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Biomedical subjects

P H Geggie

Publications and source records attributed to P H Geggie.

15 recordsLinked to original sources
PubMed1985

Multiple daily fractionated radiation therapy and misonidazole in the management of malignant astrocytoma. A preliminary report.

Various attempts have been made to improve the effectiveness of radiation in the treatment of cerebral malignant astrocytomas. A trend favoring multiple daily fractionated (MDF) radiation therapy over conventional single daily fractionated (CF) radiation therapy was identified in our previous study. In order to assess the effect of MDF with and without misonidazole, a province-wide prospective randomized trial was initiated in January 1981. By March 1984, 124 patients with histologically verified grade III and IV astrocytomas were randomized to CF (5800 cGy/6 weeks/30 fractions), MDF (6141 cGy/4.5 weeks/69 fractions at 89 cGy every 3-4 hours, three times a day) and MDF in combination with misonidazole (1.25 g/m2 three times weekly for the first 3 weeks). Thirty-eight patients were randomized to CF, 43 patients to MDF, and 43 patients to MDF and misonidazole. At the preliminary assessment in July 1984, the median survival time was 27 weeks for the CF group, 39 weeks for the MDF group and 49 weeks for MDF and misonidazole group. The 1-year actuarial survival rate from surgery was 20% for CF group, 41% for MDF group, and 45% for MDF and misonidazole group. There is a statistically significant difference (P less than 0.001) between the CF and MDF group. However, the addition of misonidazole does not significantly alter survival.

Adolescent↗
PubMed1984

Misonidazole combined with hyperfractionation in the management of malignant glioma.

Multiple daily fractionated radiation therapy (MDF) may be more effective than conventionally fractionated radiation therapy (CF) in the treatment of malignant glioma. The hypoxic cell sensitizer misonidazole (MISO) could be more effective when employed with small fractions of radiation every 4 hours to take advantage of the long half-life of the drug. To evaluate MDF and MDF in combination with MISO, a randomized prospective trial was initiated. Between January 1981, and December 1982, patients with histologically verified astrocytoma with anaplastic foci or glioblastoma multiforme were randomized to CF (5800 cGy, 30 fractions, 6 weeks), MDF (6141 cGy, 69 fractions, 4 1/2 weeks, at 89 cGy every 4 hours 3 times daily) and MDF in combination with MISO (1.25 gm/M2 three times weekly for the first 3 weeks). In January 1983, the CF arm was dropped and a high dose MDF arm added (7120 cGy, 80 fractions, 5 1/2 weeks, at 89 cGy per fraction every 4 hours 3 times daily). CCNU chemotherapy was given at the time of tumor progression. One hundred and twenty-eight patients were evaluated (38 CF, 42 MDF, 37 MDF plus MISO, and 11 high dose MDF). Median survival was 29 weeks for CF, 45 weeks for MDF and 50 weeks for MDF plus MISO. Survival was significantly improved for patients treated with MDF compared to patients treated with CF (p less than .002). The addition of MISO to MDF did not result in further improvement in survival. Acute toxicity was acceptable. No clinically apparent delayed toxicity was observed.

Adolescent↗
PubMed1983

Superfractionation radiation therapy in the treatment of malignant astrocytoma.

Superfractionation (SF) radiation therapy is the administration of three fractions per day. We have assessed the effect of SF in a prospective randomized clinical study of malignant astrocytomas from July 1978 to December 1980. Thirty-five patients were randomized to SF (4000 rad in 45 fractions in 3 weeks whole brain and 1000 rad in five fractions in one week local boost). Thirty-four patients were randomized to conventional fractions (3400 rad in 17 fractions whole brain in 3.5 weeks and 1600 rad in eight fractions in 1.5 weeks local boost). Both treatment arms received chemotherapy with CCNU. The 1- and 2-year actuarial survival rate is 54% and 21% for SF group and 32% and 10% for CF group. The other advantages of SF include shorter mean duration of steroid administration and improved performance status following radiation therapy.

Age Factors↗
PubMed1981

Care in the terminal stage of carcinoma of the pancreas.

Palliative care of the patient with terminal cancer of the pancreas concerns itself with pain, anorexia, nausea and vomiting, bowel and bladder disturbances, sleep aberrations, jaundice, hydration, nutritional state, neuropsychiatric disorders and attitude of patient and family towards the disease and its implications. Each of these facets has a bearing on the quality of life remaining. The administration of pain medication should consider the role of anxiety in the intensification of pain and an anxiolytic or sedative agent can be added if necessary. Specific kinds of pain should be dealt with in specific ways. Gastrointestinal conditions such as constipation, nausea and obstruction should be eliminated. Anorexia may cause debilitation and may also rob the patient of purpose and emotional pleasure.

Anorexia↗