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Biomedical subjects

R D Hunter

Publications and source records attributed to R D Hunter.

88 records · Page 5Linked to original sources
PubMed1981

Treatment of advanced head and neck carcinoma with synchronous irradiation and methotrexate.

Thirty-four patients with advanced head and neck cancer were treated by synchronous radiotherapy and methotrexate (MTX) (100 mg/m2). Complete resolution of disease was obtained in 18 patients, the median remission of patients being 17 months. In general, treatment was well tolerated, although mucosal reaction was prolonged in 50% of patients. Drug-induced hematological toxicity was observed in six patients (18%) and one patient died. As a result of these findings, a random clinical trial to compare X-ray therapy with X-ray therapy and MTX in advanced head and neck cancer has been commenced.

Blood Cell Count↗
PubMed1980

Dose-rate considerations in the introduction of low-dose-rate afterloading intracavitary techniques for radiotherapy.

An investigation has been made into the changes in total dose required as a consequence of proposed increases in dose-rate in low-dose-rate treatments of cancer of the uterine cervix. The relationship between total irradiation time and dose-rate has been measured using an assay based on mouse-tail radionecrosis, with irradiation schedules similar to existing and proposed human cervix treatments. This relationship, which is similar to that observed in other biological systems, predicts that the total dose for epithelial tolerance should be reduced by about one third when the dose-rate is increased from 1.0 to 3.5 Gy per hour. The clinical implications of this finding are discussed.

Animals↗
PubMed1979

Whole body electron therapy in mycosis fungoides--a successful translational technique achieved by modification of an established linear accelerator.

A translational technique, adapting an established MEL SL75/10 linear accelerator, which gives a satisfactory physical and clinical 3 MeV whole-body electron treatment in mycosis fungoides is described. Tolerance of the patients proved excellent and 16 out of 21 achieved satisfactory remission of the disease. In spite of delivering significant skin doses it was possible to re-treat two relapsing patients without complications and with clinical success.

Adult↗
PubMed1977

The tolerance of re-irradiation of heavily irradiated human skin.

The clinical course of a group of 15 female patients treated with X-ray therapy for radiation-induced hypopharyngeal tumours is reviewed. Neither acute nor late skin reactions exceeded those expected in similar radical treatments of patients not previously irradiated. One patient appeared to have been cured by the treatment and four achieved two years' palliation. It is suggested that the tolerance of skin to re-irradiation following a long period may approach normal.

Aged↗
PubMedDate not supplied

Pattern of failure and long-term morbidity in patients undergoing postoperative radiotherapy for cervical cancer.

The objective of this study was to assess treatment outcomes in a large case series of cervical cancer patients undergoing postoperative radiotherapy in a single center. Case notes of women referred to the Christie Hospital during 1985-1997 for postoperative adjuvant radiotherapy for cervical cancer were reviewed. Of 478 women eligible for analysis, 282 (58.9%) underwent radical hysterectomy and 196 (41.1%) had nonradical hysterectomy. The disease-specific 5-year survival for the study population is 70.1%, with a 5-year risk of developing any recurrence of 30.5% and a 5-year grade 3 morbidity rate of 3.9%. Survival was significantly higher, ie, 80.9% vs 62.7% (P = 0.0001) and recurrence was significantly lower, ie, 18.6% vs 38.8% (P < 0.00005) in the group of women who had adjuvant radiotherapy following a nonradical hysterectomy compared with radical surgery. Thirty percent of women having "radical" surgery had positive resection margins and required postoperative adjuvant pelvic radiotherapy. Women with node-positive disease, who received adjuvant radiotherapy, had a high rate of distant metastases. These women would receive chemoradiotherapy now as primary treatment because of the risk of developing distant metastases. If, despite staging investigations, surgery reveals node-positive disease, then these women should receive adjuvant chemoradiotherapy. Survival was better in women who had nonradical surgery due to smaller volume disease when cancers were unsuspected and hence will have been cured by surgery alone. Multidisciplinary team working, as recommended by national guidelines from 1999, should allow better patient selection for treatment.

Adenocarcinoma↗
PubMedDate not supplied

Irradiation induced expression of CD31, ICAM-1 and VCAM-1 in human microvascular endothelial cells.

The adherence and migration of leukocytes through the endothelium of blood vessels is an important early event which occurs in normal tissues following ionizing irradiation but the underlying mechanisms are not fully understood. ICAM-1, VCAM-1 and CD31 are membrane proteins of endothelial cells, mediate this process when the vasculature is exposed to other inflammatory stimuli. In this study, expression of ICAM-1, VCAM-1 and CD31 on human dermal microvascular endothelial cells (HDMECs) at 72 hours post-irradiation using flow cytometry and northern analysis was determined. Dose-dependent increases in the surface expression and mRNA of ICAM-1 and CD31 were observed. In contrast VCAM-1 was practically undetectable on both control and irradiated HDMECs but was strongly expressed in TNF-alpha activated positive control HDMECs. The upregulation in ICAM-1 and CD31 was independent of radiation-induced changes in cell size, number and cell cycle stage. We suggest that ICAM-1 is active over a prolonged period whereas VCAM-1 acts only transiently in leukocyte-endothelial interactions in the irradiated microvasculature. The late upregulation of CD31 is a novel finding and may have a function in radiation-induced leukocyte extravasation, platelet adherence to the vascular wall and abnormal endothelial cell proliferation. Both ICAM-1 and CD31 seem to be therapeutic targets for the amelioration of radiation-induced normal tissue damage.

Blotting, Northern↗