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Biomedical subjects

J D Cox

Publications and source records attributed to J D Cox.

At least 235 records · Page 13Linked to original sources
PubMed1975

Primary malignant germinal tumors of the mediastinum. A study of 24 cases.

The malignant germinal tumors found in the testis (seminoma, teratocarcinoma, embryonal carcinoma, choriocarcinoma, and mixtures of these) can originate in the anterior mediastinum. An occult testicular tumor must be sought, but primary mediastinal germinal tumors constitute a true entity. The details of 24 such patients treated at Walter Reed General Hospital are presented. Of 19 patients who died, 2 were women; postmortem examination of the testes of 13 men failed to reveal a primary tumor. Five patients are alive and well with no testicular abnormality. It is important to distinguish the histopathologic types. Seminomas are readily controlled with modest doses of irradiation. Embryonal carcinomas are also radiocurable with somewhat higher doses; 2 long-term disease-free survivors are reported. Teratocarcinomas are highly malignant and require higher doses for control. Choriocarcinomas progress so rapidly that chemotherapy is necessary.

Adolescent↗
PubMed1975

Irradiation of stage I and II Hodgkin's disease.

One must conclude on the basis of the above analysis that tumor doses in excess of 3,600 or 4,000 rads add only to morbidity, and not to local control. Secondly, the technique of irradiating involved lymph node groups only, leaving other areas to be treated "later," apparently denies the possibility of cure to a significant number of patients with early stage Hodgkin's disease. Recurrence or extension almost uniformly leads to eventual death from disease despite retreatment. No case of second primary cancer has been documented in the patient population included in this report. However, the number at risk is relatively small and chemotherapy was reserved only for generalized recurrence. Since the reported 20 times expected incidence occurred with the combination of total-nodal and multple-agent chemotherapy, one would not expect an increased incidence of second primary lesions in this series.

Adolescent↗
PubMedDate not supplied

Recurrence patterns by treatment modality of carcinomas of the floor of the mouth and oral tongue.

Recurrence patterns were examined by stage of disease and treatment modality in 139 patients with 141 squamous cell carcinomas of the floor of the mouth and oral tongue, reflecting an 11-year experience at two hospitals. Treatment categories included surgery, irradiation, and combined treatment. Patients who were without evidence of disease at two years, or at the time of death, were considered cured. Cures were achieved in 87 per cent of patients with Stage I disease, 83 per cent with Stage II, 40 per cent with Stage III, and 34 per cent with Stage IV. Similar results were achieved by irradiation alone and by surgery alone in controlling early lesions. Combined treatment offered the best chance of cure for patients with advanced disease. Failure was most often associated with persistence at the primary site. No patient with advanced disease was salvaged after local treatment failure. One of 51 patients who received prophylactic treatment of the neck in the absence of clinical evidence of metastases had a regional treatment failure, while seven of 26 such patients who did not receive prophylactic treatment developed regional metastases. The ten-year adjusted survival rate, as calculated by the actuarial method, was 53 +/- 4.7 per cent. Forty-two multiple primary lesions were found in the 139 patients.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Chemoradiation for malignant epithelial tumors.

Combinations of the chemotherapy and radiation therapy are increasingly a part of treatment strategies for cancer. Although directed at distant metastasis, they may have little effect on the primary tumor and regional lymph nodes. The local tumor must be controlled to 1) eliminate life-threatening complications, 2) decrease the risk of distant metastasis, and 3) permit organ conservation. Induction chemotherapy has been shown to be effective in decreasing distant metastasis, but it does affect local tumor control in common epithelial tumors. Concurrent single agent chemotherapy can increase local control with radiation therapy and combination chemotherapy concurrent with irradiation can both improve local control and decrease distant metastasis. Combination chemoradiation therapy has become a major part of research strategies of the Radiation Therapy Oncology Group (RTOG): it has been shown to improve local control and survival in carcinomas of the esophagus and nasopharynx. Combination chemoradiation has increased organ conservation in carcinoma of the anal canal and it is under investigation for carcinomas of the larynx (laryngeal preservation), other head and neck sites, lung, and cervix. The equation--increased local tumor control + decreased distant metastasis = increased survival--is the paradigm. Systemic therapy with cytotoxic drugs or hormones needs to address both potential sites of failure.

Breast Neoplasms↗