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Biomedical subjects

W P Brockmann

Publications and source records attributed to W P Brockmann.

At least 19 recordsLinked to original sources
PubMed1993

[The chemoradiotherapy of advanced colorectal carcinoma--the results and toxicity in a pilot study with 44 patients].

Forty-four evaluable patients with advanced colorectal cancer were treated with simultaneous chemoradiotherapy to the small pelvis. In 34 patients locally recurrent disease and in ten patients primary tumors had been resected. 34 patients had gross and ten patients had microscopic residual tumor after surgical resection, seven of the latter with distant metastases. Radiotherapy was given to a dose of 50 Gy in five weeks. During the first two weeks of treatment simultaneous chemotherapy was applied, using continuous 24 hour intravenous infusion of 5-fluorouracil at 500 mg/m2 on days 1 to 5 and 8 to 12 and bolus injection of mitomycin C at 5 mg/m2 on days 5 and 12. Two-year local control rates in patients with microscopic residual were 76% compared to 36% in patients with gross residual disease. Two-year survival rates were 5/7 patients for microscopical residual tumor and 13/30 patients (44%) with gross residual tumor. Considerable rates of acute and late toxicity were observed, however, these rates were not higher than results reported by others. In view of the increasing interest in chemoradiotherapy for residual and recurrent colorectal cancers, a randomized multicenter study has been opened (ARO I/91). Aim of this clinical trial is to find out, whether patients with advanced colorectal cancer benefit from simultaneous chemoradiotherapy.

Adenocarcinoma↗
PubMed1992

[Dose-finding study for hyperfractionated, accelerated radiotherapy plus simultaneous carboplatin administration in patients with locoregionally advanced head and neck cancer].

Therapy of large inoperable squamous cell-carcinomas of the head and neck is considerably problemful. Combined simultaneous radio-chemotherapy with carboplatin and radiotherapy with hyperfractionated accelerated radiation is small effective than conventional monofractionated radiotherapy alone and may reduce side effects. Aim of the following study was dosage optimisation of the applicated carboplatin.

Carboplatin↗
PubMed1992

[An atypical site of a solitary eosinophilic granuloma in the distal humerus].

The case of a ten-year old girl, presenting with pain and restricted movement of the left arm is reviewed. X-rays and bone scan suggested an Ewing's sarcoma of the left humerus, so that the child was referred to surgery. Surprisingly, the histological examination of the surgical specimen revealed a solitary eosinophilic granuloma of the bone.

Bone Diseases↗
PubMed1991

[The therapeutic results and early and late toxicities of the treatment of anal canal carcinoma by radiotherapy or chemoradiotherapy].

From 1975 to 1989 114 patients with anal canal carcinoma were treated, 81 of these with radiotherapy (RT) alone and 33 with chemoradiotherapy (CRT), 80% respectively 82% of the patients were colostomy-free at the onset of therapy. RT was given to a total dose of 60 Gy in six weeks, for CRT additional simultaneous 5-fluorouracil (500 mg/m2 days 1 to 5 and 8 to 12) and mitomycin C (5 mg/m2 days 5 and 12) was administered. 67% respectively 82% of the patients had UICC stage II to IIIB disease predominantly with G2 and G3 squamous cell carcinomas. Local control after three years was 79% for the RT group vs. 82% for the CRT group. Three-year survival rate was 68% and 71%, respectively. These differences were not significant. Only for G1- compared to G3-tumors there is a significantly higher survival rate. Acute and late damage was slightly lower for the RT treatment group (77% and 25%) compared to the CRT group (79% and 30%). In both treatment groups there was one patient needing a permanent colostomy due to radiation induced proctitis. In conclusion, RT or CRT should be the primary form of treatment in patients with and canal carcinoma and abdominoperineal resection should only be performed in case of local recurrence or tumor persistence. The final decision about the indications for RT or CRT can only be made with the results of a prospective randomized trial.

Aged↗
PubMed1990

Treatment results and acute and late toxicity of radiation therapy for testicular seminoma.

