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Biomedical subjects

A Langlands

Publications and source records attributed to A Langlands.

At least 19 recordsLinked to original sources
PubMed1997

The equivalent simple treatment visit (ESTV) model does not measure radiation oncology productivity under Australian conditions.

The measurement of workload in radiation oncology departments has been based on the number of patients treated per linear accelerator per unit time, or on the number of fields treated per linear accelerator per unit time. The Equivalent Simple Treatment Visit (ESTV) model was proposed to allow for the incorporation of a factor for complexity of treatment techniques, to permit more detailed comparisons than those offered by previous measures. This prospective study was designed to assess the suitability of the ESTV model as a measure of radiation oncology productivity within an Australian radiation oncology department. A calculated ESTV value was assigned to all treatment fractions delivered in our department over a 4-week period. Treatment fractions were then timed using a stopwatch, and average treatment times for simple, intermediate and complex techniques were calculated and analysed by multiple t-tests for statistical significance. Average treatment times were 8.1 minutes (standard deviation (SD) = 4.2) for 'simple' techniques, 14.1 minutes (SD = 4.4) for 'intermediate' techniques, and 11.8 minutes (SD = 5.6) for 'complex' techniques. These times were significantly different from each other (P < 0.05). Although ESTV attempts to allow for the incorporation of a complexity factor into productivity reporting, a revision of the model is necessary, given the inconsistency by which a 'complex' technique takes significantly less time than an 'intermediate' technique.

Adolescent↗
PubMed1995

Skin telangiectasia: the influence of radiation dose delivery parameters in the conservative management of early breast cancer.

A retrospective analysis was performed to study the occurrence of skin telangiectasia in patients with conservatively treated early breast cancer who were given postoperative radiotherapy that included an electron boost. Patients managed in two different centres were treated with identical techniques but different schedules of radiotherapy. Electron boost site telangiectasia was less common in those patients treated at the centre that employed higher doses, longer schedules and lower fraction sizes of both photons and electrons. These results require prospective confirmation but they suggest that schedules of radiotherapy employing lower fraction sizes, longer treatment times and higher total doses may minimize the incidence of skin telangiectasia.

Adult↗
PubMed1994

Locally advanced breast cancer: defining an optimum treatment regimen.

PURPOSE: This retrospective review examines response, local control and freedom from distant failure for patients with locally advanced breast cancer treated by chemotherapy and radiotherapy without routine surgery. METHODS AND MATERIALS: 67 patients were treated between January 1980 and December 1988 at Westmead Hospital, NSW, Australia. Median follow-up for surviving patients was 56 months. Four successive protocols evolved, each with three phases induction chemotherapy (adriamycin or novantrone, cyclophosphamide) (three cycles), radiotherapy then chemotherapy (cyclophosphamide, methotrexate, 5-fluorouracil) of progressively shorter duration. Radiotherapy and chemotherapy were concurrent in the fourth regimen. RESULTS: Clinical complete response (disappearance of all known disease) after chemotherapy, radiotherapy and additional chemotherapy was 18%, 55% and 79% respectively. Seven additional patients subsequently underwent mastectomy (N = 2), local excision (N = 1) or a radiation boost (N = 4) for a total complete response rate of 90%. Twenty one patients (31%) failed to achieve a complete response (N = 7) or recurred locally (N = 14). The crude 2-year rate of local recurrence was 50% for tumors > 10 cm (N = 10) and 14% for smaller tumors (n = 57) and was not influenced by protocol. Two-year actuarial freedom from distant failure was 67% at 2 years. CONCLUSION: Local control can be achieved for patients with locally advanced breast cancer with a primary tumor < 10 cm using chemotherapy and radiotherapy without routine mastectomy.

Adult↗