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T A Boon

Publications and source records attributed to T A Boon.

49 records · Page 3Linked to original sources
PubMed1993

[Sexual possibilities following total penis amputation].

A male aged 45 was subjected to total penis amputation because of a penile carcinoma; a perineal urethral stoma was created. The postoperative course was uneventful. One month after the last operation the patient for the first time felt the need for sexual contact, but his wife hesitated. After medical-sexological counselling, the partners achieved satisfactory sexual functioning with the husband occasionally having an orgasm.

Amputation, Surgical↗
PubMed1993

Safety and efficacy of lomefloxacin versus norfloxacin in the treatment of complicated urinary tract infections.

Seventy patients with complicated urinary tract infections were treated with either lomefloxacin (400 mg once daily) or norfloxacin (400 mg twice daily) for 10 to 14 days. A total of 19 (86%) of 22 patients treated with lomefloxacin and 20 (74%) of 27 patients treated with norfloxacin were cured, as defined by a negative culture five to nine days after completion of therapy (p = 0.09). After four to six weeks, the figures were 56% for lomefloxacin and 48% for norfloxacin. Adverse effects in the lomefloxacin group were observed on 20 occasions in 12 patients (one stopped treatment) compared to nine occasions in five patients treated with norfloxacin (difference not significant).

Adolescent↗
PubMed1992

Squamous cell carcinoma of the penis. II. Treatment of the primary tumor.

The treatment of the primary tumor in 110 patients with squamous cell carcinoma of the penis seen between 1956 and 1989 was reviewed. Small tumors had generally been treated by penis conserving methods, such as circumcision, local excision and external radiotherapy alone or after circumcision or local excision. Since 1982 we have used the neodymium:YAG laser as a penis conserving method. In 51 patients (46%) penis conserving treatment had been performed and 59 (54%) had undergone some form of amputation. Overall, 16 of 110 patients (15%) had local recurrence. The risk of local recurrence after penis conserving therapy was significantly related to T category, with 10% local recurrences in stage T1 tumors in contrast to 32% and 100% in stages T2 and T3 tumors, respectively. All of the recurrences in patients with stage T1 tumors were strictly local and all were salvaged. In our view penis conserving therapy is a safe procedure in patients with stage T1 tumors and should always be attempted first. Amputation is considered to be overtreatment in these cases. Of 6 recurrences in the conservatively treated stage T2 disease group 4 were strictly local. These were all well or moderately differentiated tumors, not exceeding 3.5 cm. in diameter. We suggest penile conservation for this subgroup of T2 tumors. However, partial amputation is recommended for poorly differentiated stage T2 tumors. Local failure was observed in all stage T3 tumors treated with external radiation. In general, penis conservation in stage T3 tumors should not be attempted with the treatment modalities available to date. Comparing the different methods of penis conservation, used in 49 stages T1 and T2 tumors, no difference in local recurrence rate (18%) was observed among surgery, laser and external beam radiation. In view of the low morbidity, cutting and coagulation properties and minimal tissue changes, use of the neodymium:YAG laser would be our first choice of treatment modality. Penile conservation should be attempted only when frequent and long lasting followup is guaranteed, since local recurrences can appear as late as 8 years after primary treatment.

Adult↗
PubMed1988

Sapphire probe laser surgery for localized carcinoma of the penis.

Cancer of the penis is an uncommon disease in the western world, but it causes significant morbidity and mortality worldwide. Discussions have tended to centre around issues of local tumor control and the functional status of the penis after treatment. Since November 1982 we have treated localized squamous cell penile cancer (Tis, T1 and T2, Classification UICC, Geneva 1978) with the Nd-YAG laser. Sixteen patients (3Tis, 5T1 and 8T2 tumors) are included in this study with a follow-up of 4 to 36 months (mean 17 months). Eight out of 16 patients were treated with the sapphire probe exclusively, the other eight patients by scalpel excision followed by laser irradiation. No recurrent tumor was observed in 13 patients, one patient developed a recurrence at a non-treated part of the glans penis after 14 months, one patient showed Tis after 5 months near the treated side and in one patient an incomplete laser resection was followed by partial penectomy after 1 month. Sapphire probe laser excision is a safe procedure leading to a good cosmetic aspect with maintenance of the functional integrity of the penis.

Adult↗
PubMed1987

Preliminary results with iodine-125 seeds for permanent implantation in patients with localized prostatic cancer.

