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Biomedical subjects

M F de Boer

Publications and source records attributed to M F de Boer.

24 records · Page 2Linked to original sources

Carcinoma of the paranasal sinuses. Results of a prospective pilot study.

Sixty patients with paranasal sinus cancer were treated from January 1976 until July 1981 according to a standard protocol in which surgery is combined with a low dose of irradiation and a topically applied cytostatic drug. The local control rate was 65%. Mutilation was clearly reduced. The actuarial 2-year and 5-year survival rate was 76% and 65%, respectively. The actuarial 5-year survival rate for squamous cell carcinoma and undifferentiated carcinoma of the maxillary sinus was 52%. For adenocarcinoma of the ethmoid sinus the actuarial 5-year survival rate was 100%. The results of this prospective pilot study suggest that it may be possible to achieve better results with less aggressive treatment.

Actuarial Analysis↗

Adenoid cystic carcinoma of the upper digestive and respiratory tracts. A retrospective study of 59 cases.

Fifty-nine cases of adenoid cystic carcinoma (ACC) in the head and neck were reviewed and the treatment and follow-up results from 1950 to 1983 are reported. Nearly all patients were treated with combined therapy, i.e. surgery and radiotherapy, and the actuarial survival rate was 68% after 5 years, 45% after 10 years, and 30% after 15 years. Modern radiotherapy seems a very valuable means of treatment, not only as a palliative measure.

Adult↗

Carcinoma of the base of the tongue. A review of 45 cases.

The treatment results of 45 patients with carcinoma of the base of the tongue treated in the Rotterdam Radio-Therapeutic Institute in the period 1970 to 1980 are evaluated. Most patients were treated with split course radiotherapy, three patients were operated after the first course of radiotherapy. Eighteen patients with stage III and IV disease were treated with a combination of chemotherapy and radiotherapy. Overall 5-year survival was 27%, intercurrent death corrected survival was 40%. Adequate staging is a problem in carcinoma of the base of the tongue, especially in T2 and T3 lesions. A systemic combined approach of radiotherapy and surgery is recommended.

Adult↗

Rehabilitation outcomes of long-term survivors treated for head and neck cancer.

BACKGROUND: Little is known about the rehabilitation outcomes of long-term survivors following treatment for head and neck cancer. There are, for example, no studies on physical and psychosocial rehabilitation outcomes of T1 glottic larynx carcinoma, despite the fact that these form the majority of head and neck cancer sites. Thus, this investigation afforded a unique opportunity for examining similarities and differences among T1 glottic larynx patients, laryngectomy patients, and those who had surgery for cancer of the oral cavity and/or oropharynx along a variety of physical and psychosocial dimensions. METHODS: To describe the impact of these three types of head and neck cancer and their treatment on the physical and psychosocial functioning of long-term survivors, a self-report questionnaire was completed by 110 patients treated between 2 and 6 years previously in a major cancer center. RESULTS: Data indicate that a higher percentage of patients treated with laryngectomy or commando procedures still experience severe psychosocial distress between 2 and 6 years after their last treatment than do patients treated with radiotherapy for a T1 carcinoma of the glottic larynx. Psychosocial and physical complaints are still reported by many laryngectomy patients, apparently the result of problems in effective communication with others. Many commando procedure patients experience problems with respect to food intake, and with disfigurement and its consequences. T1 larynx patients mainly experience a considerable number of physical complaints. The greater the time that had elapsed since treatment, the fewer the psychosocial problems associated with head and neck tumors. Open discussion of the illness in the family, social support, and perceptions of adequate information from the specialist are the most important predictors of positive rehabilitation outcomes. CONCLUSIONS: This study indicates that T1 larynx patients report many physical complaints even though several years had elapsed since treatment. Also, laryngectomy patients may need psychosocial guidance for a longer posttreatment period and that health care personnel must involve the partner as much as possible in all communications. Commando procedure patients in particular feel hindered by their disfigurement and its consequences. Future research with respect to validation of the specific head and neck modules is needed.

Adaptation, Psychological↗

First results with the Blom-Singer adjustable tracheostoma valve.

The Blom-Singer adjustable tracheostoma valve (ATV) is a new tracheostoma valve, introduced in 1992 to improve voice rehabilitation after total laryngectomy. Little research has been done to evaluate the benefits of this valve. Our study evaluates the advantages and disadvantages of using this device. Eighteen laryngectomized patients with a low-resistance Provox voice prosthesis received an ATV, using minimal selection criteria. The patients are evaluated according to a specific protocol. The effectiveness of the humidifilter, valve and fixation method and the benefits are evaluated. Approximately 66% of the 18 patients are still using the ATV. We report the differences between the current users and the dropout group. Patient factors are discussed that seem to have an impact on the effective use of the valve, such as age and mucus production. We consider the ATV to be a valuable device for fingerless speech in the laryngectomized patient.

Adult↗

Three-dimensional models of the tracheostoma using stereolithography.

The availability of an accurate three-dimensional (3-D) model of the tracheostoma and trachea of the laryngectomy patient would be of great help in prototyping of endotracheal prostheses. Stereolithography has been described for skull and jaw models but never for soft-tissue reconstructions of the trachea. CT was performed on tracheostomas of 8 patients. The CT data were used to make 3-D models by means of stereolithography. Inverted CT data were used to create air contour models of the same tracheostomas. Eight soft-tissue and 8 air contour models were reconstructed from CT data, showing accuracy and great detail. In this paper we present a previously unreported application of the stereolithography technique. Measurements and prosthesis prototyping, which are impossible to perform on tracheostomas in patients, can now be executed safely. We are using the 3-D tracheostoma models in our research project to develop an endotracheal fixation method for tracheostomal valves.

Humans↗