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Biomedical subjects

N A Ghossein

Publications and source records attributed to N A Ghossein.

At least 37 records · Page 2Linked to original sources

The conservative management of anorectal cancer by radiotherapy.

Thirteen patients with an anal or rectal carcinoma were given curative radiotherapy. Four had medically inoperable tumors, one had a surgically inoperable tumor and eight refused abdominoperineal resection. Six patients received external radiotherapy only. Seven patients received external radiotherapy and an interstitial implant. Nine of thirteen patients (60 per cent) are alive without evidence of disease from fifteen to fifty-five months (average, 30 months). Six of seven patients who received external radiotherapy combined with an interstitial implant were controlled locally, whereas three of six patients who received external radiotherapy only were controlled. Patients who underwent total excision and/or fulguration prior to irradiation had better local control than those who underwent either biopsy only or a subtotal excision. This treatment method may be offered as an alternative to abdominoperineal resection in patients who are medically unfit or who refuse surgery.

Adenocarcinoma↗

Possible nonspecific immunopotentiation by 2,4-dinitrochlorobenzene sensitization in patients with Hodgkin's disease.

Various immunological parameters were evaluated in untreated Hodgkin's patients before and after sensitization with dinitrochlorobenzene (DNCB). The ratio (r) of these parameters after/before DNCB sensitization for patients and second/first samples in the controls were calculated. There were significantly more patients in the r greater than 1.1 group for PHA and Con A responses and for peripheral blood T cell percentages. These data suggest that DNCB sensitization may have a nonspecific immunopotentiation effect.

Antibody Formation↗

The treatment of locally advanced carcinoma of the colon and rectum by a surgical procedure and radiotherapy postoperatively.

Following resection of locally advanced carcinomas of the rectum and colon, 95 patients received moderate dose elective radiotherapy either to an inverted T field or the entire abdomen. In 27 instances, carcinomas invaded adjacent structures and were incompletely resected. Fifty-seven patients had tumors of the rectosigmoid and had either an abdominoperineal or an anterior resection. Thirty-five patients had a mean follow-up period of 26 months. Three of 35 carcinomas recurred locally, 26 of 35 patients are alive without disease. Thirty-eight patients had carcinomas of the colon and had either a partial or hemicolectomy. Thirty-one had a mean follow-up period of 24 months. Five of 31 carcinomas recurred locally. Seventeen of 31 patients are alive, without disease. Sixty-six of 95 patients have survived two years free of disease. One death occurred from radiation enteritis. Radiotherapy postoperatively for patients at a high risk of failure resulted in a low incidence of local recurrence.

Adult↗

Primary management of operable breast cancer by minimal surgery and radiotherapy.

109 cases of breast cancer were treated by tumorectomy and radiotherapy or radiotherapy alone. Almost 30% with small tumors (T1, T2) were considered inoperable for medical reasons and 70% refused mastectomy. Over the past five years the number of patients refusing mastectomy has definitely increased. 59 cases of surgically resectable cancers (T1, T2, T3, N0, N1) had a minimum followup of two years (average 4 years +/- 3 months). Absolute and determinate survivals NED were 65% and 86%. There were four local recurrences (8%). Secondary mastectomy could be performed on three. Microscopic involvement of the surgical margin by cancer did not alter the local control rate. The cosmetic results were good in 98%. Gross removal of the tumor followed by radiotherapy may be offered as an alternative to mastectomy in patients with operable breast cancer.

Adult↗

Epstein-Barr virus (EBV) antibody in patients treated by radical radiotherapy for head and neck cancer.

Antibody against Epstein Barr Viral capsid (EBV-VCA) was measured in 65 patients with primary head and neck cancer referred for radical radiotherapy. Sixty-three percent had locally advanced cancer and 37% had early disease. Forty-eight percent had detectable antibody in their sera. Thirty-three percent had elevated titers (above 1:20 dilution). Only 19% of cases with early cancer had increased titers. Almost 50% of those with locally advanced cancer or recurrence following treatment had titers above 1:20. A rise in titer within six months following radiotherapy was associated with a significant incidence of recurrence. There was no correlation between delayed hypersensitivity skin reaction to 2--4 dinitrochlorobenzene (DNCB) and titer values. EBV-VCA may be an additional parameter which can be used to determine host defenses in patients with malignancies.

