Biomedical subjects

C Griep

Publications and source records attributed to C Griep.

6 recordsLinked to original sources

PubMed2006

[Myositis as a 'radiation-recall phenomenon' following palliative chemotherapy with carboplatin-gemcitabin for non-small-cell pulmonary carcinoma].

A 58-year-old woman suffered pain due to a stage-IV adenocarcinoma of the right upper-lung lobe with signs of growth into the right axilla. Palliative local radiotherapy directed at the primary tumour followed by combination chemotherapy with carboplatin-gemcitabin led to partial remission. During the fourth and last cycle of her three-months course of chemotherapy, the patient again complained of pain in the right half of the thorax; later, a local swelling of the pectoralis muscles was found. She was diagnosed with myositis as a delayed reaction to irradiation (radiation-recall phenomenon) based on the clinical symptoms (redness of the skin, pain and distinct swelling) but especially on the basis of a CT-scan. This revealed a clear swelling of the pectoralis muscles, even though the tumour was in remission. The possibility of myositis as a radiation-recall phenomenon should be borne in mind whenever a patient presents with skin changes or pain within a previous irradiation field during chemotherapy with, for example, gemcitabin.

Antineoplastic Agents↗

PubMed2000

Morbidity of immediate breast reconstruction (IBR) after mastectomy by a subpectorally placed silicone prosthesis: the adverse effect of radiotherapy.

AIMS: This study evaluates the incidence of local complications after immediate breast reconstruction (IBR) following mastectomy with a subpectorally placed silicone prosthesis, with emphasis on the effect of radiation treatment on IBR. METHODS: The medical records of 100 women, who underwent a mastectomy followed by IBR with a subpectorally placed silicone prosthesis at the University Hospital Rotterdam/Daniel den Hoed Cancer Center, between March 1990 and March 1995, were reviewed. Thirteen prostheses were implanted prior to radiation treatment, and 15 prostheses were implanted after irradiation of the chest wall. RESULTS: Early complications were seen in 15% of the IBR and were more often in irradiated women. At long-term follow-up, the most common complication was capsular contracture (21%). This occurred significantly more around prostheses placed in a previously irradiated area (P<0.0005), or which were irradiated after IBR (P=0.001). Loss of prosthesis was seen in 11 cases, and was significantly (P<0.005) more in irradiated women (n=5; 18%) compared to women who were not irradiated (n=6; 7%). CONCLUSIONS: Complications after IBR with a silicone prosthesis were more common in women who were treated with radiotherapy prior to or after IBR following mastectomy than in women who were not irradiated. In particular, capsular contracture around a prosthesis placed in a previously irradiated area was significantly increased. The use of musculocutaneous flaps, such as the transverse rectus abdominis muscle or latissimus dorsi flap, is preferable for reconstruction of previously irradiated breasts. There is no indication to remove the prosthesis before radiation therapy of the chest wall.

Adult↗

PubMed1999

Acute morbidity reduction using 3DCRT for prostate carcinoma: a randomized study.

PURPOSE: To study the effects on gastrointestinal and urological acute morbidity, a randomized toxicity study, comparing conventional and three-dimensional conformal radiotherapy (3DCRT) for prostate carcinoma was performed. To reveal possible volume effects, related to the observed toxicity, dose-volume histograms (DVHs) were used. METHODS AND MATERIALS: From June 1994 to March 1996, 266 patients with prostate carcinoma, stage T1-4N0M0 were enrolled in the study. All patients were treated to a dose of 66 Gy (ICRU), using the same planning procedure, treatment technique, linear accelerator, and portal imaging procedure. However, patients in the conventional treatment arm were treated with rectangular, open fields, whereas conformal radiotherapy was performed with conformally shaped fields using a multileaf collimator. All treatment plans were made with a 3D planning system. The planning target volume (PTV) was defined to be the gross target volume (GTV) + 15 mm. Acute toxicity was evaluated using the EORTC/RTOG morbidity scoring system. RESULTS: Patient and tumor characteristics were equally distributed between both study groups. The maximum toxicity was 57% grade 1 and 26% grade 2 gastrointestinal toxicity; 47% grade 1, 17% grade 2, and 2% grade > 2 urological toxicity. Comparing both study arms, a reduction in gastrointestinal toxicity was observed (32% and 19% grade 2 toxicity for conformal and conventional radiotherapy, respectively; p = 0.02). Further analysis revealed a marked reduction in medication for anal symptoms: this accounts for a large part of the statistical difference in gastrointestinal toxicity (18% vs. 14% [p = ns] grade 2 rectum/sigmoid toxicity and 16% vs. 8% [p < 0.0001] grade 2 anal toxicity for conventional and conformal radiotherapy, respectively). A strong correlation between exposure of the anus and anal toxicity was found, which explained the difference in anal toxicity between both study arms. No difference in urological toxicity between both treatment arms was found, despite a relatively large difference in bladder DVHs. CONCLUSIONS: The reduction in gastrointestinal morbidity was mainly accounted for by reduced toxicity for anal symptoms using 3DCRT. The study did not show a statistically significant reduction in acute rectum/sigmoid and bladder toxicity.

