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Biomedical subjects

R A Abrams

Publications and source records attributed to R A Abrams.

At least 55 records · Page 3Linked to original sources
PubMed1997

Pancreaticoduodenectomy for pancreatic adenocarcinoma: postoperative adjuvant chemoradiation improves survival. A prospective, single-institution experience.

OBJECTIVE: This study was designed to evaluate prospectively survival after pancreaticoduodenectomy for pancreatic adenocarcinoma, comparing two different postoperative adjuvant chemoradiation protocol to those of no adjuvant therapy. SUMMARY BACKGROUND DATA: Based on limited data from the Gastrointestinal Tumor Study Group, adjuvant chemoradiation therapy has been recommended after pancreaticoduodenectomy for adenocarcinoma of the head, neck, or uncinate process of the pancrease. However, many patients continue to receive no such therapy. METHODS: From October 1991 through September 1995, all patients with resected, pathologically confirmed adenocarcinoma of the head, neck, or uncinate process of the pancreas were reviewed by a multidisciplinary group (surgery, radiation oncology, medical oncology, and pathology) and were offered three options for postoperative treatment after pancreaticoduodenectomy: 1) standard therapy: external beam radiation therapy to the pancreatic bed (4000-4500 cGy) given with two 3-day fluorouracil (5-FU) courses and followed by weekly bolus 5-FU (500 mg/m2 per day) for 4 months; 2) intensive therapy: external beam radiation therapy to the pancreatic bed (5040-5760 cGy) with prophylactic hepatic irradiation (2340-2700 cGy) given with and followed by infusional 5-FU (200 mg/m2 per day) plus leucovorin (5 mg/m2 per day) for 5 of 7 days for 4 months; or 3) no therapy: no postoperative radiation therapy or chemotherapy. RESULTS: Pancreaticoduodenectomy was performed in 174 patients, with 1 in-hospital death (0.6%). Ninety-nine patients elected standard therapy, 21 elected intensive therapy, and 53 patients declined therapy. The three groups were comparable with respect to race, gender, intraoperative blood loss, tumor differentiation, lymph node status, tumor diameter, and resection margin status. Univariate analyses indicated that tumor diameter < 3 cm, intraoperative blood loss < 700 mL, absence of intraoperative blood transfusions, and use of adjuvant chemoradiation therapy were associated with significantly longer survival (p < 0.05). By Cox proportional hazards survival analysis, the most powerful predictors of outcome were tumor diameter, intraoperative blood loss, status of resection margins, and use of postoperative adjuvant therapy. The use of postoperative adjuvant chemoradiation therapy was a predictor of improved survival (median survival, 19.5 months compared to 13.5 months without therapy; p = 0.003). The intensive therapy group had no survival advantage when compared to that of the standard therapy group (median survival, 17.5 months vs. 21 months, p = not significant). CONCLUSIONS: Adjuvant chemoradiation therapy significantly improves survival after pancreaticoduodenectomy for adenocarcinoma of the head, neck, or uncinate process of the pancreas. Based on these survival data, standard adjuvant chemoradiation therapy appears to be indicated for patients treated by pancreaticoduodenectomy for adenocarcinoma of the head, neck, or uncinate process of the pancreas. Intensive therapy conferred no survival advantage over standard therapy in this analysis.

Adenocarcinoma↗
PubMed1997

Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes.

