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Biomedical subjects

A Jakobsen

Publications and source records attributed to A Jakobsen.

At least 109 records · Page 6Linked to original sources
PubMed1987

A new system for patient fixation in radiotherapy.

A new system for patient fixation in radiation treatment is described. The system consists of an airtight plastic bag with a contents of polysterol microspheres. A valve allows evacuation which results in a rigid close fitting cast. The system was compared with conventional foam cast fixation in 29 patients who were treated for carcinoma of the breast. The patients received radiation treatment over 22 fractions, and portal X-ray pictures were obtained at every second treatment. The portal films were compared with the stimulator radiographs and the variation in the position of the centre cross were measured in cranio-caudal and transversal direction as well as the rotation of the centre cross. The results showed that the daily reproducibility of the patient set-up was considerably improved by the new system, the centre cross deviation of the position of the actual radiation field to the centre cross of the intended field being less than 1 mm in 50% of the cases. The system is time-saving and cheap compared to conventional fixation systems.

Breast Neoplasms↗
PubMed1987

Evidence of a castration-mediated effect of adjuvant cytotoxic chemotherapy in premenopausal breast cancer.

This prospective randomized trial, conducted by the Danish Breast Cancer Cooperative Group, is the largest study, so far, of adjuvant chemotherapy in premenopausal breast cancer. The trial is unique in that it is nationwide and based on a nonselected population of patients, and is the only adjuvant trial studying the effect of cyclophosphamide monotherapy. After total mastectomy with axillary node sampling, followed by local radiotherapy, 1,032 pre- and perimenopausal women with operable breast cancer were randomized to observation alone, or to adjuvant chemotherapy for 1 year with either cyclophosphamide monotherapy or with a combination of cyclophosphamide, methotrexate, and 5-fluorouracil (CMF). As of January 1987, median follow-up was 68 months. From early on both cyclophosphamide alone and CMF were found to improve recurrence-free survival (RFS) significantly and to a similar degree (P = .0001). However, an overall survival advantage did not become evident until 5 years after the start of treatment. So far, this advantage appears to be more pronounced in CMF (P = .0065) than in cyclophosphamide-only patients (P = .08). Thus, the study confirms the findings of the National Surgical Adjuvant Breast Project (NSABP) and Milan trials that adjuvant chemotherapy prolongs the survival of premenopausal women with early breast cancer. A retrospective analysis revealed that, in contrast with CMF, cyclophosphamide alone did not improve RFS significantly in subsets of patients without amenorrhea, with estrogen-receptor (ER) negative tumors, and with tumors of low histological differentiation. Assuming that cyclophosphamide alone is a less tumoricidal treatment than CMF, these findings suggest that the effect of adjuvant cytotoxic chemotherapy is mediated partly through chemical castration, and partly through a purely cytotoxic effect.

Adult↗
PubMed1987

Orgotein in radiation treatment of bladder cancer. A report on allergic reactions and lack of radioprotective effect.

The possible protective effect of orgotein (a superoxide dismutase) on radiation cystitis and proctitis was studied in patients with carcinoma of the urinary bladder. A double-blind study in 60 patients was planned but due to unacceptable side effects only 30 patients were included. Radiation treatment was given with curative intent at a dose of 63 Gy in 30 fractions. Orgotein was injected 15 min after each daily radiation treatment at a dose of 4 or 8 mg. No effect of orgotein on tumour radiation response or on the acute radiation reactions in the bladder and rectum was detected. Marked subcutaneous infiltration and redness was seen at the local injection site in 5 patients. No general symptoms were observed. Intradermal tests and antibody titration tests showed that the local reactions were due to allergic reactions to the drug itself. The lack of radioprotective effect and the high frequency of unacceptable side effects makes orgotein an unsuitable drug in clinical radiation therapy.

Actuarial Analysis↗
PubMed1986

Medroxyprogesterone acetate and prednisone in advanced breast cancer. A randomized trial.