From 1977 to 1988, 215 patients with a diagnosis of testicular seminoma were referred to the University Hospital, Hamburg, West Germany, for radiation therapy (RT). In 15 patients a careful review of the histologic condition showed signs of embryonal cell carcinoma. Three patients refused completion of therapy. No patient was lost to follow-up. On this basis, a retrospective review of 197 patients was carried out. One hundred thirty-three patients were classified as Stage I (67%), 39 as Stage II (20%), 8 as Stage III (4%), and 17 as Stage IV (9%). One hundred eighty patients had classic seminoma and 17 had anaplastic seminoma. All patients underwent high inguinal orchiectomy before treatment. Seven patients with Stages III and IV received chemotherapy before RT. Patients with Stages I and II were treated with 40-Gy photons to paraaortic and parailiac fields. Ten patients with Stage III and IV seminoma received 30-Gy photons to mediastinal and supraclavicular fields as well. Sixty patients received additional inguinal RT. The overall 5-year survival rate (corrected for intercurrent death, except for treatment toxicity) was 100% for Stage I, 100% for Stage II, 87% for Stage III, and 87% for Stage IV. The mean follow-up time was 6.3 years (range, 0.6 to 11.9 years). An evaluation of all patients showed no difference according to histologic condition or prior chemotherapy. Mediastinal and supraclavicular irradiation showed no improvement in treatment results. Acute toxicity consisted of mild to moderate emesis, increased bowel frequency, erythema, and, in four cases leucopenia and thrombopenia (all World Health Organization [WHO] Grades I to II). However, one patient died of a pulmonary fibrosis 1 month after mediastinal irradiation and 2 months after polychemotherapy, and a gastroduodenal ulcer developed in another patient 1.5 months after paraaortic RT and prior polychemotherapy. Overall, the data suggest that to avoid overtreatment and consecutive treatment morbidity reduced doses of 30 Gy and a restrictive treatment planning adapted to the individual risk are sufficient for RT for testicular seminoma. An alternative to postoperative RT in Stage I (and possibly Stage II) seminoma could be no RT, but close follow-up instead.

Combined Modality Therapy↗
PubMed1990

Results of fast neutron therapy of adenoidcystic carcinomas of the head and neck at the neutron facility Hamburg-Eppendorf.

Between July 1977 and March 1988, 31 patients with an adenoidcystic carcinoma were treated with fast neutrons of a 14 MeV-DT-generator at our department. Primary locations were: parotid gland eight cases, paranasal sinus five cases, submandibular gland five cases, trachea four cases and other locations nine cases. The median follow-up of our patients was 16 months. Most of the patients had advanced tumors. The calculated local control rate is 65% at two years.

Adult↗
PubMed1989

Results of fast neutron therapy of adenoid-cystic carcinomas of the head and neck at the neutron therapy facility Hamburg-Eppendorf.

Between 1977 and 1987, 30 patients with adenoid-cystic carcinomas of the head and neck region were treated, at the Hamburg-Eppendorf neutron therapy facility, with a 14 MeV-DT-generator. The present review deals with 15 patients treated before October 1986 e.g. with follow up longer than one year. These results, although preliminary, tend to confirm that fast neutrons is the best irradiation modality of adenoid-cystic carcinomas of the head and neck region, especially when surgery is not possible, or cannot be radical.

Adult↗
PubMed1988

[Clinical studies of the quantitative changes in mineral salt content of irradiated vertebral body metastases with 2-energy computerized tomography].

Results are represented a clinical experimental series of examinations in 19 patients having osteolytic and osteoplastic metastases in the region of the vertebral column. An attempt was made to quantify the changes in mineral salt content after high-voltage therapy, via two-energy computed tomography. The vertebral bodies with osteolytic affection showed directly after completion of the irradiation an individually highly differentiated increase in mineral salt content. This was due both to recalcification of the osteolysis and an increase in mineral salt content of the still intact spongiosa. Likewise, an increase in mineral salt content was seen in patients with osteoplastic metastases, in the tumour-free bony substance. The methodical approach is described and the different reactive behaviour of the vertebral body metastases in response to radiotherapy is discussed.

Adult↗
PubMed1986

[Realtime sonography of intrascrotal space-occupying lesions].

In 848 examinations of the testes in 317 patients, including 253 follow-up and/or multiple follow-up examinations and 36 unilateral testicle examinations (e.g., orchidectomy, aplasia or nondescent) it was shown that sonography is a diagnostic method which is on the one hand capable of clearly differentiating cystic from solid space-occupying processes, and on the other hand also offers certain possibilities for evaluating the status of solid findings. Histologic identification of malignant tumors was only achieved with teratomas. The differential diagnostic problem was in differentiating scrotal tumors from focal orchitis, chronic epididymitis, testicular torsion and contusion, and in differentiation between paratesticular neoplasms and epididymitides. The testicular findings included testicular neoplasms, cicatrization and cysts of the tunic, sequelae of trauma, orchitis, cryptorchism, hypoplasia, aplasia, and testicular cysts. Paratesticular findings included hydroceles, spermatoceles, varicoceles, paratesticular neoplasms, epididymitides, paratesticular scars, and thickening of the testicular coat.

