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Biomedical subjects

D Nori

Publications and source records attributed to D Nori.

At least 91 records · Page 5Linked to original sources
PubMed1984

Pleurectomy and intraoperative brachytherapy and postoperative radiation in the treatment of malignant pleural mesothelioma.

Forty-one patients with diffuse, pleural mesothelioma limited to one hemi-thorax underwent a thoracotomy at Memorial Sloan-Kettering Cancer Center from January 1976 to July 1982. Treatment at thoracotomy consisted of as complete a parietal pleurectomy as was possible to remove the bulk of the tumor. Measurable gross residual disease was treated whenever feasible, with permanent 125I implantation; residual diffuse disease was treated by a temporary 192Ir implantation or by postoperative instillation of 32P. External radiation therapy was given 4-6 weeks postoperatively to the involved hemi-thorax, shielding the lung and utilizing a combination of electron and a photon beam. A dose of 4500 rad in 4.5 weeks was given to the pleural surface by the mixed beam. There was no postoperative mortality in this group of 41 patients. Complications developed in 6 patients (15%). The median survival was 21 months; the one year survival was 65% and the two year survival was 40%. The median disease-free survival was 11 months and the one and two year disease-free survival 44 and 13% respectively. This study suggests that the combination of pleurectomy, intraoperative brachytherapy and postoperative external radiation increased the local control of the tumor and prolonged the survival.

Adult↗
PubMed1984

A versatile permanent planar implant technique utilizing iodine-125 seeds imbedded in gelfoam.

Tumors attached or adjacent to critical structures can often not be completely resected or resected with adequate surgical margins. Sites involving major blood vessels, the vertebral column or the brain with small residual tumors or suspicious margins often present technical difficulties for standard I-125 or Ir-192 implants. A relatively simple, accurate and inexpensive implant method is described using I-125 seeds imbedded in gelfoam to implant permanently into small residual tumors or suspicious margins where standard implant techniques may be unsatisfactory. A method for planning the treatment dose for such an implant is described. Cases involving paraspinal and brain tumors are reported to illustrate the technique.

Adolescent↗
PubMed1983

Metronidazole as a radiosensitizer and high-dose radiation in advanced vulvovaginal malignancies, a pilot study.

Advanced vulvovaginal cancers have a survival of less than 25% in 5 years when treated with radiotherapy alone. The radiosensitizer metronidazole was used with unconventional radiation fractions in 10 patients. Local control was achieved in 9 out of 10 patients treated. Five of 10 patients have remained free of disease 9-30 months postdiagnosis. Two patients died with metastatic disease, but with local control. In only 1 patient did this approach fail to control local disease. The outcome of these 10 patients represents a significant improvement over conventional radiation. A randomized prospective study has been started on the basis of this pilot study.

Adult↗
PubMed1983

The role of radioactive colloids in malignant peritoneal mesotheliomas.

Malignant peritoneal mesothelioma remains a therapeutic problem. A review of the use of intraperitoneal 32P and a review of the status of therapy for this disease are presented. Six patients treated with 32P and combinations of external radiation therapy, surgery, and chemotherapy are reviewed with survival times from 5 months to 18 years. Overall survival in this disease is poor, about 44.2 months. This series suggests that with combined therapy with intraperitoneal 32P and chemotherapy, longer survivals can be achieved.

Adolescent↗
PubMed1983

Value of perioperative brachytherapy in the management of non-oat cell carcinoma of the lung.

Nearly one-half of all patients with non-oat cell carcinoma of the lung are found to have mediastinal lymph node metastases at the time of initial presentation. There is no consensus today on what constitutes best treatment in patients whose disease is confined to the chest and in whom mediastinal lymph node metastases are the only evident site of tumor spread. The overall survival of these patients is so low that the majority have been either excluded from therapy or have been treated palliatively by external radiation therapy. In an attempt to improve the control of mediastinal lymph node metastases in the operable patients, we began a pilot study in 1977 at Memorial Hospital to determine the value of perioperative brachytherapy (permanent Iodine-125 implantation of primary lung and a temporary Iridium-192 implantation of the mediastinum) with or without resection followed by a moderate dose of postoperative external beam irradiation. Eighty-eight patients with disease limited to one hemithorax (N2 MO) were treated with this combined method during the period 1977 through 1980. Locoregional control was observed in 76% of the 88 patients. The median survival is 26 months and the 2 year actuarial survival is 51%. There was no post-operative mortality. This pilot study has demonstrated that the combination of surgery, perioperative brachytherapy and external beam irradiation in non-oat cell carcinoma of the lung, metastatic to mediastinal lymph nodes, can improve the locoregional control and prolong survival with minimal early or late morbidity.

Adenocarcinoma↗
PubMed1983

Radiation therapy of primary vaginal carcinoma.

Primary carcinoma of the vagina is rare, constituting only 1 to 2% of all neoplasms arising in the female genital tract. From 1950-1974, 36 patients with carcinoma of the vagina were treated with radiation at Memorial Sloan-Kettering Cancer Center (MSKCC); 35 (96%) had epidermoid carcinoma and one patient (4%) had adenocarcinoma. These patients were staged according to FIGO. Fourteen patients (39%) were Stage I; six patients (17%) were Stage II; three patients (8%) were Stage III; and 13 patients (36%) were Stage IV. Nine patients (25%) were treated with external radiation and interstitial implant; seven patients (20%) were treated with interstitial implant alone; nine patients (25%) were treated with external radiation alone and 11 patients (30%) with external radiation and intracavitary radiation. The five year NED survival was 71% in Stage I, 66% in Stage II, 33% in Stage III and 0% in Stage IV. This paper discusses radiotherapy management of primary carcinoma of the vagina.

Adenocarcinoma↗
PubMed1983

Role of radiation therapy in the treatment of advanced vulvar carcinoma.

To evaluate different methods of radiation therapy for advanced vulvar malignancy, a retrospective study was done on 33 patients treated with radiation between 1950 and 1979. Group I consisted of 18 patients treated with surgery and radiation and group II of 15 patients treated with radiation alone. The patients received several kinds of radiation therapy. Group I received radiotherapy because of local recurrence or positive lymph nodes found in the groin and/or pelvis; the overall survival in that group ranged from 3 months to 11 years. Group II received radiation only because of locally advanced disease and/or associated medical problems; the overall survival in that group ranged from 2 to 40 months. We concluded that megavoltage radiation minimized the local reaction and that better local control was obtained with a combination of photons and electrons and an interstitial implant. Postoperative radiation for positive lymph nodes prevented local recurrence but did not seem to improve survival.

Adenocarcinoma↗
PubMed1982

Bronchogenic carcinoma with invasion of the spine. Treatment with combined surgery and perioperative brachytherapy.

A 64-year-old man with bronchogenic carcinoma was noted to have invasion of the chest wall and spine at time of diagnosis. Computed tomography and myelography demonstrated destruction of the vertebral body with epidural extension. After preoperative radiotherapy, resection of the involved lung, chest wall, and spine was accomplished. Afterloading catheters were placed for tumor-bed perioperative iridium 192 irradiation. The patient is free to disease two years after treatment. We describe the afterloading perioperative brachytherapy technique used and suggest this multidisciplinary approach for bronchogenic carcinoma invading the spine.

Brachytherapy↗