Malcolm A. Bagshaw

Ninety-six (12.3%) of a total of 779 patients with head and neck cancer were found (clinically or at autopsy) to have distant metastases in the period from 1955 to 1967, in a study at the Division of Radiation Therapy, Stanford University School of Medicine. The study was confined to adults with epithelial tumors. All areas in the head and neck region were reviewed, except the paranasal sinuses, eye, ear, and thyroid gland. Metastases to the lungs, bone, and liver were the most common, but unexpected metastases to the heart, spleen, and gastrointestinal tract were frequently found. The most advanced primary tumors (T4) were most likely to have metastases. More than 50% of patients in whom the primary site was effectively controlled developed metastases. Forty patients of the 96 with metastases had an autopsy; further metastatic sites, not apparent clinically, were found in most of these patients.

Journal Article Supervoltage Orbital Radiotherapy for Graves' Ophthalmopathy Get access SARAH S. DONALDSON, SARAH S. DONALDSON 1Departments of Radiology and Medicine, Stanford University School of Medicine Stanford, California Search for other works by this author on: Oxford Academic Google Scholar MALCOLM A. BAGSHAW, MALCOLM A. BAGSHAW 1Departments of Radiology and Medicine, Stanford University School of Medicine Stanford, California Search for other works by this author on: Oxford Academic Google Scholar JOSEPH P. KRISS JOSEPH P. KRISS 1Departments of Radiology and Medicine, Stanford University School of Medicine Stanford, California Search for other works by this author on: Oxford Academic Google Scholar The Journal of Clinical Endocrinology & Metabolism, Volume 37, Issue 2, 1 August 1973, Pages 276–285, https://doi.org/10.1210/jcem-37-2-276 Published: 01 August 1973 Article history Received: 18 January 1973 Published: 01 August 1973

The charts of 310 consecutive patients with localized prostatic carcinoma treated definitively with small-field external-beam irradiation were reviewed. The 5- and 10-year uncorrected actuarial survival rates for patients with disease limited to the prostate were 72 and 48%, respectively, compared to 48 and 30% in patients with palpable extracapsular extension. Patients for whom the interval between histological diagnosis and initiation of radiotherapy was less than one year had a significantly higher survival rate than those for whom this interval was longer. Severe symptoms which persisted beyond one year after treatment developed in 5%. Sexual potency was maintained in 70% of patients not hormonally manipulated following radiotherapy.

From 1956 through 1973, 82 patients with carcinoma of the nasopharynx received high dose megavoltage radiation therapy at Stanford University. The actuarial disease-free (NED) survival was 62% at 5 years and 56% at 10 years. The NED survivals at 5 years for patients with T1, T2, and T3 lesions were 76%, 68%, and 55%, respectively. No T4 patients were salvaged, but two of 10 patients who presented with cranial nerve dysfunction were long-term survivors. The degree of nodal involvement also had prognostic significance. Involved lymph nodes were successfully controlled in all instances when doses of at least 6500 rads were given. Initial treatment failed in 32 patients. In 24 (75%) this occurred within 18 months. Thirteen patients with initial recurrences in head and neck sites were retreated and three remain alive. Survival after retreatment ranged from 2 months fo 10 years, with a median of 16 months. Although nearly one-third (6/17) of the patients with local recurrences had initial T1 or T2 lesions, there have been no failures in patients treated for these early stages in the last 7 years. This may be attributed to the use of larger treatment fields. Likewise, prophylactic irradiation of the neck was always successful in preventing nodal disease if the primary site was controlled.