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Biomedical subjects

W Newton

Publications and source records attributed to W Newton.

67 records · Page 4Linked to original sources
PubMed1983

Mortality among children with rhabdomyosarcomas of the alveolar histologic subtype.

Of 116 patients with rhabdomyosarcoma of the alveolar histologic subtype who entered the Intergroup Rhabdomyosarcoma Study (IRS) from 1972 to 1978, there were 72 deaths (63%), compared with a mortality of 39% among patients with all nonalveolar types combined. The subgroup with alveolar histology contributed greater than 29% of the total mortality, although it represented 20% of the total patients (p less than .001). This recurrence rate reflects increased local, regional, and distant relapse. Differences were most marked in patients with grossly excised tumors (clinical groups I and II) in which the mortality was 44% in patients with alveolar tumors (48 patients) versus 13.5% in those with embryonal histology (111 patients), and 16% in all patients with nonalveolar tumor types. When survival was influenced by primary tumor site this reflected, in most body areas, an increase in the proportion of patients with the alveolar histology in that site. Patients with unresected or disseminated tumors (clinical groups III and IV) of the alveolar subtype have initial response rates to VAC and radiotherapy which are similar to those of patients with tumors of other cell subtypes (70% for group III and 50% for group IV). In these clinical groups, the differences in survival related to histologic subtype are not significant. The presence of the alveolar histologic subtype represents a rational basis for employing more intensive therapy in the management of patients with rhabdomyosarcomas.

Adolescent↗
PubMed1978

Incidence of meningeal involvement by rhabdomyosarcoma of the head and neck in children: a report of the Intergroup Rhabdomyosarcoma Study (IRS).

141 patients with embryonal rhabdomyosarcoma (RMS) of the head and neck are reviewed. 57/141 had lesions of para-meningeal sites. 20/57 (35%) developed evidence of direct meningeal extension. 18/20 (90%) died of this complication. Radiation portals and doses were limited in 42% and 32%, respectively. All patients had chemotherapy for 6 weeks prior to radiation. The significance of the adequacy of radiation factors and the timing of chemotherapy are reviewed. Recommendations for managing these patients include earlier use of radiation and increased coverage of adjacent meninges by radiation including total craniospinal axis radiation when brain meningeal involvement exists.

Child↗
PubMed1978

Extraskeletal Ewing's sarcoma: a preliminary review of 26 cases encountered in the Intergroup Rhabdomyosarcoma Study.

Twenty-six of three hundred and fourteen (26/314) patients whose tumors were reviewed by the Pathology Evaluation Committee of the Intergroup Rhabdomyosarcoma Study have histologic subtypes I and II which have morphologic characteristics similar to Ewing's sarcoma of bone. They are somewhat more common in an extremity lesion but have no relation to patient age. Disease-free survival is good; seventeen of twenty-six (17/26) or sixty-five (65%) percent thus far.

Child↗
PubMed1977

Treatment of rhabdomyosarcoma in children with surgery, radiotherapy and chemotherapy.

From May, 1970 through December, 1972, Children's Cancer Study Group entered 112 patients on an amended treatment program for rhabdomyosarcoma and undifferentiated sarcoma in children. These patients had Group II disease with residual tumor remaining after surgery, or metastatic disease at onset. Another group consisted of patients who previously had treatment with surgery and radiotherapy and had recurrent disease. Cyclophosphamide was added to a previously used drug regimen which consisted of actinomycin D and vincristine. The drugs were given sequentially in repeated cycles for 18 months. Of 97 evaluable patients, there were 24 with microscopic residual disease, 37 with gross residual disease, 22 with metastatic disease at onset, and 14 patients who were treated with chemotherapy for the first time with recurrent or metastatic disease. All patients have been followed for 3 or more years. Survival in each group was 70.8%, 43.2%, 27.2%, and 28.2%, respectively. Although the number of complete remissions was greater than with two-drug therapy, survival with three-drug therapy was not significantly different than that seen in the earlier study.

Adolescent↗
PubMed1976

Decreased risk of radiation-associated second malignant neoplasms in actinomycin-D-treated patients.

One hundred two long-term survivors of childhood cancers with second malignant neoplasms (SMNs) were collected from 10 institutions. Forty-seven cases fulfilling study criteria were studied to determine the risk of developing a SMN in irradiated fields after exposure to various chemotherapeutic agents. The case control method was used. The risk of developing such tumors was decreased by a factor of 7 in patients receiving actinomycin-D (AMD). The "protective" effect of AMD was more pronounced in patients receiving repeated courses of the agent. No change in relative risk was found for children given antifolates, the vinca alkaloids, or alkylating agents. AMD "protection" is an unexpected finding because the agent is an oncogen in animals and an enhancer of radiation, the latter being a known carcinogen. Possible mechanisms, which remain speculative, are discussed. These results indicate the need for careful long-term observation of cancer survivors to gain understanding of the late effects of multimodal treatments.

Child↗
PubMed1974

The impact of chemotherapy on advanced neuroblastoma. Survival of patients diagnosed in 1956, 1962, and 1966-68 in Children's Cancer Study Group A.

Survival statistics from 50 children with disseminated neuroblastoma, treated according to two CCSGA protocols between 1966 and 1968, are compared to those collected by Sutow and associates for 1956 and 1962. Little improvement occurred in the median survival rates of the children in these groups. Survival at 24 months is 13, 22, and 13 per cent, respectively, for the three groups. The lack of improvement in the median survival rate following treatment with a combination of VCR and CPM is attributed to an initial response rate of less than 40 per cent in the treated patients. The survival of patients who did respond, when compared to those who did not, was twice as long (15 vs. 7 months). Clearly, improved chemotherapy or other modes of treatment are needed for patients with advanced neuroblastoma at the time of diagnosis.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

The primary care research fellowship: an early assessment.

BACKGROUND: To address the continuing need for research-oriented faculty in primary care, the Bureau of Health Professions in 1988 funded 10 National Research Service Award (NRSA) Primary Care Fellowship Program grants. We report an early evaluation of these programs. METHOD: Descriptions of fellowship programs were obtained from grant proposals. Fellows with at least one year of training completed a mailed questionnaire that included both structured and open-ended items. RESULTS: All programs emphasized research and gave mentorship explicit attention. Nine offered degree programs; six offered a third year of study. Twenty-seven of 32 eligible fellows returned the survey. They reported a median of three research projects during the fellowship. Sixty percent of fellows had extramural funding; 48% submitted manuscripts for publication; and 22% had work accepted for publication. In open-ended responses, fellows emphasized the importance of mentors' guidance on projects, accessibility, and emotional support; rarely did they mention help in establishing professional networks or in securing project funding. Fellows most appreciated the collegiality and protected atmosphere of fellowship programs, although they felt that both human and material resources were less than optimal. CONCLUSIONS: Fellowship environments are generally conducive to productivity, and fellows undertake relevant primary care research. Programs should devote more attention to mentoring, especially regarding networking and obtaining funding. Funding agencies should increase support for training-related expenses in lieu of research grants that subsidize NRSA training in other specialties.

Curriculum↗