Diagnosis, Differential↗
PubMed1985

[Sonography in the diagnosis of pyelonephritis scars].

Radiological and ultrasound examinations were performed in 34 women with recurrent urinary tract infection, as part of a prospective study of pyelonephritis. Ultrasound was found to be valuable in the recognition of new pyelonephritic scars and for screening. In assessing ultrasound and radiological findings the criteria of Hodson are equally valuable in differential diagnosis. Taking into account radiation exposure, ultrasound should not replace intravenous urography in this field, but if regular serial examinations are necessary it can be used alternately with urography.

Female↗
PubMed1985

[Thyroid gland and parathyroid gland changes in ultrasound (real time B image)].

Using a high-resolution real-time B-imager, examinations of the thyroid and parathyroid glands of 112 patients revealed small focal lesions (more than 3 mm diameter: thyroid gland, parathyroid gland) as well as diffuse alterations (thyroid gland). The following focal lesions were found: Adenomas of the parathyroid gland (n = 9), haemangiomas of thyroid gland (n = 3), adenomas of thyroid gland (n = 2), metastases into the thyroid gland (n = 7), primary cancer of the thyroid gland or its recurrence (n = 3) and metastases of different cancers in soft tissue of the neck regions (n = 8). A struma nodosa was diagnosed in 15 patients. With regard to diffuse alterations of the thyroid gland, atrophies (n = 6), aplasieas of 1 lobe (n = 2), thyreoiditides (n = 3), and struma diffuse (n = 5). In 49 of 52 cases morphological alterations of the thyroid gland could be excluded, while for the other 3 patients, who had been operated on in the region of the neck, no final evaluation was possible. On comparing these findings with the results of computed tomography and scintigraphy, ultrasound as a screening method showed the highest sensitivity while its specificity could be enlarged by considering the results of scintigraphy. Decision by ultrasound only as to whether a focal lesion was benign or malignant was only possible under certain circumstances. However, a histological diagnosis could not be made by ultrasound.

Adenoma↗
PubMed1985

[Changes in the peripheral lymph nodes seen by ultrasonics].

Sonographic examinations of 1 416 patients performed between 1980 and 1983 with particular reference to the inguinal, axillary and neck regions have shown that it is quite possible to effect sonographic differentiation between enlarged lymph nodes with cicatricial indurations after non-specific inflammation on the one hand, and primary lymphomas or metastases of lymph nodes on the other. In many cases, it is also possible to differentiate between the enlargement of a total lymph node (acute inflammatory, primary malignant) and metastases in a lymph node. Positive findings in the soft parts were seen in 278 patients; of these, 175 were confirmed histologically and cytologically (via puncture with sonographic control). One finding was revealed as false positive. In 102 patients the sonographic finding was confirmed by means of lymphographies (n = 12), computed tomography (n = 27) or via the subsequent clinical course, proving the fact that it is also possible to detect sonographically the ability of lymphomas to respond to treatment with antibiotics, cytostatics, and radiation; the effects can be recognised and interpreted via changes of the echo patterns.

Biopsy, Needle↗
PubMed1985

[Diagnostic imaging of the remission of a metastasized hormone-producing pancreatic carcinoma (PPom) as affected by polychemotherapy].

The pros and cons of various imaging methods (sonography: plain CT, with contrast medium intravenously/serial CT; x-ray angiography or digital subtraction angiography) in recognising a slow but steady remission of a primary tumour and of liver metastases are discussed, basing on the course of disease in a female patient with a metastasised gastrointestinal malignoma under chemotherapy. Initial chemotherapeutic treatment lasted for two years. Renewed progression after another 2 1/2 years had meanwhile been stopped again by chemotherapy. Sonography and CT control follow-ups were performed on a three-month basis for a total period of more than five years. In sonography, remission was noticeable on the one hand by changes of echo-internal structure of the tumour and liver metastases, and on the other hand by size reduction. Sonography possesses the advantage over CT that sections can be performed multidirectionally and are reproducible, for example for the purpose of documenting the largest tumour diameter. A drawback is in our opinion the lack of information supplied by the method in respect of the vascular situation within the area of malignant space-occupying growths. A valuable asset of computed tomography is the possibility of demonstrating hypervascularisation in a solid space-occupying growth by using an intravenously applied contrast medium which is easily passed through the kidneys, especially in "serial CT" procedures. This is similarly true for angiography, which, however, does not play any significant part in closely-meshed follow-up schedules because if its invasiveness. As a matter of fact, it can even simulate a florid tumour or metastasising process.

Angiography↗