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W F Regine

Publications and source records attributed to W F Regine.

43 records · Page 3Linked to original sources
PubMed1993

Long-term results of pediatric and adult craniopharyngiomas treated with combined surgery and radiation.

From 1958 to 1982, 58 patients with craniopharyngioma were treated with external beam radiation, 56 post surgery. Nineteen were pediatric (< 16 years) and 39 were adult. Forty patients underwent primary treatment while 18 (7 pediatric and 11 adult) were treated for recurrence. Median follow-up is 17 years. Tumor dose and 'maximum dose' (i.e. dose to smallest isodose > 1 cm) were recorded. The mean tumor and maximum dose for pediatric patients was 5588 and 5870 cGy vs. 6243 and 6542 cGy, respectively for adults. The actuarial 5- and 10-year survivals for pediatric patients were 84% and 72%, respectively and were significantly better than the 54% and 51% for adults (p = 0.01). However, overall disease recurrence rates were 26% (5/19) for pediatric patients and 18% (7/39) for adults. Of the multiple patient and treatment parameters analyzed, initial disease type (i.e. primary vs. recurrence) in pediatric patients, surgical extent, tumor dose, maximum dose, age of adults and use of pretreatment CT evaluation appeared to impact on patient outcome. Pediatric patients treated for primary disease showed improved survival over those treated for recurrence. The same was not observed in adults and appeared to be due to treatment toxicity. Surgical morbidity correlated with extent of surgery. All patients who underwent total resection developed surgical sequelae. Forty-four percent (4/9) of patients receiving tumor doses of < or = 5400 cGy developed recurrences vs. 16% (8/49) in those receiving > 5400 cGy. Nine of the 12 recurrences were in patients who did not undergo pretreatment CT evaluation.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMed1992

Impact of adjuvant therapy on locally advanced adenocarcinoma of the stomach.

From 1975 to 1988, 120 consecutive patients with locally advanced (T3/T4 or N1/N2) adenocarcinoma of the stomach underwent attempted curative resection. Seventy patients were treated with surgery alone while 50 patients also received adjuvant therapy consisting of either chemotherapy (5-FU/FAM) alone, radiation therapy alone, or chemotherapy+radiation therapy. Adjuvant therapy was tolerated relatively well with only one patient experiencing a grade 3 (RTOG/EORTC) toxicity, and none experiencing grade 4/5 toxicity. In patients with T3/T4 tumors, the median survival was 10 months for surgery alone as compared to 18 months for the adjuvant treatment group, and a 5-year survival of 10% versus 24% in the adjuvant therapy group (p = .01). In patients with lymph node positive disease, the median survival was 10 months in patients treated with surgery as compared to 15 months for those treated with adjuvant therapy, and a 5-year survival of 8% for surgery alone versus 16% for the adjuvant therapy group (p = .04). Patients having both T3/T4 tumor and positive lymph nodes had a median survival of 9 months with surgery versus 13 months for the adjuvant therapy group, and a 5-year survival of 4% versus 22% (p = .03) for the adjuvant group. Seventy-four patients were evaluable for pattern of relapse. Thirty developed locoregional recurrence; 17 of 38 (45%) in the surgery alone group and 13 of 36 (36%) in the adjuvant therapy group. The improvement in local control in the adjuvant group was totally accounted for by the group receiving both chemotherapy and radiation therapy, in which the recurrence rate was 19%. Statistically significant improvement in the 2-year local control rate was limited to patients with negative surgical margins who received radiation, 93%, versus those who did not, 55% (p = 0.03). The modest improvement in survival seen in patients receiving adjuvant therapy appears to be related to improved local control. No improvement in the rate of distant failure was seen. Chemotherapeutic regimens used seem to be critical in enhancing the effects of radiation in improving local control and survival. Results may be further improved by the extended use of intraoperative radiation.

Adenocarcinoma↗
PubMed1992

Pediatric craniopharyngiomas: long term results of combined treatment with surgery and radiation.

