Biography:

In the past Luther W. Brady has collaborated on articles with Burton H. Goldstein and Sriprayoon Prasasvinichai. One of their most recent publications is Dystrophic calcification in the tongue: A late sequel to radiation therapy. Which was published in journal Oral Surgery, Oral Medicine, Oral Pathology.

More information about Luther W. Brady research including statistics on their citations can be found on their Copernicus Academic profile page.

Luther W. Brady's Articles: (19)

Evolution of radiotherapeutic techniques☆

AbstractAdenocarcinoma is the most common kind of tumor involving the uterine corpus, occurring in a frequency of 90% or better and found predominantly in postmenopausal women. Because of vaginal bleeding, diagnosis is made early and control rates are good. Regional lymph node metastases are found to occur in about 20% of all operable patients and more frequently in those with advanced lesions near the cervix.Surgery alone fails not only because of metastases but also because of persistence in the vaginal vault and in the periurethral region. From a theoretical and practical viewpoint, preoperative irradiation is a valuable and important role in the treatment of carcinoma of the endometrium. Treatment calls for a technique that will effectively irradiate the uterine tissue, the vaginal vault, and the immediate extrauterine tissues in which postsurgical persistence is known to appear.From the standpoint of survival, both preoperative external therapy and preoperative radium therapy are effective with equivalent survival figures. The incidence in our experience of vaginal recurrence in those patients who were irradiated preoperatively with external beam therapy techniques would indicate the need for supplemental radium within the vaginal vault.

Original contributionThe effect of sublethal X-irradiation on erythropoiesis in the mouse

AbstractBALC/c female mice were exposed to 300 R of total body X-irradiation following which erythropoiesis was studied for the next 8 weeks. The data indicate that the initial effects of radiation injury on erythropoiesis is marked depression of both splenic and marrow erynthropoiesis and the development of ineffective release of maturing RBCs from these organs, as demonstrated by marked decreases in organ radioiron uptake and in radioiron reappearance in RBCs, respectively. The data suggest a complex interrelationship between splenic and marrow erythropoiesis following erythropoietic perturbation. We conclude that the mouse spleen may function in a booster capacity to marrow erythropoiesis in the attainment and maintenance of a new steady-state condition.

Original contributionCarcinoma of the penis☆

AbstractThe emphasis of this report is on the role of radiation therapy in the management of carcinoma of the penis. The 5 year results are comparable with the results of surgery3–5,7–10 (Tables 1 and 2). Radiation therapy is superior from a cosmetic, functional and psychological point of view. Surgery should be reserved exclusively for recurrence of the disease. Treatment of inguinai regions should be included in the initial plan of treatment. Prophylactic nodal treatment is urged strongly for unreliable patients or patients with massive primary lesions.

Original contributionRadiation therapy of glottic carcinoma☆

AbstractA total of 89 patients with glottic carcinoma were treated at Hahnemann Medical College and Hospital, and affiliate institutions from 1959 to 1971 inclusive. Patients were grouped into tumor, node, metastasis (TNM) categories and placed into appropriate stages; there were 38 (43%) Stage I, 21 (24%) Stage II, 19 (21%) Stage III, and 11 (12%) Stage IV. All patients were treated primarily by radiation therapy with surgery utilized only for recurrences. The 5 year tumor free survivals were: 89% for Stage I, 76% for Stage II, 53% for Stage III, and 9% for Stage IV. There were no significant complications from the radiation therapy course.

Original contributionPostoperative pelvic irradiation of stage II ovarian carcinoma☆

AbstractClinical Stage II carcinoma of the ovary (1964 FIGO classification) represents a small proportion of total patients and has not been studied extensively. Even though the disease apparently is localized, end-results have been poor. Between 1960 and 1970, 24 patients with clinical Stage II disease received postoperative megavoltage pelvic irradiation following surgical procedures of varying extent. All patients but one received between 5000 and 6000 rad tumor dose to the whole pelvis and all patients were evaluable at a minimum of 5 years. Of 4 Stage II-A patients one was alive without disease. No patients were alive with recurrent tumor. Recurrences in the pelvis occurred only in 2 patients; 4 patients had recurrent disease in the pelvis and upper abdomen. A total of 8 patients developed upper abdominal recurrences in the apparent absence of pelvic disease. These results and those of others which are discussed in this paper suggest that surgery and irradiation to the pelvis only will not eradicate disease completely in over 60% of patients with clinical Stage II ovarian carcinoma.

Original contributionTreatment of recurrent carcinoma of the cervix☆

AbstractFrom 1960 to 1970, 68 patients were referred to the Radiation Therapy Department of Hahnemann Medical College and Hospital with the diagnosis of recurrent or persistent carcinoma of the cervix. In 51 patients, tumor was limited to the pelvis. An aggressive retreatment program was pursued in all patients using either radiation or surgery. Among those patients with recurrent tumor limited to the pelvis, 5196 survived one year and 17.6% survived 5 years. The complication rate was acceptable. The choice of modality for retreatment depended on the original form of therapy employed, the site of recurrence, and the patient's general condition.

