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Biomedical subjects

W B Peeling

Publications and source records attributed to W B Peeling.

At least 55 records · Page 3Linked to original sources
PubMed1989

Transrectal ultrasound in monitoring response to treatment of prostate disease.

Transrectal ultrasound provides a safe method for repeated assessments of the prostate gland in the follow-up of prostatic cancer. Changes in the echo pattern of the gland may be observed following treatment, but these may be difficult to interpret. The capsule may be restored; the tumor may appear smaller, and in some cases, ultrasound identification of the tumor may become impossible. The total gland volume decreases with chemotherapy and hormonal manipulation (subcapsular orchidectomy or drug-induced). The volume generally decreases after radiotherapy but may show a transient increase if there is some associated radiation proctitis. The rate of decrease of total prostatic volume has not been established as a reliable indicator of the subsequent prognosis. Future studies should assess whether sequential measurements of the tumor volume rather than the total prostatic volume may be a more useful guide to prognosis.

Humans↗
PubMed1988

How accurate is the index finger? A comparison of digital and ultrasound examination of the prostatic nodule.

The per-rectal ultrasound scans and digital assessments of 193 patients with prostatic nodules were analysed retrospectively. There were 88 histologically proven cancers and per-rectal ultrasound demonstrated extracapsular spread of tumour in 36 of these patients. In the diagnosis of prostatic cancer, ultrasound had a sensitivity of 97.6% and a specificity of 93.8% whereas digital examination had a sensitivity of 96.5% and a specificity of 53.3%.

Adult↗
PubMed1988

U.K. trials of treatment for M1 prostatic cancer. The LH-RH analogue Zoladex vs. orchidectomy.

A randomized, controlled trial of the treatment of metastatic prostatic cancer using either the LH-RH analogue Zoladex or orchidectomy is reported. The trial was conducted in the U.K. and Ireland and involved participants in 17 centers. The design of the trial is outlined and the response criteria discussed. The results show that the patient characteristics in the two treatment groups were comparable upon entry. Repeated administration of Zoladex every 28 days has been shown to be as effective as orchidectomy in lowering serum testosterone to castrate levels. The subjective and objective response rates were similar, as were the duration of response, time to treatment failure, and survival rates. The withdrawals from the trial and adverse reactions are discussed. These results, 10 months after the closure of recruitment to the trial, seem to indicate that Zoladex and orchidectomy are equivalent treatments and that Zoladex seems to be a truly medical alternative to surgical castration. Finally, other ongoing U.K. trials of the treatment of advanced prostate cancer are outlined.

Aged↗
PubMed1987

Treatment of patients with advanced cancer of the prostate: phase III trial, zoladex against castration; a study of the British Prostate Group.

The interim results of the randomised, Phase III trial of Zoladex against castration in the management of patients with metastatic carcinoma of the prostate is discussed. Trials commenced in October 1984 and incorporated 359 patients when recruitment ceased in January 1986. The preliminary report concerns the first 240 patients who had a minimum of 3 months follow-up. Entry criteria included patients who had no previous treatment with the exception of first-line localised radiotherapy and those who had distant bone or soft tissue metastases. Fourteen patients were excluded on the basis of protocol violations. The objective assessment of response was based on the British Prostate Group Criteria and was performed monthly for the first 3 months and 3-monthly thereafter. Pre-treatment disease characteristics of patients in both groups were similar at entry and there were no significant differences in the subjective response data of patients between the orchidectomy (n = 106) and the Zoladex group (n = 120). Objective response rates at 12 and 24 weeks of treatment were also identical for both treatment groups. Serum testosterone concentrations were below the 'castrate' level (less than 2 nmol/L) for Zoladex group as well as the orchidectomy group up to 48 weeks. The drug was well-tolerated with minimal side effects, those resulting from testosterone withdrawal were similar in both groups. The report therefore indicates clearly that this partical formulation of LH-RH analogue provides a valuable alternative to the surgical procedure in the treatment of carcinoma of the prostate.

Buserelin↗
PubMed1987

The ultrasound appearances of prostatic cancer with histological correlation.

An analysis of the ultrasound appearances of the prostate with its capsule and periprostatic structures was performed in 221 patients with a histologically confirmed diagnosis of prostatic cancer. The cancers were histologically graded into well, moderate and poorly differentiated adenocarcinoma and transitional cell carcinoma. The results of this study indicate that an ill-defined hypoechoic area is the commonest appearance of prostatic cancer; this was seen in 96% of our 221 patients. The cancers were staged by ultrasound into confined (T0, T1, T2) and unconfined (T3) cancers. A breach of the capsule was seen in 55% of cases. In this unconfined group all cancers were hypoechoic in comparison with 92% in the confined group. In the confined cancer group the areas of abnormal echogenicity were present in more than one prostatic quadrant in 76%. Mostly commonly two prostatic quadrants were affected. The abnormal echogenicity was noted in the posterior quadrants of the prostate more commonly (58%) than in the anterior quadrants. The prostate gland appeared round in 67%, semicircular in 25% and crescentic in 8%. The gland was symmetrical in 68%. The prostatic capsule appeared regular in 86% of patients with a confined cancer. In 70% of cases of extensive but confined cancer there was loss of demarcation between the central and peripheral zones of the gland. The unconfined cancer group all had a breach of the capsule and all glands were heterogeneous due to hypoechoic areas. The breach affected more than one quadrant in 81% and most commonly the capsular breach involved two prostatic quadrants. An anterior breach of the capsule was noted much more frequently than a posterior breach. Forty-four per cent of cases had three or four quadrants of the gland involved. In 3% of cases of proven prostatic cancer no definite ultrasound abnormality could be detected. Calcification was seen within the gland in association with the cancer in 63% with approximately equal frequency in confined and unconfined disease. The seminal vesicles showed definite evidence of infiltration in 10%. Both seminal vesicles were seen in 61% and thought to be normal. In 8% only one was seen. Failure to demonstrate either seminal vesicle occurred in 21%. There was no correlation between the ultrasound appearances of prostatic cancer and the histological grading of the tumour.

