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Biomedical subjects

J T Roberts

Publications and source records attributed to J T Roberts.

At least 55 records · Page 3Linked to original sources
PubMed1994

Treatment of oral cancers using iridium-192 interstitial irradiation.

OBJECTIVE: To assess retrospectively the outcome and morbidity of Iridium-192 brachytherapy in the treatment of oral cancers. DESIGN: Retrospective audit of cases treated between 1981 and 1991. SETTING: Newcastle upon Tyne, England. SUBJECTS: 73 patients with oral cancer treated with Iridium-192. MAIN OUTCOME MEASURES: Local control, crude and cause specific survival, and local morbidity. RESULTS: Seventy four cases of squamous cell carcinoma of the oral cavity were treated using interstitial Iridium-192. The disease specific 5-year survival rates were 69% for T1, 67% for T2, and 0% for T3 tumours. Mortality from recurrent cancer was 20%, and from intercurrent disease was 28%. The incidence of major radiation induced morbidity was 11%, and the local control rate was 81% for T1, 69% for T2, and 50% for T3 tumours. CONCLUSION: Interstitial radiotherapy remains a viable and valuable mode of treatment for a small proportion of patients presenting with early (T1 and T2) oral cancers.

Adolescent↗
PubMed1993

A prospective randomized double-blind trial comparing ondansetron versus prochlorperazine for the prevention of nausea and vomiting in patients undergoing fractionated radiotherapy.

In a multicentre, international double-blind trial, patients undergoing courses of five or more daily radiotherapy treatments to the upper abdomen were randomized to receive either oral ondansetron 8 mg t.d.s. or oral prochlorperazine 10 mg t.d.s. throughout their radiation course in order to try to prevent nausea and vomiting. A total of 192 patients were recruited, 135 of whom were included in the efficacy analysis; of these, 70 received ondansetron and 65 prochlorperazine. Forty-three (61%) of the patients prescribed ondansetron and 23 (35%) of those given prochlorperazine had a complete response, with no emetic episodes throughout their treatment course (P = 0.002). There was, however, no significant difference between the two groups with respect to the incidence and severity of nausea. Seventeen (24%) of the patients on ondansetron and 19 (29%) of those given prochlorperazine were treatment failures, experiencing more than five emetic episodes on their worst day during the study. Both drugs were well tolerated, although constipation was seen more commonly with ondansetron.

Adult↗
PubMed1993

Prednimustine (Sterecyt) versus cyclophosphamide both in combination with methotrexate and 5-fluorouracil in the treatment of advanced breast cancer.

153 women with advanced breast cancer were randomly allocated for treatment with SMF [prednimustine (Sterecyt) + methotrexate + 5-fluorouracil, 83 patients] or CMF (cyclophosphamide+methotrexate+5-fluorouracil, 70 patients). Prednimustine was administered orally 100 mg/m2 daily, for 5 days, and cyclophosphamide was administered orally 100 mg/m2, for 14 days, each, every 4 weeks. Methotrexate was given at a dose of 40 mg/m2 and 5-fluorouracil at 600 mg/m2 on day 1 and 8, every 4 weeks. Leucovorin was used in 39 patients to alleviate mucositis. The two treatment groups were balanced in terms of age, performance status, lymph node status, histology, menopausal status and previous therapy. Response was evaluated in 140 patients. Of 76 patients treated with SMF, 4 had a complete and 21 a partial response (CR+PR = 33%), 40 had no change (NC) and 11 had progressive disease (PD). Of 64 patients treated with CMF, 3 had a complete and 18 a partial response (CR+PR = 33%), 30 had no change (NC) and 13 had progressive disease (PD). Time to treatment failure and survival were similar in both groups. A relationship between haematological and gastrointestinal toxicity and therapeutic efficacy was demonstrated with a superior survival and response rate recorded for patients with such toxicity than in patients without. Haematological toxicity was, in general, mild to moderate with no difference between the two groups. Alopecia (P = 0.008), nausea/vomiting (P = 0.02) and euphoria (P = 0.03) were more common in the CMF-treated group. Diarrhoea was more common in the SMF group (P = 0.03). In conclusion, SMF seems to be as efficient as CMF with regard to response rate, time to treatment failure and survival. However, SMF was tolerated better than CMF.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

Oral piritrexim, an effective treatment for metastatic urothelial cancer.

