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Biomedical subjects

M J Wizenberg

Publications and source records attributed to M J Wizenberg.

At least 19 recordsLinked to original sources
PubMed1985

A therapeutic approach to primary adenocarcinoma of the cervix.

Retrospective study of 97 patients with primary adenocarcinoma of the uterine cervix was undertaken to evaluate the efficacy of two treatment methods, radiation alone and radiation plus surgery. Of 31 Stage I patients, 16 were treated with radiation alone and 15 with combined radiation plus surgery. There was no difference in 5-year disease-free survival of Stage I patients treated by either method. Of 44 Stage II patients, 30 were treated with radiation alone with 54% survival rate; while 14 were treated with a combined approach, with 86% survival rate. It is apparent from the results of this study that surgery in conjunction with radiation showed a significant improved survival rate from 54% to 86% in Stage II disease. Factors influencing the prognosis appear to be tumor volume, uterine size, and tumor grade. Furthermore, these data suggest that early primary adenocarcinoma of the cervix (Stage I, lesion smaller than 4 cm) can be treated effectively by radiation alone or radical hysterectomy with comparable results. Tumors larger than 4 cm, Stage II or beyond disease, uterine enlargement, a high-grade tumor or barrel-shaped lesion, would necessitate a combined therapy to improve the cure rate.

Adenocarcinoma↗
PubMed1984

Radiation management of carcinoma of the tonsillar region.

This is a retrospective analysis of 185 patients with squamous cell carcinoma of the tonsillar region treated at the Department of Radiation Oncology, University of Maryland Hospital from 1956 to 1977. All patients were treated by one of the following: (1) external beam therapy alone; or (2) combined external beam and interstitial brachytherapy. Five-year disease-free survivals, for early Stages (I and II), are 100% and 73%, comparable to the other series published in the literature. However, in advanced Stages III and IV, survival data showed 52% and 21%, respectively, 5-year disease-free survival better than any other reports. It is thought that the special interest of the authors in interstitial brachytherapy and a well-integrated plan of external beam and brachytherapy is responsible for this success. The local control rate for T1, T2, T3, and T4 was 94%, 88%, 62%, and 19%, respectively, with the overall regional control rate of 83%. The prognostic factors appear to be related to the T-factor, N-factor, radiation dose, and method of treatment given, and the degree of tongue involvement. The detailed analysis of survivals and failures in the light of dosimetric study is presented along with some example cases of interstitial brachytherapy.

Adult↗
PubMed1981

Prospects of computed tomography in radiation therapy.

Computerized tomography has become an essential element in the staging of tumors and in the localization of the tumor and neighboring normal tissues for treatment planning. It offers the potential for more accurate delivery of higher doses with improved therapeutic ratio, for the identification of and correction for tissue inhomogeneities, and for three-dimensional treatment planning. For treatment planning purposes only minor changes are required in the current generation of scanners. Possibilities for the future include dynamic radiation treatment, combined CT scanners, simulators, and treatment planning computers, and a potential for significant cost saving through improvements in the results of cancer therapy.

Cost-Benefit Analysis↗
PubMed1979

Carcinoma of the breast.

In the present stage of our knowledge, it is evident that radiation therapy as a primry form of potentially curable treatment is a valid alternative to radical surgical extirpation. It offers women with early carcinoma of the breast the opportunity to avoid a serious cosmetic, functional and psychologic problem with no increased risk in terms of survival or local control of the neoplasm. The physician faced with such a patient need no longer believe that the woman who refuses mastectomy is automatically electing some inferior course. It is hoped that the demands of the modern American woman will force an appropriate clinical trial to define and evaluate fully the role of radiation therapy as definitive treatment in carcinoma of the breast. Until that occurs, we can do no less than knowledgeably assist patients un making their therapeutic decisions.

Breast Neoplasms↗
PubMed1978

Radiation treatment of primary carcinoma of the female urethra.

Because of the rarity of the primary carcinoma of the female urethra, there has been limited experience of individual institutions in management of this disease. Treatment by radiation alone required radium implant skill in early cases and individualized consideration for integrating external and internal irradiation in more advanced cases. From 1961 to 1975 a total of 16 women with histologically verified primary urethral carcinoma were given radiation treatment at the University of Maryland Hospital. Six of 16 patients were primarily treated for palliation only and 10 were receiving curative radiation treatment. The results show an excellent local control in anterior urethral disease (3/3), entire urethral disease (2/3) and urethral disease with involvement of vulva and/or vagina (3/3). Bladder neck, parametrial, inguinal lymph node, or paraortic involvement represents a poor prognosis and failure is close to 100%. Eight of 10 patients who were treated with aggressive radium alone or combination of external irradiation and interstitial therapy show complete control of disease (80%). Total dosage between 5500 to 6500 rad appears to be adequate to control the disease. Palliative treatment by irradiation alone can only offer a short term symptom-free result, and should be considered as an occasional alternative modality of choice.

Adenocarcinoma↗
PubMed1977

Radiation management of primary carcinoma of the vagina.

This 15-year retrospective study includes 71 patients with diagnosis of primary carcinoma of the vagina treated at the University of Maryland Hospital, Radiation Therapy section from 1957 to 1970. The lesions were staged according to the system advocated by International Federation of Gynecology and Obstetrics (FIGO) with a minor modification (Perez et al.11). With the exception of Stage O, histologic diagnosis was 94% (60/64) invasive squamous cell carcinoma and 6.0% (4/64) adenocarcinoma. Of 71 cases who are eligible for a minimum five-year follow-up, the absolute five-year cure rate for various clinical stages is as follows: Stage O 100% (7/7), Stage 1 83.2% (5/6), Stage 11A 65% (13/20), Stage 11B 63.5% (7/11), Stage 111 40% (8/20), Stage IV 0% (0/7). The overall absolute five-year cure-rate for all stages combined was 56.3% (40/71). A comparable result and even better in some stages (II and III) as compared to several previous reports are thought to be due to the proper intergrated irradiation combining interstitial and intracavitary radium with external super-voltage beam. Furthermore, an aggressive radium implant to the vagina, paracolpium, and specifically to parametrium and pelvic wall in Stage II and III appears to be one of the keys to our good results. The technique of treatment, stage by stage, are being fully discussed along with a few complications and failures.

Adenocarcinoma↗
PubMed1977

Pre-cystectomy radiation for carcinoma of the bladder: 17-year experience.

Our experience with pre-cystectomy radiation for carcinoma of the bladder from July 1959 through June 1976 is presented. Pre-cystectomy radiation would appear to be beneficial in the management of patients with invasive bladder cancer. There is an impressive improvement in survival rates in those patients demonstrating reduction in staging after radiation. Our experience correlates well with other comparative series. Based on this 17-year experience guide lines are outlines for the subsequent management of patients with bladder cancer.

Adult↗
PubMed1975

Treatment of primary adenocarcinoma of the cervix.

Between 1956 and 1971, a total of 74 cases of adenocarcinoma of the cervix was treatedin the Division of Radiation Therapy of the University of Maryland Hospital. Radical radiation therapy was followed by routine surgery early in the study;after 1967, surgery was used only for radiation failure. The likelihood of local control and 5-year survival was not improved by the routine addition of surgery to radical radiation, although the incidence of serious complications was markedly elevated. The results of treatment of adenocarcinoma of the cervix by radiation therapy alone are not significantly different from those achieved with squamous cell carcinoma. Surgery should be used as a salvage procedure in case of failure, rather than on a routine basis.

Adenocarcinoma↗