Search PubMed⌕ Search

Biomedical subjects

F O Stephens

Publications and source records attributed to F O Stephens.

At least 55 records · Page 3Linked to original sources
PubMed1981

Treatment of advanced cancer of the lower lip--the use of intraarterial or intravenous chemotherapy as basal treatment.

Since the linear accelerator was installed in Sydney Hospital in 1964, 27 patients who presented with previously untreated but advanced deep carcinoma of the lower lip have been treated with initial megavoltage or orthovoltage radiotherapy with or without follow-up surgery. In 17 of these, the tumor appears to have been eradicated, but in the other ten (approximately one-third), the tumor was not controlled. These results are similar to those reported from other major centers. Since January, 1974, six patients with the most advanced lesions have been treated with "basal" chemotherapy (in four cases given intra-arterially and in two cases given intravenously) prior to radiotherapy. Follow-up surgery in the form of block dissection was required in one patient, and wedge resection of a residual focus of tumor was required in a second patient, but all six patients remain well and free of disease, with from three to six years follow-up to date. A further seven patients with advanced recurrent lesions were also treated using "basal" chemotherapy as the initial treatment. In three of these the carcinoma remained uncontrolled, but in four the tumor appears to have been controlled with subsequent follow-up radiotherapy being used in two cases, surgery in a third, and intermittent chemotherapy in the fourth. The numbers of patients treated in this series are insufficient to allow conclusions to be drawn concerning present management methods. However, the trend of the results to date suggests that for advanced lesions, improved survival may well result from the combination of basal chemotherapy with subsequent radiotherapy and/or surgery.

Aged↗
PubMed1981

Intra-arterial infusion chemotherapy in the treatment of advanced squamous carcinoma of the tongue and floor of the mouth.

Our present experience with Stage III disease suggests that the most effective means of treating advanced carcinoma of the floor of the mouth and tongue are with initial chemotherapy given as basal treatment by intra-arterial infusion followed by planned radiotherapy or operation, or both. Early carcinoma of the floor of the mouth and tongue can be managed effectively with conventional techniques using surgical treatment or radiotherapy, or both, and probably does not justify the increased time and increased problems of management involved in the use of chemotherapy regimens. Our experience in comparing the two programs of treatment in patients classified as having Stage IV lesions is too small to justify valid comparisons to be made at this stage, although we currently have under investigation similar management programs for these patients.

Aged↗
PubMed1980

Intra-arterial chemotherapy as basal treatment in advanced and fungating primary breast cancer.

Occasionally patients present with stage III breast carcinoma so advanced that local radiotherapy is unlikely to achieve more than a partial and temporary local regression. 3 such patients with grossly advanced cancer involving virtually the whole of the breast, skin, and underlying muscle were treated with a regimen of intra-arterial infusion chemotherapy as basal treatment before planned irradiation. All 3 patients responded significantly to intra-arterial chemotherapy and subsequent definitive radiotherapy seems to have resulted in total regression of tumour and involved nodes in 2 patients. In the 3rd patient the response of the tumour mass to subsequent radiotherapy was considerable but incomplete; subsequent surgical resection seems to have eradicated the small foci of residual disease buried in fibrous tissue in the breast and one axillary node. All patients were given routine adjuvant chemotherapy after completion of irradiation. A 4th patient with a huge fungating breast carcinoma which was bleeding and foul-smelling who also had evidence of liver metastasis (stage IV disease) was treated in a similar manner. Local tumour regression was achieved and although the patient still requires treatment for metastatic disease there is no evidence of residual carcinoma in the breast or axilla 12 months after treatment. Further investigation of this treatment seems worthwhile, since it may be effective not only in the management of large breast cancers but also in patients with less advanced disease who refuse mastectomy or wish to avoid it.

Adult↗
PubMed1980

Intraarterial infusion chemotherapy in salvage of limbs involved with advanced neoplasms.

