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Biomedical subjects

R Strohl

Publications and source records attributed to R Strohl.

7 recordsLinked to original sources
PubMed1988

Once-a-week vs conventional daily radiation treatment for lung cancer: final report.

This is the final report of a prospective randomized clinical trial which began in 1982 and explored once-a-week hypofractionation in lung cancer patients with unresectable, non-metastatic, measurable, loco-regionally advanced disease. Stratification to this protocol has been done by histology, stage, and performance status categories. Patients with ipsilateral supraclavicular and/or brain metastases as the only evidence of distant spread, have been included in the study, but were stratified and analyzed separately. The two protocol arms were: (I) Conventional daily radiation [5 x W]-5 daily fractions of 2 Gy each to a total dose of 60 Gy in 6 weeks, protecting the spinal (SC) at 45 Gy and (II) Once-a-week radiation [1 x W]-one weekly fraction of 5 Gy each to a total tumor dose of 60 Gy in 12 weeks protecting the SC at 30 Gy. A total of 150 patients have been entered. Of these, 30 pts. are inevaluable, but the reasons of non-compliance, progression of disease or death due to intercurrent disease were of equal incidence in both groups. Of the 120 evaluable patients, 63 were treated 5 x W and 57 with 1 x W therapy. Complete tumor responses are similar in both arms with 1 x W pts demonstrating a numerical advantage (26% vs 17%). The average follow-up of the entire series is 3 yrs with a range of 12-66 months. Survival data is comparable in both groups with the 12 and 24 month actuarial survival of 49% and 23% for the 5 x W arm and 59% and 29% for the 1 x W arm. 1 x W patients continue to show a better tolerance than 5 x W pts. There are sufficient long-term survivors in both arms to assess chronic toxicity. The number of patients alive at 12, 18, and 24 months were 25, 11, and 5 for the 5 x W arm and 29, 16, and 7 for the 1 x W arm. No significant differences in late reactions have been noted. The longest surviving patient in the 1 x W arm is now 48 months after treatment.

Adenocarcinoma↗
PubMed1985

Birth defects in three common pediatric malignancies; Wilms' tumor, neuroblastoma and Ewing's sarcoma.

During the period 1965-1980, 84 patients with Wilms' tumor, neuroblastoma and Ewing's sarcoma were treated at the University of Rochester Medical Center. All patients were evaluated for the presence of congenital abnormalities. Ten of 34 (29%) patients with Wilms' tumor, 3 of 32 (9%) patients with neuroblastoma, and 0 of 18 patients with Ewing's sarcoma were so effected. In the patients with Wilms' tumor, 5 children had more than one abnormality. In this group, types of defects included genitourinary in 10 patients, central nervous system in 3, and other structural defects in 7. In the patients with neuroblastoma, the abnormalities were dissimilar. As expected, most of the 13 patients with congenital malformations were detected as having defects prior to the diagnosis of malignancy. For the patients with Wilms' tumor, median age at diagnosis for the entire group and for the subgroup with defects was 3 years, with age ranges similar. Male to female ratios were 1.3:1 and 1:1, respectively. Seventy percent of each group survived more than 5 years. For the patients with neuroblastoma, median age (range) for the entire group was 16 months (0-12 years). The patients with defects had ages of 5 days, 1 month and 9 months at diagnosis. Male to female ratio for the entire group was 0.6:1 and survival was 63% at 3 years (range 3-23 years). Those with defects are alive 3-8 years from diagnosis.

Adolescent↗
PubMed1983

Ocular and orbital complications following radiation therapy of paranasal sinus malignancies and review of literature.

During the period from March 1963 through March 1978, 30 patients with malignant neoplasms of the paranasal sinuses were treated with supervoltage technique at the University of Rochester Medical Center. Twenty-one patients had at least the medial portion of the orbit within the effective treatment volume and the rest of the patients had whole eye irradiation. In paranasal sinus malignancies, orbital involvement with ocular symptoms and signs is quite common; in many patients it can be the presenting problem. Enucleation is necessary in patients with gross orbital tumor. Eye preservation is worthwhile in patients with minimal orbital tumor. Anterior complications are a minimal risk if the technique is good. Posterior complications occur in almost all patients, but are rarely clinically significant until doses of 6000 rad or above are reached. In patients without gross orbital involvement, preservation of the eye can be considered optional treatment. It includes shielding of the anterior structures, but it is usually not possible to protect medial and posterior portions of the eye and orbit. In advanced cases, it is worthwhile to preserve the eye as cure rate is low and posterior eye complications are often late. Because the aim of treatment is cure, dose should not be compromised to prevent complications. Radiation injury to the optic nerve and retina is the major factor in visual loss, but it can be prevented by limiting the retinal and optic nerve dose to less than 6000 rad.

Aged↗