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Biomedical subjects

R H Phillips

Publications and source records attributed to R H Phillips.

At least 55 records · Page 3Linked to original sources
PubMed1987

Orchiectomy versus long-acting D-Trp-6-LHRH in advanced prostatic cancer.

One hundred and four patients were randomised for the study. Fifty-five were entered into the D-Trp-6-LHRH group and 49 into the orchiectomy group. All pre-treatment patient characteristics were similar and testosterone levels at 1 month or later were in the castrate range in both groups. Forty-six patients (83%) in the D-Trp-6-LHRH group and 40 (82%) in the orchiectomy group had a partial remission or stable disease at 3 months or later. There was no significant difference between the groups for response or survival. Three patients in the D-Trp-6-LHRH group had a disease "flare" in the first 10 days of treatment. The flare symptoms resolved by the end of 4 to 8 weeks. The incidence of flushing, decreased libido and impotence was similar in both groups. Although there was less psychological morbidity in the D-Trp-6-LHRH group the difference did not reach statistical significance. Our results indicate that long-acting D-Trp-6-LHRH offers a safe and highly effective alternative to orchiectomy.

Clinical Trials as Topic↗
PubMed1987

Interim results of treatment of breast cancer with breast conservation for all patients.

Since April 1979, all female patients who have come to this unit with carcinoma of the breast have received primary treatment with breast conservation. Until December 1984, 288 patients underwent local excision of the tumor with radical radiotherapy. After 1 to 5 years, the overall and recurrence-free survival rates have been comparable with those expected after mastectomy. Local recurrence occurred in 7 of 76 (9%) patients who had stage I disease, and in 16 of 181 (9%) and 3 of 27 (11%) patients with stage II and stage III disease, respectively. Eleven patients required a mastectomy to control recurrence of the cancer, and of the 29 patients who died of breast cancer, only three had symptomatic local disease at the time of death.

Adult↗
PubMed1985

Randomised controlled study of orchidectomy vs long-acting D-Trp-6-LHRH microcapsules in advanced prostatic carcinoma.

Safety and efficacy of a slow-release formulation of D-Trp-6-luteinising-hormone-releasing-hormone (D-Trp-6-LHRH) microcapsules were compared with orchidectomy in the initial treatment of advanced prostatic carcinoma. 41 patients were randomly assigned to D-Trp-6-LHRH and 38 to orchidectomy. Suppression of testosterone and reduction in prostatic acid phosphatase levels were similar in both groups. 87% of patients in the D-Trp-6-LHRH group and 81% in the orchidectomy group responded to treatment or showed no deterioration. Side-effects related to the decrease in testosterone were similar in both groups. 3 patients given D-Trp-6-LHRH had a disease "flare" in the first ten days of treatment which resolved completely when testosterone fell to castrate levels. Results of psychological assessment were similar in both groups before treatment, and on follow-up there was a weak trend towards decreased psychological morbidity in the hormone group. The slow-release preparation of D-Trp-6-LHRH microcapsules offers an important alternative in the management of advanced prostatic carcinoma.

Aged↗
PubMed1984

Circulating thyroid hormone changes in acute trauma: prognostic implications for clinical outcome.

Alterations in circulating thyroid hormone concentrations occur in a variety of nonthyroidal disease states. In the present study, thyroid hormone levels were measured every 8 to 12 hours in 19 otherwise healthy individuals suffering acute severe trauma necessitating admission to the Maryland Institute for Emergency Medical Services Systems. Four fatalities occurred within 48 hours of admission. The mean total T3 level fell rapidly after the onset of trauma and remained low throughout the observation period. Reverse T3 rose concurrent with the fall in T3 but gradually returned to normal in the survivors. Total and free T4 levels remained normal in the survivors but fell below normal in the fatalities on the samples obtained preceding death. Changes in free T4 were consistent in three separate radioimmunoassay systems. Pharmacologic doses of glucocorticoids administered to seven of the 15 survivors and to the four fatalities did not result in an acute depression in total and free T4 levels in the survivors. Post-mortem examination of three fatalities did not reveal evidence of significant thyroid or pituitary disease. These results suggest that in acutely traumatized patients: 1) T3 declines rapidly and remains depressed throughout the illness; 2) continued fall of T4 to subnormal levels is associated with a poor prognosis; and 3) steroid therapy alone cannot explain the acute changes observed in hormone levels.

Acute Disease↗
PubMed1984

Conservative excision and radiotherapy for early breast cancer--an acceptable alternative?

The Westminster Hospital treatment policy for operable breast cancer is presented in this paper and particular attention is paid to its technical aspects. The techniques of tumour lumpectomy, radical external beam irradiation and local boosting therapy with iridium implantation are described in detail. Our initial results with this approach are encouraging and will shortly be reported. In view of this and the obvious advantages of breast conservation we hope that techniques similar to this will be adopted by others working in this field.

Brachytherapy↗
PubMed1983

Bladder carcinoma presenting as a solitary bony metastasis.

Although bony involvement by transitional cell carcinoma of the bladder occurs frequently, its presentation as a symptomatic solitary bony metastasis is rare. Furthermore, presentation as a solitary distal metastasis with osteolytic and osteoblastic components is almost a novelty. We present such a case, which is additionally unusual in that the primary lesion in the bladder and the metastasis were resectable.

Aged↗
PubMed1983

Bone marrow transplantation for severe aplastic anaemia. A review of the Westminster experience of 24 cases.

Twenty-four patients have received bone marrow transplantation for severe aplastic anaemia at the Westminster Hospitals since 1974. Twelve patients are long term survivors. Infectious complications in association with graft rejection, graft versus host disease or prolonged neutropenia were the major cause of death. In the last 18 months the introduction of more effective conditioning regimes and Cyclosporin A as graft versus host disease prophylaxis has improved the survival rate to 85%. One patient has required regrafting for late graft failure without evidence of graft rejection.

Adolescent↗
PubMed1982

Bone marrow transplantation for acute lymphoblastic leukaemia.

Twenty patients have undergone bone marrow transplantation for acute lymphoblastic leukaemia (ALL). Eighteen patients were in complete remission and two had less than 10% leukaemic blasts in the marrow aspirate in the week prior to transplantation. Eighteen patients were grafted from HLA/MLC compatible siblings. One identical twin and one fully compatible parent were also used as donors. Two patients died of graft-versus-host disease and one of radiation-induced pneumonitis. Four have subsequently relapsed. Thirteen patients remain well and in remission from 202 to 1126 d post transplantation. These results show that morbidity and mortality from the bone marrow transplantation procedure is low. However, the major obstacle to permanent success in marrow transplantation of patients with ALL is recurrence of the disease (35% actuarial disease free survival at 1126 d).

Adolescent↗