Publications by authors named "SALZMAN F"

Low megavolt electron beam irradiation was used on 354 sites in 199 patients at the Lahey Clinic either for palliation of symptomatic hypertrophic scars or as post-operative irradiation in an attempt to prevent formation or recurrence of hypertrophic scars. Electron energies used ranged from 1.5 to 3.

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A series of 97 consecutive patients with well-differentiated thyroid carcinoma treated between 1941 and 1970 presented with distant metastatic disease or extensive nonresectable local neck disease or had residual carcinoma after thyroid resection. Men 40 years of age or younger and women 50 years of age or younger were considered at low risk for dying of disease; older patients were considered at high risk for dying of disease. Of 17 patients with distant metastatic carcinoma, 40% of younger patients in the low-risk group and 92% of older patients in the high-risk group died.

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In the course of a 5-day space flight of two rhesus-monkeys the following parameters were recorded at an interval of 16 min: core body temperature (Tc), skin temperature (Ts), and motor activity (MA). The telemetric Tc sensor was implanted subcutaneously in the right axilla, Ts thermistor was attached to the right ankle, and the MA piezotape was fixed to the inner side of the vest. Circadian rhythms of Tc varied with a period of 24 hours in one monkey and 25 hours in the other.

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Achievements in radiotherapy of head and neck cancer continue. During the past decade, bench marks have been established for certain early staged malignancies. Technical advances have occurred in higher energy accelerators with the development of dual photon and medium-range electron machines.

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Low megavolt electron beam therapy was used to treat 68 women and one man with recurrent carcinoma of the breast on the chest wall. Photon irradiation had been used previously in 53 patients. Of the 63 patients who survived 2 months or longer after electron irradiation, 59 (94%) achieved a complete response.

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A retrospective analysis was carried out to evaluate the effectiveness of small field megavolt electron irradiation for localized mycosis fungoides. Only local field electron beam therapy was employed for limited disease reserving total skin electron irradiation for multiple lesions or diffuse disease covering at least 25 per cent of the entire body surface. Of the 14 patients with limited disease treated between 1964 and 1973 with the local field technique, 10 patients (71 per cent) are alive without evidence of disease at a minimum of 5 years.

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Between 1954 and 1976, 60 patients with Kaposi's sarcoma were treated in the Department of Radiotherapy of the Lahey Clinic Foundation at the High Voltage Research Laboratory of Massachusetts Institute of Technology. Only 2 patients were free of clinical disease in the lower extremities at the time of initial presentation, and 40 patients (69%) had cutaneous lesions involving areas extending above the knees. Eight patients (13%) also presented with mucous membrane involvement in addition to skin disease.

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Thirty-one patients with carcinoma of the breast with metastases were treated by adrenalectomy-oophorectomy and randomized either for combined chemotherapy, vincristine, fluorouracil, methotrexate and thiotepa, beginning within one week after operation and continuing for three months or no chemotherapy. Statistical analyses were Gehan's modification of the Wilcoxon test for censored data, chi-square tests and life table analysis. Pretreatment characteristics--menopausal status, age, disease-free interval, prior hormone treatment and sites of metastases--of both groups were similar.

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Six hundred patients with primary differentiated thyroid carcinoma had follow-up studies for a minimum of 15 years and a maximum of 45 years. Recurrence rate and death rate were significantly different in defined high-risk and low-risk groups of patients. These basic risk groups were defined by age and sex alone; low risk consisted of men 40 years of age and younger and women 50 years of age and younger whereas the high-risk group were older patients.

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Two hundred patients with generalized cutaneous mycosis fungoides were treated with total skin electron irradiation (TSEI) in the Lahey Clinic Radiotherapy Department-MIT High Voltage Research Laboratory between 1964 and 1973. None of the patients had any clinical evidence of extracutaneous disease at presentation. The 3-year absolute survival rate was 54% (107 patients).

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The records of 200 patients with generalized cutaneous mycosis fungoides treated with whole body surface electron irradiation were reviewed. Type of skin lesion appeared to be the most important factor with respect to both survival and generalized skin disease-free interval. High-dose irradiation did not seem to influence prognosis significantly compared with a relatively conservative dose.

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A retrospective study was performed of 18 women in whom ipsilateral brachial plexus neuropathy developed after treatment for carcinoma of the breast. In the absence of metastatic tumor elsewhere, the only distinguishing feature between carcinomatous neuropathy and radiation-induced neuropathy was the symptom-free interval after mastectomy and radiation therapy. Women with an interval of less than a year have radiation-induced neuropathy.

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The estrogen rebound response in metastatic breast cancer has been reported in the past as a rare and short-lived phenomenon, not clearly associated with any aspect of the patient's clinical profile. In this series, 25% of patients responding to estrogen therapy had a further response when they no longer received the hormone. The median duration of this palliation was a minimum of 18 months and was similar to that of the initial estrogen response.

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We have reviewed our experience in a multidisciplined breast cancer clinic where we have utilized hormonal, ablative, and chemotherapetuci modalities. Our experience seesm to be similar to that of other groups in that oophorectomy treatment produces approximately a 61 per cent response (regression and arrest) rate, androgen therapy produces a 47 per cent response (regression and arrest) rate estrogen therapy produces a 40 per cent response (regression and arrest) rate, and ablative treatment produces approximately a 50 per cent response (regression and arrest) rate. Adrenalectomy and hypophysectomy showed similar response rates.

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