Antibodies, Viral↗

Elective postoperative radiotherapy for locally advanced colorectal cancer. A preliminary report.

Preoperative radiotherapy in colorectal carcinoma invalidates surgical staging and delays performing the surgical resection. Postoperative radiotherapy does neither. From October 1972, to December 1975, 40 patients at high risk for local recurrence (B2 and C) received postoperative radiotherapy. Lesions that were located in the rectum, rectosigmoid and low sigmoid colon were given 4600 rads in four and a half weeks through an inverted T-shaped field which encompassed the pelvic and paraortic nodes. Patients with tumors located above mid-sigmoid were treated to the entire abdominal cavity by the moving strip technique. Of 19 patients with rectal and rectosigmoid lesions, 14 (74%) are alive without evidence of disease. Two had local recurrence in the treated area. Of 21 patients with lesions above the mid-sigmoid, four have failed locally, while 11 (52%) are alive without evidence of disease. One of these 40 patients died to radiation enteritis. Although the follow up period is short, the results suggest that a moderate dose of radiation may prevent local recurrence in patients with locally advanced colorectal cancer.

Adult↗

Deficient mitogen-induced virus plaque-forming cells in patients with localized cancer.

The virus plaque assay (VPA), an assay capable of enumerating mitogen- or antigen-sensitive T-lymphocytes in a given cell population, was applied to the study of mitogen responses of peripheral blood leukocytes (PBL) in 50 patients with localized, solid cancers and in 29 normal controls. Concanavalin A (Con A)-responsive virus plaque-forming cells (V-PFC) were significantly reduced in the patients as compared with those of the controls. PBL from 20 of the patients but only 2 of the controls failed to show significant increments in V-PFC over background when cultured in the presence of Con A. This deficient response was also present in the patients when phytohemagglutinin was used as the mitogenic agent. Mitogen-stimulated uptake of [3H]thymidine (TdR) in parallel cultures failed to show a statistically significant difference between the patients and the controls, though some patients showed diminished stimulation in this assay. The VPA thus appeared to detect a defect of T-lymphocyte function not found in the [3H]TdR incorporation assay.

Cell Separation↗

The long-term effect of radiotherapy on the immune status of patients cured of a gynecologic malignancy.

The long-term effect of radiotherapy on the immune system were evaluated in 52 patients cured for a gynecologic malignancy from 3 to 15 years. Eighty-seven percent of the patients had no depression in cell-mediated immunity as determined by delayed hypersensitivity reaction to DNCB. The absolute lymphocyte count, as well as the circulating immunoglobulins (IgA, IgG, IgM), were within the normal range. Thus, there were no significant changes in cell-mediated immunity and circulating immunoglobulins several years after radical wide-field radiotherapy.

Adult↗

Delayed hypersensitivity and local control of patients treated by radiotherapy for head and neck cancer.

Delayed hypersensitivity of sixty-three patients with head and neck cancer treated by radiotherapy was correlated with short-term tumor control. Of eighteen patients with early disease, sixteen were DNCB-reactive and all were controlled and one of the two nonreactors was controlled. Thirty-three of forty-five patients with advanced tumors were reactive and nineteen were controlled. Only two of the twelve nonreactors were controlled.

Adult↗

Local control of breast cancer with tumorectomy plus radiotherapy or radiotherapy alone.

58 cases of breast cancer treated primarily by radiotherapy were evaluated to determine the optimum dose for local control. Of 36 patients with T1 + T2 lesions who had tumorectomy prior to radiotherapy, incomplete excision of tumor was demonstrated on microscopic examination in 18. The minimum tumor dose to the breast was 4,500 rads in 5 weeks. Treatment failed to control local tumor in only 2 (5%) and metastases in 1.26 (72%) remained disease-free for 2 to 9 years. Of the 22 patients with T3 + T4 lesions, treatment failed to control both local tumor and metastases in 12 (54%); in those who received 6,000 rads or less in 6 weeks, treatment failed to control any of these lesions. 4,500-5,500 rads controlled the tumor in 95% of those with NO + N1 disease, compared to only half of those with N2 + N3 tumors.