Since August 1981, a permanent implantation with iodine-125 seeds has been performed in 41 patients with localized prostatic cancer. The seeds are implanted through a suprapubic incision. This gives the opportunity also to perform a diagnostic dissection of the regional lymph nodes. In five patients, the nodes were positive. In 4 out of these 5 patients bone metastases became manifest within one year. Two patients died of disseminated tumor, the first also had a local recurrence. Two other patients died shortly after treatment because of heart failure, while a third patient also died of heart failure, 2 years after implantation. Out of 31 patients with a follow-up period of 6 months or longer, distant metastases were found in four, in 2 followed by a local recurrence in the prostate. We can conclude that the preliminary results of this technique are encouraging with only three local recurrences in 41 patients. The prognostic value of positive lymph nodes was once again established.

Brachytherapy↗
PubMed1982

Estrogen-induced deficiency and decrease in antithrombin III activity in patients with prostatic cancer.

Plasma antithrombin III activity was studied in 22 patients with prostatic cancer who were on estrogen therapy. Normal plasma antithrombin III activity varies between 0.80 and 1.40 U. per ml. A loading dose of 15 mg. diethylstilbestrol daily resulted in a marked decrease in plasma antithrombin III activity (mean 0.24 U. per ml.). Patients with the lower end of normal range of pre-treatment plasma antithrombin III activity may suffer acquired antithrombin III deficiency and, thus, a concomitantly increased risk of thromboembolic complications as a result of estrogen treatment. Patients on maintenance therapy of approximately 1 mg. daily appear to have normal plasma antithrombin III levels. The results obtained suggest that plasma antithrombin III activity should be monitored before and during estrogen therapy in patients with prostatic cancer.

Aged↗
PubMedDate not supplied

Comparison of intra-luminal versus intra-tumoural temperature measurements in patients with locally advanced prostate cancer treated with the coaxial TEM system: report of a feasibility study.

A study was performed on regional hyperthermia for patients with locally advanced prostate carcinoma. The primary objective was to analyse the thermometry data with an emphasis on the possibility of replacing invasive thermometry by tumour-related intra-luminal thermometry. Fourteen patients were treated with a combination of conformal external beam radiotherapy (70 Gy) and hyperthermia. Hyperthermia was delivered using the Coaxial TEM system, one treatment per week, to a total of five treatments. Thermometry was performed in bladder, urethra, rectum and esophagus. Invasive thermometry in the prostate was carried out during one or two treatments for each patient by placing transperineally a central and a peripheral catheter. Heterogeneous temperature distributions were measured in the prostate. The mean average invasive temperature range was 1.1 degrees C. Due to the temperature heterogeneity and a limited number of thermometry sensors (mean 7, range 2-13), large variability between treatments and patients existed regarding achieved temperatures and dose. The mean invasive T90 was 40.2 +/- 0.6 degrees C and T50 was 40.8 +/- 0.6 degrees C. The mean Cum min T90>40.5 degrees C per treatment was 22 (range 0-50). Importantly, intra-luminal temperatures did not reliably predict invasively measured temperatures. Invasive thermometry, therefore, remains compulsory to calculate a thermal dose for an individual patient. Changes in temperature during treatment, measured by the urethral sensors, corresponded well with changes in temperature measured by the individual invasive sensors. Similar comparison of rectal temperature changes with intra-prostatic temperature changes was not as predictive. The similarity in temperature changes between the urethral and interstial sites, suggests that urethral temperatures are sufficient for treatment optimization. The SAR profile did not correspond with the temperature profile indicating heterogeneous perfusion. Although regional hyperthermia in combination with external beam radiotherapy for locally advanced prostate carcinoma is clinically feasible, the question on the importance of invasive thermometry remains.

Aged↗
PubMedDate not supplied

Pelvic exenteration as treatment of recurrent or advanced gynecologic and urologic cancer.

Pelvic exenteration is used as therapeutic option for advanced or recurrent cancer in the pelvis. We determined the complications of and the survival after pelvic exenteration. The study was performed as a retrospective cohort (n = 62) study from January 1, 1989, until January 1, 2000. Descriptive statistics were used. Survival was estimated according to the Kaplan-Meier life table. The operative mortality was 1.6%. Seventy-five percent of the patients had postoperative complications of which ileus and urinary tract infection were the most common. Late complications occurred in 83% of the patients. Recurrent disease was observed in 38% of the women, whereas 50% had died on January 1, 2000. Five-years disease-free and overall survival were 42% (confidence interval [CI] +/- 14%) and 46% (CI +/- 14%), respectively. Elderly patients (> 70 years old) do not experience more complications. Despite considerable morbidity, pelvic exenteration is a therapeutic option for survival, even for patients of 70 years and older.

Adult↗