From 1961 to 1981, 19 pediatric patients with craniopharyngiomas were treated with external beam radiation post surgery. Twelve underwent primary treatment while seven were treated for recurrence. Median follow-up is 21 years (range 8-28 years) with an overall 20-year survival of 62%. Twenty-six percent (5/19) developed disease recurrence following radiation. Of the multiple patient and treatment parameters analyzed, only initial disease status (i.e., primary vs recurrence), surgical extent, radiation dose, and treatment prior to routine use of CT scans (1961-1974) appeared to have major influence on patient outcome. The 20-year survival for those treated for primary disease was 78% versus 25% for those treated for recurrence. Fifty percent (3/6) of patients receiving tumor doses of < or = 5400 cGy developed recurrences versus 15% (2/13) in those receiving > 5400 cGy. Four of the five recurrences occurred in patients treated during the pre-CT era. Long term effects of treatment were analyzed. Surgical morbidity correlated strongly with extent of surgery. All patients who underwent total resection developed surgical sequelae. Radiation morbidity correlated strongly with radiation dose. The incidence of vascular or neurologic complications attributable to radiation were minimal, occurring in only two patients. Both received doses higher than that given with modern therapy. Long-term results from this series are better than those reported with surgery alone. Use of modern surgical and radiation equipment/technique along with CT/MRI imaging should yield improved treatment results both in terms of lower recurrence and lower toxicity rates.

Adolescent↗
PubMed1991

Computer-CT planning of the electron boost in definitive breast irradiation.

Treatment planning of the electron boost in breast irradiation at this institution is performed by using information from CT scanning and from surgical clips used to define the tumor bed. A refinement of this technique, taking into account the surgical axis of approach, using computer-CT planning is now implemented. The location of the scar and the clips are digitized using a computer to define the tumor bed dimensions. With 3-D computer software a line, simulating the surgical axis and the central ray of the electron beam, is drawn between the deepest clip and the surgical scar. This beam's eye view along the surgical axis is projected onto a screen as a starting point. Appropriate gantry angle, treatment table position, beam energy, and precise shaping of the electron field borders with a 2 cm margin around the clips and the scar are determined. Simulation films comparing clinically set-up fields and computer-CT planned fields were reviewed. In only 5 of 17 patients did the clinically set-up field have adequate inclusion of the tumor bed within the treatment volume. Computer-CT planned fields ensured adequate inclusion of the tumor bed in all, including the remaining 12. In 7 patients obvious increased sparing of normal breast tissue was seen with computer-CT planned fields. This technique enables accurate placement of a shaped electron field and further refinement of electron boost treatment planning. This is especially true in situations in which the tumor bed is located at a site distant from the lumpectomy scar rather than directly beneath it and in cases where the tumor bed lies deep within the breast.

Breast Neoplasms↗
PubMed1989

Stage II seminoma: results of postorchiectomy irradiation.

One hundred forty patients with testicular seminoma were treated at the State University of New York Health Science Center at Syracuse between 1966 and 1985. Disease was classified as stage II in 32 patients (23%): stage IIA in 21 patients and stage IIB in 11 patients. All patients underwent irradiation below the diaphragm after a radical orchiectomy, and 28 underwent planned mediastinal and supraclavicular irradiation. The median follow-up was 8 1/2 years; 24 of 32 patients have been followed up for more than 5 years. Twenty-eight patients remain alive and well; four patients died of intercurrent disease. Two patients developed a recurrent seminoma in the mediastinum; a variant lymphangiographic pattern was shown in these patients, and they were cured. A third patient developed a non-seminomatous "recurrence" in the ipsilateral, unirradiated, inguinal nodes and is well after chemotherapy.

Adult↗
PubMedDate not supplied

Radiotherapy for adenoid cystic carcinoma of the palate.

This is an analysis of 16 patients with adenoid cystic carcinoma of the palate who were treated with curative intent by radiotherapy alone (9) or surgery and radiotherapy (7). No patient received adjuvant chemotherapy. Follow-up ranged from 3 years to 19 years with 69% of the patients having follow-up of more than 5 years. Two patients in the radiotherapy alone group developed local recurrences, and both have had long-term surgical salvage. No local failures were seen in the combined therapy group. Twelve patients (75%) are alive and disease-free. Two patients died with distant disease, one within each treatment group. One patient in the combined therapy group is alive at 8 years with distant metastases, while one in the radiotherapy alone group died of intercurrent disease at 12 years. No significant complications were seen in either treatment group. The role of radiotherapy in the treatment of adenoid cystic carcinoma of the palate is reviewed.

Adult↗