Original contributionAntibody-dependent cellular cytotoxicity in patients with mycosis fungoides and sézary syndrome

AbstractAn antibody-dependent cell-mediated cytotoxicity (ADCC) assay was utilized to measure null cell function in 37 patients with cutaneous lymphomas including mycosis fungoides (NM and Sezary syndrome. Five patients with psoriasis vulgaris were included as controls for benign dermatologic disease. Patients with MF, non-MF cutaneous lymphomas, and psoriasis had mean ADCC levels equal to or greater than control values, while patients with Sézary syndrome had significantly depressed levels (64% of control values). Although this study did not explain the reason for the depression, it indicated that the ADCC assay may prove useful as a prognostic tool and as an additional means of identifying Sezary syndrome.

Patterns of tumor recurrence after definitive irradiation for inoperable non-oat cell carcinoma of the lung☆

AbstractPreliminary analysis was carried out on a prospective randomized cooperative group study involving 375 patients with histologically proven unresectable non-oat cell carcinoma of the lung who were treated with definitive radiotherapy. The patients were randomized to one of four treatment regimens: 4000 rad split course (2000 rad in five fractions one week, two weeks rest and an additional 2000 rad, five fractions in one week) or 4000, 5000 or 6000 rad continuous courses, five fractions per week. 84 to 100 patients were accessioned to each group. The one year survival rate was about 40%; the two year survival rate was 10% to 18%. The patients who were treated with the split course had the lowest survival (10% at two years) compared with the other groups (14% to 18%). Complete and partial local tumor regression was 48 % in patients who were treated with 4000 rad, 65 % in the 5000 rad and 61 % in the 6000 rad group. The rate of initial intrathoracic recurrence was 38 % in patients who were treated with 6000 rad; 45 % in those who received 5000 rad, 51 % and 64 % with 4000 rad split or continuous course, respectively. Patients who showed complete or partial regression of the tumor following irradiation exhibited an initial local recurrence rate of 42 % and 46 % respectively in contrast to 57 % for those without tumor regression. Patients with epidermoid carcinoma had an initial local failure rate of 53%, adenocarcinoma and large cell undifferentiated carcinoma 41 %. Distant metastases concurrent with or prior to intrathoracic failure were significantly higher in the patients with adenocarcinoma or large cell adenocarcinoma (63%) than in epidermoid carcinoma (33%). The present data strongly suggest that patients who were treated with 5000 or 6000 rad had a better response, tumor control and survival than those who were treated with lower doses. Additional follow-up of patients at risk in each group will be necessary before a final conclusion is drawn. Further investigations should determine the impact that a variety of prognostic factors may have in efficacy of irradiation in patients with bronchogenic carcinoma. This information will be extremely useful in the design of future therapy for these various subpopulations of patients with different manifestations of the disease.

Original contributionPredicting the response of head and neck cancers to radiation therapy with a Multivariate modelling system: An analysis of the RTOG head and neck registry☆

AbstractTwo thousand and sixty-six patients with primary head and neck cancers were entered in the RTOG Head and Neck Cancer Registry between 1977 and 1980. Nine hundred and ninety-seven (997) evaluable patients were treated initially with radiation therapy alone. Tumor site, T-stage, N-stage, histology, degree of infiltration, degree of differentiation, patient age, sex and Karnofsky performance score were all prospectively recorded. T-stage (p < .001), N-stage (p = .007), primary site (p < .001), and initial Karnofsky performance score (p < .001) proved to be significant factors independently predictive of primary tumor clearance. Using these factors, a multivariate response model was constructed to predict primary tumor response. The predictive accuracy of the model proved to be highly reliable, and was tested by comparing the predicted vs. observed complete tumor clearance rates for each independent variable. For primary sites, the predicted number of complete responses vs. observed were: oral cavity, 139.8 predicted vs. 139 observed; nasopharynx, 51.8 predicted vs. 51 observed; oropharynx, 174.8 predicted vs. 176 observed, supraglottic larynx, 314.4 predicted vs. 318 observed; glottic larynx, 314.4 predicted vs. 318 observed; and hypopharynx, 49.4 predicted vs. 46 observed. For the entire group of patients predicted to have a 90% or better complete primary tumor response (including T3 and T, tumors), 94% remained in initial complete remission at the primary site at one year, and 87% at two years. An accurate multivariate response model, such as the one presented in this paper, should prove to be a useful tool in selecting patients with head and neck cancers suitable for treatment with radiation therapy alone.

