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Biomedical subjects

M Catterall

Publications and source records attributed to M Catterall.

At least 55 records · Page 3Linked to original sources
PubMed1976

Effects of fast neutrons on the eye.

The study of 93 eyes receiving neutron irradiation establishes the character of the ophthalmic complications of neutron. Significant changes are produced in the eyelids, conjunctiva, and cornea, but the production of cataract is relatively unimportant. No reaction was seen after neutron treatment that had not already been seen after chi or gamma radiation. That the unavoidable damage is similar to that reported with other forms of radiation, and not worse, is an important finding in view of the statistically significant benefit of neutron treatment to patients in a controlled clinical trial of advanced tumours of the head and neck (Catterall and others, 1975). The observations indicate that the improved cure rates with neutrons are not obtained at the expense of inflicting greater damage to normal structures. This investigation has also shown that the neutron effects of treating these very extensive tumours are acceptable and that, with carefully measured doses, they are predictable. The dose-response relationship in categories of clinical effect for a smaller series of patients, reported in Table 1 of our preliminary communication (Brown and other, 1976), is confirmed.

Adult↗
PubMed1976

Adenocarcinoma of the stomach: radiological and pathological correlation of effects of treatment with fast neutrons.

During the past six years 40 patients have been treated with fast neutrons for inoperable adenocarcinoma of the stomach. A number of these patients have been studied in detail both radiologically and pathologically with regard to the effects of fast neutrons on both the tumour and normal stomach. After treatment there was a constant reduction in size of the stomach capacity when compared with a control group and the motility of the stomach was lost. Mucosal changes, which were noted radiologically, appeared to be dose related. Histologically most of the tumour was destroyed. Small clumps of cells were, however, found in all except one of the patients but only in areas of the stomach which had not received the standard dose. Marked fibrosis occurred and it is our impression that the amount of fibrosis is in excess of that seen with other forms of radiotherapy.

Adenocarcinoma↗
PubMed1975

First results of a randomized clinical trial of fast neutrons compared with X or gamma rays in treatment of advanced tumours of the head and neck. Report to the Medical Research Council.

Results of the first randomized clinical trial to compare the effects of fast neutrons and those of x or gamma rays (photons) in treating patients with advanced tumours of the head and neck are reported. In 37 out of 52 patients treated with neutrons and 16 out of 50 treated with photons the local tumour completely regressed; the tumour later recurred in nine of the 16 photon patients but in none of the 37 neutron patients. The advantages to the neutron-treated patients were seen in tumours of well and poorly differentiated histology and in each site. Complications after treatment did not differ significantly between the groups. Despite these substantial differences in local control of the tumour there were no significant differences in mortality between the series. A detailed study of the effective doses and the response of tumours and normal tissue in each series indicated that the improved results from neutron therapy were due to differences in the biological quality of the beam and not to the rather higher average effective dose in the neutron series. To assess the long-term effects of neutron treatment patients in earlier stages of disease and with smaller tumours should be included in the next phase of the trial.

Clinical Trials as Topic↗
PubMed1975

The effects of fast neutrons on inoperable carcinoma of the stomach.

Thirty-nine unselected patients suffering from inoperable, recurrent, or residual adenocarcinoma of the stomach were referred for palliation with fast neutrons from the Medical Research Council's cyclotron at Hammersmith Hospital. A full course of 1440 rads given in 12 treatments over 26 days was administered to the patients. Because of the relatively low energy (7-5 MeV) of the beam from this particular machine, it was not possible to deliver the full dose uniformly throughout the tumour except in extremely thin patients. Pain, dysphagia, vomiting, and bleeding were relieved in the majority of cases. The side effects were minimal and easily controlled. Palpable masses disappeared. Five patients required surgery after neutron therapy. All the incisions were made through irradioated tissue and all except one healed normally. Tumour was present outside the treated area, but the absence of any palpable mass within the treated area was a consistent finding. Radiologically, the stomachs remained abnormal and later changes included gross mucosal abnormality and shrinkage. Fourteen patients came to necropsy and in 10 no tumour was present macroscopocally. Tumour cells were seen in all except two cases but these were few, surrounded by dense fibrous tissue, and may not have been viable. The remaining stomach was abnormal with a thickened wall and destruction of mucosa. Three of the four cases in which macroscopic tumour was present received less than the standard dose because of the inadequate penetration of the beam. Excellent regression of tumors was achieved by the neutrons, but the stomachs did not recover from this satisfactorily. Gastrectomy four to six months after treatment is therefore suggested. This operation and other surgical procedures in other patients were successfully carried out. There is a need for higher energy neutrons to improve treatment and extend it to patients of thick-set build.

Adenocarcinoma↗
PubMed1974

Treatment of advanced tumours of head and neck with fast neutrons.

Fast neutrons interact with matter in a different way from x and gamma rays. They have been used at Hammersmith Hospital for the past four years in the treatment of advanced tumours in several sites of the body, and the results of this treatment in the first 100 cases of tumours of the head and neck are described here. Altogether 62 patients who had been referred for fast neutron therapy because it was thought that no other treatment would be effective experienced complete regression of the tumours, and only two recurred. Tumours of the buccal cavity and salivary glands responded particularly well and the relief of pain and ulceration was striking. Side effects were not serious and did not differ from those seen with supervoltage radiation, apart from the reaction of the skin. Follow-up was short, however, owing to deaths from metastases, and out of 76 patients treated more than one year previously only 30 survived. Cases which have not metastasized must therefore be treated so that the effects on tumours and adjacent normal tissues can be observed for several years after treatment. The results obtained so far indicate that it is now justifiable to use neutrons in such cases.

Adenocarcinoma↗