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Biomedical subjects

W J Simpson

Publications and source records attributed to W J Simpson.

At least 73 records · Page 4Linked to original sources
PubMed1980

Irradiation as an etiologic factor in tumours of the thyroid, parathyroid and salivary glands.

Irradiation to the head and neck region, usually of low dosage, results in an increased frequency of thyroid, parathyroid and salivary gland tumours. The authors have reviewed their experience with these tumours. Fifty of 475 patients with carcinoma of the thyroid had received previous irradiation. Papillary or mixed papillar-follicular carcinoma occurred most commonly. Eleven of 100 patients with primary hyperparathyroidism had been irradiated and had a parathyroid adenoma. Twenty of 662 patients with salivary gland tumours had previously been irradiated. Mucoepidermoid carcinoma was the most common tumour. Patients who have been irradiated and have a palpable abnormality of the thyroid or the salivary glands should be treated surgically. The various noninvasive tests are of little value in distinguishing between a benign and a malignant tumour. Those with hypercalcemia, considered to be due to primary hyperparathyroidism, should be treated by exploration of the neck, identification of the four parathyroid glands and excision of an adenoma with biopsy of the three remaining glands. If more than one gland is abnormal, a subtotal parathyroidectomy is recommended.

Acne Vulgaris↗
PubMed1980

Anaplastic thyroid carcinoma: a new approach.

Less than 10% of patients with anaplastic thyroid carcinoma survive 5 years when treated by operation and conventional irradiation, but survivors who are disease-free at 2 years appear to be cured. The administration of a small number of large radiation fractions (350 to 800 rads) failed to eradicate the local disease in 14 patients, all of whom died within 9 months. Hyperfractionation (100 rads qid at 3-hour intervals) caused complete tumour regression of 6 of 14 patients and partial regression in 7 others; the 1 patient whose tumour failed to respond was treated only once daily. However, the cost was high: two patients died of spinal cord necrosis and a third of pneumonitis due to the unexpected increase in radiation toxicity caused by the concurrent administration of Adriamycin. If an effective systemic treatment can be devised for this disease, hyperfractionation may be capable of eradicating the massive local tumour masses so characteristic of anaplastic thyroid carcinoma.

Adult↗
PubMed1978

The role of external radiation in the management of papillary and follicular thyroid cancer.

Review of 137 patients with differentiated thryroid carcinoma (82 papillary and 55 follicular) demonstrates that external radiation in moderate dosage eradicates microscopic disease. Its use could lead to a decrease in surgical complications by avoiding unnecessarily radical attempts at removing all potential microscopic disease. Gross tumor also responds favorably to external radiation, but its very slow regression rate has led to the misconception that external radiation is ineffective in the treatment of these cancers. Both radioiodine and thyroid hormone play an important role in the management of differentiated thyroid cancers, but their effectiveness should not be overestimated.

Adenocarcinoma↗
PubMed1978

Pineal and suprasellar germinomas. Results of radiation treatment.

The results of radiation treatment of 52 patients with a tumor in the pineal region or a suprasellar germinoma are analyzed. The overall 5-year survival rate was 59%. Ten patients in whom initial biopsy confirmed pineal germinoma were all alive 2 to 121 months from diagnosis, although two developed meningeal seeding at 2 and 7 months. Twelve of 15 patients 25 years old or younger with an unbiopsied tumor in the pineal region were alive 12 to 225 months after irradiation, with a 5-year survival rate of 81%. In comparison only five of 16 patients older than 25 years with a pineal region tumor survived, a 5-year survival rate of 37%. This marked age dependence in survival rates was attributed to a high proportion of germinomas in the younger patients and gliomas in the older patients.

Adolescent↗
PubMed1975

Radiotherapy in thyroid cancer.

Although resection is the mainstay of treatment of thyroid cancer, and radioactive iodine (131-1) is curative in a small number of patients with differentiated cancers, external irradiation is much more effective than is generally believed. This has been clearly shown in a review of 138 patients with thyroid cancer referred to a cancer centre, in most cases after an initial operation. External irradiation should be considered in all patients except those with pure papillary tumours that have been completely excised. It should be used (a) in conjunction with surgery if there is even a remote doubt as to the completeness of excision; (b) in conjunction with 131-1 in treating inoperable primary tumours or metastatic lesions; () alone for differentiated tumours (primary or metastatic) that do not take up 131-1; and, (d) perhaps combined with chemotherapy, for medullary and anaplastic tumours.

Adenocarcinoma↗
PubMed1975

The effects of preoperative irradiation on primary tracheal anastomosis.

Preoperative radiotherapy was used in the management of selected patients with cancer of the lung or trachea who might subsequently require segmental resection of bronchus or trachea and reconstruction by primary anastomosis. This study was designed to determine the effects of varying dosages of preoperative irradiation on anastomotic healing. Two rings were resected from the cervical trachea of 20 dogs following irradiation with varying doses of cesium. There were no important adverse effects on healing of the trachea or adjacent organs in dogs receiving up to 3,500 rads. All dogs receiving a higher dose than this developed some anastomotic stenosis, which was severe in 6 of 8 animals. Similar adverse effects were observed in 2 patients managed by preoperative radiotherapy (4,000 rads in three weeks) and tracheal resection with primary anastomosis.

Animals↗
PubMed1972

External irradiation of the hypophysis for Cushing's disease.

During the past 12 years 17 patients with Cushing's disease (bilateral adrenal hyperplasia secondary to excessive pituitary adrenocorticotrophic hormone) have been treated initially with external pituitary irradiation. Of the 15 patients who have had adequate follow-up, nine showed complete biochemical remission, and one showed biochemical improvement. There were no complications. It is therefore recommended that the first mode of therapy for all patients with Cushing's disease should be pituitary irradiation if the patient's clinical condition permits.

17-Hydroxycorticosteroids↗