Adenocarcinoma↗
PubMed1987

The treatment of metastatic prostatic cancer with the slow release LH-RH analogue Zoladex ICI 118630.

The clinical and endocrine response to a depot preparation of the LH-RH analogue ICI 118630 (Zoladex) was assessed in 55 untreated patients with advanced prostatic cancer. Whereas gonadal androgen suppression was achieved in all patients, subjective and objective clinical response occurred in only 69%, indicated by a relief of bone pain, a decrease in the size of the primary tumour and lymph node metastases and improvement in bone scan appearances. A third of these patients, however, subsequently showed progression of their disease. Serious side effects were not encountered in this study. The depot formulation is a simple, safe and convenient method of administering Zoladex and offers an alternative treatment for metastatic prostatic cancer.

Acid Phosphatase↗
PubMed1986

Evaluation of biopsy techniques for androgen receptor assay in human prostatic tissue.

Androgen receptors were assayed in nuclei prepared from human benign hypertrophic prostate tissue obtained at retropubic prostatectomy by transurethral resection (TURP) and by cold punch resection. Androgen receptor was not detected in 70% of the transurethrally resected samples, and in those cases where receptors were observed they showed no correlation with enucleated samples. However, androgen receptors were detected in all cold punch resected samples and enucleated tissue with similar concentrations evident in samples from the same gland. These results suggest that prostate specimens collected by TURP are not suitable for androgen receptor analysis, whereas the technique of cold punch resection yields prostate samples that are more reliable for a correct evaluation of androgen receptor content.

Aged↗
PubMed1985

A prognostic index for the clinical management of patients with advanced prostatic cancer: a British Prostate Study Group investigation.

Patients with histologically proven carcinoma of the prostate (n = 186) were initially assessed and followed up according to the standardized protocol of the British Prostate Study Group, urologists from which contributed patients to this investigation. These patients were given either endocrine therapy or orchidectomy as first line treatment; the ratio of the number of patients receiving these two treatments was similar in each group of subjects compared for survival. Prognostic indices were derived for all patients and for those classified according to the presence (M1) or absence (M0) of metastases. The prognostic indices were derived from clinical and hormone data obtained at initial presentation. Whereas the degree of tumor differentiation and plasma testosterone concentrations were significant prognostic factors in both M0 and M1 disease, growth hormone was only significant in M1 patients, where age was also of borderline significance; elevated growth hormone, higher Gleason grade, younger age, and lower testosterone indicated a poorer prognosis in M1 patients. These findings indicated the feasibility of selecting a poor prognostic group of patients that may derive benefit from a more aggressive therapy.

Age Factors↗
PubMed1984

Ultrasonic appearances associated with prostatic inflammation: a preliminary study.

Per-rectal ultrasonography was performed on 40 patients in whom a diagnosis of prostatitis had been made on the basis of symptoms and signs of prostatic inflammation confirmed by bacteriology, microscopy or pH changes of expressed prostatic secretion. Certain ultrasonic features were present in all patients to a variable degree. A change in volume and weight of the prostate could be an indicator of treatment response.

Adolescent↗
PubMed1984

Growth hormone and prostatic tumours: localization using a monoclonal human growth hormone antibody.

The immunocytochemical detection of endogenous human GH and the binding of exogenously applied human GH in tumour tissue from patients with benign prostatic hyperplasia or prostatic carcinoma is reported. Monoclonal human GH antibody binding was exclusively to the connective tissue in both benign and carcinomatous specimens. Specificity control experiments indicated that the antibody could be absorbed with human GH but not with human prolactin. Preincubating the sections with human GH considerably altered the immunocytochemical staining, reducing the reaction product within the connective tissue in a concentration-dependent manner and revealing a binding site for GH within the cytoplasm of epithelial cells.

Antibodies, Monoclonal↗
PubMed1984

Treatment of patients with advanced cancer of the prostate using a slow-release (depot) formulation of the LHRH agonist ICI 118630 (Zoladex).

Twenty two patients with advanced carcinoma of the prostate have been treated for up to 3 months with the slow-release (depot) formulation of the luteinizing hormone-releasing hormone (LHRH) agonist ICI 118630. Patients were randomized to receive one of three different doses of ICI 118630 of 0.9, 1.8 or 3.6 mg. The depot preparation was injected subcutaneously every 4 weeks. At the highest dose, the concentration of testosterone in serum was significantly reduced to castrate values after 2-3 weeks of therapy. The smaller doses of ICI 118630 (1.8 or 0.9 mg every 4 weeks) similarly reduced serum testosterone concentrations although, at the lowest dose, testosterone values were not suppressed in all patients during the first month. Hormonal changes were accompanied by subjective clinical improvement in symptomatic patients and there were no significant side effects. The data clearly demonstrate the considerable therapeutic potential of ICI 118630 in the depot formulation for the treatment of advanced carcinoma of the prostate.

Buserelin↗