Piritrexim is a lipid-soluble inhibitor of dihydrofolate reductase (DHFR) that enters tumour cells rapidly by passive diffusion, cannot be polyglutamated, and is as effective as methotrexate in inhibiting DHFR. Bioavailability after oral dosing is approximately 75%. We performed a phase II study with oral piritrexim in non-chemotherapy pretreated patients with metastatic urothelial cancer. Thirty-three patients were treated with 25 mg three times daily for 5 consecutive days, repeated weekly, with provision for dose escalation or reduction according to the toxicity observed. Of 29 evaluable patients, one patient achieved a complete response of 19+ weeks duration, and ten patients achieved a partial response with a median duration of 22 weeks (range 16-48), for a total response rate of 38%. Piritrexim was generally well tolerated, with myelosuppression as the major toxicity, that frequently required dose modification. We conclude that piritrexim appears to be an active agent in patients with metastatic urothelial cancer when administered as a 5-day, low-dose oral schedule. It would be attractive to investigate the combination of piritrexim and cisplatin.

Administration, Oral↗
PubMed1993

Risk factors for carcinoma in situ of the contralateral testis in patients with testicular cancer. An interim report.

In a study aimed at evaluating risk factors for carcinoma in situ (CIS) in the contralateral testis of selected patients with testicular cancer, information from 89 patients who have had contralateral testicular biopsies is available. The biopsies were performed because of the coexistence of the previously established risk factors - atrophy of the remaining testis, or a history of maldescent. CIS was diagnosed in 13% of patients, the prevalence being the same for both open and needle biopsies. Compared to its overall prevalence in the contralateral testis in testicular cancer an increased risk of CIS has been found in clinically atrophic testes but has not been found for maldescent. Patients found to have CIS were younger than those in whom it was not detected.

Adult↗
PubMed1992

A European Organization for Research and Treatment of Cancer--Genitourinary Group phase 2 study of chemotherapy in stage T3-4N0-XM0 transitional cell cancer of the bladder: evaluation of clinical response.

From 1986 to 1990 the European Organization for Research and Treatment of Cancer--Genitourinary Group conducted a phase 2 trial of neoadjuvant chemotherapy in patients with stage T3-4N0-XM0 transitional cell carcinoma of the bladder. The objectives were to evaluate the clinical response in relation to the pathological response, and to measure the side effects of chemotherapy. Of 171 patients entered 136 were fully evaluable: 18% had clinical complete remissions, 36% had clinical partial remissions, 39% had no clinical remissions and 10% had unknown response. A selected subgroup of 76 patients underwent cystectomy after 2 or 4 courses of chemotherapy: 2 were not evaluable for pathological response because of preoperative radiotherapy after neoadjuvant chemotherapy, 16 had a pathological complete remission, 7 had a pathological partial remission and 51 had no pathological remission. Comparison of the clinical response or T category only after 2 courses of chemotherapy with the pathological response after 2 or 4 courses of chemotherapy showed that in a number of patients the disease status could be downstaged to pathological complete or partial remission by additional courses of chemotherapy. If the discrepancies between clinical and pathological responses, or between T and P categories, induced by further downstaging after additional chemotherapy were left out, it was shown that clinical complete and partial remissions were a heterogeneous group but nonresponders could be delineated with a 100% accuracy by clinical response evaluation and transurethral resection biopsy only. Furthermore it seems important to establish the number of chemotherapy courses to induce a maximal response of the primary tumor.

Adult↗
PubMed1992

Hypertrichosis lanuginosa acquisita following cytotoxic chemotherapy.

Hypertrichosis lanuginosa acquisita (HLA) refers to abnormal and excessive growth of fine downy hair. It is a rare condition which has been reported in association with both malignancy and certain drug therapy. We report three cases occurring after administration of cytotoxic chemotherapy for cancer. A possible relationship is discussed and previous literature reviewed.

Adult↗
PubMed1992

A pilot study of accelerated fractionation in the radiotherapy of invasive carcinoma of the bladder.

24 patients with muscle invasive carcinoma of the bladder were treated in a pilot study of twice daily fractionation at radiation doses of 1.8-2.0 Gy per fraction to total doses of 54-64 Gy to the bladder and 39.6-44 Gy to the whole pelvis. The treatment aim was to give 32 fractions in 22 days. The interfraction interval was a minimum of 6 h. The principle objective was to record acute and late tolerance, but local control and survival data is also presented. Acute radiation morbidity was scored according to the RTOG system. Grade 2 large bowel effects were seen in 52% of patients, Grade 3 effects in 26% and there was one Grade 4 and one Grade 5 effect. The mean duration of effect was 4.5 weeks although the more severe reactions were also more protracted. Grade 2 urinary effects occurred in 30% and Grade 3 in 17% of patients. The mean duration of effect was 7.2 weeks. There were no Grade 4 or 5 acute urinary effects. Late radiation morbidity was scored according to the EORTC/RTOG system and was assessable in 16 cases who survived more than 6 months. There were two cases (12%) of Grade 1 bowel toxicity, two cases of Grade 1 and three of Grade 2 urinary toxicity. There were no cases of late skin effects. Actuarial analysis at 2 years shows a local control probability of 56% and survival probability of 35%.

