We compared the survival of 302 patients with a primary choroidal or ciliary body melanoma treate... more We compared the survival of 302 patients with a primary choroidal or ciliary body melanoma treated by cobalt-60 plaque radiotherapy between 1976 and 1982 with the survival of 134 patients treated by enucleation during the same period. Tumor size, location of the anterior margin of the tumor, and patient age at the time of treatment were identified as simultaneous significant clinical variables for predicting melanoma-specific mortality by multivariate Cox proportional hazards modeling. We computed a prognostic index for each patient based on this model and found that patients in the enucleation group had slightly higher values of this index than did patients in the cobalt-60 plaque radiotherapy group. Risk ratios for the treatment effect computed from a Cox model incorporating prognostic index and the treatment variable were found to be approximately equal to 1, both for analysis of melanoma-specific mortality and total mortality. These results indicate that when one controls for differences in prognostic index between the groups, cobalt-60 plaque therapy and enucleation are essentially equivalent in their effect on survival.
In 1987, the American Cancer Society has anticipated that 965000 new cases of invasive cancer wil... more In 1987, the American Cancer Society has anticipated that 965000 new cases of invasive cancer will be diagnosed in the United States. About 40% of those patients can be treated for cure with organ preservation using radiation therapy. The basic biologic background for such an approach to the problem has become well established. The clinical data to substantiate the validity of the concept date from 1902 until the present. Organ preservation has become a major and important concept in the management of the patient with invasive cancer. New and innovative techniques for treatment are enabling the organ to be preserved, the cancer to be cured, and appropriate cosmesis and function to be preserved. Many tumor sites are appropriate for this treatment technique, including breast, eye, larynx, prostate, soft tissue sarcomas, etc.
Nuclear Medicine Review Central Eastern Europe Journal of Bulgarian Czech Macedonian Polish Romanian Russian Slovak Yugoslav Societies of Nuclear Medicine and Ukrainian Society of Radiology, Feb 1, 2002
BACKGROUND: In this paper we present the preliminary results of a prospective trial of the effica... more BACKGROUND: In this paper we present the preliminary results of a prospective trial of the efficacy of simultaneous radiotherapy and anti-EGFR 125 I radioimmunotherapy of malignant gliomas with 2 years' total survival as the end-point, raising the question whether anti-EGFR 125 I radioimmunotherapy influences the disease-free survival in these patients. MATERIAL AND METHODS: Patients with anaplastic astrocytoma or primary glioblastoma were previously treated by a mac-roscopically radical neurosurgical approach and randomized either to radiotherapy + radioimmunotherapy arm or treated by radiotherapy alone. Seven patients were included in the group with radioimmunotherapy, among them five with GBM and two with AA, and five patients in the control arm. Patients were irradiated to 60 Gy using three-dimensional conformal noncoplanar techniques. Anti-EGFR 125 I monoclonal antibody 425 radioimmunotherapy (50 mCi/course) was started during 4 th week of radiotherapy and was repeated three times in one week intervals. RESULTS: Time of follow-up ranges between 2 and 10 months in the anti-EGFR 125 I radioimmunotherapy arm and 4 and 9 months in the control arm. Recurrence was diagnosed in all patients in the EGFR 125 I group with a lethal outcome in two of them and in 4 patients in the control group. Median time to recurrence was 2 and 5 months respectively. CONCLUSIONS: Taking into account early recurrences observed, we propose to continue the studies on the efficacy of adjuvant anti-EGFR 125 I radioimmunotherapy in a selected group of patients in whom the greatest benefit may be expected on the basis of molecular studies, among them EGFR expression investigation.
Bone scanning has been shown to have a higher rate of accuracy in diagnosing osseous metastatic l... more Bone scanning has been shown to have a higher rate of accuracy in diagnosing osseous metastatic lesions from carcinomas of the lung and breast. In the present report, we have demonstrated this to be true for osseous metastases from carcinomas of the colon and rectum. We found that a high percentage (75%) of patients who have pelvic or back pain have positive 99mTc bone scans for metastases in spite of the negative radiographs. The previously reported incidence of 5-6% of osseous involvement from these tumors is probably lower than the actual incidence, as these studies were reported without the benefit of bone scanning.
The interim results of planned lymphadenectomy and 125Iodine implantation for carcinoma of the pr... more The interim results of planned lymphadenectomy and 125Iodine implantation for carcinoma of the prostate in 122 patients are reported. The incidence of positive pelvic lymph nodes found at lymphadenectomy ranged from 15% in A-2 to 55% in B-2 lesions, as well as in 13% of well-differentiated tumors. Poorly differentiated histology, B-2 and D-1 tumors, had early treatment failure indicating a group of patients in whom this procedure is contraindicated. Occult disease (A-2) and well-differentiated tumors do not exhibit early failure. However, these patients will also fare well with radical external radiation or prostatectomy. The radiobiology of the low dose rate continuous irradiation of 125Iodine is questioned. It may be inadequate for long-term tumor control. Longer follow-up of this series may indicate that external radiation for clinically localized carcinoma of the prostate is the most effective treatment policy.
