Search PubMed⌕ Search

Biomedical subjects

V M Dalley

Publications and source records attributed to V M Dalley.

At least 19 recordsLinked to original sources
PubMed1984

Cancer of the paranasal sinuses and nasal cavities. Part II. Results of treatment.

Part I of this account of a large consecutive series of 561 patients with cancer of the paranasal sinuses and nasal cavities treated at the Royal Marsden Hospital reveals some significant clinical and radiological features. The histopathology of every case has been carefully reviewed by one pathologist. Carcinoma was found to account for almost 80 per cent of tumours. An account is given of treatment methods in present use. End-results are reported in Part II of the paper and demonstrate that patients with sinus cancer receiving combined treatment in one centre have a better prognosis than when it is given in two or more hospitals. The discussion also concentrates on the use of main treatment methods and emphasizes some advances in surgical techniques. The value of initial cytotoxic chemotherapy is unproven but may offer some further advantage in prognosis. Precise comparison with the results of other series is not possible owing to lack of agreement on classification, variable case selection and differing treatment techniques.

Combined Modality Therapy↗
PubMed1984

24-hour combination chemotherapy without cisplatin in patients with recurrent or metastatic head and neck cancer.

Sixty-three patients with advanced histologically proven squamous cell carcinomas of the head and neck, considered untreatable other than by chemotherapy, received a combination of vincristine, bleomycin, methotrexate, 5-fluorouracil, and hydrocortisone administered over 24 hours, followed by a folinic acid rescue, every 3 weeks. Fifty-seven patients had received prior radiotherapy and 78% of recurrences were within the radiation field. Sixty-one patients were assessable for response to chemotherapy and 25 (41%) achieved objective responses. Side effects from 167 courses of chemotherapy were minimal and were present only in 38% of patients. There were no cases of bone marrow depression and no drug-induced deaths. Patient compliance was 98%. Chemotherapy responders had a longer median duration of survival of 11.9 months (with four patients still alive at 10, 22, 30, and 90 months) compared with 4.96 months for nonresponders (with two patients alive at 7 and 15 months), p less than 0.001. Ten of 24 chemotherapy responders went on to surgery and eight achieved a complete remission (CR), while only 6/36 nonresponders underwent salvage surgery and all became disease-free. Patients achieving a complete remission had improved survival (median 24.5 months). The presence of metastatic disease was a poor prognostic sign; only 8/30 (27%) responded to chemotherapy and none subsequently achieved complete remission. This safe drug protocol appears to benefit only a small subset of patients, namely those who respond to chemotherapy rendering their tumors operable, but is of no general value in this group of previously irradiated patients since 92% of all patients treated were dead at 2 years.

Actuarial Analysis↗
PubMed1980

The irradiated radical neck dissection in squamous carcinoma: a clinico-pathological study.

A preliminary clinico-pathological survey is presented of radical neck dissections from 50 patients with advanced (T3, T4) squamous carcinomas of the head and neck, previously treated by irradiation and combination chemotherapy. The total yield of lymph nodes (1411) from these dissections was high--mean of 28 nodes/dissection, range 8-60; the proportion of nodes containing metastatic carcinoma was low--100 (7%)--with only 1 or 2 nodal masses/dissection in most instances. The involved nodes tended to be concentrated in 1 or 2 anatomical groups, principally in the upper anterior neck, with apparent sparing of nodes in the posterior triangle. There was a high incidence (88%) of transcapsular spread. Keratin granulomas, with or without intact metastatic carcinoma, were commonly found; on occasions they formed large masses simulating nodal metastases. The morphological patterns in uninvolved lymph nodes were shown to be of no prognostic significance. Initial data on postoperative follow-up indicated a crude survival of 52% (24 patients) at 30 months. Most deaths (80%) occurred within 12 months of major surgery; the majority (72%) died with residual malignant disease; and uncontrolled primary tumour, particularly in the oral cavity and oropharynx, was found more frequently than metastatic disease in the neck or elsewhere. Clinical implications are discussed with reference to the use of modified radical neck dissection in the surgical salvage of this poor-risk group of previously irradiated patients.

Adult↗
PubMed1979

Advanced head and neck cancer treated by combined radiotherapy and VBM cytotoxic regimen--four-year results.

The 4-year results of treatment of advanced squamous cell cancer of the head and neck regions by radiotherapy combined with a cytotoxic regimen VBM (Vincristine, Bleomycin, Methotrexate) given synchronously are compared with those obtained with radiotherapy alone in similar patients. There was a statistically significant improvement in the results of the combined treatment at four years in terms of crude survival rate (56.1% v. 24.5%) and disease free survival rate (56.5% v. 21.8%). Both groups are examined for general prognostic features which might account for the difference. In the absence of such features it must be concluded that the addition of VBM to radiotherapy had produced a marked therapeutic improvement.

Bleomycin↗
PubMed1977

Synchronous VBM and radiotherapy in the treatment of squamous cell carcinoma of the head and neck.

Since April 1974, 60 patients with squamous cell carcinoma of the head and neck region, of poor prognosis and generally in advanced stages, were treated with the combination of a cytotoxic regimen--VBM (Vincristine, Bleomycin and Methotrexate) and radical radiotherapy. The essential feature of the combination is the administration of pulses of VBM synchronous with a course of fractionated external radiotherapy in order to achieve potentiation of radiotherapy. On average 4-5 pulses of VBM were given during treatment, combined with radiotherapy on a Cobalt unit. The selection, preparation and management of the patients are described. Intense mucositis and intercurrent infection provide the main problems during treatment and close management is essential. Late complications have not been a serious problem. The crude actuarial survival rate at 24 months is 61%. The probability of survival without any recurrence to 24 months following initial treatment is 46%. Local control was achieved by the initial treatment in 43 patients. These results suggest that potentiation of radiotherapy and an increased therapeutic ratio has been obtained by the addition of VBM to radiotherapy and there is a possibility that the occurrence of distant metastases has been reduced or postponed.

Bleomycin↗
PubMed1975

Treatment of radiation-induced gastrointestinal distress with acetylsalicylate.

Highly buffered acetylsalicylate was used to treat diarrhoea and other gastrointestinal side-effects of radiotherapy in 28 women who were receiving treatment for uterine cancer. In a double-blind, balanced, and randomised trial, acetylsalicylate significantly reduced the number of bowel motions and relieved abdominal pain and flatulence.

Antacids↗
PubMed1970

Struma ovarii.

Explore the source record for details and available documents.

Female↗