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Biomedical subjects

P P Kumar

Publications and source records attributed to P P Kumar.

At least 55 records · Page 3Linked to original sources
PubMed1987

Rotational subtotal skin electron beam therapy for management of carcinoma en cuirasse.

Recurrent or primary carcinoma of the breast en cuirasse, which may involve the skin of the entire thorax and abdomen, cannot be controlled by means of surgery or conventional local irradiation. The authors' technique and a review of dosimetry of rotational subtotal skin electron beam therapy (SSEBT) used for palliation in patients with this difficult clinical problem are presented. The dosimetry, ease of setup, and required treatment time are superior for the rotational technique compared with two-field, four-field, and six-field techniques.

Aged↗
PubMed1987

Survival of patients with unresectable non-small cell lung cancer following 6,000 rad megavoltage radiotherapy.

One hundred and fifty-seven patients with histologically proven, locally advanced, unresectable or inoperable non-small cell lung cancer were treated in a uniform fashion with external-beam megavoltage radiotherapy. Patients received a continuous course of 6,000 rad in 7½ weeks (four fractions of 200 rad per fraction each week). The comparatively high, uncorrected one-year survival rate of 48.7 percent, and uncorrected two-year survival rate of 25.7 percent, would be expected following uniform treatment with a relatively high external-beam tumor dose. The five-year uncorrected actuarial survival rate of 2.7 percent demonstrates that although the median survival can be increased by the use of higher radiation doses and better delivery technique, the ultimate cure rate and prognosis for inoperable and unresectable non-small cell lung cancer remains poor with current equipment and methods of radiotherapy.

Adult↗
PubMed1987

Technique of postoperative pelvic radiation in the management of rectal and rectosigmoid carcinoma.

Improper postoperative pelvic radiation of 5,000 rad in five weeks results in poor patient tolerance, unacceptable complications, and increased local recurrence. Preoperative or postoperative low-dose pelvic radiation results in better tolerance; however, in patients with resectable adenocarcinoma of the rectum and rectosigmoid, low-dose radiation improves neither the local failure rate nor the survival rate compared with treatment by surgery alone. The authors' technique was to deliver 5,000 rad in six weeks only to the pelvic tissues at risk for recurrence following surgery.

Adenocarcinoma↗
PubMed1987

Extended-field isocentric irradiation for Hodgkin's disease.

Extended-field therapeutic irradiation is the treatment of choice for the majority of patients diagnosed with pathologic stages I and II Hodgkin's disease, and total nodal irradiation can be effectively used to treat selected stage III Hodgkin's patients. Standard 100-cm source-to-axis distance extended-field isocentric technique and results are presented.

Hodgkin Disease↗
PubMed1986

Intraoperative remote afterloading endocurietherapy with high-activity 60cobalt for treatment of glioblastoma multiforme.

An intraoperative remote afterloading endocurietherapy technique with high-activity 60Co for the treatment of glioblastoma multiforme is described. The technique can be used for initial management of the unresectable tumor or for retreatment of patients with recurrent tumor who have been treated previously with surgery and postoperative radiotherapy. Neither intraoperative nor postoperative complications were encountered in our treatment of 11 patients in this Phase I toxicity study.

Adult↗
PubMed1986

Complete response of granulosa cell tumor metastatic to liver after hepatic irradiation: a case report.

A case of granulosa cell tumor of the ovary with extensive metastases to the liver was treated by a course of fractionated hepatic irradiation consisting of 30.00 Gray delivered to the whole liver, followed by boost to gross disease for a total dose of 50.00 Gray given in six weeks. This was followed by complete tumor response with normal liver function tests, and computed tomography demonstrated a normal liver two years after radiotherapy. Liver metastases from granulosa cell tumor of the ovary are unusual, and little information has been published regarding management of this problem.

Aged↗
PubMed1986

Vicryl carrier for I-125 seeds: percutaneous transperineal insertion.

The use of vicryl carriers for permanent iodine-125 implantation in the prostate with the percutaneous transperineal template technique improves the symmetry of the implant and prevents seed loss into the pelvis. The procedure is accomplished quickly with the administration of spinal or general anesthesia. Implantation into the prostate is accomplished without celiotomy and does not require the use of an iodine seed gun.