OBJECTIVE: The authors reviewed the pathology, complications, and outcomes in a consecutive group of 650 patients undergoing pancreaticoduodenectomy in the 1990s. SUMMARY BACKGROUND DATA: Pancreaticoduodenectomy has been used increasingly in recent years to resect a variety of malignant and benign diseases of the pancreas and periampullary region. METHODS: Between January 1990 and July 1996, inclusive, 650 patients underwent pancreaticoduodenal resection at The Johns Hopkins Hospital. Data were recorded prospectively on all patients. All pathology specimens were reviewed and categorized. Statistical analyses were performed using both univariate and multivariate models. RESULTS: The patients had a mean age of 63 +/- 12.8 years, with 54% male and 91% white. The number of resections per year rose from 60 in 1990 to 161 in 1995. Pathologic examination results showed pancreatic cancer (n = 282; 43%), ampullary cancer (n = 70; 11%), distal common bile duct cancer (n = 65; 10%), duodenal cancer (n = 26; 4%), chronic pancreatitis (n = 71; 11%), neuroendocrine tumor (n = 31; 5%), periampullary adenoma (n = 21; 3%), cystadenocarcinoma (n = 14; 2%), cystadenoma (n = 25; 4%), and other (n = 45; 7%). The surgical procedure involved pylorus preservation in 82%, partial pancreatectomy in 95%, and portal or superior mesenteric venous resection in 4%. Pancreatic-enteric reconstruction, when appropriate, was via pancreaticojejunostomy in 71% and pancreaticogastrostomy in 29%. The median intraoperative blood loss was 625 mL, median units of red cells transfused was zero, and the median operative time was 7 hours. During this period, 190 consecutive pancreaticoduodenectomies were performed without a mortality. Nine deaths occurred in-hospital or within 30 days of operation (1.4% operative mortality). The postoperative complication rate was 41%, with the most common complications being early delayed gastric emptying (19%), pancreatic fistula (14%), and wound infection (10%). Twenty-three patients required reoperation in the immediate postoperative period (3.5%), most commonly for bleeding, abscess, or dehiscence. The median postoperative length of stay was 13 days. A multivariate analysis of the 443 patients with periampullary adenocarcinoma indicated that the most powerful independent predictors favoring long-term survival included a pathologic diagnosis of duodenal adenocarcinoma, tumor diameter <3 cm, negative resection margins, absence of lymph node metastases, well-differentiated histology, and no reoperation. CONCLUSIONS: This single institution, high-volume experience indicates that pancreaticoduodenectomy can be performed safely for a variety of malignant and benign disorders of the pancreas and periampullary region. Overall survival is determined largely by the pathology within the resection specimen.

Adenocarcinoma↗
PubMed1997

Hodgkin and non-Hodgkin lymphoma: local-regional radiation therapy after bone marrow transplantation.

PURPOSE: To assess the acute toxicity and therapeutic effect of local-regional radiation therapy after bone marrow transplantation performed for lymphoma in resistant relapse. MATERIALS AND METHODS: Twenty-one patients with Hodgkin (n = 12) or non-Hodgkin lymphoma (n = 9) underwent local-regional radiation therapy after bone marrow transplantation. Posttransplantation radiation was delivered to the dominant site of pretransplantation disease. Three patients with Hodgkin lymphoma and four with non-Hodgkin lymphoma underwent radiation therapy for posttransplantation recurrence. Total body irradiation was used in 10 patients. Mean radiation dose was lower in patients who underwent total body irradiation than in those who did not (P = .05). RESULTS: Nineteen of 21 patients completed local-regional therapy. Nonhematologic toxicity was mild in 20 patients. Hematologic toxicity was severe in five patients, four of whom began radiation therapy with low platelet counts. In-field disease progression occurred in six of 15 patients with relapse, including four with disease progression at the start of radiation therapy. Median progression-free survival was 12 months in patients with Hodgkin lymphoma and 1 month in patients with non-Hodgkin lymphoma. CONCLUSION: Posttransplantation local-regional radiation therapy can be safely administered in patients with lymphoma. Severe hematologic toxicity is a concern, however, in patients with low platelet counts.

Adolescent↗
PubMed1996

Early evaluation of abdominal/hepatic irradiation and 5-fluorouracil/leucovorin infusion after pancreaticoduodenectomy.

PURPOSE: To describe the toxicities of a combined modality adjuvant regimen for patients with resectable periampullary adenocarcinoma. METHODS AND MATERIALS: Fourteen patients with surgically resected periampullary adenocarcinoma were treated with adjuvant therapy consisting of prophylactic hepatic irradiation and pancreatic bed irradiation and concurrent infusional 5-fluorouracil and leucovorin (5-FU/LV). Starting within 60 days of surgery, patients received radiation treatments of 1.8 Gy per fraction to the liver and pancreatic bed (13 fractions), followed by 1.8 Gy per fraction to the pancreatic region (15 fractions). All radiation treatments were given with infusional 5-FU (200 mg/m2/day) and leucovorin (5 mg/m2/day) for 5 out of every 7 days during the 38-day treatment sequence. After a 1-month break, patients were scheduled to receive four cycles of infusional 5-FU/LV (2 weeks on/2 weeks off). RESULTS: All 14 patients completed the initial combination treatment. Toxicities were tolerable; three patients had Grade 3/4 toxicities that were primarily gastrointestinal in nature. Six patients required hospitalization during therapy for treatment-related toxicities. Two patients required radiation treatment breaks of less than 1 week, and two others had radiation held for 2-4 weeks. Three patients required chemotherapy dose reductions secondary to toxicities. Toxicities in the subsequent chemotherapy-alone cycles were few and primarily manifested by Grade 2 rises in liver injury tests. Higher toxicity grades were associated with tumor progression. Twelve patients have developed recurrent disease with an equal number of recurrences occurring in the pancreatic bed as in the liver over the 12-month median follow-up. Median survival for this cohort is 417 days, not significantly different from previously reported adjuvant trials in this patient population. CONCLUSION: These data indicate that adjuvant therapy with concomitant large-field radiation and infusional chemotherapy is feasible and associated with mangeable toxicities in patients undergoing pancreaticoduodenectomy for periampullary adenocarcinoma. Improvement in survival over other adjuvant regimens has not thus far been observed. Modification of this strategy may be required.

