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Biomedical subjects

R D Leeper

Publications and source records attributed to R D Leeper.

13 recordsLinked to original sources
PubMed1987

Treatment of locally advanced thyroid carcinoma with combination doxorubicin and radiation therapy.

Since 1979, 41 patients with locally advanced thyroid cancers have been prospectively treated in our institution according to a combination regimen of low-dose Adriamycin (doxorubicin) and external-beam radiation therapy. Two types of treatment regimen were used depending on tumor histologic type. Group 1 patients with well-differentiated papillary, follicular, or mixed type tumor (n = 22) received the combined regimen consisting of once weekly administration of Adriamycin (10 mg/m2) before radiation therapy (RT). Radiation therapy was carried out with a daily dose of 200 cGy for 5 days per week to a total tumor dose of 5600 cGy. Group 2 patients with anaplastic giant and spindle cell carcinoma of the thyroid (n = 19) received the combined regimen, consisting of once weekly administration of Adriamycin (10 mg/m2) before hyperfractionated RT. Radiation therapy was carried out with a fractional dose of 160 cGy per treatment twice a day for 3 days per week to a total dose of 5760 cGy in 40 days. Initial complete tumor response rates in the group 1 and 2 were 91% and 84%, respectively. Local tumor control rates at 2 years after combined therapy were 77% and 68%, respectively. The median survival time was 4 years for group 1 and 1 year for group 2. There was no disproportionately enhanced normal tissue morbidity seen with this combined approach. Patients in group 1 have a good quality of life, once the local disease is under control due to the indolent course of the disease. On the contrary, most patients in group 2 promptly developed distant metastases and died from the disease.

Adult↗
PubMed1985

Thyroid cancer.

Thyroid cancer encompasses some forms that practically have no identifiable mortality to one of the most lethal soft tissue cancers known. Because of this variation, a knowledge of the role that age, histology, and extent of disease play in establishing a prognosis is necessary to provide a rational therapeutic program. Younger patients (under age 40) with differentiated cancer, even those with lymph node metastases, should not be overtreated with extensive surgery and 131I or external beam therapy because the prognosis in these patients is so extremely good. Thyroid hormone suppression is probably adequate therapy for patients in this group after obvious disease has been resected. Recurrences can usually be effectively treated with 131I. On the other hand, older patients should be treated more aggressively, especially with the routine use of 131I ablation and therapy after resection of disease. Radiation therapy as described for recurrent disease should be considered at an early point and should be used immediately once the diagnosis of anaplastic cancer has been established. Finally, patience and observation alone should be considered a good therapeutic alternative, for example, in hypercalcitoninemic patients with medullary cancer that has been apparently adequately resected. Repeat operations in these patients fail to eliminate elevated serum calcitonin levels in the majority of cases, and the patients may live for many years with a good quality of life.

Carcinoma↗
PubMed1983

Treatment of anaplastic giant and spindle cell carcinoma of the thyroid gland with combination Adriamycin and radiation therapy. A new approach.

The authors have devised a new treatment regimen consisting of combination Adriamycin and hyperfractionated radiation therapy for the treatment of anaplastic giant and spindle cell carcinoma of the thyroid gland. The regimen consists of a once weekly administration of low-dose Adriamycin (doxorubicin) (10 mg/m2) and hyperfractionated radiation therapy. The radiation therapy is carried out with fractional dose of 160 rad per treatment twice a day for three days per week. The total tumor dose is 5760 rad delivered in 40 days. Since 1979, nine patients underwent the foregoing combination treatment regimen. Eight of nine achieved complete tumor regression in the primary treated area and six remained free of disease in the neck until time of death or last follow-up. There was no disproportionately enhanced normal tissue morbidity seen with this combined approach. If an effective systemic treatment regimen can be devised for anaplastic carcinoma of the thyroid, the present Adriamycin and hyperfractionated radiation therapy may be capable of achieving improved survival time.

Aged↗
PubMed1983

Combination adriamycin and radiation therapy for locally advanced carcinoma of the thyroid gland.

We have devised a new treatment regimen consisting of combination adriamycin and radiation therapy for the treatment of locally advanced differentiated carcinoma of the thyroid gland. The regimen consists of a once weekly administration of low dose adriamycin (10 mg/m2) and radiation therapy. The radiation therapy is carried out with a fractional dose of 200 rad per treatment, five times per week, for 5 1/2 weeks. Since 1979, eight patients underwent the combination treatment regimen and seven out of eight achieved complete tumor regression in the primary treated area. There was no disproportionately enhanced normal tissue morbidity seen with this approach.

Adenocarcinoma↗
PubMed1980

Bone scans in bone metastases from functioning thyroid carcinoma.

Sixty percent of differentiated thyroid carcinoma bone metastases identified by local radioactive iodide uptake and radiographic changes were negative in the bone scans. Another 20% of the bony metastases showed only a minimal increased uptake of bone imaging radionuclides. It is concluded that the bone scan is not a useful tool in the work-up for metastatic thyroid cancer.

Adenocarcinoma↗
PubMed1977

A study of filling defects in the liver and spleen with multiple radionuclides.

Studies were made to determine if examination with multiple radiopharmaceuticals would improve the sensitivity and specificity of colloid liver spleen scans. Increased uptake of Ga-67 citrate and In-111 bleomycin was found in most Tc-99m sulfur colloid scan defects caused by hepatocellular hepatoma or lymphoma. Increased uptake of these agents was found in some defects caused by malignant melanoma, breast carcinoma and carcinoma of the lung, and was rarely seen in defects caused by cholangiocarcinoma or gastrointestinal neoplasms. Gallium was useful in the followup of patients with hepatoma. Procedures designed to evaluate the gall bladder fossa, renal impression, or blood pool activity of an apparent tumor were found to be helpful and simple to perform. Iodine-131 as NaI was useful in studying functioning liver metastases from thyroid carcinoma as were bone scanning agents in evaluating hepatic metastases from osteogenic sarcoma. Multiple radiopharmaceutical evaluation of the physiologic and biochemical characteristics of liver lesions supplements current radiologic examinations and increases diagnostic specificity.

Adenoma, Bile Duct↗