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Biomedical subjects

W Duncan

Publications and source records attributed to W Duncan.

At least 91 records · Page 5Linked to original sources
PubMed1985

A report of a randomized trial of d(15)+Be neutrons compared with megavoltage X ray therapy of bladder cancer.

The results of a randomized trial of d(15)+Be neutrons compared with 4 or 6 MV photons for the treatment of transitional cell carcinoma of the bladder. Between December 1978 and December 1981, 113 patients were accrued, 53 allocated to be treated by neutrons and 60 by photons. Complete local tumor regression was observed in 64% of patients treated by neutrons and 62% treated by photons. Recurrent cancer was subsequently confirmed in 31% of patients, similar in both treatment groups. There was no significant difference in the control rates by T stage between the two treatment groups. Late morbidity was significantly worse in patients treated by neutrons. Following neutron therapy, 78% of patients had serious late morbidity in at least one tissue compared with 38% in the group treated by photons. Survival was significantly better in the photon treated group 45.3% (+/- 11%) at 5 years compared with 12% (+/- 6%) after neutron therapy.

Aged↗
PubMed1985

Bladder cancer: the value of routine bone scintigraphy.

Two hundred and twenty-one patients with invasive bladder cancer had routine bone scintigraphy performed as part of tumour staging. The incidence of detectable metastases was 12%. Skeletal scintigraphy at diagnosis has a sensitivity of only 38%. The predictive value of a negative examination was 92%. These results suggest that skeletal scintigraphy is not indicated as a routine staging procedure in carcinoma of the bladder.

Aged↗
PubMed1985

Results of a randomised study to evaluate influence of dose on morbidity in radiotherapy for bladder cancer.

Ninety-four patients with invasive transitional-cell carcinoma of the bladder were randomised to receive three different doses of megavoltage X-rays. Doses of 50.0 Gy, 52.5 Gy and 57.5 Gy were given in 20 daily fractions. Patients were stratified into two groups by tumour size: less than 5.0 cm and 5.0-7.0 cm in diameter. The large tumours were more advanced (higher T stage) and included a larger number of patients with less well differentiated tumours. Comparisons of morbidity are made in each dose group defined by tumour size. Early and late morbidity was carefully assessed during follow-up and was found to be unacceptably high in the group who received 57.5 Gy in 20 daily fractions.

Actuarial Analysis↗
PubMed1985

A retrospective study of the role of radiotherapy in the treatment of soft-tissue sarcoma.

One hundred and forty patients with soft-tissue sarcoma were seen between 1965 and 1974 and the pathology has been reviewed in 93 cases. One hundred and eight patients were treated radically. Their overall survival rate was 53% at 5 years and 41% at 10 years. Overall local control was 63% but primary local control varied considerably with treatment, being highest for those receiving surgery and post-operative radiotherapy. The poor prognosis of patients with paravertebral tumours is confirmed.

Actuarial Analysis↗
PubMed1985

Monoclonal antibody assay of serum placental alkaline phosphatase in the monitoring of testicular tumours.

A monoclonal antibody (H17E2) recognising both placental alkaline phosphatase (PLAP) and testicular PLAP-like alkaline phosphatase was incorporated in a solid phase immunoassay. This was used to measure levels of PLAP in 257 sera from 148 patients with germ cell neoplasms of the testis. High levels of PLAP were found in all patients with active seminomas (mean 0.85 O.D.) compared to those in clinical remission (mean 0.20 O.D.) (P less than 0.0001). More importantly, changing levels of PLAP correlated with the course of disease in 79 samples from 33 patients with seminoma (P less than 0.0001). Elevated PLAP levels were also noted in patients in remission who were smokers (mean 0.32 O.D.) compared to non-smokers (mean 0.15 O.D.) (P less than 0.001). These data demonstrate that determination of PLAP levels using this sensitive immunoassay is an important new adjunct in the monitoring of the response to treatment in patients with seminoma.

Adult↗
PubMed1985

The management of early stage non-seminomatous germ cell tumours of the testis: Edinburgh 1970-1981.

This study describes the management of early stage non-seminomatous germ cell tumours of the testis in Edinburgh between 1970 and 1981. There were 69 patients in clinical Stage I and 22 patients in clinical Stage IIA. All were treated by orchiectomy and radiotherapy to the para-aortic nodes. Some of the patients with Stage IIA disease received additional therapy. The overall 5-year actuarial survival rate was 83%. In a group of 52 patients with Stage I disease who had had lymphography as part of their initial staging the 5-year actuarial survival rate was 94.2%. The overall relapse rate was 27/91 (29.7%). The relapse rate in State IIA disease was 11/22 (50%) and the 5-year actuarial survival rate was 64%. Patients with primary tumours beyond T1 had a significantly higher relapse rate than patients with T1 primary tumours: 10/20 (50%) and 13/52 (25%) respectively. The histology of the primary tumour did not have a statistically significant influence upon relapse rate.

