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Biomedical subjects

R C Watson

Publications and source records attributed to R C Watson.

At least 19 recordsLinked to original sources

A critical analysis of response criteria in patients with prostatic cancer treated with cis-diamminedichloride platinum II.

Cis-diamminedichloride platinum II (DDP), 50--70 mg/m2 iv, q 3w was administered to 25 patients with Stage D adenocarcinoma of the prostate. Since the assessment of tumor regression in a disease-oriented phase II study demands a clear end-point of response, case selection was restricted to patients who had objectively measurable lesions, i.e., nodes, skin, lung, and liver metastasis. Partial remission occurred in 3 (12%) and stabilization of disease in 1 patient. Responders lived 53 weeks vs. 20 weeks for non-responders. In the dosage and schedule used in this protocol, DDP was not an active agent in the treatment of prostatic cancer. Various patient characteristics are examined and correlations made between remission rates and survival in this study vs. 4 other response schemata. A critical analysis of patient selection, "lead time" -- diagnosis to chemotherapy, and the definitions of the terms "measurable" lesions, "evaluable" parameters, "objective response", stabilization of disease and response criteria employed in the 4 schemata are also discussed.

Adenocarcinoma

Computed tomography of lower extremity tumors.

Fifty cases of lower extremity tumors examined with computed tomography were reviewed. Of the 50 cases, 41 had gross pathologic correlation, either by enbloc resection (26) or by amputation (15). Important information regarding size, location, definition, and anatomic relation of tumors to vital structures (neural, vascular, and osseous) may be ascertained by this means with great accuracy. Localization of vessels by intravenous infusion of contrast material during the scan, or after arteriography with intraarterial contrast infusion, is found to enhance such evaluation. This information is particularly important where the feasibility of en-bloc resection is being evaluated.

Femoral Neoplasms

Giant-cell tumor of the sacrum. Clinical and radiologic features in 13 patients.

Thirteen patients were found to have giant-cell tumors during a study of 91 primary tumors of the sacrum. This tumor was second only to the chordoma in incidence. Giant-cell tumor is by far the commonest benign lesion of the sarcrum, yet it has a bad prognosis. Recurrences occurred in seven patients and five died of disease or a complication. All were histologically benign when first seen, but one developed a malignant giant-cell tumor and died within two years, and one developed a radiation-induced sarcoma 10 years following treatment. Computed tomography in two recent patients proved to be the most valuable single examination. Arteriography is helpful in showing the degree of vascularity of the tumor and the exact position of the large vessels, particularly important when surgical resection is planned.

Adolescent

The value of diagnostic aids in detecting pancreas cancer.

By contract with the National Cancer Institute, the accuracy of diagnostic techniques was assessed in 184 patients suspected of having pancreas cancer. Of 138 patients who were operated upon, 89 were found to have pancreas duct cancer, 30 had cancer of a different site of origin in the head of the pancreas region and in 19 there was no evidence of cancer at operation. All of the 46 patients who were not operated upon, 13 proven to have cancer and 33 patients discharged as free of cancer, were followed in our clinic. The majority of our patients presented with signs and symptoms of biliary obstruction. Computerized transaxial tomography (CTT) gave a "correct" diagnosis in 31 of 33 patients (94%) with proven cancer, there were 2 patients with a false negative report and a false positive diagnosis occurred in 8 of 20 patients (40%) without cancer. Celiac angiography (CA) gave a correct diagnosis in 78 of 94 patients (83%) with cancer, a false negative in 17%, and a false positive in 32%. 76Selenomethionine pancreas scan correctly diagnosed 27 of 36 patients (75%) with cancer, gave a false negative in 25% and a false positive in 31%. Ultrasonography gave a correct diagnosis in 18 of 27 patients with cancer (67%), a false negative in 33% and a false positive in 28%. Endoscopic retrograde cholangiopancreatography diagnosed correctly 8 of 11 cases (73%) of cancer, there were false negative diagnoses in 3 cases (27%) and false positives in 3 of 14 patients (21%). Duodenal aspiration techniques gave a very low percentage of correct diagnoses. Chronic pancreatitis most commonly gave rise to a false positive diagnosis. Serum alkaline phosphatase was elevated in 82% of patients, gave 18% false negatives and 33% false positives. Carcinoembryonic antigen (CEA) was elevated (greater than 2.5 ng/ml) in most of the pancreas cancer patients but also in patients with other cancers and with non-cancerous diseases. In our hands, CTT, CA, alkaline phosphatase, 75Se-methionine and ultrasonography, in descending order, have given the highest percentage of correct diagnoses but false positive and false negative diagnoses prevented any single test from being conclusive.