Acute Disease↗
PubMed1992

The possibility of school milk as a vehicle for fluoride: epidemiological, organisational and legal considerations.

The aim of this study was to investigate the epidemiological, organisational and legal considerations of using school milk as a vehicle for fluoride. The background to the work was the need to develop alternative methods of fluoride supplementation for high risk groups living in areas where water fluoridation is unlikely. St Helens in Merseyside was chosen as the study area, where 23 per cent of 4-year-old children were identified as having a high caries experience (dmft > or = 4). It was found that 65 per cent of 3 and 4-year-old children attend local authority educational facilities, where milk is provided on a daily basis for children aged 2 to 7 years. This group included 62 per cent of the 4-year-old group with high caries experience. The legal aspects of adding fluoride to milk were found to be complex but it was concluded that there may be considerable potential for using school milk as a vehicle for fluoride, and a large-scale study is now planned.

Animals↗
PubMed1991

Disposable tuberculin tests: available and needed. A review.

The literature relating to the value of imotest and the tine test in comparison with the Mantoux test and the Heaf test is reviewed. The reports on the concordance of the results of Heaf and Mantoux tests are also considered. It is concluded that the tine test and the imotest have significant advantages in terms of safety so far as cross-infection risks are concerned. Large-scale multicentre trials to attain consensus on the interpretation of results from all four tests are suggested.

Cross Infection↗
PubMed1991

Systemic chemotherapy for urothelial cancer in patients with ureteric obstruction.

The aims of this study were to document the toxicity of systemic chemotherapy and response rates in patients with ureteric obstruction caused by urothelial cancer. The study group included 91 patients who received cisplatin and methotrexate; 36 (40%) had upper tract dilatation, 9 of whom had drainage by stenting or nephrostomy and 55 (60%) had normal upper tracts. The response rate was documented in 65 patients (71%) who had measurable primary or metastatic disease. No significant differences were found between the dilated/drained group, the dilated/undrained group and the normal group in biochemical measurements of renal function during or after the courses of chemotherapy. Serious haematological toxicity occurred in 10% (10/104 cycles) of the dilated/undrained group and in 6% (12/200 cycles) of the normal group. The complete response rate in the dilated group was 15% compared with 41% in the normal group. No increased chemotherapy toxicity was observed in patients with upper tract dilatation and a significant complete response rate was found in patients with upper tract dilatation without renal impairment.

Acute Kidney Injury↗
PubMed1991

Results of Medical Research Council phase II study of low dose cisplatin and methotrexate in the primary treatment of locally advanced (T3 and T4) transitional cell carcinoma of the bladder.

A series of 49 previously untreated patients with category T3 or T4 bladder cancer underwent treatment with low dose methotrexate and cisplatin; 44 patients were eligible for assessment of response. Complete response (CR) was seen in 5 patients (11%) and partial response in 15 (34%) (overall response rate 45%). Treatment was reasonably well tolerated with no major morbidity and no treatment-related deaths. After a median follow-up of 3.5 years, the 1-year and 2-year survival rates were 70 and 30% respectively. Ten patients remain recurrence-free without having received "definitive local therapy" (cystectomy and/or radiotherapy) at follow-up extending from 20 to 50 months.

Adult↗
PubMed1990

Immature presacral teratoma in an adult female.

A case of immature presacral teratoma in an adult female presenting in pregnancy is described. She remains free of disease 12 months following treatment with a combination of chemotherapy, radiotherapy, and surgery. Serum alpha-fetoprotein levels appeared to correlate more with tumor "aggression" than with tumor growth.

Adult↗
PubMed1990

Blindness and partial-sight: aetiological factors and data collection systems.

271 BD 8 Forms completed by consultant ophthalmologists to enable blind and partially sighted patients to be registered by the social services department were analysed for aetiological factors. This set of data for 1982 to 1986 is tabulated and compared with historical and contemporary data for the country as a whole and some data from Strathclyde, Avon and Leicestershire. It is suggested that in order to monitor epidemiological trends in the causation of visual disability, a composite picture for England could be obtained by requiring one district in each of the fourteen English regional health authorities to collect and analyse the local data. Form BD 8 should be revised, simplified and made computer compatible.

Adolescent↗