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K Greven

Publications and source records attributed to K Greven.

At least 19 recordsLinked to original sources
PubMed1999

Current developments in the treatment of newly diagnosed cervical cancer.

The International Federation of Gynecology and Obstetrics (FIGO) staging of cervical cancer relies on physical examination. However, surgical staging, which helps determine the extent of invasion of lymph nodes by cancer, is currently used more widely to define the need for additional therapies. Examples of these additional treatments include high-dose-rate brachytherapy techniques, extension of radiotherapy fields, surgery, concurrent chemotherapy and radiotherapy, and neoadjuvant chemotherapy prior to surgery. Currently there are many ongoing randomized studies that strive to define the risk-to-benefit ratio of these additional therapies.

Female↗
PubMed1998

PET scanning in head and neck oncology: a review.

BACKGROUND: The objective of this study was to review and describe the usage of fluorine-labeled deoxyglucose (FDG) and positron emission tomography (PET) in the diagnosis and management of head and neck cancer. METHODS: Several prospective series,-including 159 newly diagnosed and previously untreated and 23 previously irradiated head and neck squamous cell carcinoma patients initially seen at the Wake Forest University Medical Center and evaluated by clinical examination, conventional computed tomography/ magnetic resonance imaging (CT/MRI) scans, PET scans, and histopathologic studies,-were reviewed and the findings summarized for comparison of the correct differentiation of primary and metastatic cancers and for postirradiation tumor clearance in a subsegment of those cases. RESULTS: Positron emission tomography scanning using a fluorine-labeled deoxyglucose (FDG) radiotracer proved as reliable as conventional scanning for primary and metastatic tumor identification. Compared with clinical examination, PET was better for identification of nodal metastatic tumors but poorer for small primary tumors. For previously irradiated patients treated at least 4 months before the test, PET scanning was clearly superior to clinical examination and conventional imaging in differentiating tumor recurrence from soft-tissue irradiation effects. CONCLUSIONS: Fluorine-labeled deoxyglucose-PET scanning is comparable to conventional imaging of head and neck cancers in detecting primary and metastatic carcinoma. Lack of anatomic detail remains its major drawback. Currently, its greatest role is in the evaluation of the postradiotherapy patient.

Fluorodeoxyglucose F18↗
PubMed1997

The influence of x-ray energy on lung dose uniformity in total-body irradiation.

PURPOSE: In this study we examine the influence of x-ray energy on the uniformity of the dose within the lung in total-body irradiation treatments in which partial transmission blocks are used to control the lung dose. METHODS AND MATERIALS: A solid water phantom with a cork insert to simulate a lung was irradiated by x-rays with energies of either 6, 10, or 18 MV. The source to phantom distance was 3.9 meters. The cork insert was either 10 cm wide or 6 cm wide. Partial transmission blocks with transmission factors of 50% were placed anterior to the cork insert. The blocks were either 8 or 4 cm in width. Kodak XV-2 film was placed in the midline of the phantom to record the dose. Midplane dose profiles were measured with a densitometer. RESULTS: For the 10 cm wide cork insert the uniformity of the dose over 80% of the block width varied from 6.6% for the 6 MV x-rays to 12.2% for the 18 MV x-rays. For the 6 cm wide cork insert the uniformity was comparable for all three x-ray energies, but for 18 MV the central dose increased by 9.4% compared to the 10 cm wide insert. CONCLUSION: Many factors must be considered in optimizing the dose for total-body irradiation. This study suggests that for AP/PA techniques lung dose uniformity is superior with 6 MV irradiation. The blanket recommendation that the highest x-ray energy be used in TBI is not valid for all situations.

Lung↗
PubMed1994

Comparative voice results after laser resection or irradiation of T1 vocal cord carcinoma.

OBJECTIVE: To compare voice results following laser resection or radiation therapy for T1a glottic carcinomas. DESIGN: Objective recordings of acoustical data that were analyzed and calculated by an acoustic analyzer and subjective scores by patients, speech therapists, surgeons, and radiation therapists are compared. SETTING: Academic medical center speech laboratory at an institution where patients had been treated. Archival files were searched and patients were solicited by letter to participate in this analysis. PATIENTS: Men treated at least 6 months previously and who were without active laryngeal disease. Criteria were unilateral vocal cord carcinomatous involvement with no subglottic, anterior commissure, or arytenoid extension and tumor invasion clinically judged to be less than half of the cordal depth. INTERVENTIONS: Thirteen patients had received approximately 63 Gy in 28 fractions, five fractions a week, with laterally opposed fields using a linear accelerator. Eleven patients had had resection of less than half of the cordal depth by using a carbon dioxide laser with a 300-microns spot size working at a 400-mm distance; 13- to 15-W power intensity with a one tenth of a second burn in a noncontinuous mode. RESULTS: No statistically significant differences between the two study groups were found. Patients and physicians subjectively rated (1 indicates normal; 5, aphonic) the quality of voices of patients in the irradiation group (1.5 and 2.0) as slightly better than the quality of voices of patients in the laser group (2.0 and 2.4). Speech pathologists rated the voices of patients in the laser and irradiation group as indistinguishable and mildly abnormal (2.75 and 2.73). CONCLUSION: Voice quality in highly selected patients with vocal cord carcinoma treated by laser resection can be as good as that in patients whose cancer was similarly staged after radiation therapy.

