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Biomedical subjects

J Fontanesi

Publications and source records attributed to J Fontanesi.

65 records · Page 4Linked to original sources
PubMed1989

Palliative hemibody irradiation in hormonally refractory metastatic prostate cancer.

Ten patients with hormonally refractory symptomatic metastatic prostate carcinoma underwent palliative hemibody irradiation (HBI). Four of the patients also had had previous irradiation to symptomatic focal sites. Two of the patients underwent upper body HBI with 5 Gy, while 6 patients underwent lower body HBI with 7 Gy. Two patients received sequential lower body HBI followed by upper body HBI. All 10 patients reported subjective pain relief within the immediate forty-eight to ninety-six hours following therapy. The average response lasted four months. Therefore the majority of our patients achieved symptomatic pain relief for the remainder of their lives which averaged five months (range 1.5-12 months). All 10 patients suffered transient but clinically insignificant hematologic toxicity. There was no death or other significant morbidity attributable to the treatment. We conclude that HBI is safe and effective palliation of bone pain in patients who have failed conventional therapy for prostate cancer.

Aged↗
PubMed1989

Effect of dose rate on local control and complications in the reirradiation of head and neck tumors with interstitial iridium-192.

Interstitial Iridium-192 was used as the sole treatment for 23 previously irradiated patients with recurrent or second primary malignancy in the head and neck region. Doses used in initial external beam treatment ranged from 50.0 to 72.0 Gy, in daily fractions of 180 to 200 cGy. Retreatment with interstitial implant using the Quimby system delivered total doses between 38.5 and 60 Gy, with hourly dose rates of 30 to 66 cGy. Local control in the implanted volume was seen in 21 of 23 patients at 5 to 34 months post-implant (median 10 months). Dose rate (hourly dose delivered at 0.5 cm beyond the periphery of the implanted tumor volume) did not affect local control, but did have a significant impact on severe complications (soft tissue necrosis and fistulae; p = 0.26). No effect on either local control or complication rate was found for volume of implant, initial external beam radiation dose, time to recurrence, or anatomic site of treatment. These findings suggest that interstitial irradiation is effective treatment for head and neck cancers in previously irradiated sites. Dose rates as low as 32 cGy/hr provided adequate local control, with few long-term complications to date; doses above 42 cGy/hr may be associated with severe and even fatal complications.

Adult↗
PubMed1988

External radiation therapy of stage I cancer of the endometrium: a need for reappraisal of this adjunctive modality.

One hundred and eighty-five patients with Stage I cancer of the endometrium were irradiated preoperatively. All were irradiated to the whole pelvis by external beam only using supermegavoltage apparati. The total mid-pelvis dose ranged from 4500 cGy/5 weeks to 5500 cGy/6 1/2 weeks. Surgery followed usually in 6 weeks. Complications were minimal. Disease-free survival at Stage IA was 92.4% 5-year, 87.7% 10-year; Stage IB was 83.5% 5-year, 74.6% 10-year. Prognosis was related to stage, grade, depth of myometrial penetration, the presence of "residual" tumor at hysterectomy. External beam preoperative irradiation is recommended for all Stage I patients; Stage IB with higher grade pathology should have intracavitary irradiation supplemental to the external irradiation.

Adenocarcinoma↗
PubMed1988

The effects of irradiation on alaryngeal voice of totally laryngectomized patients.

The effects of radiation therapy on the ability of totally laryngectomized patients to produce voice and speech were examined using objective non-invasive methods. Moderate to severe losses were noted in patients producing voice with all types of alaryngeal modalities: tracheoesophageal, esophageal, and electrolaryngeal. Voice and speech losses were related to the impaired motility and vibratory capability of the esophageal wall and mucosa, to fibrosis of the submandibular region and to trismus. Tracheoesophageal and esophageal voice was recovered some weeks after completion of irradiation. No voice losses were observed in alaryngeal speakers who did not undergo voice restoration until after irradiation. All irradiated patients also showed various degrees of dysphagia during the treatment.

Humans↗
PubMed1988

Cognitive profile of Rett syndrome.

We report preliminary studies in 18 girls with Rett syndrome (15 typical, three atypical cases) who were studied using a number of neuropsychologic measures. Results indicate a relative preservation of gross motor and daily living skills at the developmental level of the age of onset of the condition. Other adaptive functions were more depressed. Higher levels of object permanency were found in this population than reported previously. Our results indicate that islands of motor and intellectual function persist in Rett syndrome patients. These data may be useful for therapeutic intervention.

Adolescent↗
PubMed1988

Speech restoration post-pharyngolaryngoesophagectomy using tracheogastric fistula.

Restoration of voice and speech in patients with gastric pull-up presents a formidable challenge, and many of these patients are left at best with a poorly functional electrolaryngeal speech. To improve this condition, a tracheogastric puncture stented with a biflanged self-retaining Groningen voice button was accomplished, resulting in gastric mucosa vibrations during exhalatory phase. The biomechanical characteristics of gastric vibrations and tracheogastric puncture candidate selection criteria are discussed.

Aged↗
PubMedDate not supplied

Hepatoblastoma with spinal metastases.

Spinal cord compression secondary to metastases is an infrequent complication of childhood cancer. We describe an infant with hepatoblastoma in whom cord compression developed because of extensive epidural metastases during treatment. This is a hitherto undescribed metastatic site for hepatoblastoma.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

The cost to immunize during well-child visits.

The objective of this study was to determine the incremental labor costs or opportunity costs associated with the provision of immunizations in ambulatory care settings. A time and motion analysis of primary care health visits by pediatric patients was performed in 10 community clinics and 5 private primary care practices. These clinics and practices were located in areas designated as Health Professional Shortage Areas, with traditionally low immunization coverage rates and other unmet primary care needs. The outcome measure for this study was the comparative duration of the visit, contrasting well-child visits during which immunization was given with well-child visits during which no immunization was given. The results suggested that immunizations present an opportunity cost during well-child visits. The average time of patient-provider contact found in this study supports other findings showing that this time is now significantly longer than that reported in the past. In order for providers to comply with increased recommendations and requirements for preventive health care services, the allotted visit time, capitation rates, and overall clinic system effectiveness need to be reexamined.

California↗
PubMedDate not supplied

Chemotherapy for extraocular retinoblastoma.

Because few patients with extraocular retinoblastoma are seen in the United States and Europe, it has been difficult to establish the optimal role of chemotherapy in such cases. We examined the efficacy of two chemotherapy combinations (cisplatin/etoposide and cyclophosphamide/doxorubicin) in patients with extraretinal retinoblastoma, administered prior to radiotherapy in four patients with recurrent or advanced primary disease. Responses were evaluable in three patients, each of whom was treated by both chemotherapy regimens and radiotherapy. Multimodality therapy promises to be of benefit to patients with extraocular retinoblastoma, and future studies will explore alternative chemotherapy combinations for this purpose.

Antineoplastic Combined Chemotherapy Protocols↗