Humans↗
PubMed1986

Combined modality treatment of cutaneous T cell lymphoma: results of a 6-year follow-up.

Thirty-nine patients with cutaneous T cell lymphoma (CTCL; including mycosis fungoides or the Sezary syndrome) with no previous treatment other than topical therapy or oral corticosteroids, received total skin electron beam irradiation (TSEB) and either sequential or simultaneous systemic chemotherapy. Median follow-up, measured from the time of initiation of therapy to the time of analysis, is in excess of 6 years and extends to 100+ months. Thirteen patients with stage I disease (limited to skin with no adenopathy) received 3,000 rad total skin electron beam irradiation followed by three 2-week courses of daily intravenous (IV) mechlorethamine. Twenty-six patients with advanced disease (stage II-IV) received 2,400 rad of TSEB and simultaneous chemotherapy with two alternating three-drug regimens: vinblastine, doxorubicin, and bleomycin (VAB) alternating with cyclophosphamide, methotrexate, and prednisone (CMP) administered over 54 weeks. The overall response rate was 92% with 16 of 39 patients (41%) achieving a histologically documented complete response (CR). Stage I patients had a significantly increased CR rate (77%) compared with stage II-IV (P less than .01). The overall 6-year survival was 92% for stage I patients and 26% for stage II-IV patients (23%) (P less than .001). Among ten completely responding stage I patients, six remain alive and disease-free in excess of 72 months. The median disease-free survival is 26 months for completely responding stage II-IV patients (P = .04), but none are continuous disease-free survivors after protocol treatment. We conclude that combined modality treatment can be safely administered and produces prolonged disease-free survival in some stage I patients, but not in more advanced stage patients.

Adult↗
PubMed1986

Simple, accurate, safe, and cost-effective percutaneous transperineal template technique for permanent 125iodine interstitial brachytherapy of prostate cancer.

We present the technique, intraoperative and postoperative complications of percutaneous transperineal template permanent 125iodine interstitial brachytherapy of prostate cancer. The percutaneous transperineal template permanent iodine interstitial brachytherapy under "C-arm" fluoroscopic guidance is a simple, easily-learned, accurate and rapid procedure which can be performed without subjecting the patient to celiotomy. We have treated 58 patients by the transperineal percutaneous permanent interstitial brachytherapy. 33 of 58 patients also had a staging celiotomy just prior to the brachytherapy. In the group of 22 patients undergoing brachytherapy without celiotomy and without adjuvant external-beam pelvic radiotherapy, there were no major complications. Blood transfusions were not required by any patients who underwent percutaneous transperineal permanent iodine interstitial brachytherapy without celiotomy.

Brachytherapy↗
PubMed1986

Trial of high-dose cytarabine, cyclophosphamide, total-body irradiation, and autologous marrow transplantation for refractory lymphoma.

Twenty-one patients with advanced non-Hodgkin's lymphoma or Hodgkin's disease who had failed to be cured with standard therapy were the subjects of this clinical trial. The patients received cytarabine (3 g/m2 at 12-hour intervals for six or eight doses), cyclophosphamide (90 mg/kg once), and total-body irradiation (one 900-cGy fraction or five 250-cGy fractions). Bone marrow was aspirated and cryopreserved before treatment and reinfused after the completion of radiotherapy. Eighteen patients (86%) had objective response and 12 (57%) achieved complete response. Three patients remain in continuous complete remission for 566+, 604+, and 1035+ days after marrow infusion. Six complete responders had tumor recurrence. One of these patients developed a localized lymphoma of another histology that was successfully treated with local radiotherapy and the patient is currently well 1004+ days after marrow infusion. Another relapsing patient responded to a brief course of salvage chemotherapy and is in remission at 1271+ days. Three of the complete responders died from infectious complications. This regimen was associated with significant toxicity. Six patients died from sepsis during the period of aplasia and three others died from interstitial pneumonia 42-105 days after marrow infusion. Although this regimen demonstrated a high level of antitumor activity, the value of adding high-dose cytarabine to the combination of cyclophosphamide and total-body irradiation remains unclear and would require a randomized clinical trial to demonstrate.