We compared the survival of 302 patients with a primary choroidal or ciliary body melanoma treate... more We compared the survival of 302 patients with a primary choroidal or ciliary body melanoma treated by cobalt-60 plaque radiotherapy between 1976 and 1982 with the survival of 134 patients treated by enucleation during the same period. Tumor size, location of the anterior margin of the tumor, and patient age at the time of treatment were identified as simultaneous significant clinical variables for predicting melanoma-specific mortality by multivariate Cox proportional hazards modeling. We computed a prognostic index for each patient based on this model and found that patients in the enucleation group had slightly higher values of this index than did patients in the cobalt-60 plaque radiotherapy group. Risk ratios for the treatment effect computed from a Cox model incorporating prognostic index and the treatment variable were found to be approximately equal to 1, both for analysis of melanoma-specific mortality and total mortality. These results indicate that when one controls for differences in prognostic index between the groups, cobalt-60 plaque therapy and enucleation are essentially equivalent in their effect on survival.
In 1987, the American Cancer Society has anticipated that 965000 new cases of invasive cancer wil... more In 1987, the American Cancer Society has anticipated that 965000 new cases of invasive cancer will be diagnosed in the United States. About 40% of those patients can be treated for cure with organ preservation using radiation therapy. The basic biologic background for such an approach to the problem has become well established. The clinical data to substantiate the validity of the concept date from 1902 until the present. Organ preservation has become a major and important concept in the management of the patient with invasive cancer. New and innovative techniques for treatment are enabling the organ to be preserved, the cancer to be cured, and appropriate cosmesis and function to be preserved. Many tumor sites are appropriate for this treatment technique, including breast, eye, larynx, prostate, soft tissue sarcomas, etc.
Nuclear Medicine Review Central Eastern Europe Journal of Bulgarian Czech Macedonian Polish Romanian Russian Slovak Yugoslav Societies of Nuclear Medicine and Ukrainian Society of Radiology, Feb 1, 2002
BACKGROUND: In this paper we present the preliminary results of a prospective trial of the effica... more BACKGROUND: In this paper we present the preliminary results of a prospective trial of the efficacy of simultaneous radiotherapy and anti-EGFR 125 I radioimmunotherapy of malignant gliomas with 2 years' total survival as the end-point, raising the question whether anti-EGFR 125 I radioimmunotherapy influences the disease-free survival in these patients. MATERIAL AND METHODS: Patients with anaplastic astrocytoma or primary glioblastoma were previously treated by a mac-roscopically radical neurosurgical approach and randomized either to radiotherapy + radioimmunotherapy arm or treated by radiotherapy alone. Seven patients were included in the group with radioimmunotherapy, among them five with GBM and two with AA, and five patients in the control arm. Patients were irradiated to 60 Gy using three-dimensional conformal noncoplanar techniques. Anti-EGFR 125 I monoclonal antibody 425 radioimmunotherapy (50 mCi/course) was started during 4 th week of radiotherapy and was repeated three times in one week intervals. RESULTS: Time of follow-up ranges between 2 and 10 months in the anti-EGFR 125 I radioimmunotherapy arm and 4 and 9 months in the control arm. Recurrence was diagnosed in all patients in the EGFR 125 I group with a lethal outcome in two of them and in 4 patients in the control group. Median time to recurrence was 2 and 5 months respectively. CONCLUSIONS: Taking into account early recurrences observed, we propose to continue the studies on the efficacy of adjuvant anti-EGFR 125 I radioimmunotherapy in a selected group of patients in whom the greatest benefit may be expected on the basis of molecular studies, among them EGFR expression investigation.
Bone scanning has been shown to have a higher rate of accuracy in diagnosing osseous metastatic l... more Bone scanning has been shown to have a higher rate of accuracy in diagnosing osseous metastatic lesions from carcinomas of the lung and breast. In the present report, we have demonstrated this to be true for osseous metastases from carcinomas of the colon and rectum. We found that a high percentage (75%) of patients who have pelvic or back pain have positive 99mTc bone scans for metastases in spite of the negative radiographs. The previously reported incidence of 5-6% of osseous involvement from these tumors is probably lower than the actual incidence, as these studies were reported without the benefit of bone scanning.
The interim results of planned lymphadenectomy and 125Iodine implantation for carcinoma of the pr... more The interim results of planned lymphadenectomy and 125Iodine implantation for carcinoma of the prostate in 122 patients are reported. The incidence of positive pelvic lymph nodes found at lymphadenectomy ranged from 15% in A-2 to 55% in B-2 lesions, as well as in 13% of well-differentiated tumors. Poorly differentiated histology, B-2 and D-1 tumors, had early treatment failure indicating a group of patients in whom this procedure is contraindicated. Occult disease (A-2) and well-differentiated tumors do not exhibit early failure. However, these patients will also fare well with radical external radiation or prostatectomy. The radiobiology of the low dose rate continuous irradiation of 125Iodine is questioned. It may be inadequate for long-term tumor control. Longer follow-up of this series may indicate that external radiation for clinically localized carcinoma of the prostate is the most effective treatment policy.
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Papers by Luther Brady