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Biomedical subjects

M Mohiuddin

Publications and source records attributed to M Mohiuddin.

At least 145 records · Page 8Linked to original sources
PubMed1982

Combined pre- and postoperative adjuvant radiotherapy for bladder cancer.

Thirty-nine patients with invasive bladder cancer were treated using a new approach to adjuvant radiation therapy. All patients had histologic evidence of bladder muscle invasion on biopsy and were considered suitable for surgical resection. Low-dose preoperative radiation (500 rad) was delivered either on the day of or the day before cystectomy. In most instances, a radical cystectomy was performed and patients were then stratified according to pathologic stagings. Those patients with pathologically good prognostic indicators, Stage B1 low grade (I or II) disease, were followed up with no further treatment. Patients at high risk for local recurrence and pelvic lymph node involvement, Stages B1 high grade (III or IV), B2, and C, were given aggressive postoperative radiation (4,500 rad in five weeks). Patients with advanced disease, Stage D2, were given palliative therapy. All patients received the dose of preoperative radiation as planned. Preliminary results indicate that combined pre- and postoperative radiation in bladder cancer gives excellent local control of disease. A significant potential for improved long-term survival of patients has been observed.

Follow-Up Studies↗
PubMed1982

Combined pre and postoperative radiation for carcinoma of the rectum.

Since 1976, a new approach to adjuvant radiation therapy in carcinoma of the rectum has been used at Thomas Jefferson University Hospital. Seventy-eight patients with biopsy-proven invasive carcinoma of the rectum have been treated with low dose preoperative radiation, 500 rad given either on the day of or the day before surgery. Following surgery, the lesions were pathologically staged according to Astler-Coller's Modification of Duke's staging. Patients with good prognostic features (Stage A or B1) were followed with no further treatment while patients with poor prognostic characteristics (Stage B2, C1 and C2) were treated with aggressive postoperative pelvic radiation, 4500 rad delivered in five weeks. All patients entered into this study received the preoperative dose of 500 rad. Fifty-six patients underwent an A-P resection, four patients underwent a low anterior resection and ten patients had a combined abdominal transsacral resection. Eight patients were found to have liver metastasis at laparotomy and underwent a colostomy followed by palliative therapy. Twenty-nine patients were found to have early disease, Stage A or B1, and were given no further therapy. Of 41 patients with Stage B2 or C, 25 patients received the full course of postoperative radiation. Sixteen patients did not receive postoperative radiation for a variety of reasons. Follow-up in these patients ranges from six months to a maximum of 48 months with a median follow-up of 18 months. Sixty-nine of the total group of 78 patients are currently alive. Two patients with early tumor (Stage A or B1) have died of metastasis. One other patient with Stage A carcinoma died of unrelated causes. Two of the 25 patients receiving postoperative radiation developed metastatic disease, but none of the patients developed local recurrence in the pelvis. Six of 16 patients who should have received postoperative radiation, but did not recurred. Four of these six recurrences have been in the pelvis. Both the incidence of failure and the pattern of recurrence between these two groups of patients who did not receive postoperative radiation is suggestive of a better effect in the PR unrelated group. Survival of patients treated with this approach appears to be improved.

Follow-Up Studies↗
PubMed1982

Preliminary results of RTOG phase I/II study of misonidazole and radiation for bladder cancer.

Eleven patients were entered in a phase I/II study to evaluate the toxicity and effectiveness of the use of misonidazole with radiation in cancer of the bladder. The radiation fractionization used is shown in Figure 1. Misonidazole was administered in a dose of 1.5 g/m2, 4-6 hours before the radiation dose. The large radiation dose (400 rad) used with misonidazole was designed to obtain maximum enhancement of radiation sensitizer effect. Only minor misonidazole toxicity was observed. Tumor regression was dramatic, with 7/9 patients achieving complete regression of disease. Three patients however, developed severe small bowel complications, probably from the unconventional radiation fractionation used. In view of this high complication rate, this study was terminated.

Aged↗
PubMed1981

Combined pre- and postoperative adjuvant radiotherapy for bladder cancer: results of RTOG/Jefferson Study.