Adult↗

The value of aspiration cytology in the diagnosis of breast cancer: experience at the Fondation Curie.

Aspiration cytology was performed on 2772 breast masses, all of which subsequently had open biopsies. Of the 1745 histologically malignant tumors, 1539 (88%) had a concordant cytologic diagnosis: 54 (0.3%) were diagnosed as probably malignant; 63 (3.6%) were false negatives; and 80 (0.5%) had inadequate smears for diagnosis. Of the histologically benign lesions, 916 (89%) had a concordant cytology: only 3 (0.3%) were false positives; cancer was suggested in 42 (0.4%); and the smears were inadequate in 66 cases (6.4%). Very small or very large sized cancer and a high degree of differentation were major causes of false negative aspirates. Recurrent tumors in those breasts exclusively treated by radiotherapy were documented by cytology in 56 of 69 cases (78%). Aspiration cytology is highly reliable when the diagnosis of cancer is made, but should be ignored if no malignant cells are observed.

Biopsy, Needle↗

The effect of radial radiotherapy on delayed hypersensitivity and the inflammatory response.

Delayed hypersensitivity to DNCB and the inflammatory response to croton oil wereevaluated in 144 and 121 patients respectively, prior ro and 3 to 6 months following curative radiotherapy. Eighty-one patients had in vitri lymphocyte transformation by PHA;59 (41%) were nonreactors to DNCB and 27 (22%) to croton oil; 29 of 59 (49%) initiallyreactive became anergic. Similiar improvement of the inflammatory response was obtained. Patients who became DNCB-reactive following radiotherapy had the same favorable prognosis as those who were initially reactive. Radiotherapy did not adversely affect either delayed hypersensitivity or the inflammatory response. There was a 50% decrease in PHA stimulation and lymphocyte count after treatment. No correlation was found between DNCB reactivity and lymphocyte transfermation prior to or following radiotherapy. The evaluation of the effect of radiotherapy on cell-mediated immunity depends on the tests used.

Animals↗

Delayed hypersensitivity in patients treated by curative radiotherapy. Its relation to tumor response and short-term survival.

Delayed hypersensitivity, as determined by skin reactivity to 2-4 dinitrochlorobenzene (DNCB), was tested in 112 patients prior to their undergoing curative radiotherapy. Of the strong DNCB reactors, 84% had an excellent radiation tumor response, while only 48% of the negative reactors had an equivalent response. Almost twice as many strong DNCB reactors were alive and free of disease (NED) at 6 months (70% vs. 38% for nonreactors). Similarly, the positive DNCB reactors had a median survival of 18 months, compared to 10 months for the nonreactors.

Adolescent↗

The induction of non-specific autoimmune phenomena by radiotherapy.

Induction of autoimmune phenomena by radiotherapy was evaluated with fluorescent antinuclear antibodies (FANA), latex fixation, and C'3 complement. 27 random serum samples obtained prior to radiotherapy revealed only a low C'3 in a patient with Hodgkin's disease and Sjögren's syndrome. 33 random serum samples obtained after radiotherapy revealed 7 positive values (5 FANA, 1 latex fixation, and 1 C'3). The increase in positive values was statistically significant.

Antibodies, Antinuclear↗

Radiation-related eosinophilia. Correlation with delayed hypersensitivity, lymphocyte count, and survival in patients treated by curative radiotherapy.

Abdominal irradiation may produce eosinophilia. The relationship between radiation-related eosinophilia (RRE), reactivity to 2-4 dinitrochlorobenzene (DNCB), lymphocyte count, and prognosis was evaluated in 98 patients irradiated for tumors below the diaphragm. Forty-two per cent manifested RRE and 62% reacted to DNCB. Fifteen of 19 (79%) reactors who had RRE were disease-free at 6 months. Fourteen of 22 (64%) nonreactors who had RRE and 26 of 42 (62%) DNCB reactors without RRE were controlled. Fourteen of 15 (93%) nonreactors without RRE had disease at 6 months. Those who had RRE had double the median survival of those who did not.

Abdominal Neoplasms↗