Biomedical subjects
Publications and source records attributed to R A Potish.
The utility of adjuvant CMF in the treatment of breast cancer has been reanalyzed. The actual percentage of patients who benefit from adjuvant CMF has been shown to be relatively small. The widespread use of adjuvant CMF must be further examined.
A recent report in the literature was unable to associate the local--regional recurrence rates in breast cancer with deviations from the protocol's recommended dosages. The investigators proceeded to infer that there was "acceptable leeway" in the use of radiotherapy. The present manuscript examines the validity of certain statistical inferences drawn by these investigators.
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In order to predict which patients have a high risk for radiation-related small-bowel damage, the concept of the dose-response curve was applied to the predisposing factors (number of previous laparotomies, extent of surgery, thin physique, hypertension, age, cancer stage, number of treatment days, fractionation, and weight change during radiotherapy) present in 92 patients receiving identical radiation doses and volumes. This analysis allows an estimate of the probability of complications to be assigned to individual patients. The utility and limitations of the dose-response concept are discussed.
From 1970 through 1977, 92 patients with ovarian cancer received 20 Gy (2,000 rad) to the abdomen, followed by 30 Gy (3,000 rad) to the pelvis. Small-bowel obstruction developed in 7 (7.6%). The number of previous laparotomies, thin physique, and hypertension were significantly associated with complications. Two patients receiving isoniazid and 2 receiving Premarin had enteric complications. Pre-existing vascular damage may potentiate radiation damage to the small bowel.