Adolescent↗
PubMed1986

Immunodiagnosis by prostatic acid phosphatase to differentiate primary male breast cancer from metastatic prostate cancer.

A patient who was treated with estrogens for carcinoma of the prostate was later diagnosed with apparent primary cancer of the male breast. He received chest-wall radiation therapy with curative intent. Later, immunodiagnosis by immunoperoxidase staining for human prostate-specific acid phosphatase of the breast tissue revealed that the patient actually had metastatic prostate cancer to the breast rather than primary breast cancer secondary to estrogen therapy. Use of highly specific peroxidase-antiperoxidase tissue staining for human prostate-specific acid phosphatase is recommended to differentiate primary male breast cancer from metastatic prostate cancer.

Acid Phosphatase↗
PubMed1986

Retreatment of recurrent cystic craniopharyngioma with chromic phosphorus P 32.

A cystic craniopharyngioma in a two-year-old boy recurred six months after surgery and postoperative external-beam radiotherapy. Successful retreatment was accomplished with radioisotope injection of 0.5 mCi of chromic phosphorus P 32 into the intracranial cyst, which delivered approximately 300.00 Gy to the cyst wall. The patient's symptoms were relieved, and he is without evidence of disease or cystic fluid accumulation four years after intracavitary (32)P irradiation.

Child, Preschool↗
PubMed1986

The significance of incomplete resection and postoperative pelvic recurrence on the prognosis of rectosigmoid cancer.

Ninety-eight patients underwent successful complete anterior or abdominoperineal resection for primary adenocarcinoma of the rectum, sigmoid, and rectosigmoid. At the time of diagnosis of relapse in 71 of these 98 patients, 36 patients had local-regional recurrence alone, without distant metastases.Twenty-two patients underwent curative resection and were classified with Dukes' stage D(1) lesions. The prognosis of these patients was similar to that of those who developed pelvic recurrence after initial complete resection. Of the 36 patients initially thought to have only localized pelvic recurrences, 15 patients (42 percent) subsequently developed overt distant metastases by the end of the study. Approximately one third (30 percent) of the 71 relapsed patients would have been potentially curable by new modalities currently under investigation by the authors-interstitial endocurietherapy (ECT) and intraoperative electron beam therapy (EBT).

Combined Modality Therapy↗
PubMed1986

Accurate and economical intracavitary endocurietherapy in the treatment of uterine cervix cancer.

A modified afterloading cervical applicator and intracavitary endocurietherapy application technique eliminates several problems associated with the Henschke cervical applicator, and conventional preloading technique. The Kumar cervical applicator minimizes patient discomfort, and improves patient mobility while reducing the tendency of the applicator to rotate during the 40 to 50 hours of uterine intracavitary endocurietherapy. The use of hygroscopic laminaria tent for gradual cervical dilatation in place of manual cervical dilatation, and the use of inflatable Foley balloon threaded onto the tandem instead of vaginal packing, to separate the 137Cesium sources away from the rectum and bladder, eliminate the need of general anesthesia for the majority of patients undergoing intracavitary endocurietherapy.

Brachytherapy↗
PubMed1986

Computerized tomography: its role in interstitial brachytherapy of pelvic malignancies.

The advantages of computerized tomography (CT) in the treatment planning of external beam radiation therapy have been shown in several studies. The authors extended the use of CT to the interstitial brachytherapy treatment planning of pelvic malignancies. CT was found to be invaluable in localizing pelvic tumors, selecting implant techniques, and checking the accuracy of the implant.

Brachytherapy↗
PubMed1984

Indication for interstitial brachytherapy in carcinoma of the uterine cervix.

More than 40 patients with gynecological, genitourinary, and gastrointestinal malignancies, both primary and recurrent but confined to the pelvis, were treated with interstitial irradiation over a four-year period. Interstitial irradiation was the choice of treatment for early carcinoma of the prostate, carcinoma of the anal canal less than T2, recurrent carcinoma of the uterine cervix, and carcinoma of the cervical stump. The authors' experience in treating recurrent carcinoma of the uterine cervix with interstitial irradiation is the basis for the indications for selecting the technique of interstitial irradiation presented.

Brachytherapy↗