Biomedical subjects

N Willich

Publications and source records attributed to N Willich.

121 records · Page 7Linked to original sources

PubMed1983

[Simplified methods for the measurement of renal clearance. Comparison of the results of Cr51-EDTA slope clearance, iodohippurate clearance and endogenous creatinine clearance].

Endogenous creatinine clearance proved to be unreliable in comparison to the 51Cr-EDTA-slope clearance with compartment analysis (examination time 4 hours). Tauxe's method of estimation of GFR can be recommended because of nearly perfect correlation with the 51Cr-EDTA-slope clearance (r = 0.959, n = 169, p less than 0.001). Estimation of ERPF according to Tauxe showed a moderate good correlation (r = 0.843, n = 140, p less than 0.001) with Oberhausen's method of clearance calculation (shoulder detector technique).

Chromium Radioisotopes↗

PubMedDate not supplied

Fast neutron irradiation in advanced pre-irradiated head and neck tumors.

AIMS AND BACKGROUND: Radiotherapy with fast neutrons offers radiobiological advantages in the treatment of hypoxic and slowly proliferating tumors. Tumors recurring in pre-irradiated areas of the head and neck usually exhibit a low radiation sensitivity that seems to promise little success for a repeated irradiation with photons. In such a situation, radiotherapy with fast neutrons may offer an alternative treatment option. To evaluate the question, the Muenster patients were retrospectively analyzed. METHODS: During the period July 1986 to January 1994, 26 patients with local-regional recurrences of pre-irradiated head and neck tumors were treated with fast neutrons at our department. RESULTS: Median survival calculated by the Kaplan-Meier method was 7.4 months. The 1-year survival probability was 29.3% and the 2-year survival probability 5.9%. The objective tumor remission (complete + partial) was 50%. A subjective improvement of symptoms was reported by 42.3% of all patients. CONCLUSIONS: Despite relatively unfavorable survival rates produced by the therapy, good remission rates and thereby a good palliative effect can be attained with a short treatment time and tolerable side effects.

Adult↗

PubMedDate not supplied

Prostate-specific antigen (PSA) and radiotherapy in locally confined prostate cancer.

BACKGROUND: During the last years, prostate-specific antigen (PSA) has been established as the most important tumor marker for prostate cancer. The aim of our study was to evaluate the response of PSA during and after radiotherapy of prostate cancer. PATIENTS AND METHODS: From 1/95 to 6/97, 26 patients were irradiated for locally confined prostate cancer (11/26 patients primarily and 15/26 patients after radical prostatectomy). Radiation therapy was carried out with a linear accelerator with a total dose of 60 Gy to the prostate bed. PSA values were measured immediately before, weekly during radiation therapy and every three months after in the usual follow-up pattern. RESULTS: During radiotherapy, median PSA values fell and continued to fall after radiotherapy. The median PSA half-life was reached 3 months after irradiation, the PSA nadir after 15 months. 5 patients with increasing PSA levels relapsed. DISCUSSION: During and after radiotherapy, PSA kinetics are low with a median half-life of 3 months in our patient population. Rising PSA profile indicates progression of tumor.

Adenocarcinoma↗

PubMedDate not supplied

Persistent elevation of CA 19-9 levels in a patient with an extended retroperitoneal dermoid.

CA 19-9 has been established as sensitive tumor marker in a variety of malignant diseases, especially in carcinomas of the exocrine pancreas. The specificity of CA 19-9 is limited by many benign diseases causing abnormal values. A case of a patient with a retroperitoneal dermoid showing high serum levels of CA 19-9 will be described. The patient suffered from a large retroperitoneal mass (7 x 6 x 9 cm). A CT-guided fine needle biopsy of the tumor was performed and the histology was compatible with a benign dermoid. The CT-scans of the abdomen showed also the typical features of a dermoid. Tumor markers and lab counts stayed in the normal range except CA 19-9, which was constantly elevated with value between 131 and 329 U/ml. A benign or malignant disorder was excluded. An immunoscintigraphy and a SPECT with a I-131-labeled monoclonal antibody against CA 19-9 revealed the retroperitoneal mass as the source of the CA 19-9 elevation. This is the first case described in English scientific literature of a retroperitoneal dermoid (benign teratoma) as a source of a persistently elevated level of CA 19-9.

Adult↗

PubMedDate not supplied

Radiotherapy on adult patients with soft tissue sarcoma with fast neutrons or photons.