Adenocarcinoma↗
PubMed1996

Spatially diffuse inhibition affects multiple locations: a reply to Tipper, Weaver, and Watson (1996).

S. Tipper, B. Weaver, and F. Watson (1996) suggest that J. Pratt and R.A. Abrams's (1995) failure to find inhibition of return for more than the most recently cued location was because their 2-target display did not adequately capture some of the complexity of real-world visual environments. However, Tipper et al. tested a special case because they always cued 3 out of 4 potential targets (allowing cued and uncued locations to be segregated into 2 spatial regions). The authors show that only the 1 most recently cued location will be inhibited when 2 nonadjacent targets out of 4 possible targets are cued, but both cued locations will be inhibited when they are adjacent. Also, only the 1 most recently cued location was inhibited when 3 nonadjacent targets out of 6 potential target locations were cued. Thus, in a complex environment in which several cued locations are interspersed among noncued locations, inhibition of return will occur for only the 1 most recently attended location, consistent with conclusions of Pratt and Abrams.

Adult↗
PubMed1996

Pancreaticoduodenectomy. Does it have a role in the palliation of pancreatic cancer?

OBJECTIVE: The authors define the role of palliative pancreaticoduodenectomy in patients with pancreatic carcinoma. BACKGROUND: Decreases in perioperative morbidity and mortality and improved long-term survival associated with pancreaticoduodenectomy for patients with pancreatic carcinoma have clearly established a role for this operation when performed with curative intent. However, most surgeons remain hesitant to perform pancreaticoduodenectomy unless surgical margins are widely clear, choosing rather to perform palliative biliary and gastric bypass. METHODS: A single-institution retrospective review was performed comparing the outcome of 64 consecutive patients undergoing pancreaticoduodenectomy for pancreatic carcinoma with gross or microscopic evidence of adenocarcinoma at the surgical resection margins, and 62 consecutive patients found to be unresectable at the time of laparotomy because of local invasion without evidence of metastatic disease (stage III). Combined biliary and gastric bypass were performed in 87% of patients not resected. RESULTS: The two groups were similar with respect to age, gender, race, and presenting symptoms. The hospital mortality rate was identical in both groups (1.6%). Fifty-eight percent of patients undergoing pancreaticoduodenectomy had an uncomplicated postoperative course compared with 68% of patients undergoing palliative bypass (not significant). The length of postoperative hospital stay after pancreaticoduodenectomy was 18.4 days, which was significantly longer (p < 0.05) than for patients undergoing palliative bypass (15.0 days). The overall actuarial survival (Kaplan-Meier) was improved significantly in patients undergoing pancreaticoduodenectomy (p < 0.02). Postoperative chemotherapy and radiation therapy improved survival in both groups. CONCLUSIONS: Pancreaticoduodenectomy can be performed with a similar perioperative morbidity and mortality and only a minimal increase in hospital stay when compared with traditional surgical palliation. Pancreaticoduodenectomy with postoperative chemotherapy and radiation therapy is associated with improved long-term survival when compared with patients treated with surgical bypass. These data support the role of palliative pancreaticoduodenectomy in patients with pancreatic carcinoma and with local residual disease.

Adenocarcinoma↗
PubMed1996

Cholangiocarcinoma. A spectrum of intrahepatic, perihilar, and distal tumors.

