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Biomedical subjects

L L Doss

Publications and source records attributed to L L Doss.

At least 19 recordsLinked to original sources
PubMed1986

A 192Ir nomogram system for single plane implants.

Nomograms for square planar arrays spanning the range from 3 X 3 cm to 10 X 10 cm were developed. The nomograms are intended to be used for pretreatment planning of implant geometry, so that the therapist may enter the operating room with a plan for the optimal implant in mind. We show that clinically useful implants are those in which the reference isodoses are fully coupled. Decoupling occurs when ribbon spacing exceeds approximately 1.2 cm and leads to undesirable "cold spots" within the treatment volume. Ribbon spacing of 1.0 cm is recommended. This represents a trade-off between adequate ribbon coupling and minimum tissue damage from trocar placement. For clinically useful arrays, the area enclosed by the reference isodose contour (85% of the maximum dose rate) is approximately 50% of the array area. Reference isodose contour and its enclosed area are independent of seed strength for a given array, as long as all seeds within the array are of equal strength.

Brachytherapy↗
PubMed1984

Carcinosarcoma of the uterus: a 40-year experience from the state of Missouri.

Uterine carcinosarcoma is a rare and rapidly fatal malignancy. The records of 49 patients with carcinosarcoma were studied; from these studies emerged a symptom complex of vaginal bleeding and abdominal or pelvic pain. Eleven patients had been previously irradiated at an average of 16.4 years before they developed uterine carcinosarcoma. Celiotomies revealed more extensive tumor than could be determined by pelvic examination under anesthesia. The majority of the patients died from local recurrence in the pelvis rather than from distant metastases. The overall 5-year survival was 6%. Celiotomies are recommended to stage carcinosarcomas and guide treatment decisions.

Adult↗
PubMed1983

The Syed-Neblett interstitial template in locally advanced gynecological malignancies.

Twenty-eight patients with locally advanced malignancies of the cervix and vagina were treated with a combination of external radiation therapy and afterloading Syed-Neblett iridium template. There were 22 patients with squamous cell cancer and two patients with adenocarcinomas of the cervix. Four patients with squamous cell cancer of the vagina were treated with this method. Only patients with locally advanced disease (cervical lesion greater than 4 cm in diameter) and poor vaginal anatomy were selected for this modality of therapy. In our series the incidence of distant failures of 39% seems to confirm the significance of local volume of disease as a prognostic indicator; despite a local control rate of 59%, only 33% of our patients are alive from 25-51 months. Complications occurred in 12 patients (42%). Six patients (22%) developed severe rectal stricture or rectovaginal fistula necessitating diverting sigmoid colostomy; five patients (18%) developed hemorrhagic proctitis with diarrhea and tenesmus; one patient developed vaginal vault necrosis. Complications occurred 7 to 24 months following therapy. Six of the 12 patients developing complications are dead of disease. On the basis of this study and because of the low cure rate and high incidence of complications, the value of the Syed-Neblett template in locally advanced gynecologic malignancies should be reconsidered.

Adenocarcinoma↗
PubMed1982

The radioresponsiveness of melanoma.

The variability of malignant melanoma in its response to irradiation is well documented. Recent radiobiological studies suggest that high individual dose and low total fraction regimens will enhance the responsiveness of this tumor to irradiation. The experience of the Ellis Fischel State Cancer Hospital and the Cancer Research Center, Columbia, Missouri was reviewed with particular attention to such radiotherapeutic regimens. Of 41 lesions in 27 patients, the overall response rate to irradiation was 37%. When regimens using more than 400 cGy per fraction were analyzed, a 67% response rate was noted. Complete response and small volume of tumor correlated significantly (p = 0.008) with long-term survival.

Female↗
PubMed1981

Pseudo-obstruction of the colon during pelvic radiotherapy.

Pseudo-obstruction of the colon, or Ogilvie's syndrome, is characterized by an adynamic, dilated, unobstructed colon, the exact cause of which remains obscure. Although several precipitating factors have been described in the literature, we have observed three patients whose pseudo-obstruction of the colon occurred during interstitial and intracavitary pelvic irradiation. Such a cause has not been noted previously. Pseudo-obstruction of the colon can have serious consequences if it is not recognized early and treated vigorously.

Aged↗
PubMed1981

Inflammatory carcinoma of the breast: therapeutic perspective.

The management of inflammatory carcinoma of the breast remains a therapeutic dilemma because of two basic conceptual problems: local control and systemic micrometastatic disease. Appropriate management requires a multidisciplinary approach involving radiation therapy, surgery, and medical oncology.

Antineoplastic Agents↗
PubMed1979

The influence of location of the crossing needle on dose distributions from planar implants.

Three typical planar radium implants with one uncrossed end were investigated for optimization of the crossing needle location. Isodose distributions in a plane 0.5 cm from the plane of the implant were calculated and the sizes and shapes of the areas receiving at least 85% of the maximum dose were evaluated. The merits of each implant geometry are discussed along with certain clinical considerations. As a refinement to the Paterson-Parker rules of geometry, it was found that an optimum distribution is achieved when the crossing needle is located near the physical ends of the parallel needles.

Brachytherapy↗
PubMed1978

Simultaneous extramedullary plasmacytomas of the vagina and vulva: a case report and review of the literature.

An unusual case of simultaneous plasmacytomas of the vagina and vulva is presented along with a review of the literature on urogenital extramedullary plasmacytoma. The diagnosis in this case was obtained by vaginal cytological smear and later confirmed by histological examination of tumor biopsies. Of the four previously reported cases of malignant plasmacytoma of the vagina, one recurred locally and none was associated with metastases. In the case presented, local recurrence as well as multiple osseous metastases occurred.

Adult↗