Abstract
Purpose: To evaluate the efficacy of encapsulated {sup 241}Am in the treatment of primary gynecological malignancies and in previously irradiated patients with recurrent disease in the pelvis. Materials and Methods: Encapsulated {sup 241}Am primarily emits 60keV photons which are effectively shielded by thin layers of high atomic number materials. Dose distributions in water are similar to those produced by Cs-137 photons but with a half-value layer that is considerably less. Cases of 28 patients (12-primary, 16-recurrent) who have been treated with {sup 241}Am at the Yale University School of Medicine since 1986 were retrospectively reviewed. Data concerning dosimetry, disease site, prior treatment, recurrence, disease-free survival, overall survival, and complications were evaluated. Results: Median follow up for the 12 patients with primary gynecological tumors was 19 months (7mo-51mo). There were 6 vulvar, 3 vaginal, 2 cervical and 1 endometrial carcinomas. Median surface dose of {sup 241}Am was 42.2 Gy (23.3Gy-106.6Gy). As part of their initial therapy 11 received pelvic external beam radiation therapy, 6 underwent surgery and 2 received other forms of intracavitary brachytherapy. Of these 12 patients, 11 achieved a complete response (CR) with the duration of CR ranging from 7 to 51 months. Actuarial disease-free survival at 3 years
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Citation Formats
Chung, Joyce Y, Peschel, Richard E, Kacinski, Barry, Nath, Ravinder, Pourang, Rauman, Roberts, Kenneth, Fischer, Diana, Chambers, Joseph, Schwartz, Peter E, and Wilson, Lynn.
Treatment of selected primary gynecologic and pelvic malignancies with {sup 241}Americium.
United States: N. p.,
1995.
Web.
doi:10.1016/0360-3016(95)97833-M.
Chung, Joyce Y, Peschel, Richard E, Kacinski, Barry, Nath, Ravinder, Pourang, Rauman, Roberts, Kenneth, Fischer, Diana, Chambers, Joseph, Schwartz, Peter E, & Wilson, Lynn.
Treatment of selected primary gynecologic and pelvic malignancies with {sup 241}Americium.
United States.
https://doi.org/10.1016/0360-3016(95)97833-M
Chung, Joyce Y, Peschel, Richard E, Kacinski, Barry, Nath, Ravinder, Pourang, Rauman, Roberts, Kenneth, Fischer, Diana, Chambers, Joseph, Schwartz, Peter E, and Wilson, Lynn.
1995.
"Treatment of selected primary gynecologic and pelvic malignancies with {sup 241}Americium."
United States.
https://doi.org/10.1016/0360-3016(95)97833-M.
@misc{etde_20420688,
title = {Treatment of selected primary gynecologic and pelvic malignancies with {sup 241}Americium}
author = {Chung, Joyce Y, Peschel, Richard E, Kacinski, Barry, Nath, Ravinder, Pourang, Rauman, Roberts, Kenneth, Fischer, Diana, Chambers, Joseph, Schwartz, Peter E, and Wilson, Lynn}
abstractNote = {Purpose: To evaluate the efficacy of encapsulated {sup 241}Am in the treatment of primary gynecological malignancies and in previously irradiated patients with recurrent disease in the pelvis. Materials and Methods: Encapsulated {sup 241}Am primarily emits 60keV photons which are effectively shielded by thin layers of high atomic number materials. Dose distributions in water are similar to those produced by Cs-137 photons but with a half-value layer that is considerably less. Cases of 28 patients (12-primary, 16-recurrent) who have been treated with {sup 241}Am at the Yale University School of Medicine since 1986 were retrospectively reviewed. Data concerning dosimetry, disease site, prior treatment, recurrence, disease-free survival, overall survival, and complications were evaluated. Results: Median follow up for the 12 patients with primary gynecological tumors was 19 months (7mo-51mo). There were 6 vulvar, 3 vaginal, 2 cervical and 1 endometrial carcinomas. Median surface dose of {sup 241}Am was 42.2 Gy (23.3Gy-106.6Gy). As part of their initial therapy 11 received pelvic external beam radiation therapy, 6 underwent surgery and 2 received other forms of intracavitary brachytherapy. Of these 12 patients, 11 achieved a complete response (CR) with the duration of CR ranging from 7 to 51 months. Actuarial disease-free survival at 3 years was 66% (S.E.