Dysgerminoma↗
PubMed1985

Cisplatin combination chemotherapy for advanced germ-cell testicular tumours.

Thirty-six patients with advanced non-seminomatous germ-cell testicular tumours and two patients with advanced seminomas were treated with cisplatin-containing combination chemotherapy. Thirty-four patients received cisplatin 100 mg/m2 iv, vinblastine 0.3 mg/kg iv and bleomycin 30 mg iv (PVB) and three patients received this combination with etoposide (VP16-213) 120 mg/m2 iv on 3 consecutive days substituted for vinblastine (BEP). One patient received cisplatin and bleomycin only. All 35 evaluable patients with non-seminomatous tumours responded; 22 patients (61%) achieved a complete response (CR); 16 of these (73%) are alive with no evidence of disease at follow-up ranging from 18 to 55 months (median 36). Of 13 patients achieving a partial response (PR), 11 have died of progressive disease at 7 to 30 months (median 11) and two are alive with disease which has continued to regress following chemotherapy. Of 32 patients who received adequate chemotherapy, 16 (50%) are alive and disease-free and three (9%) are alive with evidence of disease. The chances of achieving a CR were reduced in those patients with bulky disease or high levels of AFP or beta hCG at presentation but not in those who had received prior radiotherapy. Toxicity was considerable, including alopecia and nausea or vomiting in all patients, and haematological toxicity, neurotoxicity, hearing loss and dyspnoea in a substantial number of patients.

Adult↗
PubMed1985

Cis-platin and methotrexate in the treatment of transitional cell carcinoma of the urinary tract.

Nineteen patients with recurrent or metastatic transitional cell carcinoma of the urinary tract were treated with a 3-weekly combination of methotrexate 200 mg/m2 as a 24-h infusion with folinic acid rescue and cis-platin 100 mg/m2. An objective response rate of 68% was obtained, with 4 patients (21%) achieving complete remission. Pulmonary disease and lymph node metastases were particularly sensitive to this therapy. The median duration of response was 21 weeks with a median survival of 54 weeks in the responding patients. This regimen warrants further investigation in the treatment of invasive bladder carcinoma.

Aged↗
PubMed1985

The role of endoscopic treatment after radical radiotherapy for invasive bladder cancer.

In a 6-year period 232 patients were treated by radical radiotherapy for transitional cell cancer of the bladder. Fifty-eight patients had secondary surgical management to control either locally persistent or recurrent tumour. Endoscopic treatment alone was used in 31 patients with down-staged tumours and the survival of this group compared favourably with that of 27 patients selected for salvage cystectomy (5-year survival rate 88% cf. 44%). A group of patients with favourable prognostic factors may be identified in whom cystectomy can be avoided without prejudice to survival.

Carcinoma, Transitional Cell↗
PubMed1985

Prediction of response to radiotherapy for localised prostatic cancer.

Fifty-one patients with TO-4 NX MO carcinoma of the prostate were treated by external beam radiotherapy. Comparison with 40 patients with TO-3 NX MO disease, whose treatment was deferred initially, showed a higher incidence of local progression in the untreated patients. Age at presentation and initial T category did not have a significant influence upon the probability of disease progression after radiotherapy, whereas all but one of the irradiated patients with Gleason sum scores greater than or equal to 6 progressed. Treatment-related morbidity was appreciable and prolonged proctitis occurred in 31 patients. There was one treatment-related death. Biopsy 1 year after treatment did not yield information of prognostic significance. It is recommended that the selection of patients with localised carcinoma of the prostate for treatment by radiotherapy is based on histological grade. The Gleason score is a practical method for identifying those who would best be treated by other methods.

Aged↗
PubMed1984

Fast neutrons in the treatment of head and neck cancers: the results of a multi-centre randomly controlled trial.

The results are presented of a multi-centre randomly controlled trial of fast neutron irradiation and mega-voltage X-rays in the treatment of patients with locally advanced squamous cell carcinoma of the head and neck region. No significant difference was observed in local tumour control rates. Salvage surgery was performed in a similar number of patients in the two groups. Late morbidity was also similar in the two treatment groups. Patients in a subgroup with cancer of the larynx treated by photons had a significantly better survival than those in the neutron treated group.

Aged↗
PubMed1984

Avian tuberculosis in pigs: miliary lesions in bacon pigs.

An outbreak of tuberculosis caused by Mycobacterium avium type 2 is described which resulted in the total condemnation of 26 carcasses and partial condemnation of tissues and organs of a further 200 animals. Circumstantial evidence is presented that hens running in the farmyard were the source of the infection. Examinations of the carcasses and organs of the diseased pigs suggested that the accepted pathogenesis of the disease is incorrect and a new hypothesis is presented. The problems for the meat inspector in differentiating tuberculosis from 'milk-spot liver' are discussed and recommendations made. The findings of the study are discussed in the light of 'The Meat Inspection Regulations 1963' and it is recommended that where tuberculosis is suspected there is no longer any necessity to split the carcasses. The public health implications of this study are discussed.

Animals↗