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Biomedical subjects

R S Coltart

Publications and source records attributed to R S Coltart.

10 recordsLinked to original sources
PubMed1993

Trial of aminoglutethimide vs hydrocortisone as second-line hormone treatment of advanced breast cancer.

In a randomized trial of second line hormone therapy 56 postmenopausal women with advanced breast cancer received low dose aminoglutethimide (AGT) 125 mg twice daily without hydrocortisone (27 patients), or hydrocortisone (HC) 20 mg twice daily (29 patients). The two groups were well-matched for previous response to tamoxifen (TAM) therapy (AGT (35%) vs HC (32%)) and for relapse on adjuvant TAM. The mean age of the two groups was 69.2 years (AGT) and 63.2 years (HC). Liver metastases were present in 29% (AGT) and 33% (HC). The response rates were 11% (AGT) and 21% (HC). At 12 months the failure of treatment rate was 80% (AGT) and 70% (HC). Survival at 12 months was 50% for both groups. At 12 months 5/12 survivors were still on AGT and 8/12 on HC. These preliminary findings have so far failed to show any statistical difference in tumour response, time to treatment failure or survival between low-dose AGT and HC as second-line hormone treatment post-tamoxifen in advanced breast cancer.

Aged↗
PubMed1988

Hyperthermia improves local tumour control in locally advanced breast cancer.

We report three patients with advanced breast cancer who received hyperthermia (43 degrees C over 1 h, weekly x 4) and radiotherapy as palliative treatment for chest-wall recurrence. The case reports demonstrate situations where hyperthermia may be beneficial. These include tumours where radiotherapy alone is not expected to achieve control, such as large fungating tumours, and in previously irradiated areas. In these patients, hyperthermia with radiation achieves better local control of the tumour and delays the need for systemic chemotherapy. This may improve the quality of palliation.

Aged↗
PubMed1987

A CT based dosimetry system for intracavitary therapy in carcinoma of the cervix.

The physical dose distribution from intracavitary sources used in the treatment of carcinoma of the cervix can be accurately calculated in three dimensions. However, it is no simple matter to relate dose to critical tissues within the pelvis. We have studied 10 patients and have used CT scanning with dummy sources to determine the dose to lymph nodes, bladder and rectum. This technique may be superior to the use of orthogonal radiographs and highlights the limitations of the use of the flexible rectal dose meter. Further work will required to determine whether or not the morbidity of radical radiotherapy can be reduced using such detailed dosimetry to adjust therapy and eliminate small areas of high dose to critical normal tissues. In one case, CT showed a spontaneous and unexplained uterine perforation by the intrauterine tube one day after check films had shown a satisfactory position.

Adult↗
PubMed1986

A pilot study of high dose abdominopelvic radiotherapy following surgery and chemotherapy for stage III epithelial carcinoma of the ovary.

Ten patients with FIGO stage III carcinoma of the ovary received abdominopelvic radiotherapy using the abdominal bath technique in combination with surgery and intravenous cyclophosphamide and cis-platinum. The mean midplane dose to the abdominal cavity was 3120 cGy which is significantly higher than other series. Despite this high dose, there was no serious morbidity from radiation hepatitis, enteritis, and nephritis, and the treatment was tolerable. The actuarial survival of the group at 37 months was 30%.

Actuarial Analysis↗
PubMed1986

Circumferential para-aortic masses: computed tomographic observations.

Of 59 patients in whom computed tomography (CT) demonstrated large para-aortic masses engulfing the aorta, lymphoma was responsible in 32 (54%). In 22 (69%) of these 32 patients the mass appeared confluent while in 10 some nodularity could be discerned. Thirty-five of the 59 patients were known to have an underlying malignancy at the time of the CT; in every case the underlying malignancy proved to be responsible for the mass. Amongst 24 patients in whom the CT abnormality was found in the course of initial diagnosis, lymphoma proved to be responsible in 11 (46%), periaortitis in 4 (17%) and various malignancies in 9 (38%). In none of the patients with periaortitis was the aorta displaced from the vertebral body. The combination of such aortic displacement and mesenteric lymphadenopathy is highly characteristic of non-Hodgkin's lymphoma. Knowledge of these results should assist the choice of the appropriate type of biopsy in this situation.

Abdominal Neoplasms↗
PubMed1985

Severe constrictive pericarditis after single 16 MeV anterior mantle irradiation for Hodgkin's disease.

Severe constrictive pericarditis developed in 4 of 73 patients after single anterior 16 MeV mantle field irradiation for Hodgkin's disease. 3 patients (4.1%) died; the other had successful pericardectomy. Use of a single anterior mantle field of high-energy X-rays is clearly more hazardous than conventional opposed-field techniques, and the resulting radiation pericarditis is difficult to treat.

Adolescent↗
PubMed1985

The value of radionuclide venography in superior vena caval obstruction.

A prospective study on 27 patients with suspected obstruction of the superior vena cava (SVC) and 10 control patients with no known chest disease was undertaken to determine the value of radionuclide venography in aiding diagnosis and treatment of the condition. The technique proved simple, safe and non-invasive and could rapidly confirm or exclude the diagnosis when in doubt. In addition, the technique had a role in radiotherapy planning, highlighting unsuspected superior mediastinal disease not visible on the chest radiograph. However, follow-up post-treatment scans were of little help due to the good clinical markers of obstruction of the SVC. The normal and abnormal scan appearances are described.

Collateral Circulation↗
PubMedDate not supplied

The effect of hyperthermia and radiation on small bowel permeability using 51Cr EDTA and 14C mannitol in man.

A prospective study was conducted to study the effect of radiotherapy (RT) and regional pelvic hyperthermia (HT) on intestinal permeability in three groups of patients. Fifteen acted as cancer controls, receiving RT away from the peritoneal cavity, 21 patients received radical pelvic or abdominopelvic RT and 13 patients pelvic RT followed by pelvic HT using a BSD 1000 phased array applicator. Small bowel permeability was measured by oral administration of a mixture of [51Cr]EDTA, [14C]mannitol and lactulose before and after a course of treatment. The absorption of each marker was calculated by measuring the urinary excretion over 0-6 and 0-12 hours. The 6 hour collection gave results similar to the 12 hour collection, but had logistical advantages. The EDTA absorption rose and the mannitol absorption fell during a course of treatment, but the best index of permeability change was the EDTA/mannitol ratio (E/M). The E/M ratio rose by a factor of 2.4 (P less than 0.001) and 1.82 (P = 0.05) following RT and RT/HT respectively. There was no significant difference between the RT and RT/HT groups but the thermal dose to the RT/HT group was low (23 min./equiv 43 degrees C over three or four fractions in 4 weeks). There was no correlation between small bowel permeability and bowel frequency. The E/M permeability test is a useful simple functional assay for assessing small bowel damage after RT and RT/HT.

Adult↗