OBJECTIVE: The objective of this article is to introduce a simple method for classifying cholangiocarcinomas and to apply this system to analyze a large number of patients from a single institution. SUMMARY BACKGROUND DATA: For the past 2 decades, most western reports on cholangiocarcinoma have separated intrahepatic from extrahepatic tumors and have subclassified this latter group into proximal, middle, and distal subgroups. However, "middle" lesions are uncommon and are managed most often either with hilar resection or with pancreatoduodenectomy. The spectrum of cholangiocarcinoma, therefore, is best classified into three broad groups: 1) intrahepatic, 2) perihilar, and 3) distal tumors. These categories correlate with anatomic distribution and imply preferred treatment. METHODS: The records of all patients with histologically confirmed cholangiocarcinoma who underwent surgical exploration at The Johns Hopkins Hospital over a 23-year period were reviewed. RESULTS: Of 294 patients with cholangiocarcinoma, 18 (6%) had intrahepatic, 196 (67%) had perihilar, and 80 (27%) had distal tumors. Age, gender, race, and associated diseases were similar among the three groups. Patients with intrahepatic tumors, by definition, were less likely (p < 0.01) to be jaundiced and more likely (p < 0.05) to present with abdominal pain. The resectability rate increased with a more distal location (50% vs. 56% vs. 91%), and resection improved survival at each site. Five-year survival rates for resected intrahepatic, perihilar, and distal tumors were 44%, 11%, and 28%, and median survival rates were 26, 19, and 22 months, respectively. Postoperative radiation therapy did not improve survival. In a multivariate analysis resection (p < 0.001. hazard ratio 2.80), negative microscopic margins (p < 0.01, hazard ratio 1.79), preoperative serum albumin (p < 0.04, hazard ratio 0.82), and postoperative sepsis (p < 0.001, hard ratio 0.27) were the best predictors of outcome. CONCLUSIONS: Cholangiocarcinoma is best classified into three broad categories. Resection remains the primary treatment, whereas postoperative adjuvant radiation has no influence on survival. Therefore, new agents or strategies to deliver adjuvant therapy are needed to improve survival.

Bile Duct Neoplasms↗
PubMed1996

Lengthening the terminal portion of a tendon.

In the operative reattachment of an avulsed or lacerated tendon, additional tendon length is occasionally needed to reach the proposed reinsertion site. This is encountered when there is loss of distal tendon substance or when muscle shortening and tendon retraction has occurred. The following describes a technique of lengthening the terminal portion of the tendon to facilitate reattachment.

Humans↗
PubMed1996

The gap effect for eye and hand movements.

A temporal gap between fixation point offset and stimulus onset typically yields shorter saccadic latencies to the stimulus than if the fixation stimulus remained on. Several researchers have explored the extent to which this gap also reduces latencies of other responses but have failed to find a gap effect isolated from general warning effects. Experiment 1, however, showed a robust gap effect for aimed hand movements (which required determination of a precise spatial location), regardless of whether the hand moved alone or was accompanied by a saccadic eye movement. Experiment 2 replicated this aimed hand gap effect and also showed a smaller effect for choice manual keypress responses (which required determination of the direction of response only). Experiment 3 showed no gap effect for simple manual keypress responses (which required no spatial determination). The results are consistent with an interpretation of the gap effect in terms of facilitation of spatially oriented responses.

Acoustic Stimulation↗
PubMed1996

Ischemic contracture of the foot and ankle: principles of management and prevention.

A variety of clinical presentations can be encountered following compartment syndrome of the leg and foot. Deformity and functional impairment in the foot and ankle secondary to ischemia are determined by: 1) which leg compartments have been affected and to what degree extrinsic flexor or extensor "overpull" is exhibited, 2) degree of nerve injury sustained causing weakness or paralysis of extrinsic or intrinsic foot and ankle muscles, 3) which foot compartments have been affected and to what degree intrinsic "overpull" is exhibited, and 4) degree of sensory nerve injury leading to anesthesia, hypoesthesia, or hyperesthesia of the foot. Nonoperative therapy attempts to obtain or preserve joint mobility, increase strength, and provide corrective bracing and accommodative foot wear. Operative management is undertaken for treatment of residual nerve compression or refractory problematic deformities. Established surgical protocols are performed in a stepwise fashion, and include: 1) release of residual or secondary nerve compression; 2) release of fixed contractures, using infarct excision, myotendinous lengthening, muscle recession, or tenotomy; 3) tendon transfers or arthrodesis to increase function; and 4) osteotomy or amputation for severe, non-salvageable deformities.

Acute Disease↗
PubMed1996

Role of radiation therapy in the management of the patient with pancreatic cancer.