=.16) and actuarial overall survival at 3 years was 91% (S.E.=.08). Median follow up for the 16 patients with recurrent pelvic malignancies was 72 months (20mo-99mo). There were 9 cases of endometrial, 3 vulvar, 3 colorectal, and 1 cervical carinomas. Fifteen of 16 received some form of surgery and radiotherapy prior to their treatment with {sup 241}Am. Median surface dose of {sup 241}Am was 40.3 (17.6Gy-141.7Gy). Of these 16 patients, 10 achieved a CR with the duration of CR ranging from 3 to 88 months. Actuarial disease-free survival at 5 years was 51% (S.E.=.16) and actuarial overall survival at 5 years was 43% (S.E.=.14). Complications were observed in 1 primarily treated patient (soft tissue necrosis) and in 3 patients with recurrent disease (colonic obstruction, rectal fissure, and GI bleed, respectively). Conclusion: The unique dosimetric characteristics of {sup 241}Am allow effective and safe treatment of selected primary gynecological malignancies and in previously irradiated patients with recurrent pelvic malignancies.}
doi = {10.1016/0360-3016(95)97833-M}
journal = []
issue = {971}
volume = {32}
journal type = {AC}
place = {United States}
year = {1995}
month = {Jul}
}
title = {Treatment of selected primary gynecologic and pelvic malignancies with {sup 241}Americium}
author = {Chung, Joyce Y, Peschel, Richard E, Kacinski, Barry, Nath, Ravinder, Pourang, Rauman, Roberts, Kenneth, Fischer, Diana, Chambers, Joseph, Schwartz, Peter E, and Wilson, Lynn}
abstractNote = {Purpose: To evaluate the efficacy of encapsulated {sup 241}Am in the treatment of primary gynecological malignancies and in previously irradiated patients with recurrent disease in the pelvis. Materials and Methods: Encapsulated {sup 241}Am primarily emits 60keV photons which are effectively shielded by thin layers of high atomic number materials. Dose distributions in water are similar to those produced by Cs-137 photons but with a half-value layer that is considerably less. Cases of 28 patients (12-primary, 16-recurrent) who have been treated with {sup 241}Am at the Yale University School of Medicine since 1986 were retrospectively reviewed. Data concerning dosimetry, disease site, prior treatment, recurrence, disease-free survival, overall survival, and complications were evaluated. Results: Median follow up for the 12 patients with primary gynecological tumors was 19 months (7mo-51mo). There were 6 vulvar, 3 vaginal, 2 cervical and 1 endometrial carcinomas. Median surface dose of {sup 241}Am was 42.2 Gy (23.3Gy-106.6Gy). As part of their initial therapy 11 received pelvic external beam radiation therapy, 6 underwent surgery and 2 received other forms of intracavitary brachytherapy. Of these 12 patients, 11 achieved a complete response (CR) with the duration of CR ranging from 7 to 51 months. Actuarial disease-free survival at 3 years was 66% (S.E.=.16) and actuarial overall survival at 3 years was 91% (S.E.=.08). Median follow up for the 16 patients with recurrent pelvic malignancies was 72 months (20mo-99mo). There were 9 cases of endometrial, 3 vulvar, 3 colorectal, and 1 cervical carinomas. Fifteen of 16 received some form of surgery and radiotherapy prior to their treatment with {sup 241}Am. Median surface dose of {sup 241}Am was 40.3 (17.6Gy-141.7Gy). Of these 16 patients, 10 achieved a CR with the duration of CR ranging from 3 to 88 months. Actuarial disease-free survival at 5 years was 51% (S.E.=.16) and actuarial overall survival at 5 years was 43% (S.E.=.14). Complications were observed in 1 primarily treated patient (soft tissue necrosis) and in 3 patients with recurrent disease (colonic obstruction, rectal fissure, and GI bleed, respectively). Conclusion: The unique dosimetric characteristics of {sup 241}Am allow effective and safe treatment of selected primary gynecological malignancies and in previously irradiated patients with recurrent pelvic malignancies.}
doi = {10.1016/0360-3016(95)97833-M}
journal = []
issue = {971}
volume = {32}
journal type = {AC}
place = {United States}
year = {1995}
month = {Jul}
}