Biopsy, Needle

Adriamycin in advanced urinary tract cancer: experience in 42 patients and review of the literature.

Forty-two patients with measureable, advanced, genito-urinary cancer received Adriamycin. Significant clinical responses (CR/PR) occurred in only five (14%) of 35 adequately treated patients. Four additional patients achieved a minimal response anf four others showed stabilization of their disease for 4 to 9 months. Review of the literature suggests an overall response rate of 20%. Patients with a urinary diversion lived significantly longer (P 0.006) than patients who did not have this procedure (42.5 months vs 21.5 months). The need to define various patient characteristics in future chemotherapeutic trials in bladder cancer is discussed.

Adenocarcinoma

Radiation treatment planning.

Radiation treatment planning has developed into a substantial and effective component of the entire radiation treatment approach. Over the last 2 decades, with the development of high energy electron and x-ray sources, and also with the availability of new radionuclides and techniques for internally applied radiation, all of which permit a high degree of concentration of radiation, treatment planning has been developed to make best use of these modalities. The use of automatic computation has proved necessary in order to handle the large amounts of radiation data involved in treatment dose calculation. Tumor and anatomical localization has been carried out with increasing precision. Several cases are described which illustrate planning and in particular the use of computerized transverse tomography. The use of moving shadow-shields is also described. For internally applied radiation, the features of iodine-125 are illustrated.

Adult

Tumor vascularity as a prognostic factor for hepatic tumors.

The prognostic and therapeutic significance of tumor vascularity was studied in 36 patients with hepatoma or metastatic colon cancer in the liver. All patients had nonresectable tumor and were treated by hepatic artery ligation and hepatic arterial infusion chemotherapy. Chemotherapy consisted of methotrexate, actinomycin-D, 5-fluorouracil and cyclophosphamide. Hepatic tumors were categorized into Grades I to III in the order of increasing vascularity as determined by preoperative hepatic angiography. Tumor vascularity of 15 patients with hepatoma was Grade III in 11 (73%) and Grade II in 4 (27%). No patient with hepatoma had a Grade I tumor. The median survival of patients was 10 and 6 months for Grade III and II hepatomas, respectively, after hepatic artery ligation, and 18 and 8.5 months for Grade III and II, respectively, from the time of diagnosis of hepatoma. Tumor vascularity of 21 patients with metastatic colon cancer was as follows: Grade III in 3 (14%); Grade II in 10 (48%); and Grade I in 8 (38%). The median survival was 11, 10.5 and 4 months for Grades III, II and I, respectively, after hepatic artery ligation, and 17, 14.5 and 7.2 months for Grades III, II and I, respectively, from the time of diagnosis of hepatic metastases of colon cancer. The results indicate that the more vascular the hepatic tumor on angiogram, the better the prognosis following hepatic artery ligation and infusional chemotherapy.

Antineoplastic Agents

Intrapericardial installation of radioactive chromic phosphate in malignant effusion.

Treatment of 28 patients with malignant pericardial effusion was accomplished primarily by intrapericardial instillation of radioactive chromic phosphate. At time of diagnosis of pericardial disease, 14 patients had major manifestations of tamponade; the rest had little or no clinical evidence of effusion. Only eight of the 28 patients had further problems with effusion after the initial pericardiocentesis and 32P instillation. Additional aspirations were done on those patients 2 weeks to 5 months later. The average survival was 9 months; seven patients lived more than 1 year.

Adult

The neuropathology of malignant external otitis.

A case report of malignant external otitis is presented with particular emphasis on the neuropathological sequelae. The most striking finding was a mycotic aneurysm of the basilar artery with resultant thrombosis and brain stem infarction. Diffuse pachymeningitis was also present. The severity of the changes described in this case further point out the need for early recognition and adequate treatment of this potentially fatal disease complex.

Aneurysm, Infected

Cis-dichlorodiammineplatinum(II) in advanced bladder cancer.

Cis-dichlorodiammineplatinum(II) (DDP) was given at a dose of 1.25 or 1.6 mg/kg to 24 patients with advanced measurable, urinary tract cancer. Eight patients (35%) achieved a partial remission and four additional patients had a minor response. There were 14 patients with epidermoid (transitional cell) bladder cancer who had had no prior chemotherapy and all eight partial responders were in this group. DDP appears to be one of the more active antineoplastic agents in bladder cancer.

Aged