Most patients who have pancreatic cancer present with advanced disease that is not amenable to surgery. For patients whose disease is amenable to surgery and who are managed with surgical resection alone, local recurrence rates are high and long-term survival rates are low. The use of radiation therapy to treat pancreatic cancer has been studied in various clinical contexts. Preoperative radiation therapy for resectable or borderline unresectable disease may benefit some patients but is not used routinely. For patients with resected disease, data from the Gastrointestinal Tumor Study Group (GITSG) trials support the use of adjuvant chemoradiation. For patients with locally unresectable disease, the use of radiation therapy plus chemotherapy provides modest benefit, as suggested by the clinical trials of the GITSG and other groups. Additional studies employing modified radiation therapy techniques and improved chemotherapeutic regimens, with enhanced radiosensitization and direct cytotoxicity, are needed to optimize treatment regimens for patients with this disease.

Chemotherapy, Adjuvant↗
PubMed1996

Recurrent carpal tunnel syndrome.

Recurrent symptoms of CTS have been shown to occur in 0% to 19% of patients following CTR, with up to 12% requiring re-exploration. Common causes of recurrent CTS are incomplete release of the TCL, fibrous proliferation, or recurrent tenosynovitis. The prognosis for re-exploration is fair; improvement can be achieved in many cases, but prognosis is not as favorable as in primary CTR. The most predictable improvement seems to be in patients with CTS caused by granulomatous infections, in which proper surgery and medical therapy can usually result in a satisfactory outcome. For the heavily scarred carpal tunnel with fibrous proliferation, many operative options are available. These procedures include external nerve lysis and mobilization, followed by application of local muscle flaps, fat grafts, or vein wrapping. There appear to be higher recurrence rates and poorer outcomes in patients with occupation-related CTS.

Aged↗
PubMed1995

Results of an RTOG phase III trial (RTOG 85-27) comparing radiotherapy plus etanidazole with radiotherapy alone for locally advanced head and neck carcinomas.

PURPOSE: The objectives of this study were to determine the efficacy and toxicity of Etanidazole (ETA), a hypoxic cell sensitizer, when combined with conventional radiotherapy (RT) in the management of advanced head and neck carcinomas. METHODS AND MATERIALS: From March 1988 to September 1991, 521 patients who had Stage III or IV head and neck carcinomas were randomized to receive conventional RT alone (66 Gy in 33 fractions to 74 Gy in 37 fractions, 5 fractions per week) or RT+ETA (2.0 g/m2 thrice weekly for 17 doses), of whom 504 were eligible and analyzable. Treatment assignments were stratified before randomization according to the primary site (oral cavity + hypopharynx vs. supraglottic larynx + oropharynx + nasopharynx), T-stage (T1-3 vs. T4), and N-stage (N0-2 vs. N3). Pretreatment characteristics were balanced. In the RT-alone arm, 39% of patients had T3 and 34% had T4 disease, whereas in the RT+ETA arm, 42% of patients had T3 and 33% had T4 disease. Thirty-eight percent of the RT-alone patients and 37% of the RT+ETA patients had N3 disease. The median follow-up of surviving patients was 3.38 years, with a range between 0.96 and 5.63 years. RESULTS: One hundred and ninety-four of the 252 (77%) RT+ETA patients received at least 14 doses of the drug. Overall RT protocol compliance rate was 82% in the RT-alone arm and 86% in the RT+ETA arm. No Grade 3 or 4 central nervous system or peripheral neuropathy was observed in the RT+ETA arm. Eighteen percent of the patients developed Grade 1 and 5% developed Grade 2 peripheral neuropathy. Other drug related toxicities included nausea/vomiting (27%), low blood counts (15%), and allergy (9%). Most of these toxicities were Grade 1 and 2. The incidence of severe acute and late radiation effects were similar between the two arms. The 2-year actuarial local-regional control rate (LCR) was 40% for the RT-alone arm and 40% for the RT+ETA arm. Two-year actuarial survival was 41% for the RT-alone arm and 43% for the RT+ETA arm (p = 0.65). Multivariate analyses were performed to investigate the influence of covariates on treatment effects. A strong treatment interaction with N-stage was revealed: LCR (50% vs. 40% at 2 years), RT+ETA improved for patients with N0-2 disease but not for N3 patients (22% for RT+ETA and 40% for RT). Further analyses showed that RT+ETA was more advantageous in N0-1 patients, with a 2-year LCR of 55% for RT+ETA vs. 37% for RT only (p = 0.03). A similar phenomenon was observed when using survival as the end point. CONCLUSION: The results showed that adding Etanidazole to conventional RT produced no global benefit for patients who had advanced head and neck carcinomas. There was a suggested benefit for patients who had N0-1 disease, and that needs to be confirmed by another study.