Colon, Sigmoid↗

PubMed1998

[Coronary stenosis following successful radiotherapy for Hodgkin disease].

Three male patients, aged 43, 41 and 44 years, were referred to the cardiologist because of complaints of angina pectoris; one of them also had an aortic valve stenosis. Nine to 22 years before, they had received radiotherapy on the mediastinum because of Hodgkin's disease. Coronary angiography showed severe stenoses of the ostium of the right coronary artery or of the main left coronary artery, following which the patients were treated with coronary artery bypass surgery, aortic valve replacement and (or) drugs. These locations are very unusual in patients with angina who did not receive any radiation therapy, but they are seen frequently in patients who have received radiotherapy on the mediastinum. The pathogenesis of these lesions is not exactly known. The normal risk factors for atherosclerosis plus free oxygen radicals are probably involved. The free oxygen radicals, generated by radiation, locally activate coagulation via various hypothetical mechanisms. The damaging effect of radiotherapy could therefore be prevented by antioxidants. However, the therapeutic effect of radiation would most likely decrease as well. A more rational approach to prevent these vascular lesions would be to reduce the radiation load, to treat the risk factors for atherosclerosis and to give platelet aggregation inhibitors such as acetylsalicylic acid.

Adult↗

PubMed1996

[Electron beam irradiation is effective in the treatment of skin carcinomas; a comparison with superficial roentgen therapy].

OBJECTIVE: To compare recurrence rates and cosmetic results after electron beam therapy versus superficial X-ray therapy for basal cell and squamous cell carcinomas of the skin. SETTING: Department of Radiotherapy, University Hospital Leiden, the Netherlands. DESIGN: Retrospective. METHODS: A retrospective analysis was performed of 389 histologically confirmed basal cell and squamous cell carcinomas of the skin (1980-1990), treated with either superficial X-rays or electron beam therapy, with regard to local recurrence rates and cosmetics scored with an arbitrary three point scale. RESULTS: Of 389 patients 19 developed a local recurrence (4.9%). For small tumours (irradiated surfaces < or = 10 cm2) a local recurrence rate of 2.2% was observed, both after electron beam therapy and after superficial X-ray therapy. Large tumours (irradiated surface > 50 cm2, treated with electron beam) had a higher recurrence rate (13.8%) as had tumours which had been treated before. The cosmetic results with electron beam treatment were better, because smaller fractions were used compared with superficial X-ray treatment. CONCLUSION: In our hands electron beam treatment was not inferior to superficial X-ray treatment, cosmetically even better and also applicable in case of larger tumours. The inferior results of electron beam therapy reported in literature may be due to technical factors.

Aged↗

PubMed1995

Electron beam therapy is not inferior to superficial x-ray therapy in the treatment of skin carcinoma.

PURPOSE: To compare recurrence rates and cosmetic results after electron beam therapy vs. superficial x-ray therapy for nonmelanoma skin carcinoma. METHODS AND MATERIALS: A retrospective analysis was performed on 389 histologically confirmed basal cell and squamous cell carcinomas of the skin, treated with either superficial x-rays or electron beam therapy, with regard to local control rates and cosmetics, as scored with an arbitrary three-point scale. RESULTS: The overall local recurrence rate was 4.9% (19 out of 389). For small tumors (irradiated surfaces < or = 10 cm2) a local recurrence rate of 2.2% was observed, both after electron beam therapy and after superficial x-ray therapy. Tumor size and previous treatment proved to be important prognostic factors with regard to control rate. The well-fractionated electron beam therapy yielded better cosmetic results than the large fraction superficial x-ray therapy. CONCLUSION: Electron beam treatment is not inferior to superficial x-ray treatment and even better for larger tumors. The inferior results of electron beam therapy reported in literature might be due to technical factors, which are discussed.

Aged↗