Search PubMed⌕ Search

Biomedical subjects

G R Prout

Publications and source records attributed to G R Prout.

At least 109 records · Page 6Linked to original sources
PubMed1981

Immunological detection of metastases from prostatic adenocarcinoma.

In six patients with known prostatic adenocarcinoma, extraprostatic (metastatic) tumor was suspected on radiographic or radionucleotide studies. When cytological examination of tissue obtained by needle aspiration or biopsy was nondiagnostic, radial gel immunodiffusion was used to identify the presence of prostatic acid phosphatase in the tissue. Four specimens demonstrated prostate-specific acid phosphatase activity, permitting the diagnosis of metastatic prostatic adenocarcinoma. The technique is simple and highly specific.

Acid Phosphatase↗
PubMed1981

Comparison of estramustine phosphate and vincristine alone or in combination for patients with advanced, hormone refractory, previously irradiated carcinoma of the prostate.

There were 121 men with hormonally refractory metastatic cancer of the prostate who were randomized to receive estramustine phosphate or vincristine, or the combination of these 2 agents. All patients had received prior radiation therapy (greater than 2,000 rad). There were 90 patients who could be compared for response. The objective response rates (partial regression or stabilization of disease) for the 3 treatment groups were 26 per cent for estramustine phosphate, 24 per cent for estramustine phosphate plus vincristine and 15 per cent for vincristine. Subjective parameters varied little among the 3 regimens. The median duration of response for those responding to estramustine phosphate was similar (20 weeks) to that for vincristine (22 weeks) and greater than that for the combination (13 weeks). The probability of survival did not differ significantly for patients randomized to each of the 3 regimens. The addition of vincristine to estramustine phosphate did not enhance the response rate achieved by estramustine phosphate alone and vincristine alone produced the lowest response rate. Estramustine phosphate continues to be the most active agent in previously irradiated patients with hormonally refractory metastatic cancer of the prostate.

Drug Therapy, Combination↗
PubMed1981

A comparison of hydroxyurea, methyl-chloroethyl-cyclohexy-nitrosourea and cyclophosphamide in patients with advanced carcinoma of the prostate.

This is the fifth completed randomized clinical trial of the National Prostatic Cancer Project. There were 125 patients with histologically confirmed relapsing clinical stage D prostatic cancer randomized to receive hydroxyurea, methyl-chloroethyl-cyclohexy-nitrosourea or cyclophosphamide. All patients had received and failed previous hormonal therapy. Patients whose disease progressed after 12 weeks on the initial therapy were crossed over or randomized to receive an alternate drug. There were 98 patients available for comparison of treatments. Objective responses included patients with complete or partial regression as well as stable disease. The response rates were 35 per cent for cyclophosphamide, 30 per cent for methyl-chloroethyl-cyclohexy-nitrosourea and 15 per cent for hydroxyurea. Subjective response parameters included improvement in performance status and relief of pain. Pain was improved in a fifth of the patients on each treatment area. Methyl-chloroethyl-cyclohexy-nitrosourea and hydroxyurea showed activity in advanced prostatic cancer patients but at the expense of excessive toxicity. Cyclophosphamide continues to be the most active single agent in this type of patient, particularly with regard to duration of response and survival. There was a statistically demonstrable advantage for cyclophosphamide over hydroxyurea and a marginal advantage over methyl-chloroethyl-cyclohexy-nitrosourea in survival experience.

Acid Phosphatase↗
PubMed1980

Nodal involvement as a prognostic indicator in patients with prostatic carcinoma.

Between 1969 and 1976, 92 patients with proved prostatic carcinoma in stages T0 and T4 underwent pelvic lymphadenectomy. Median followup has been 43 months. All patients had normal serum acid phosphatase levels and no clinical evidence of metastases as determined by physical examination, bone scans and metastatic bone surveys. Pelvic lymph node metastases were noted in 32 cases. Radical prostatectomy was done in 34 cases and 45 patients received radiotherapy, 11 of whom had 125iodine seeds implanted. Progression of the neoplastic process, almost exclusively in the form of bony metastases, occurred in 18 of the 32 patients who had positive pelvic nodes and in 6 of the 60 patients with negative nodes (p less than 0.001). Patients with poorly differentiated carcinoma were more likely to have progression of the disease than those with moderately differentiated carcinoma (p less than 0.01) and no patient with a well differentiated carcinoma had disease progression.

Aged↗
PubMed1980

Preoperative irradiation, lymphadenectomy and 125iodine implant for patients with localized prostatic carcinoma: a correlation of implant dosimetry with clinical results.

The 30 patients with clinically and surgically localized prostatic carcinoma who were selected for treatment by a short course of preoperative irradiation (1,050 rad), pelvic lymphadenectomy and 125iodine implant have been followed for 1 to 4 years. Perioperative morbidity (10 per cent), postimplant impotence (11 per cent), lymphedema (17 per cent), tumor recurrence (4 per cent) and distant metastasis (4 per cent) have been minimal to date. However, urinary irritative symptoms, which usually subsided in 6 to 9 months, occurred in half of the patients and correlated with implant volume. Total dose and total dose per unit of implanted activity were calculated. Of the various implant parameters evaluated implant dose homogeneity has corrrelated with the rate of tumor regression.