Partial or complete limb salvage has been achieved in seven patients by the use of basal intraarterial infusion chemotherapy. All had either refused amputation or had been considered unsuitable for it. Results in all cases showed marked tumour regression to a size where local measures were then successful in controlling the disease. Six of the patients are alive and well with no sign of recurrence at periods ranging from four months to six years.

Aged↗
PubMed1980

The intraarterial infusion of chemotherapeutic agents as "basal" treatment of cancer: evidence of increased drug activity in regionally infused tissues.

There is evidence from a number of centres that some forms of locally advanced and aggressive cancers which are difficult to eradicate by standard means can be reduced by the use of "basal" chemotherapy and/or surgery. Clinicians have been divided as to whether there is an advantage in giving the chemotherapeutic agents directly into a regional artery of supply where this is feasible, as opposed to their systemic administration. This paper documents supportive evidence that some and possibly many chemotherapeutic agents are more effective if given regionally into an artery of supply. There is a higher incidence of local side-effects in the region infused, including loss of hair, inflammatory changes, and ulceration of the skin or mucosa of the region infused. After intraarterial infusion of tagged bleomycin (indium-III bleomycin) into a limb, the radioactive isotope remained more concentrated in the limb infused than in the opposite limb for at least 24 hours. Systemic side-effects, including bone-marrow depression, are less frequent and less severe in patients given chemotherapeutic agents by intra-arterial infusion than if the same doses of agents are given intravenously. There is now sufficient evidence of the value of basal chemotherapy used in this way to make it mandatory that medical oncologists and surgeons, working together, should plan controlled studies to determine the most appropriate applications of this technique of management.

Antineoplastic Agents↗
PubMed1979

Hodgkin's disease: evaluation of staging procedures for abdominal involvement.

Results of preoperative assessment procedures and subsequent staging laparotomy are evaluated in 32 consecutive patients who presented with extra-abdominal Hodgkin's disease which was not already known to be in an advanced stage. Disease was found in the abdominal cavity of 10 of the 27 patients who presented with disease above the diaphragm, and of two of the five patients in whom disease presented in the inguinal nodes. In patients who initially presented with disease above the diaphragm, the spleen was involved in all 10 cases where abdominal disease was detected. Lymphography was not found to be reliable as a diagnostic aid in doubtful cases. Neither liver nor spleen scans were found to be helpful in assessment of these patients.

Abdominal Neoplasms↗
PubMed1979

Preoperative basal chemotherapy in the management of cancer of the stomach: a preliminary report.

Nine patients with advanced gastric carcinoma have been treated with a programme of chemotherapy as the first stage of management with the objective of reducing tumour extent and viability in preparation for subsequent surgery where feasible. In eight patients the chemotherapy was given by intraarterial infusion into the coeliac axis, and the remaining patient was given intravenous chemotherapy. Most patients gained symptomatic improvement, including pain relief, and in seven patients tumour regression was achieved. In six patients tumour regression was followed by gastrectomy. Residual tumour was found in five of these six patients, and was not found in one.

Adult↗
PubMed1978

Laser surgery.

Explore the source record for details and available documents.

Carbon Dioxide↗
PubMed1978

"CRAB" chemotherapy. Curative, relieving, adjuvant, and basal.

A selection of patients with a variety of tumors treated effectively by chemotherapy followed by radiotherapy or surgery or both is presented. The best success has been achieved with lesions not previously treated by radiotherapy or surgery and which have no fixed lymph node masses. Where possible, we prefer to administer chemotherapeutic agents by direct infusion into the regional artery supplying the tumor mass.

Adult↗
PubMed1976

"Crab" care and cancer chemotherapy.

The letters CRAB indicate that there are four broad uses of chemotherapy in treating solid tumours: (i) curative, which is always the aim but as yet can rarely be reliably achieved with chemotherapy alone; (ii) relieving chemotherapy for widespread or incurable disease; (iii) adjuvant care to prevent peripheral occult disease developing after standard surgery or radiotherapy; and (iv) basal chemotherapy, to reduce the size, viability and especially the peripheral extent of large, localized tumour masses in preparation for definitive treatment usually by radiotherapy and/or extirpative surgery.

Adult↗