Carcinoma, Squamous Cell↗
PubMed1995

Radiation therapy in the management of patients with malignant carcinoid tumors.

BACKGROUND: The purpose of this study was to analyze the effectiveness of radiotherapy for symptomatic, metastatic, and/or unresectable carcinoid tumors. METHODS: From 1975 to 1991, 18 patients with histologically proven carcinoid tumors, including 7 with symptomatic hepatic involvement, received radiotherapy to a total of 31 anatomic sites of metastatic or unresectable carcinoid tumors. Symptomatic response to treatment, date of symptomatic or radiographic progression, and survival after diagnosis and completion of radiotherapy were determined. Clinical improvement was defined as symptomatic relief and/or objective reduction in size of tumor mass sustained for at least 4 weeks. RESULTS: After radiotherapy of 31 sites in 18 patients, 3 patients died in less than 3 months. Of the remaining 15 patients, survival from initial radiotherapy ranged from 8 to 108 months (median, 23 months), and 8 (53%) died without symptomatic progression in the treated region. Clinical improvement occurred in 27/31 sites (87%). Acute side effects were mild, and no late side effects were recorded. Median survivals from diagnosis were: 39 months for patients with primary tumors of the lung, 33 months for patients with brain metastases, and 32 months for patients with hepatic involvement. Patients with the carcinoid syndrome responded in 19/22 sites (86%) compared with 8/9 sites (89%) for patients without the syndrome (P = not significant). CONCLUSIONS: Radiation therapy can achieve symptomatic palliation for patients with metastatic/unresectable malignant carcinoid tumors, and it is well tolerated. Clinical improvement occurs after irradiation in patients with or without the carcinoid syndrome.

Adult↗
PubMed1995

Androgen deprivation with radiation therapy compared with radiation therapy alone for locally advanced prostatic carcinoma: a randomized comparative trial of the Radiation Therapy Oncology Group.

OBJECTIVES: Androgen deprivation therapy before and during radiation therapy could, by reducing tumor volume, increase local tumor control, disease-free survival, and overall survival in patients with locally advanced adenocarcinomas of the prostate. METHODS: In a randomized controlled clinical trial, patients with large T2, T3, and T4 prostate tumors, but no evidence of osseous metastasis, were randomized to receive goserelin 3.6 mg subcutaneously every 4 weeks and flutamide 250 mg orally three times daily 2 months before and during the radiation therapy course (Arm I) compared with radiation therapy alone (Arm II). Pelvic irradiation was administered with 1.8 to 2.0 Gy per day to a total dose of 45 +/- 1 Gy followed by a boost to the prostate target volume to a total dose of 65 to 70 Gy. RESULTS: Of 471 randomized patients, 456 were evaluable, 226 on Arm I and 230 on Arm II. With a median potential follow-up of 4.5 years, the cumulative incidence of local progression at 5 years was 46% in Arm I and 71% in Arm II (P < 0.001). The 5-year incidence of distant metastasis on Arms I and II was 34% and 41%, respectively (P = 0.09). Progression-free survival rates including normal prostate-specific antigen (PSA) levels for 396 patients with at least one PSA recorded were 36% in Arm I and 15% in Arm II at 5 years (P < 0.001). At this time, no significant difference in overall survival could be detected (P = 0.7). CONCLUSIONS: Short-term androgen deprivation with radiation therapy results in a marked increase in local control and disease-free survival compared with pelvic irradiation alone in patients with locally advanced carcinoma of the prostate. Long-term surveillance is required to assess effects on overall survival.

Adenocarcinoma↗
PubMed1995

Inhibition of return to successively cued spatial locations.

Inhibition of return refers to a bias against returning attention to a location that has been recently attended. Experiments are reported that examined inhibition of return to multiple exogenously cued spatial locations. When 2 peripheral locations were cued in succession, inhibition was found for only the 1 most recently cued location. In addition, more inhibition occurred at the location of the most recent cue if the earlier cue had also been presented there, as compared with an earlier cue at a different location. Thus, the magnitude of the inhibition for a location appears to depend on the effectiveness of the attentional cue to that location. Other results suggest that candidate locations for inhibition are displaced by subsequent cues--they do not simply decay. The results provide an initial framework within which to study inhibition of return to multiple spatial locations.

Attention↗