Brachytherapy↗
PubMed1980

Experimental ureteral lengthening in dogs.

The right ureters of eight dogs were divided and the end of the proximal segments were attached to a spring generating a constant tension force of 26 to 30 mm Hg. After 2 weeks, the segments had elongated by an average of 33%; one segment did not elongate because of a spring failure. Six of the seven elongated segments were viable. Microscopically, the segments revealed muscular hypertrophy, increased collagen and elastic tissue, and periureteral inflammation and edema. This study indicates that a dog ureter may be mechanically elongated and its tissue viability maintained by applying a constant tension external stretching force.

Animals↗
PubMed1979

Proton radiation as boost therapy for localized prostatic carcinoma.

A 160-MeV proton beam has been modified to irradiate patients with localized tumors by using convention treatment schedules. This proton beam has the physical advantage of megavoltage x-rays of reducing the radiation dose to normal tissues adjacent to the tumor volume. A perineal proton technique used as boost therapy (2,000 to 2,500 rads) was evaluated in the definitive irradiation of 17 patients with localized prostatic carcinoma. This technique allows repeated daily treatment of the carefully defined target volume with a precision of +/- 2 mm. Total dose to the prostatic tumor, but not to the posterior rectum, has been increased by 500 to 700 rads. After 12 to 27 months of observation, no noteworthy rectal reaction has developed in a patient, easily managed urethral strictures have developed in two patients, and all but one are locally controlled.

Adenocarcinoma↗
PubMed1979

Bladder carcinoma as a systemic disease.

Pne hundred and fifty-one patients with transitional cell carcinoma of the bladder who were evaluated by conventional means preoperatively underwent a radical cystectomy. They were then classified according to the highest known pathological stage, first site of postoperative metastasis and the temporal relationship of the cystectomy to the appearance of the metastasis. Fifty patients developed metastases, 80% of which were proven histologically. Thirty-nine of fifty patients (78%) who developed metastases did so within a year of cystectomy. Extent of local tumor was directly related to the incidence of positive pelvic nodes. Metastases occurred most commonly in lung and bone. Soft tissues of the pelvis were involved in thirteen (16%) of the patients who developed metastatic carcinoma and those patients with positive pelvic nodes were more likely to have these kinds of recurrent disease. These evaluations suggest that the metastases must be present at cystectomy or as a result of it. The data imply the existence of appreciable heterogeneity among patients and/or their invasive bladder carcinoma. Disseminated but silent metastases suggest that a relationship between the primary tumor and the occurrence of metastatic disease may exist. Knowledge of this relationship is very important in planning subsequent therapeutic strategies.

Carcinoma, Transitional Cell↗
PubMed1979

A longitudinal study of patients with superficial bladder carcinoma successfully treated with weekly intravesical thio-tepa.

Herein is reported further results of a prospective clinical investigation to determine the effect of weekly intravesical bladder instillation of thio-tepa in the treatment of superficial bladder cancer. Patients with superficial bladder carcinoma were treated according to 2 protocols. The first protocol consisted of patients with persistent tumor who were treated with weekly thio-tepa for 8 weeks. Of the 33 patients 18 responded to this therapy, and they and 24 other patients who had been rendered free of tumor by transurethral resection alone were assigned to the second protocol in which patients either were treated with monthly instillations of thio-tepa or they were observed every 3 months in a prescribed fashion. Monthly thio-tepa instillations had no significant effect in lowering the recurrence rate in either group. However, in the patients who had responded to weekly thio-tepa benefit was noted in terms of 1) fewer recurrences, with 8 of 18 (44 per cent) previously pre-treated patients having a recurrence versus 19 of 24 patients (79 per cent) previously untreated, 2) delay in tumor recurrence with an interval free of tumor of 15.1 months in pre-treated patients versus 4.3 months in the untreated group and 3) diminished frequency of new tumors (0.33 recurrences yearly) in comparison to the untreated group (1.78 recurrences yearly). The remaining patients are free of tumors at 15.7 months average followup.

Carcinoma, Transitional Cell↗
PubMed1979

Comparison of procarbazine, imidazole-carboxamide and cyclophosphamide in relapsing patients with advanced carcinoma of the prostate.

In this third cooperative chemotherapy trial of the National Prostatic Cancer Project 165 patients with histologically confirmed, relapsing clinical stage D prostatic cancer were randomized to receive either imidazole-carboxamide, procarbazine or cyclophosphamide. All patients had received and failed previous hormonal therapy. Patients whose disease progressed after 12 weeks on initial therapy were crossed over or randomized to receive an alternate drug. There were 129 patients available for comparison of treatments. The objective response rates (partial regression plus stable disease) were 26% for cyclophosphamide, 27% for imidazole-carboxamide and 14% for procarbazine. Subjective responses were noted in pain relief, improvement in performance status and weight gain. Procarbazine was associated with excessive toxicity, resulting in many patients (28%) discontinuing therapy within the first 3 weeks and closure of this particular arm of the study. The regimen of initial imidazole-carboxamide therapy with a later cross-over to cyclophosphamide when the disease continues to progress is associated with the longest increase in survival. Imidazole-carboxamide and cyclophosphamide appear to be active agents in advanced prostatic cancer and are worthy of continued use in this disease.

Aged↗