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Biomedical subjects

Laurel Williams

Publications and source records attributed to Laurel Williams.

4 recordsLinked to original sources
PubMed2005

Thermal dose is related to duration of local control in canine sarcomas treated with thermoradiotherapy.

PURPOSE: To test that prospective delivery of higher thermal dose is associated with longer tumor control duration. EXPERIMENTAL DESIGN: 122 dogs with a heatable soft tissue sarcoma were randomized to receive a low (2-5 CEM43 degrees CT90) or high (20-50 CEM43 degrees CT90) thermal dose in combination with radiotherapy. Most dogs (90%) received four to six hyperthermia treatments over 5 weeks. RESULTS: In the primary analysis, median (95% confidence interval) duration of local control in the low-dose group was 1.2 (0.7-2.1) years versus 1.9 (1.4-3.2) years in the high-dose group (log-rank P = 0.28). The probability (95% confidence interval) of tumor control at 1 year in the low-dose versus high-dose groups was 0.57 (0.43-0.70) versus 0.74 (0.62-0.86), respectively. Using multivariable procedure, thermal dose group (P = 0.023), total duration of heating (P = 0.008), tumor volume (P = 0.041), and tumor grade (P = 0.027) were significantly related to duration of local tumor control. When correcting for volume, grade, and duration of heating, dogs in the low-dose group were 2.3 times as likely to experience local failure. CONCLUSIONS: Thermal dose is directly related to local control duration in irradiated canine sarcomas. Longer heating being associated with shorter local tumor control was unexpected. However, the effect of thermal dose on tumor control was stronger than for heating duration. The heating duration effect is possibly mediated through deleterious effects on tumor oxygenation. These results are the first to show the value of prospectively controlled thermal dose in achieving local tumor control with thermoradiotherapy, and they establish a paradigm for prescribing thermoradiotherapy and writing a thermal prescription.

Animals↗
PubMedDate not supplied

Liver transplantation in children: maternal and family stress, coping, and adaptation.

ISSUES AND PURPOSE: This study examined the relationship of family stress, severity of the stressor, uncertainty, coping, and family adaptation from pretransplantation to posttransplantation. DESIGN AND METHODS: A descriptive, longitudinal study of 15 mothers whose children were at least 5 years posttransplantation. RESULTS: Maternal stress, coping, and uncertainty demonstrated significant changes over time, whereas family stress did not. Pretransplantation family stress, anger, and confusion were related to poorer family adaptation. PRACTICE IMPLICATIONS: Interventions for mothers pretransplantation should account for the coping, levels of stress, and uncertainty present at each phase of the transplantation process. Interventions need to be tailored to the transplantation phase. Long-term interventions remain necessary and should be directed at reinforcement of teaching, as well as assessment and provision of parental support relevant to the long-term needs of the family.

Adaptation, Psychological↗
PubMedDate not supplied

Carboplatin and doxorubicin combination chemotherapy for the treatment of appendicular osteosarcoma in the dog.

Twenty-four client-owned dogs with histologically diagnosed appendicular osteosarcoma (OSA) and no evidence of gross metastatic disease were treated with amputation or limb salvage followed by combination chemotherapy consisting of carboplatin (175mg/ m2 IV, day 1) and doxorubicin (15 mg/m2 IV, day 2) given on a 21-day cycle for a maximum of 4 cycles. Hematologic and gastrointestinal adverse effects were graded according to National Cancer Institute guidelines. Thoracic radiographs were obtained before the 3rd chemotherapy cycle and then every 2 months. Median disease-free interval was 195 days (95% confidence interval 111-228 days) and median survival was 235 days (95% confidence interval 150-283 days). Two patients required dose reductions: 1 for grade 3 thrombocytopenia and 1 for grade 3 adverse gastrointestinal effects. Patients with a longer duration of clinical signs before definitive diagnosis and surgery (greater than 30 days) were more likely to develop progressive disease and to die or be euthanized because of progressive disease on any day; hazard ratios were 3.0 (P = .02) and 3.7 (P .02), respectively. In conclusion, although this combination chemotherapy protocol was well tolerated, it did not provide any improvement over historical single-agent protocols.

Animals↗