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Biomedical subjects

B Emami

Publications and source records attributed to B Emami.

At least 127 records · Page 7Linked to original sources
PubMed1984

Sequencing of the total course of hyperthermia and irradiation.

The effect of sequencing of the total course of hyperthermia and irradiation on local tumor control was studied on a murine tumor system (RIF). The results showed a 20% control rate for the treatment arms: (a) total course of irradiation followed by total course of hyperthermia; or (b) total course of hyperthermia followed by total course of irradiation. A superior (70%) control rate was achieved when irradiation and heat were given close to each other on each session. The detailed results are presented.

Animals↗
PubMed1983

Clinical results of irradiation combined with local hyperthermia.

This report updates a previous publication describing the experience at the Mallinckrodt Institute of Radiology with irradiation and hyperthermia in the treatment of superficial metastatic and recurrent malignant tumors. In a dose-seeking Phase I-II clinical study, a total of 101 lesions have been treated. Twenty-two tumors were treated with doses of irradiation ranging from 1000 to 3000 rad and the rest with doses between 3000 and 4000 rad. Irradiation was delivered twice weekly (every 72 hours) in tumor doses of 400 rad, usually with electrons (9-16 MeV). Hyperthermia was initiated within 30 minutes following irradiation, most of the patients being treated with 915 MHz microwaves, 41-43 degrees C, for 60-90 minutes every 72 hours. Adequate temperatures were reached in most lesions measuring less than 2 cm in thickness, 70% of those 2-4 cm and only in 30% of those thicker than 4 cm. Of 36 measurable lesions in the head and neck, 20 had a complete response and 12 a partial response. In 16 of the 20 patients (80%) showing a complete response the tumor was controlled from three to 36 months. Of 30 adenocarcinoma of the breast lesions, recurrent in the chest wall, 16 showed a complete response and 9 a partial regression. Twelve of the 16 lesions that regressed completely (71.4%) showed long-lasting tumor control. Of 22 metastatic or recurrent melanoma lesions, 16 had a complete regression and six a partial response. Of the 16 patients with complete response, 13 (81%) had no evidence of recurrence lasting from three to 36 months. Three sarcoma lesions responded well to the combination of irradiation and heat and did not recur after treatment. Patients treated with doses larger than 3000 rad in the head and neck or in the chest wall (epidermoid carcinoma or adenocarcinoma, respectively) showed better tumor response than those treated with lower doses. However, in melanoma satisfactory results (80% or higher response) were observed with doses as low as 2000 rad. This combined therapy has been well tolerated by the normal tissues. In 6% of the patients there was evidence of tumor necrosis with ulceration and in 5% thermal burns which healed after 2 to 3 months, with conservative management.(ABSTRACT TRUNCATED AT 400 WORDS)

Adenocarcinoma↗
PubMed1983

Retreatment of recurrent carcinoma of the head and neck by afterloading interstitial 192Ir implant.

From January 1975 to December 1980, 25 patients with persistent or recurrent carcinomas of the head and neck were retreated for palliation at the Division of Radiation Oncology, Mallinckrodt Institute of Radiology. These patients had all undergone extensive previous treatment by surgery and/or radiation. All were retreated with 192Ir interstitial implant with or without external radiation and/or surgical excision. Of 25 patients, 13 had complete response (CR) and 6 had partial response for a follow-up period of 1 to 7 years. Of 13 patients with CR, 6 are alive with no evidence of disease (NED) and two died NED. We present detailed results and discuss our new strategy for such patients.

Aged↗
PubMed1983

Anatomic considerations in radiotherapeutic management of bladder cancer.

From July 1975 to December 1981, a total of 47 patients with intact bladders had pelvic CT scans. All patients had biopsy-proven bladder cancer. Utilizing CT scans, we measured the bladder extensions in three dimensions. Evacuation of the bladder prior to each treatment is, according to our survey of 48 radiotherapy departments, a rarely practiced procedure. Therefore, it was reasonable to assume that the partially distended bladder, as seen on CT scans, is the target volume for definitive radiotherapy of bladder cancer as practiced in most departments. Analysis of our results indicates that routinely recommended booster ports of 8 X 8, 10 X 10, and 12 X 12 cm would result in gross misses in approximately 50%, 26%, and 7% of patients, respectively. It would appear that geographic misses might contribute significantly to the high incidence of local failures usually reported for definitive radiotherapy in carcinoma of the bladder.

Adult↗
PubMed1982

Treatment of endometrial carcinoma with radiation therapy alone.

Of 393 patients treated at Tufts-New England Medical Center for endometrial carcinoma from 1968-1977, 66 patients underwent radiation therapy alone because of medical contraindications to surgery. The median age for this group was 70 years. The patient distribution was Stage I (39), Stage II (11), and Stage III and IV (16). Therapy consisted of pelvic irradiation to a dose of 4000-5000 rads followed by an intrauterine radium application (3000-5000 mg hr.) and a vaginal radium application (2000-4000 rads to the surface). Local control was achieved in 37 of 50 patients with Stages I and II disease with a three-year actuarial survival of 78%. Patients with Stages III and IV disease had a median survival of 15 months; 4 of 16 patients survived for 36 months. In this group of patients, bleeding pain, and vaginal discharge was palliated. Four patients in the series had treatment-related bowel complications requiring colostomy. This is an effective method of treatment for endometrial carcinoma patients who are not surgical candidates.

Brachytherapy↗
PubMed1982

The value of "routine tests" in the staging evaluation of gynecologic malignancies: a cost effectiveness analysis.

