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C C Vernon

Publications and source records attributed to C C Vernon.

10 recordsLinked to original sources
PubMed1996

Radiotherapy with or without hyperthermia in the treatment of superficial localized breast cancer: results from five randomized controlled trials. International Collaborative Hyperthermia Group.

PURPOSE: Claims for the value of hyperthermia as an adjunct to radiotherapy in the treatment of cancer have mostly been based on small Phase I or II trials. To test the benefit of this form of treatment, randomized Phase III trials were needed. METHODS AND MATERIALS: Five randomized trials addressing this question were started between 1988 and 1991. In these trials, patients were eligible if they had advanced primary or recurrent breast cancer, and local radiotherapy was indicated in preference to surgery. In addition, heating of the lesions and treatment with a prescribed (re)irradiation schedule had to be feasible and informed consent was obtained. The primary endpoint of all trials was local complete response. Slow recruitment led to a decision to collaborate and combine the trial results in one analysis, and report them simultaneously in one publication. Interim analyses were carried out and the trials were closed to recruitment when a previously agreed statistically significant difference in complete response rate was observed in the two larger trials. RESULTS: We report on pretreatment characteristics, the treatments received, the local response observed, duration of response, time to local failure, distant progression and survival, and treatment toxicity of the 306 patients randomized. The overall CR rate for RT alone was 41% and for the combined treatment arm was 59%, giving, after stratification by trial, an odds ratio of 2.3. Not all trials demonstrated an advantage for the combined treatment, although the 95% confidence intervals of the different trials all contain the pooled odds ratio. The greatest effect was observed in patients with recurrent lesions in previously irradiated areas, where further irradiation was limited to low doses. CONCLUSION: The combined result of the five trials has demonstrated the efficacy of hyperthermia as an adjunct to radiotherapy for treatment of recurrent breast cancer. The implication of these encouraging results is that hyperthermia appears to have an important role in the clinical management of this disease, and there should be no doubt that further studies of the use of hyperthermia are warranted.

Breast Neoplasms↗
PubMedDate not supplied

Second primary renal cell carcinomas following solid tumors. Four case reports and review of the literature.

We report multiple malignancies in four patients with metachronous renal adenocarcinomas. The group of patients includes two women treated for primary breast and ovarian cancer and two men with prostate and colon cancer respectively. The occurrence of renal cancer following these primary solid tumors was not associated with previous treatments. The authors review the literature and discuss pathogenic mechanisms underlying renal cell carcinoma.

Adenocarcinoma, Clear Cell↗
PubMedDate not supplied

Early experience of a commercial scanned focused ultrasound hyperthermia system.

Preliminary experiences of the Sonotherm 6500 scanned focused ultrasound (SFUS) system in the hyperthermic treatment of bulky tumours in breast, superficial sites and within the pelvis in 22 patients are reported. Tumour volumes ranged from 235 to 603 cm3 (breast), 105 to 209 cm3 (superficial sites) and 24 to 905 cm3 (pelvis). Temperature distributions in 58 evaluable treatments were analysed in terms of temporal peak and time-averaged temperatures (highest and lowest temperatures, percentage of sensors exceeding index temperatures, etc.) achieved within scanned volumes. Mean number of sensors implanted into tumour was 14 in breast and superficial tumours and approximately 11 in pelvic tumours. Mean time-averaged maximum and minimum temperatures for the best treatments (i.e. for each patient, that with the highest percentage of sensors recording time averaged temperatures greater than or equal to 42 degrees C) administered to patients with tumours in the breast and superficial sites were 44.6 +/- 1.7 degrees C and 39.7 +/- 1.1 degrees C, respectively and the mean number of sensors exceeding 42 degrees C was 58 +/- 19%. In the case of pelvic tumours these figures were 41.6 +/- 0.9 degrees C, 40.0 +/- 0.6 degrees C and 8 +/- 12%, respectively. Patient tolerance to treatments was, in general, good. Areas where technical improvement of the system is appropriate and further research and development are required are identified; these should lead to a better realization of the potential of the SFUS technique, particularly for pelvic tumours.

Breast Neoplasms↗
PubMedDate not supplied

Analysis of thermal parameters obtained during phase III trials of hyperthermia as an adjunct to radiotherapy in the treatment of breast carcinoma.

An analysis of 351 HT treatment sessions administered to 101 patients receiving radiotherapy and hyperthermia (RT + HT) who were entered into Phase III concurrent randomized trials for recurrent (BrR) and intact (BrI) breast tumours is presented. A complete response (CR) was recorded in 50 of 84 (59.5%) fields in the case of recurrent breast patients and in 10 of 17 (59%) fields in the case of the intact breast patients. In comparison, 15 of 60 (25%) patients entered into BrR who received RT alone and 8 of 12 (66.7%) patients receiving RT alone entered into BrI trial achieved CR. A set of thermal parameters is defined and evaluated on a treatment by treatment basis. Patient and tumour characteristics influential on CR are identified and thermal parameters which have additional prognostic value are investigated. Multivariate logistic analysis of the non-thermal data showed that maximum depth of tumour, presence or history of disease outside the treated area and RT regimen were most influential on CR. Tumour volume (cm3) (OR = 0.996, 95% CI = 0.993-1.004, p = 0.08) was not a strong prognostic covariate; tumour area and linear dimensions were even less significant (p = 0.41). The cumulative minimum thermal isoeffect dose (equivalent minutes at 43 degrees C) accrued over the 1st, 1st and 2nd, and 1st, 2nd and 3rd treatment sessions was the only thermal parameter to exhibit an association with CR consistently, Other thermal parameters found to contribute to the predictive models were MINTIME > 42 degrees C calculated for the first treatment session and %sensors > 43 degrees C (peak) calculated for the 2nd treatment session.

Aged↗