In a randomised trial patients with progressive metastatic breast cancer were allocated to one of three different treatments. A: Prednisone 10 mg X 3 daily. B: Medroxyprogesterone acetate (MPA) orally 500 mg daily. C: MPA i.m. 1000 mg daily for 3 weeks followed by 500 mg i.m. weekly. The study included 150 patients and was well-balanced with respect to different prognostic parameters. Most patients (83%) were postmenopausal, and 95% had previously received chemo- or hormonal therapy. In the MPA treated patients, analysis of serum MPA levels was performed once a month. The response rates were 4.6, 7.9 and 12.5% in treatments A, B and C, respectively. This difference was not statistically significant (P greater than 0.05). Furthermore, the follow-up of serum MPA levels revealed no significant difference between responders and non-responders. Analysis of time to progression did not indicate any advantage of MPA over prednisone, irrespective of MPA schedule. In accordance with these data, there was no difference as regards survival in the three groups. In conclusion, the study indicated that MPA is not superior to prednisone in this group of heavily pretreated patients with advanced breast cancer.

Administration, Oral↗
PubMed1985

New prognostic factors in squamous cell carcinoma of cervix uteri.

The prognostic importance of a detailed histopathological grading system and the ploidy level as determined by flow cytometry were investigated in squamous cell carcinoma of the uterine cervix. The study included 79 patients, Stages Ib-III. A multiple regression analysis of different prognostic variables identified stage and size as highly correlated. Stage was a significant prognostic variable when size was excluded. The histopathological degree of differentiation held no significant prognostic information, but the ploidy level was highly significant in that respect and should be used for a rational planning of new treatment schedules.

Carcinoma, Squamous Cell↗
PubMed1985

Histopathologic grading and prognosis of uterine cervical carcinoma.

In a retrospective study of 275 patients with invasive squamous cell carcinoma of the cervix, a recently developed histopathologic malignancy system, MGS, was investigated for its prognostic value. The system is based on an evaluation of eight parameters: structure, cell type, nuclear polymorphism, mitoses, mode of invasion, stage of invasion, vascular invasion, and lymphoplasmocytic response. Each parameter is graded from 1 to 3 points, with total score variation ranging from 8 to 24 points. A Kaplan-Meyer plot showed that the crude survival of patients with an MGS index less than or equal to 14 was significantly better than the survival of patients with an MGS index greater than 14. There was no correlation between the clinical stage of the patients and the MGS score. This suggests that, in addition to clinical staging, the MGS index could be of considerable prognostic value and a help in the selection of high risk patients for more aggressive therapy.

Carcinoma, Squamous Cell↗
PubMed1984

Ploidy level and short-time prognosis of early cervix cancer.

The DNA distribution in carcinoma of the uterine cervix was investigated by flow cytometric analysis. The study includes 105 patients stages Ib and IIa. Approximately 80% of the tumours contained aneuploid cell populations. According to the distribution of ploidy levels the tumours were divided into two groups with a cellular DNA content below and above 1.5 X the normal diploid DNA content, respectively. The ploidy level was not correlated with the extension of the tumours, but an obvious correspondence was found between the ploidy level and the frequency of lymph node metastases in surgically treated patients. A statistically significant correlation was also demonstrated between the ploidy level and the recurrence frequency irrespective of treatment with radiotherapy or surgery.

DNA, Neoplasm↗
PubMed1984

Prognostic impact of ploidy level in carcinoma of the cervix.

The single cell DNA content was analyzed by use of flow cytometry in cervical carcinoma. The study included 171 patients, Stages Ib-III. The ploidy level was calculated as a DNA index by comparison with diploid lymphocytes. Accordingly, the tumors were divided into two groups with DNA index below and above 1.5. This division proved to be important to the recurrence frequency. In all stages investigated, a statistically significant higher recurrence frequency was found in the group with DNA index above 1.5. The same relation applied concerning the survival. It is concluded that the DNA distribution is an important prognostic factor in cervical carcinoma.

Brachytherapy↗