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Biomedical subjects

T K Wheeler

Publications and source records attributed to T K Wheeler.

16 recordsLinked to original sources
PubMed2000

P53 autoantibodies in 1006 patients followed up for breast cancer.

Serial plasma samples from 1006 patients with breast cancer revealed: (i) no correlation of p53 autoantibody status with disease status at the time of sample collection, or with menopausal status at time of primary diagnosis of breast cancer; (ii) 155 out of 1006 (15%) of patients were positive for p53 autoantibodies, and these patients tended to have a persistent autoantibody status throughout follow up, irrespective of disease behaviour; and (iii) where a negative autoantibody status was found at primary diagnosis of breast cancer, this negative status persisted throughout follow up, irrespective of later disease behaviour. We conclude that screening for p53 autoantibody status is not informative on residual tumour activity nor on therapeutic responsiveness.

Adult↗
PubMed1993

Computed tomography or magnetic resonance imaging for axillary symptoms following treatment of breast carcinoma? A randomized trial.

Fifty-eight patients presenting with axillary symptoms (pain, oedema, etc) following radiation therapy for breast carcinoma were randomized to be investigated by either computed tomography (CT: 29 patients) or magnetic resonance imaging (MRI: 28). The objectives of the study were to compare the efficacy of the two tests in identifying the presence of tumour and their effectiveness as judged by quality of life (QOL) outcome measurements. Both tests proved efficacious; the predictive values for a positive result (tumour present) were 100% for both tests; the predictive values for negative findings were in the range of 76 to 90% for CT and 81 to 100% for MRI. As regards outcome, complete QOL data were available in 37 patients (17 of these patients had CT, 20 MRI). Although the mean change in QOL over 6 months was slightly more favourable in the patients investigated by MRI than in the CT group, the difference did not reach statistical significance.

Aged↗
PubMed1990

Axillary fibrosis or recurrent tumour. An MRI study in breast cancer.

Magnetic resonance imaging was performed in 35 patients with breast carcinoma in an attempt to elucidate the cause for arm oedema or neurological symptoms. In each patient the clinician was asked to predict at the outset whether tumour recurrence or radiation fibrosis was more likely on clinical grounds. MRI demonstrated features compatible with fibrosis in 21 and tumour recurrence in 10; the MRI findings were equivocal in four patients. The range of these appearances is described and demonstrated. The MRI findings were at gross variance with the clinical opinion in 10 patients, upgrading eight patients to tumour recurrence and downgrading two to radiation fibrosis. Although histological confirmation is only available in three patients, corroborative evidence (that is repeat MRI, clinical follow up) is presented which suggests that the MRI interpretation was correct in the remaining patients. MRI can provide a working diagnosis in these patients; this allows a more rational approach to treatment than a diagnosis based on clinical examination alone.

Adult↗
PubMed1990

Tumour markers in breast cancer: a report on the extensive clinical use of B5 and CA15.3.

The B5 antigen is an integral component of human erythrocyte membranes which becomes enhanced in cancer patients. Here we have measured the correlation between B5 status and disease status in 456 patients with breast cancer. A B5-positive status was found in 45/335 (13%) of patients who were long-term disease free and without recurrence (group A), and in 12/53 (23%) of patients who were disease-free following recurrence (group B). In contrast, the majority of patients with progressive disease were B5 positive, including 27/41 (66%) with progressive relapsed disease (group C) and 21/27 (78%) whose disease was progressive from diagnosis (group D). In a similar analysis of CA15.3 in 289 patients, abnormally high marker levels were found in 1/210 group A; 1/35 group B; 20/29 group C; and 8/15 group D patients. Changes in B5 level showed a high correlation with disease behaviour: rising B5 levels occurred in 56 patients, of whom 50 (89%) were found to have recurrent disease. A decrease in B5 was associated with remission in 53/55 (96%) patients. CA15.3 is a marker for breast cancer which related to tumour bulk, and combination of CA15.3 with B5 increased sensitivity for active disease as 21/24 (88%) of patients with recently relapsed disease were positive for either B5 or CA15.3: 16/24 (67%) of these patients had a positive marker result at, or prior to, clinical diagnosis of their recurrence. Overall, the combined use of CA15.3 and B5 gave clinically relevant data which was more informative than either marker alone.

