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Biomedical subjects

P Rubin

Publications and source records attributed to P Rubin.

At least 325 records · Page 18Linked to original sources
PubMed1977

Adenosquamous carcinoma of the endometrium. An entity with an inherent poor prognosis?

Mixed adenosquamous carcinoma of the endometrium have been reported in recent years to have a steady increase in incidence, extreme aggressiveness, poor responses to radiation therapy, and a low five-year survival (less than 20%). In the present report, 87 mixed carcinoma (MC) are compared with 260 pure adenocarcinomas (AC) and 29 adenoacanthomas (AA). There were no basic differences in incidence, clinical history, responses to radiation therapy, and prognosis for any of these three entities. Adenocarcinomas of the endometrium with and without squamous elements should be regarded and approached as any pure AC. There is an overall tendency for endometrial carcinomas to be at an early stage at diagnosis and the five-year survival regardless of pathologic type, stage, grade, myometrial invasion, and therapy is 80%.

Adenocarcinoma↗
PubMed1977

Therapeutic acupuncture: a selective review.

The use and effectiveness of acupuncture has become a major controversy. The limited data on the subject and the wide variety of methods referred to as "therapeutic acupuncture" have added to the confusion. Among physicians who use acupuncture as one modality of treatment, there exist many opinions regarding the definition of an acupuncture point, the usefulness of the concepts of traditional acupuncture, the methods of stimulating the acupuncture points, the selection of points used, and the optimal frequency and number of treatments. This review analyzes some of the studies published in English language journals pertaining to these controversies. The possible effects of acupuncture in releasing endorphins and stimulating the autonomic nervous system are discussed. The differences in methods must be identified and resolved before an accurate assessment of "acupuncture" can be made.

Acupuncture Therapy↗
PubMed1976

Predictors of radiation response in lung cancer. A clinico-pathobiological analysis.

From February 1972 to July 1975, 200 lung cancer patients were seen at the University of Rochester Cancer Center's Division of Radiation Oncology; 40% had squamous cell tumors and 87.5% had advanced disease localized to the thorax. Of the 160 patients who completed treatment, 101 were treated with continuous therapy schedules, and 59 were treated with split-course schedules, and 59 were treated with split-course schedules; 40 patients did not complete treatment because of early metastatic disease or death. Radiation therapy was very effective in local tumor ablation. To assess local tumor response, doubling times were obtained in measurable lesions prior to treatment. The doubling times (DT) were 25 days for small cell cancers and 192 days for adenocarcinoma. More than 50% tumor shadow regression was a good prognosticator of local tumor response; this increased as the mean DT decreased. The order of kinetic increase in tumor ablation per histology was the opposite of the one-year survival results because of the metastatic spread patterns of the different tumors. Survival rates in lung cancer emerge as simplistic and inadequate to explain local radiation effectiveness. Survival is conditioned by stage, histology, and modality of treatment, total dose delivered, and local tumor response. Although the most effective treatment dose seems to be over 6000 rads, the most efficient schedules were split-course delivering lower tumor doses. This modality of treatment is proposed as the optimal schedule to be combined with other forms of therapy with the goal of achieving better survival.

Adenocarcinoma↗
PubMed1976

Patterns of failure in intracranial astrocytomas after irradiation: analysis of dose and field factors.

The choice of tumor dose and treatment volume are the two most important radiation factors influencing survival in glioblastomas. Patients treated to their whole brain survive longer than those treated with limited fields. Glioblastomas treated with over 5,000 rads (1,300 rets) survive longer than those treated with smaller doses. Other factors affecting survival are: the pathological grade; age at diagnosis; and surgical treatment performed. Failure patterns in glioblastomas represent intrinsic qualities of the tumor, the host, and the treatment employed. They dictate the strategy to follow. Perhaps some of these are unaffected by irradiation. An increase in dose and the extension of fields in glioblastomas have produced a gain in both the quantity and the quality of survival. The whole brain is treated (5,000-6,000 rads) and the target volume is boosted to 7,000 to 8,000 rads. Grade II astrocytomas perhaps should be treated with whole brain irradiation (4,500 rads) and a boost to the target volume of an additional 1,000 rads.

Adolescent↗
PubMed1975

Improved survival of patients with intracranial ependymomas by irradiation: doseselection and field extension.

Intracranial ependymomas, treated with postoperative irradiation, have a 50% 5-year survival. Although this rate is good, the issue remains whether the quantity and qualityof survival can be improved by the proper selection of treatment factors, i.e. field size and dose-time relationship. Factors influencing survival and the effect of doseand field selection are considered in 28 intracranial ependymomas. Nineteen spinal primaries are also presented for comparison. Only 10% of the patients treated with dosesbelow 1350 rets are alive, vs. 56% of the patients treated with higher doses. Only21% of the patients treated with partial brain irradiation survived, vs. 57% of those treated with whole brain irradiation. Although an apparent 5-year survival difference was found for the low-grade (63%) vs. high grade (13%) tumors, high-dose whole brain irradiation had a significant effect only on the survival of thehigh-grade tumors. Local recurrences accounted for the majority of theraputic failures. Ten consecutive patients were treated with elctive craniospinal irradiation and exhibited a 3-year survival of 70%, vs. 35% in those treated conventionally to the brain only. Elective craniospinal irradiation, advocated for the high-grade, particularly infratentorial, ependymomas, has currently yieldedhigher survival, lower recurrences, good tolerance, no complications, and excellent quality of survival. Further documentation of this treatment approach is suggested.

Adolescent↗
PubMed1975

Uterine sarcoma.

Thirty-four cases of uterine sarcoma were studied with regard to their pathologic characteristics and response to treatment. Pathologic features did not always correlate with subsequent course. Combined therapy seems to enhance two-year survival in endometrial stromal sarcoma (ESS), although some patients may have low-grade tumors and hence represent a more favorable group. Adjuvant irradiation may improve local control rates in some mixed mesodermal sarcomas (MMS), but does not add appreciably to survival. It is of doubtful benefit in the leiomyosarcoma (LMS) group. When irradiation is employed, preoperative therapy is preferred except in the highly malignant mixed mesodermal sarcomas where prompt surgery seems indicated first. Supplemental brachytherapy may also be employed.

Adult↗
PubMed1975

Preoperative irradiation in renal cancer. Evaluation of radiation treatment plans.

1. Analysis of radiation treatment plans of a preoperative irradiation study of the kidney indicates that the primary cancer has been treated to levels of 4,500 rads plus or minus 10 per cent in 90 per cent of the instances. 2. The major problem, from the point of view of the radiation therapist's treatment planning, is the delivery of adequate doses to the regional nodal volume. Only 25 per cent received the prescribed dose. Special booster fields are required. 3. Surgical resection of regional lymph nodes and renal vein thrombus, if present, is recommended, since the deliverance of full radiation doses is not likely without exceeding tolerance of vital normal tissues.

Humans↗