Search PubMed⌕ Search

Biomedical subjects

L Eapen

Publications and source records attributed to L Eapen.

22 records · Page 2Linked to original sources

Does parasternal irradiation reduce thoracic vertebral metastases in breast cancer?

A review of 197 patients with bone metastases from breast carcinoma was undertaken to assess the effect of adjuvant parasternal irradiation on the distribution of those metastases. A total of 128 patients (Group I) received radiation. The control group consisted of 69 patients (Group II) who did not receive adjuvant radiation. The dose absorbed by the mid-thoracic vertebrae (T3 to T8) varied from 10 Gy in 3 weeks to 20 Gy in 4 weeks. The distribution of bone metastases was analyzed at the initial development in the 197 patients. Repeat assessments (X ray/scans) were available for analysis in 132 patients. Patients in Group I had less metastases from T3 to T8: 37/128 (29%), vs 30/69 (43.5%) for patients in Group II: (chi 2 = 3.62; p less than 0.10). For the 132 patients with serial assessments, the difference at last evaluation was more significant: 45/86 (52%) in Group I, vs 36/46 (78%) in Group II: (chi 2 = 7.44; p less than 0.01). The data shows that patients receiving low-dose exit beam irradiation from the parasternal field have fewer mid-thoracic bone metastases. Potential implications are discussed.

Breast Neoplasms↗

Intra-arterial cisplatin for bladder cancer.

Cisplatin (25 to 120 mg. per m.2) was injected into the internal iliac arteries of 33 patients with locally advanced bladder cancer. Of the patients 9 were inevaluable for response to the cisplatin, since they began radiotherapy to the bladder before course 2 of cisplatin as part of a preplanned therapeutic approach. One patient received the treatment as postoperative adjuvant therapy, 1 did not return for followup and 1 with metastatic disease did not undergo repeat cystoscopy. Of 21 evaluable patients 3 (14 per cent) achieved complete remission, 12 (57 per cent) achieved partial remission, 2 (14 per cent) were stable and 4 (19 per cent) failed. The response rate was higher in patients receiving 100 to 120 mg. per m.2 per course than in patients receiving lower doses (all except 1 of whom received 60 or less mg. per m.2 per course) (86 versus 64 per cent) and it was higher in patients without prior radiotherapy or chemotherapy. The response rate in patients with previously untreated invasive transitional cell carcinoma was 88 per cent. Of the 33 patients 21 were alive at last followup, with a median duration of followup of 32 weeks. Toxicity was dose-related and local neurotoxicity was excessive at cisplatin doses of 100 to 120 mg. per m.2. Diabetic patients were particularly prone to have neurotoxicity. Other toxicity generally was not severe and consisted of ototoxicity, nephrotoxicity, myelosuppression, nausea, vomiting and diarrhea. Even elderly patients and patients with cardiac disease tolerated the treatment well. We plan to proceed with further intra-arterial cisplatin studies in which all patients except those more than 80 years old will be treated with an intra-arterial cisplatin dose of 90 mg. per m.2 per course combined with radiotherapy with or without cystectomy.

Adult↗

Homogeneous irradiation of the "short-necked" laryngeal cancer patient.

A technique for homogeneous irradiation of the "short-necked" laryngeal cancer patient is presented. The method is similar to a previously described technique in that inferiorly angled opposed lateral beams are used with tissue compensators and beam wedges. The advantages of the technique presented here are that the patient is treated supine rather than sitting and therapy simulation is more easily carried out. Experimental verification of the calculated radiation distributions was carried out in a water phantom having the same shape as the patient. These results show the extent of dose homogeneity and in addition show that neglecting tissue inhomogeneity, the measured and calculated dose distributions agree within 2%.

Glottis↗