Showing papers by "William Small published in 2006"
TL;DR: Preoperative gemcitabine/radiotherapy is well tolerated and safe when delivered in a multi-institutional setting, with acceptable morbidity, and the high rate of negative margins and uninvolved nodes suggests a significant tumor response.
Abstract: We report the results of a multi-institutional phase II trial that used preoperative full-dose gemcitabine and radiotherapy for patients with potentially resectable pancreatic carcinoma. Patients were treated before surgery with three cycles of full-dose gemcitabine (1000 mg/m2 intravenously), with radiation during the second cycle (36 Gy in daily 2.4-Gy fractions). Patients underwent surgery 4 to 6 weeks after the last gemcitabine infusion. There were 10 men and 10 women, with a median age of 58 years (range, 50–80 years). Nineteen patients (95%) completed therapy without interruption, and one experienced grade 3 gastrointestinal toxicity. The mean weight loss after therapy was 4.0%. Of 20 patients taken to surgery, 17 (85%) underwent resections (16 pancreaticoduodenectomies and 1 distal pancreatectomy). The complication rate was 24%, with an average length of stay of 13.5 days. There were no operative deaths. Pathologic analysis revealed clear margins in 16 (94%) of 17 and uninvolved lymph nodes in 11 (65%) of 17 specimens. One specimen contained no residual tumor, and three specimens revealed only microscopic foci of residual disease. With a median follow-up of 18 months, 7 (41%) of the 17 patients with resected disease are alive with no recurrence, 3 (18%) are alive with distant metastases, and 7 (41%) have died. Preoperative gemcitabine/radiotherapy is well tolerated and safe when delivered in a multi-institutional setting. This protocol had a high rate of subsequent resection, with acceptable morbidity. The high rate of negative margins and uninvolved nodes suggests a significant tumor response. Preliminary survival data are encouraging. This regimen should be considered in future neoadjuvant trials for pancreatic cancer.
235 citations
TL;DR: The radiologist can play a pivotal role by being aware of predisposing factors, clinical presentation, and management of adverse reactions to contrast media, which can range from transient minor reactions to life-threatening severe reactions.
Abstract: Adverse reactions to intravenous iodinated contrast media may be classified as general and organ-specific, such as contrast-induced nephrotoxicity. General adverse reactions may be subclassified into acute and delayed types. Acute general adverse reactions can range from transient minor reactions to life-threatening severe reactions. Non-ionic contrast media have lower risk of mild and moderate adverse reactions. However, the risk of fatal reactions is similar for ionic and non-ionic contrast media. Adequate preprocedure evaluation should be performed to identify predisposing risk factors. Prompt recognition and treatment of acute adverse reactions is crucial. Risk of contrast induced nephrotoxicity can be reduced by use of non-ionic contrast media, less volume of contrast, and adequate hydration. The radiologist can play a pivotal role by being aware of predisposing factors, clinical presentation, and management of adverse reactions to contrast media.
182 citations
TL;DR: Assessment of patients before intravenous contrast injection can help in detecting predisposing risk factors for adverse reactions to contrast media.
49 citations
01 Jan 2006
TL;DR: List of Contributors Introduction William Smal, Jr. and Gayle Woloschak and William Small Jr.
Abstract: List of Contributors Introduction William Smal, Jr. and Gayle Woloschak 1. The Management of Radiation-Induced Brain Injury Edward G. Shaw and Mike E. Robbins 2. Management of Radiation-Induced Head and Neck Injury Angel I. Blanco and Clifford Chao 3. Radiation Pneumonitis and Esophagitis in Thoracic Irradiation Jeffrey Bradley and Benjamin Movsas 4. Toxicity from Radiation in Breast Cancer Julia White and Michael C. Joiner 5. Upper Gastrointestinal Tract Johanna C. Bendell and Christopher Willett 6. Radiation Complications of the Pelvis Kathryn McConnell Greven and Tatjana Paunesku 7. Radiation-Induced Skeletal Injury Mark A. Engleman, Gayle Woloschak and William Small Jr. 8. Skin Changes Gloria Wood, Linda Casey and Andy Trotti Index
29 citations
TL;DR: Arterial phase MDCT images alone can be used to detect renal venous anomalies, and to identify small left kidney venous branches namely, the left gonadal, adrenal and lumbar veins in renal donors.
28 citations
Seattle Cancer Care Alliance1, Memorial Sloan Kettering Cancer Center2, Fox Chase Cancer Center3, Johns Hopkins University4, Dana Corporation5, University of Michigan6, Ohio State University7, University of Texas MD Anderson Cancer Center8, Roswell Park Cancer Institute9, Stanford University10, University Of Tennessee System11, Northwestern University12, City of Hope National Medical Center13, University of Alabama14, University of California, San Francisco15, University of Nebraska–Lincoln16, Duke University17
14 citations
TL;DR: The role of MDCT in preoperative evaluation of potential laparoscopic renal donors is reviewed and renal vascular anomalies detected by MDCT can help the surgeon in planning donor nephrectomy.
12 citations
TL;DR: The article will review the parameters for anterior tooth positioning, proportions, contours, and techniques to predictably manage space management dilemmas, and describe the composite bonding technique that will serve as a predictable, functional, and aesthetic solution to these complex situations.
8 citations
TL;DR: In renal allograft transplant recipients who experienced acute rejection episodes refractory to modern chemical immunosuppression, LGI was well tolerated and remains a viable salvage treatment option.
Abstract: Objective:To evaluate the outcome and prognostic factors of patients who underwent local graft irradiation for acute renal allograft rejection refractory to modern immunosuppressive medications.Methods:From 1996 to 2005, 33 patients received local graft irradiation (LGI), with 3 patients receiving 2
6 citations
5 citations
Journal Article•
01 Mar 2006
TL;DR: Adequate preprocedure evaluation should include identification of predisposing risk factors such as asthma, allergy, pre-existing azotemia, previous adverse reactions to intravenous iodinated contrast material, and myeloma.
Abstract: Adverse reactions to intravenous iodinated contrast material range from transient, minor reactions to life-threatening, severe reactions. Adequate preprocedure evaluation should include identification of predisposing risk factors such as asthma, allergy, pre-existing azotemia, previous adverse reactions to intravenous iodinated contrast material, and myeloma. Prompt recognition and treatment of acute adverse reactions are imperative to prevent them from becoming life threatening. The radiologist can play a pivotal role in the management of adverse reactions to intravenous iodinated contrast material.
Journal Article•
TL;DR: The topics range from the management of early-stage disease to the phase III randomized studies that have established the current standard of care for patients with locally advanced cancer of the cervix.
Abstract: This article summarizes the current management of patients with newly diagnosed cervical cancer. The topics range from the management of early-stage disease to the phase III randomized studies that have established the current standard of care for patients with locally advanced cancer of the cervix. New approaches to combined-modality therapy with the goal of improving outcomes and decreasing complications are also described.