Carcinoma, Squamous Cell↗
PubMed1990

Role of intracavitary cuff boost after adjuvant external irradiation in early endometrial carcinoma.

Management of early endometrial carcinoma often consists of surgicopathologic staging followed by adjuvant radiation therapy (RT) for patients at risk of local recurrence. While an intracavitary vaginal cuff boost (VCB) is commonly given after external beam radiation therapy, its effects on local control and complication rates are unknown. To assess these effects, we reviewed 157 patients with FIGO Stage I (n = 134) or incidentally diagnosed (n = 23) endometrial adenocarcinomas. After surgery and external radiation therapy, 103 patients (65.6%) received a vaginal cuff boost of 3000-5000 cGy surface dose (Group I) and 54 (34.4%) did not (Group II). One hundred and two Group I and 52 Group II patients were evaluable for analysis. Median follow-up was 78.0 months for Group I and 60.0 months for Group II. Despite a preponderance of poor prognostic factors in Group II, no significant difference in local failure was seen. A component of local failure was seen in 6 Group I patients (6.0%) and 4 Group II patients (7.7%), p = 0.74. Distant failure, reflecting more advanced disease, was higher in Group II (19.2%) than in Group I (9.0%). Late complications included rectal bleeding/proctitis in 18.6% of Group I patients and 3.8% of Group II patients (p = 0.01). Overall, grade 2 complications occurred in 27.5% and 15.4% of Group I and II patients, respectively (p = 0.09). No difference in frequency of grade 3 complications was evident. Based on this retrospective study, intracavitary vaginal cuff boost after surgery and postoperative external beam radiation therapy does not appear to improve local control in early endometrial adenocarcinoma. Its possible effect on complication rates is uncertain.

Adult↗
PubMed1987

Radiotherapy in the management of endometrial carcinoma with cervical involvement.

From 1971 to 1982, 29 patients with endometrial carcinoma involving the cervix were treated in the Radiation Therapy Department of North Carolina Baptist Hospital. Twenty-six patients completed combined surgery and adjuvant radiation therapy. The majority of these patients were treated postoperatively. Excluding four patients who died of intercurrent disease, this series had a 5-year survival rate of 86%. This figure compares favorably with results of other series reporting similar survivals in patients treated with preoperative radiation and surgery. No prognostic significance was demonstrated based on grade of differentiation, depth of myometrial penetration, or clinical stage of disease.

Adenocarcinoma↗
PubMed1987

Isolated vaginal recurrences of endometrial adenocarcinoma and their management.

Eighteen patients with isolated vaginal recurrence of their previously treated endometrial carcinoma were treated with radiation therapy at North Carolina Baptist Hospital, Winston-Salem between 1971 and 1982. Most patients received external beam irradiation which were followed by boost treatments that were delivered with external beam (two patients) or intravaginal ovoid (11 patients). A local control rate of 44.4% with a 3-year minimum follow-up was obtained. Currently 33% are alive without evidence of disease 3 to 10 years following treatment. The most important prognostic indicator of outcome was size of vaginal recurrence. Of seven evaluable patients with tumors smaller than 2 cm there was one local failure. In contrast there were eight local failures in ten patients treated for tumors larger than 2 cm. Close follow-up and prompt diagnosis will enhance the chance of cure in endometrial cancer patients who do have recurrences.

Adenocarcinoma↗
PubMed1978

[Not Available].

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Germany↗
PubMed1977

Stress relaxation compared with relaxation after contraction in smooth muscles.

The time courses of relaxation after contraction and of stress relaxation were found to be different. In the first case, but not in the latter, the time curves have a sigmoid shape. Furthermore, stress relaxation is characterized by a remaining higher resting tension. The differences can be explained by different functional conditions underlying both events.

Animals↗