occurred in 5 (45%), and no response occurred in 2 (18%). No tumor grew after radiotherapy. Some relief in symptoms occurred in all 13 patients; 10 (77%) had complete resolution of symptoms. In both patients with life-threatening cytopenias, hematologic values returned to normal after treatment. Because the majority of the patients responded to all dose levels administered, no firm dose-response relationship was evident. However, objective (measurable) complete responses occurred in two (50%) of the four patients receiving doses of 30 Gy or greater compared with only two (29%) of the seven patients who received lesser doses. No long-term morbidity occurred. Radiotherapy of large unresectable and partially resected hemangiomas yields long-term relief of symptoms and tumor shrinkage in the majority of patients treated.

Adolescent↗