Original contributionSecond malignancies in patients who have head and neck cancer: Incidence, effect on survival and implications based on the RTOG experience

AbstractThe development of second malignant tumors (SMTs), in patients who have had their first tumor treated successfully, represents a serious limitation of current therapeutic strategies for head and neck cancers. To improve our understanding of the current magnitude of the problem and the various factors that might influence its importance, we reviewed the Radiation Therapy Oncology Group's (RTOG) prospectively collected registry of all head and neck patients seen in participating member institutions between February 1977 and April 1980. A total of 928 patients were identified who had squamous cell carcinomas of the head and neck region, no prior or coincident history of another malignant tumor, and whose planned treatment consisted of radiation therapy only. A total of 110 second, independent, malignant tumors occurred in these patients. Overall, the estimated risk of developing a second tumor within 3 years of radiotherapy was 10%, within 5 years 15%, and within 8 years 23%. Minor differences in frequency were observed for different primary sites. These SMTs unquestionably influenced subsequent survival adversely. Analysis of the database also revealed that the extent of the primary tumor influenced the risk of a second; most occurred in patients who presented with the smallest primary tumors because of their better survival. Our data indicate that preventive medicine should have its greatest impact in those patients who are treated for an early stage primary tumor.

Special featureRadiation oncology: Postgraduate medical education in the United States, 1988

AbstractThe fourteenth survey of postgraduate medical education in radiation oncology in the United States was conducted in the first three months of 1988. It revealed stability in the number of approved programs, positions offered, and physicians in training compared with 1986. The proportion of trainees who were U.S. citizens by birth rose to an all-time high of 88%, and the proportion of foreign medical graduates decreased to 9%. The proportion of women in residency has remained unchanged (24%) over the past 6 years. At present, approximately 150 physicians complete residency and enter practice each year, one-third of whom commence in an academic setting. A high proportion of recent graduates of approved programs successfully completes the examinations and becomes certified by the American Board of Radiology.

Original contributionAccelerated fractionation radiation therapy for liver metastases: Selection of an optimal patient population for the evaluation of late hepatic injury in rtog studies☆

AbstractThe palliation of hepatic metastases represents a major therapeutic problem in oncology. The generally unfavorable prognosis of patients with liver metastasis may complicate the evaluation of the efficacy and toxicity of various therapeutic modalities. The Radiation Therapy Oncology Group (RTOG) is evaluating new accelerated fractionation schemes for hepatic irradiation. In designing this study it became necessary to identify a favorable subpopulation of patients with an expected median survival of 6 months in whom the late effects of treatment could be evaluated. Data from two RTOG liver metastases studies (7605 and 8003) were analyzed using multi-variate techniques. Cases with a serum bilirubin level of greater than 1.5 mg%, performance score of less than 50, and gastric or pancreatic primary carcinomas were initially excluded because of the adverse influence of these factors on survival. One hundred and ninety cases met the criteria for inclusion in this analysis. A loglinear model was used to identify the patient characteristics associated with a favorable prognosis for survival. These included a performance score of 80–100, colorectal carcinoma primary, and no extrahepatic metastases. A logistic regression equation was derived and confirmed that the probability of surviving at least 6 months depended on the effects of performance score, primary site and the presence or absence of extra-hepatic metastases. Patients with all three favorable factors constituted 30% of the evaluable study population and had a predicted survival of 50% at 6 months. A patient population with these characteristics will be used to study the late effects of accelerated fractionated radiation therapy on the liver.

Intracavitary uses of colloids

Pleural and peritoneal effusion secondary to primary malignancy is a significant problem in the management of the cancer patient. Respiratory embarrassment and discomfort associated with the formation and collection of fluid in the chest and abdomen are among the most distressing symptoms encountered as a result of malignant disease. The guidelines for treatment should be based on respiratory symptoms, and with the understanding that the procedure is palliative. Both surgical and medical forms of treatment have been used. These include thoracostomy-tube drainage alone or with the instillation of antimicrobial agents. Pleurectomy is effective but should be reserved for situations in which conservative approaches have failed. Antitumor agents, such as nitrogen mustard, are effective but toxic. The mode of action of antineoplastic agents is related to their ability to cause pleural sclerosis and obliterate the pleural space. Systemic chemotherapy and external beam radiation are rarely effective. The intracavitary application of radioactive colloids has been used since 1945. Colloidal radioactive gold Au 198 has been replaced by the pure beta emitter, colloidal chromic phosphate P 32. Instillation of a colloidal suspension of radioactive phosphorus represents a significant and effective palliative therapeutic modality for malignant effusion.

Implications of lymphoscintigraphy in oncologic practice:Principles and differences vis-a-vis other imaging modalities*

The prompt availability of interstitial lymphoscintigraphy and its utilization offer significant advantages over other techniques. Computed tomography represents a highly sensitive technique that suffers from lack of specificity in detecting small lesions. The expense and accessibility of machine time limit its usefulness as a routine survey procedure. Radiographic lymphangiography represents a tedious and difficult process necessitating identification of lymphatic channels for injection of the contrast material for visualization of the lymph nodes in the region being evaluated. With these demonstrated difficulties, the lymph node scanning technique has emerged as a simple, reliable, and reproducible technique for evaluation of multiple lymph node groups.

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