Antigens, Neoplasm↗
PubMed1984

A comparison of two doses of tamoxifen (Nolvadex) in postmenopausal women with advanced breast cancer: 10 mg bd versus 20 mg bd.

In a comparative double-blind trial involving 263 postmenopausal women with advanced breast cancer treated with tamoxifen, the mean objective tumour response rate and duration was 32% and 15 months respectively. No significant difference was found in clinical response and adverse effects between those randomised to 10 mg and those to 20 mg twice daily. Although the mean serum concentration of tamoxifen in the 20 mg bd group was significantly higher no correlation between serum level and clinical benefit was demonstrated.

Adult↗
PubMed1983

Atypical (endometrial) carcinoma of the prostate.

Three cases of atypical (endometrial) carcinoma of the prostate are reported. In the light of the uncertain response to oestrogen therapy, all three patients were treated with radical radiotherapy.

Adenocarcinoma↗
PubMed1981

Medulloblastoma in childhood: long-term results of treatment.

Thirty-one children under the age of 15 years with verified medulloblastoma were treated at Addenbrookes Hospital from 1940 to 1976. In addition to surgical treatment, all received high dose irradiation to the whole neuraxis. Nine were still alive in 1979, of whom eight were examined. All these patients showed some residual problems, but five were leading active lives and had only minor physical disability. There was evidence of disturbance in growth, with shortening of the spine in relation to the limbs, in all the children. The height centile was lower than expected from parental height in four and one was severely dwarfed. Growth hormone secretion in response to exercise was, however, normal in five of six patients tested. Three children also showed failure of growth of the jaw sufficiently severe to be a cosmetic problem. Frank mental retardation was present in three children. A raised resting TSH level was found in two children, one of whom had a multinodular goiter. Of the three children with severe problems, two had been treated when under two years of age. Long-term follow-up of children who survive medulloblastoma is clearly necessary and consideration should perhaps be given to revision of current treatment regimes in very young children.

Adolescent↗
PubMed1980

Metastases outside the central nervous system from a presumed pineal germinoma. Case report.

A case of a presumed pineal germinoma in a 17-year-old boy is presented. Metastases in the left loin musculature developed 3 years after presentation, and on biopsy were found to be typical of a seminoma. Bone marrow and chest films showed no evidence of disease. It is therefore considered likely that spread occurred via the lumbar foramina by direct extension from known spinal metastases rather than via the ventriculoatrial shunt. The testes remained normal at all times, and a small testicular primary tumor giving rise to cerebral symptoms from mestastases is considered unlikely, since cerebral metastases from testicular tumors are rare without prior metastasis to the chest. Four previous cases of pineal tumors with chest metastases are reviewed.

Adolescent↗
PubMed1976

A computer-based radiotherapy clinical record system using mark-sense forms.

A computer-based system for radiotherapy clinical records is described. Its main features are the use of a single mark-sense form for input of data at all stages of the patient's progress, and the provision of a plain language print-out of the patient's record after each updating. The programs are written in Fortran and are implemented on a Rank Xerox Sigma 6 computer.

Computers↗
PubMed1974

Assessment of an in vitro screening test of cytotoxic agents in the treatment of advanced malignant disease.

The value of a screening test for sytoxic chemotherapeutic agents in the treatment of advanced malignant disease is assessed by comparing the performances of 32 patients whose treatment followed closely the test recommendations with that of 31 patients whose treatment did not follow the predictions. The significant improvement in short-term prognosis (p=0.004) indicates that the test is of clinical value. The limitations of retrospective analysis are discussed in detail.

Adult↗