M. D. Anderson This is Me

 Web References

1. 1. M. D. Anderson Cancer Center - Department of Cancer Biology: Faculty

   www.mdanderson.org/departments - [Cached]

   Published on: 12/29/2001   Last Visited: 12/29/2001

   M. D. Anderson Patients and Public Cancer Professionals About M. D. Anderson Site Map Contact Us
   
   Care Centers --------------------
   ...
   Bar-Eli, Menashe M., Ph.D. Associate Professor

2. 2. Chapter 8 Sec5

   www.downwinders.org/chap8.html - [Cached]

   Published on: 1/5/1996   Last Visited: 8/13/2000

   The M. D. Anderson TBI-effects study extended from 1951 to 1956 and involved 263 cancer patients. [ 64 ] M. D. Anderson had a well-established and ongoing radiation treatment program. The project began at the same time that M. D. Anderson received the first cobalt 60 teletherapy unit developed by the AEC's Oak Ridge Institute of Nuclear Studies (ORINS).
   ...
   With respect to the biomedical findings, a 1954 Air Force review noted that M. D. Anderson had obtained positive preliminary results by finding a biological dosimeter in the blood. However, one of the reviewers commented that because the patients were not normal people the changes could very well be the effect of the radiation on the abnormal tissue. [ 70 ] The review noted that an effort earlier in the study to find a marker in patients who received repetitive small doses of radiation, similar to what might occur on repeated NEPA flights, was not successful ; accordingly, the researchers looked for it in patients who received larger doses in single exposures. [ 71 ].
   
   An additional aspect of the M. D. Anderson study was the mental and psychomotor tests that most of the patients were subjected to before and after receiving TBI. (The patients reportedly participated by their own consent and judgment of the hospital staff. [ 72 ]) They performed three tests related to the skills required for piloting aircraft. But the value of testing the abilities of extremely ill patients as a measure for the performance of highly fit pilots was doubtful to the Air Force. [ 73 ] In an attempt to lessen this problem, the investigators sought outpatients who were in reasonably good physical and mental condition. [ 74 ] Nonetheless, because patients received TBI radiation doses according to the severity of their disease rather than from an arbitrary experimental protocol, there was difficulty in determining whether the performance changes noted resulted from the underlying disease or the radiation. [ 75 ].
   
   The M. D. Anderson researchers found medical benefit in three of thirty patients who received 200 R : [ 76 ] 200 [ roentgens ] whole-body x-irradiation produced a definite transitory amelioration of the disease in 3 cases, and a questionable improvement in several additional patients. [ 77 ] The study concluded that the threshold dose, beyond which in a small percentage of patients severe complications begin to appear, lies somewhere between 150 and 200 r. [ 78 ] This conclusion seems to have moved the threshold tolerance level for acute effects slightly higher than the 1950 level ; at that time the AEC's ad hoc NEPA committee had decided that doses above 150 R would pose grave risks to troops.
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   The studies began before M. D. Anderson had published any of its findings.
   
   From 1954 to 1963, Baylor University College of Medicine in Houston, Texas, performed TBI on 112 patients (54 of whom had radioresistant cancers) during the military study ; doses ranged from 25 to 250 R, and a 2-megavolt (MV) machine was used in place of a 250-KV machine after the first two years. [ 82 ] The principal researchers, Drs.
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   The Baylor researchers recognized the same problem that confronted M. D. Anderson : that seeking data from sick patients who require therapeutic TBI treatments may be in conflict with an optimal experimental design. [ 85 ] They also noted the problems with giving last-resort treatment of this kind :.
   
   When patients are referred as a last resort, the radiotherapist does not wish to withhold treatment that may offer possible benefit but he cannot be certain that the benefit will outweigh the risk. The risk is not that the patient will die but that the undesirable effects of radiation [ i.e., bone marrow suppression ] will appear more severe in the terminal cancer patient and that the time of death may be destined to coincide with the undesirable effects of radiation. [ 86 ].
   
   They concluded that for patients, radiation sickness may be avoided for doses up to 200 R by administering proper care (the researchers suggested that nausea and vomiting for some patients may have been caused by the power of suggestion) . [ 87 ] They then hypothesized that with correct information and proper preparation, normal healthy individuals could tolerate even higher exposures without undue incapacitation. [ 88 ] Efforts to find a biological dosimeter were said to be unsuccessful because the pool of patients was too small and many either died or were unable to tolerate the necessary tests. [ 89 ].
   
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   The early postwar TBI researchers, such as those at M. D. Anderson, may have been enthusiastic to test the new cobalt 60 teletherapy TBI technology on cancers that resisted older TBI techniques, but by the end of the 1950s the new technology did not appear to be producing any more favorable results on radioresistant cancers.