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Biomedical subjects

M B Levene

Publications and source records attributed to M B Levene.

At least 19 recordsLinked to original sources
PubMed1980

Radiation therapy of early carcinoma of the breast without mastectomy.

The results of the treatment of 176 patients with early breast cancer, using radiation therapy without mastectomy are reported. The likelihood of local recurrence was 5% for Stage I patients and 7% for Stage II patients. Local control was significantly greater in those patients receiving and iridium implant (1/73 vs. 10/111, P less than .05). The cumulative survival probability at five years is 96% for Stage I and 68% for Stage II. Local control with good cosmetic results is greatly influenced by surgical and radiotherapeutic technique. Gross tumor resection with careful reapproximation of the breast tissue and well-placed incisions facilitates the radiation therapy. Homogeneous external beam radiation to the breast and draining lymph nodes (4500--5000 rads) and supplemental local radiation to the sites of the primary lesion (in this series using interstitial implantation) are recommended.

Adult↗
PubMed1980

Radiation therapy in stage II ovarian carcinoma: the influence of histologic grade.

Between September 1968, and December 1975, 40 patients with Stage II epithelial tumors of the ovary were treated at the Joint Center for Radiation Therapy. Thirty-six patients had undergone a total abdominal hysterectomy and bilateral salpingo-oophorectomy (BSOH) with attempted total removal of disease, and all patients received postoperative pelvic irradiation. The five-year actuarial relapse-free survival rate is 66% and the overall survival rate 70% for the entire group of patients. The histology was reviewed in all cases and graded for the percentage of solid vs. papillary or glandular in the specimen. Of the 36 patients treated with a BSOH, 18 had well-differentiated tumors defined as containing less than a 10% solid architectural pattern. There have been no relapses in this group of patients. In contrast, 9 of 18 patients with moderately or poorly differentiated tumors containing a 10% or more solid pattern have relapsed; five diffusely in the abdomen, two in the pelvis, and two in the lungs or pleura. It appears that a BSOH followed by pelvic irradiation is sufficient treatment for Stage II patients with well-differentiated tumors showing less than a 10% solid pattern. In contrast, patients with less well-differentiated tumors have a high risk of relapse outside of the pelvis and need additional treatment. Alternative treatment options are discussed.

Adenocarcinoma↗
PubMed1979

Results of treating stage III carcinoma of the breast by primary radiation therapy.

One hundred sixteen patients with stage III carcinoma of the breast were treated by primary radiation therapy. The 5-year actuarial survival and relapse-free survival were 25% and 22%, respectively. The 5-year actuarial probability of local tumor control for the entire group was 64%. In patients undergoing an excisional biopsy and an interstitial implant of the primary tumor area, local control was 100%. In patients who had either an excisional biopsy or an implant, the 5-year actuarial probability of local control was 77% and 76%, respectively. In contrast, in patients having neither an excisional biopsy nor an implant, local control was only 41%. In patients receiving a total dose of greater than 6000 rad, from external beam treatment or from external beam plus an interstitial implant, the local control was 78% compared to 39% in patients receiving a total dose of less than 6000 rad. Forty-one patients received some form of adjuvant therapy. Both local control and relapse-free survival were improved in patients receiving chemotherapy as the sole adjuvant and in patients receiving chemotherapy combined with an endocrine ablative procedure. However, patients treated with only an endocrine ablative procedure had no improvement in survival nor in local control. These results indicate that primary radiation therapy can provide local control in a high proportion of patients with stage III carcinoma of the breast and suggest that chemotherapy is effective in improving both local control and survival in these patients.

Adult↗
PubMed1978

Computer-controlled radiation therapy.

Radiation therapy is often hampered in important body regions by the need to transit sensitive normal tissues which act as dose-limiting barriers. Computer-controlled radiation therapy permits the simultaneous variation of multiple treatment parameters during irradiation of the patient, producing improved dose distributions with the potential for improved local control. Equipment used for this purpose includes a Mevatron XII linear accelerator, redesigned for automatic control, and a PDP 11/45 minicomputer. Dose distributions are shown and potential clinical gains discussed.

Computers↗
PubMed1978

Results of treating stage I and II carcinoma of the breast with primary radiation therapy.

Eighty patients with stage I and II carcinoma of the breast were treated with primary radiation therapy between July 1968 and December 1975 at the Joint Center for Radiation Therapy. The median followup time was 41 months. Only one local recurrence was observed. The survival at 5 years was 88% for stage I and 72% for stage II. The relapse-free survival at 5 years was 91% for stage I and 56% for stage II. Of breasts evaluated for cosmetic results, 66% were judged good or excellent by physicians and 81% were judged good or excellent by patients. One patient developed a pericardial reaction related to treatment which required hospitalization. Other complications were mild and cleared without additional therapy.

Adult↗
PubMed1977

Radiation therapy as initial treatment for early stage cancer of the breast without mastectomy.

This report describes 150 patients with clinical stage I and II carcinoma of the breast treated at four institutions--Yale University School of Medicine, Harvard Medical School-Joint Center for Radiation Therapy, Hahnemann Medical College, Jefferson Medical College--with radiotherapy only following excisional biopsy. Closely similar treatment policies were followed at all four centers, 4500-5000 rads minimum tumor dose being delivered to the entire breast and axillary, supraclavicular and internal mammary nodes. Forty-six of 49 stage I patients treated are alive without disease, the actuarial relapse-free survival being 91% at 5 years. Of the 101 stage II patients, 75 are alive without disease with a relapse-free actuarial survival of 60% at 5 years. Local failure has occurred in 10 patients (9 stage II and 1 stage I, 6.6%) 5 of whom are disease-free following mastectomy. The results obtained in this study are comparable to those of conventional surgery. It is our conclusion that mastectomy is not a necessary part of the treatment of small breast cancers, that radiation without mastectomy is an acceptable alternative with far superior cosmetic and functional results. Adjuvant chemotherapy should be considered particularly in stage II patients in view of their 40% relapse rate.

Antineoplastic Agents↗
PubMed1977

Treatment of carcinoma of the breast by radiation therapy.

One hundred and fifty patients with carcinoma of the breast were treated by radiation therapy without mastectomy. Seventy-seven patients had excisional biopsy of the breast mass while the remainder had incisional biopsy or needle biopsy. There has been 100% local control in patients with Stage I or Stage II disease. The local control rate in Stage III is 67.5%. Those patients who had excisional biopsy had a significantly lower incidence of local recurrence than did those in whom the tumor was left in situ. The cumulative survival probability at five years is 100% for Stage I, 65% for Stage II and 26% for Stage III. Recommendations are made concerning axillary node sampling and adjuvant chemotherapy for patients treated by this technique.

Brachial Plexus↗
PubMed1977

Radiation therapy of thalamic, midbrain and brain stem gliomas.

The case histories of 40 patients with gliomas of the thalamus and midbrain (Group I) or caudal brain stem (Group II) were reviewed to determine the effect of radiation therapy on neurologic functional status and survival. Nine of 14 (64%) patients in Group I demonstrated an improvement in functional status following radiotherapy, as did 19 of 26 (73%) patients in Group II. Eight (57%) patients in Group I and 10 (38%) patients in Group II are alive with no evidence of disease after periods of 12 to 65 months following completion of treatment. Acturial survival data indicate a better survival rate in Group I patients. Based on our findings, an aggressive and potentially curative attempt with use of radiation therapy for gliomas of the thalamus, midbrain, and brain stem is justified.

Adolescent↗