Through adjuvant photon radiotherapy, it is possible to improve tumor control as well as avoid ultra radical surgery in patients with soft tissue sarcoma. Similar results have been obtained in cases of incomplete resected G1/G2 sarcoma after applying neutron radiotherapy. We compared the results of a group of patients with soft tissue sarcoma treated with those having received photon therapy (100 patients) or neutron therapy (61 patients). The median dose in the photon treated group was 60 Gy (range 45 to 65 Gy). The neutron therapy group received a median dose of 14.1 Gy (range 5.0 to 18.57 Gy). Patients treated with mixed-beam irradiation received an average dose of 36.5 Gy photon and 8.5 Gy neutrons. The 5-year survival rate of the photon group rated 43.1%. In the neutron group we found 42.5%, respectively. In both groups the results of surgical resection and grading were of high significance according to survival. 4% of the patients belonging to the photon group developed grade III/IV WHO side effects. In the neutron group side effects grade III/IV WHO were observed in 11% of the cases. Comparing treatment results of neutron and photon therapy we demonstrated that incompletely resected G1 and G2 tumor patients show greater benefit in the case of neutron radiotherapy.

Adult↗

PubMedDate not supplied

Results of fast neutron therapy of adenoid cystic carcinoma of the salivary glands.

BACKGROUND: Adenoid cystic carcinomas (ACC) seem to have a better response to fast neutron irradiation than to photon beam therapy because of the higher relative biological effectiveness of neutron radiation. METHODS: Between 1986 and 1995, 72 patients with ACC of the salivary glands were treated in Münster with fast neutrons. The median age was 54 years. All the patients had either recurrent or macroscopic rest tumor prior to neutron therapy. The median total dose was 15.03 Gy. Median follow-up was 50 months. RESULTS: 39.1% of the patients achieved a complete remission and 48.6% a partial remission. The survival probability was 86% after one year, 73% after two years and 53% after five years. The recurrence-free survival was 83% after one year, 71% after two years and 45% after five years. CONCLUSION: Neutron beam therapy seems to have been an effective treatment in these selected patients.

Adolescent↗

PubMedDate not supplied

Prostate-specific antigen (PSA) in the monitoring of prostate cancer after radical prostatectomy and external beam radiation.

BACKGROUND: During the last few years, prostate-specific antigen (PSA) has been established as the most important tumor marker for prostate cancer. The aim of our study was to evaluate the response of PSA after surgery and radiotherapy of prostate cancer. PATIENTS AND METHODS: From 1/1995 to 9/1997, 32 patients were treated by radical prostatectomy and subsequent radiotherapy. Radiation therapy was carried out using a linear accelerator to the prostate bed, a total dose of 60 Gy was given. PSA values were measured immediately before irradiation, weekly during radiation therapy and every three months thereafter in the usual follow-up pattern. RESULTS: 21 of 32 patients had no measurable PSA after surgery. In the remaining 11 patients the median PSA half-life was reached 3 months after irradiation, the nadir after 15 months. 5 patients with increasing PSA levels suffered from a relapse (15.6%). CONCLUSIONS: We found that PSA monitoring is a useful marker for treatment outcome and that adjuvant radiotherapy after surgery improves local control as well as biochemical failure rate. If PSA is still detectable after surgery the risk for biochemical failure is significantly higher (45.5%).

Aged↗

PubMedDate not supplied

The impact of squamous cell carcinoma (SCC) antigen in the follow-up after radiotherapy in patients with cervical cancer.

The impact of Squamous cell carcinoma antigen (SCC) in the follow-up of patients with cervical cancer treated with radiotherapy was evaluated. 72 patients with a histologically proven squamous cell carcinoma of the uterine cervix were treated at the Department of Radiotherapy and Radiation Ocology, Munster, Germany. The pretherapeutic serum level of SCC was elevated in 60% of patients (cut-off-level: 2.5 ng/ml). The median serum level correlated with the tumor stage. After the end of radiation treatment, 98% of patients in complete remission and 87% of patients in partial remission had a serum level below the cut-off. In the case of recurrent disease, 71% of patients had a significant increase of SCC serum levels before clinical manifestation of relapse. The leading time ranged between one and 16 months (median: 3.1 months). In conclusion, SCC is a useful tumor marker in the follow-up of patients with squamous cell carcinoma of the uterine cervix.

Antigens, Neoplasm↗

PubMedDate not supplied

A pivoting appliance for intracavitary brachytherapy in patients with reduced mouth opening.