This paper presents the results of adjuvant "sandwich" radiotherapy for bladder cancer in 65 patients treated in a Radiation Therapy Oncology Group (RTOG) phase II study and at Thomas Jefferson University Hospital. In this approach of adjuvant therapy, patients with clinical stages B or C bladder cancer were given low dose preoperative irradiation (500 rads) to the whole pelvis on the day before or on the day of surgery. Following cystectomy, patients were pathologically staged. Those with high grade (III or IV) stage B1 tumors or stages B2 or C were given 4500 rads in five weeks postoperative radiation. Thirty-four of these 65 patients were entered in the RTOG protocol and 31 in the Jefferson Study. TWenty patients had early lesions (stage 0, A or B1, grade I-II) and did not receive postoperative irradiation. Six patients had stage D cancer and were given palliative therapy. Of 39 patients eligible for postoperative irradiation, 29 received the full course of pre- and postoperative irradiation. Ten patients did not receive treatment. Follow-up ranged from six months to three years with a median of 18 months. Treatment was extremely well tolerated. Incidence of major complications was 6% (4/65). Local control of disease was excellent, with no failures in pelvis response. Actuarial survival at three years is 78%. At this preliminary analysis, these survival results appear to be better than those obtained with other approaches using preoperative irradiation and surgery.

Clinical Trials as Topic↗
PubMed1980

Adjuvant "sandwich" radiation therapy for bladder cancer.

Preliminary results of a study using a new concept of adjuvant "sandwich" radiotherapy in bladder cancer are presented. In this approach low-dose preoperative irradiation (500 rads) is delivered prior to cystectomy, and then on the basis of histopathologic staging patients with superficial tumors (Stage A and B) are followed with no further treatment; patients with deeply invasive tumors (Stage B, Grade III or IV, B2 or C) are treated with high-dose postoperative irradiation (4,500 rads in five weeks); and patients with advanced or metastatic disease (Stage D) are treated palliatively. Eighteen patients were treated with this approach, and all patients have been followed for at least one year. Sixteen (89 per cent) are alive with no evidence of tumor. One patient died of distant metastasis, and 1 patient died of peritonitis without evidence of disease. Since recurrence is known to develop in 50 per cent of patients within the first year after treatment, the low rate of failure obtained using this approach of adjuvant "sandwich" radiotherapy with a minimum follow-up of one year appears to be promising. This approach ideally balances the risk versus benefit ratio of adjuvant therapy sparing patients with superficial tumors from unnecessary treatment while treating patients with more advanced disease aggressively.

Follow-Up Studies↗
PubMed1979

Optimum fractionation for irradiation of carcinoma of the bladder. Experiments based on one case.

A patient with multiple metastases of transitional cell carcinoma of the bladder to the skin and subcutaneous tissues proved a model where most of the biologic and host-related factors were constant. The effects of varying the physical factors of radiation dose and time were observed. The results indicate that fractionated irradiation at intervals of 48 h was more effective than at intervals of 24 h and that superfractionation (intervals of 5 h) was not an effective method for the treatment of this tumor. The possible reasons for this effect and the implication for the treatment of bladder carcinoma are discussed.

Carcinoma, Transitional Cell↗
PubMed1978

Adjuvant radiotherapy--preoperative, postoperative, or both: a proposal for a new approach.

A new approach to adjuvant radiotherapy is presented using a "sandwich technique" of low-dose preoperative irradiation (500 rads) and high-dose postoperative irradiation (4500 rads in 5 weeks) in the treatment of operable carcinomas of the rectum and bladder. The rationale for this approach and the preliminary results of a pilot study in 28 patients (19 with carcinoma of the rectum and nine with carcinoma of the bladder) are presented. This appears to be a very feasible and logical approach to treatment, with very few complications and excellent local control of disease.

Humans↗
PubMedDate not supplied

Adjuvant radiotherapy with selective sandwich technique in treatment of rectal cancer: results of a continuing study.

Sixty-two patients with carcinoma of the rectum were treated with "selective sandwich" adjuvant radiotherapy in a pilot study which began in September 1976 at Thomas Jefferson University Hospital. All patients received 500 rads preoperative irradiation on the day of or day preceding surgery. Following surgery, the lesions were staged pathologically according to Astler-Coller's modification of Dukes' staging. Patients with poor prognostic characteristics (Stages B2, C1, and C2) were treated with aggressive postoperative pelvic irradiation (4500 rads in five weeks). All 62 patients received the single preoperative dose of 500 rads. Forty-four patients underwent abdominoperineal resection, four patients, a low anterior resection, ten patients, a combined abdominotranssacral resection, and four patients found to have liver metastasis at laparotomy had colostomy followed by palliative therapy. Twenty-one patients found to have early disease (Stages A or B1) were given no further therapy. Of 37 patients with Stages B2 or C disease, 21 received postoperative irradiation. Follow-up ranged from 6 months to 36 months, with a median of 18 months. Of patients with Stage A or B1 disease, one patient has died with metastasis. Two of 21 patients receiving postoperative irradiation have developed metastatic disease; neither has failed in the pelvis. Of 16 patients who did not receive postoperative irradiation, three have had metastasis to the pelvis and two others have developed distant metastasis.

Follow-Up Studies↗