The value of tests employed in the clinical staging of patients with carcinomas of the cervix and endometrium has been examined in a retrospective review of 739 consecutive patients seen at Tufts-New England Medical Center. The yield of positive results of the barium enema (0%) and proctosigmoidoscopy (0.8%) in carcinoma of the cervix suggests that some of these studies may be omitted in asymptomatic patients with early disease on pelvic examinations. Similarly, for carcinoma of the endometrium, the yields from barium enema (0.9%) cytoscopy (0.9%) and proctosigmoidoscopy (0.6) are low. It is concluded that optimal patient care (with respect to morbidity and costs) may be provided without routinely performing these studies in staging asymptomatic patients with cervical and endometrial carcinomas.

Barium Sulfate↗
PubMed1982

Effect of preoperative irradiation on resectability of colorectal carcinomas.

From 1968 to January 1, 1977, 44 patients with initially unresectable colorectal carcinoma were treated with preoperative radiotherapy and surgery. On presentation, unresectability was determined either clinically (26 patients) or by preradiotherapy laparotomy (18 patients). Preoperative irradiation consisted of 4500-5000 rad. After radiotherapy, 33 of 44 lesions were considered resectable. Seven of 33 patients underwent incomplete resection with mean survival of 17 months. Resection was complete in 26 of the 33 patients. Of the latter group (26), 18 patients are alive with no evidence of disease with minimum follow-up of 36 months. Detailed results are discussed.

Adult↗
PubMed1981

Effects of single-dose irradiation in tumor blood flow studied by 15O decay after proton activation in situ.

A noninvasive technique employing photon activation of tissue oxygen in situ and detection of subsequent 15O positron decay was used to study the effects of single-dose 60Co irradiation on capillary blood flow in transplanted rat rhabdomyosarcomas. Tumor blood flow was measured before irradiation with 16.5, 38.5, or 60.5 Gy and at several intervals afterward (0-72 hr.). Pre-irradiation values of volume-averaged blood flow in the tumor ranged from 7 to 44 ml/min./100 g. Several hours after irradiation, blood flow fell by up to 50% for 60.5 Gy and up to 35% for 16.5 Gy. However, 24 hours after irradiation, tumor blood flow had recovered completely in the 16.5-Gy group and substantially in the others. For smaller doses such as the fractions typically employed in radiotherapy, no changes in tumor blood flow were observed.

Animals↗
PubMed1980

Computed tomography of the chest wall.

Computed tomography of the chest wall has been mentioned in the literature, but the emphasis has been on evaluation of diseases of the pleura and mediastinum and depiction of metastatic nodules. The authors have attempted to demonstrate the usefulness of CT in the detection and treatment of chest wall disease and show that the incidence of involvement is great enough to warrant evaluation of the chest wall on all CT images of this region.

Axilla↗
PubMed1980

Physiological effects of hyperthermia: response of capillary blood flow and structure to local tumor heating.

Specific capillary blood flow and small-vessel pathology in animal tumors (rhabdomyosarcoma BA-1112) of WAG/Rij rats were examined following local tumor heating to 40-44.5 degrees C. Blood flow in tumors heated to 40-41 degrees C for 40 minutes was reduced initially by about 50%, but returned to near preheating values within 72 hours, consistent with the histopathological observations indicating small-vessel dilation and temporary congestion. The application of hyperthermia greater than 43 degrees C (for 40 minutes) resulted in the virtual elimination of capillary blood flow, consistent with pathological findings of widespread vessel rupture and hemorrhage in this temperature range.

Animals↗
PubMed1979

Tissue perfusion rate determined from the decay of oxygen-15 activity after photon activation in situ.

Rates of cerebral perfusion were obtained from measurements of the disappearance (wash-out) of oxygen-15 after in situ tissue activation with 45-million-volt x-rays. In an anesthetized cat, typical values were 90 milliliters per minute per 100 grams of tissue, with 55 percent wash-out. In a specific radiotherapy patient, the value was 65 milliliters per minute per 100 grams of tissue, with 63 percent wash-out of oxygen-15 through incorporation into tissue water.

Animals↗
PubMed1979

Radical radiation therapy of advanced lung cancer: evaluation of prognostic factors and results of continuous and split course treatment.

One hundred patients with inoperable (80) or unresectable (20) bronchogenic carcinoma without evidence of spread beyond the thorax and supraclavicular nodes were planned for radical radiotherapy. Seventy-six patients received continuous irradiation (6000 rads in 30 treatments in 6 weeks, TDF 99) and 24 received split course therapy (2 courses of 2500 rads in 10 treatments with a 3 week break between courses, TDF 88). Forty-three patients had squamous cell carcinoma or adenocarcinoma and were considered to have favorable prognostic factors, while 57 patients had unfavorable prognostic factors: undifferentiated large cell or small cell carcinoma, supraclavicular metastases, SVC obstruction, superior sulcus tumors, or bone erosion in continuity with the tumor. Ninety-two patients completed the planned course of treatment. In patients completing treatment, local control of cancer within the irradiated volume was achieved in 58.5% of continuously irradiated patients and 45.4% of patients receiving split course therapy. Median survival was 1.2 months in patients not completing treatment and 12 months for the patients who completed treatment; 19% of the total group survived 3 years. Median and 3 year survivals of 14 months and 20.4% and of 9 months and 11% were observed for patients treated continuously and by the split course techniques, respectively. Corresponding survival figures for patients with favorable and unfavorable prognostic signs were 21 months and 26%, and 4 months and 11%, respectively. Implications of these data for treatment planning and patient selection for radical radiotherapy in bronchogenic carcinoma are discussed.

Adenocarcinoma↗