PURPOSE: The risks of radiotherapy to normal tissues are well known. In many cases, a tumor patient suffering a relapse cannot undergo radiotherapy a second time. One exception may be the local application of brachytherapy. Afterloading devices allow the position of radiating materials near the site for treatment exactly according to three-dimensional treatment planning. This report shows the technical procedure for the fabrication of an intracavitary afterloading radiation device. MATERIALS AND METHODS: A 48-year-old woman who had received neutron radiotherapy and tumor surgery for adenoid cystic carcinoma had to be treated for relapse. The mouth opening was limited to 15 mm. The mixing tip of a silicone impression system was used as an axis for a pivoting appliance. RESULTS: Two years after reradiation, the patient was free of relapse symptoms, although an increased limitation of mouth opening was recorded. CONCLUSION: Even if the mouth opening is severely limited after tumor surgery and/or radiation, intracavitary brachytherapy still can be performed in edentulous patients using a pivoting device.

Brachytherapy↗

PubMedDate not supplied

Alpha-fetoprotein-positive carcinoma of the pancreas: a case report.

We report on the case of a 19-year-old male with an alpha-fetoprotein (AFP)-producing acinar cell carcinoma of the pancreas. Tumour markers other than AFP were normal. Because of inoperability, a combined radiochemotherapy was initiated with a hyperfractionated dose of 44.8 Gy. Initially, the tumour showed a good response to irradiation and 5-fluorouracil (5-FU) application, and therapy showed sufficient local control. After combined radio-chemotherapy, AFP levels declined from about 3000 ng/ml (reference area: 0-7 ng/ml) to 18 ng/ml, but increased when widespread metastasis appeared. The patient died 18 months after the initial therapy due to general tumour progression. Originally, AFP was thought to be specific to hepatocellular carcinoma and germ cell tumours. Rarely has it been reported in other malignancies. Rare cases of acinar cell carcinomas of the pancreas were found to express AFP. Our patient is the youngest reported in the literature to date. When present, AFP expression is useful for diagnosis and as a marker for monitoring therapeutic response and recurrence of the disease.

Adult↗

PubMedDate not supplied

The use of prostate-specific antigen (PSA) for the monitoring of radiation therapy in prostate cancer.

BACKGROUND: The classic methods for surveilling the efficacy of radiotherapy in prostate cancer are not accurate enough. The objective of this analysis was to determine whether prostate-specific antigen could perform this task. MATERIALS AND METHODS: From 1/95 to 10/95, 16 patients were treated at our clinic. 7 of these underwent primary irradiation, 4 treatment for local recurrence, and 5 had adjuvant radiotherapy. Radiotherapy was carried out with a total dose of 60 Gy in 30 fractions, 10 fractions per week, to the prostate bed plus 2 cm safety margin. RESULTS: PSA levels usually start to decline between the 3rd and the 4th week of radiotherapy with a half-life of 2.5 months. Five patients had equal or rising PSA levels, including all three patients with recurrent tumor. DISCUSSION: In most cases, PSA declined continuously from the 3rd week of therapy. Our median half-life was similar to other reported results. Persisting or rising PSA levels are an indicator for local or distant recurrence; all our patients who developed a recurrence showed a corresponding PSA increase.

Humans↗

PubMedDate not supplied

Circadian variations of interleukin-2 receptors, serum thymidine kinase and beta-2-microglobulin in patients with non-Hodgkin's lymphoma and normal controls.

In this study we investigated whether circadian rhythms of interleukin-2 receptors (sIL-2R), serum thymidine kinase (sTK) and beta-2-microglobulin (beta 2M) are apparent, which may influence tumor marker detection. Blood was drawn every two hours over 24 hours from 6 patients with NHL, 3 healthy donors and three patients with non-hematologic disorders. The serum levels of the three markers were measured. The three normal volunteers showed circadian variations of sIL-2R, sTK and beta 2M best described by a sinusoidal curve. This rhythm could also be demonstrated in three of the six patients with NHL for all three markers. In three patients the circadian rhythm of one marker was disturbed. The three NHL-patients with consistent circadian rhythms in all three markers achieved a complete remission, whereas the patients with disturbed rhythm progressed under therapy. We showed that circadian variations of sIL-2R, sTK and beta 2M follow a sinusoidal circadian rhythm in normals and patients with NHL. Disturbance of this rhythm may be related to a worse prognosis.

Adult↗

PubMedDate not supplied

Lymphoedema of the arm after primary treatment of breast cancer.

The incidence of lymphoedema of the arm depends on the radical nature of the primary treatment-radical mastectomy modified radical mastectomy and breast-preserving operation. Adjuvant radiotherapy increased significantly the oedema rate of each operative modality. The quality of life could be improved by minimising the incidence of lymphoedema if current standards of breast-preserving surgery were generally practised.

Adult↗