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F Volterrani

Publications and source records attributed to F Volterrani.

At least 55 records · Page 3Linked to original sources
PubMed1978

Failures (cause and time) of radiotherapy in oral cancer.

The results of retrospective clinical evaluation concerning 434 cases of oral carcinomas treated with radiotherapy from January 1959 to December 1967 are presented. The analysis of the results obtained shows that radiotherapy alone may offer a reasonable possiblity of success in limited lesions (68.3% 5-year survival of Stage I patients). In more advanced local cases, and especially those with regional adenopathies, radiotherapy alone cannot consistently control the disease for a long period of time; 5-year survival from the onset of treatment was respectively 36.5% and 24.5% for Stage II and III cases. Moreover, if controlateral of bilateral metastatic adenopathies or fixed lymph nodes are present, the prognosis becomes dramatic (2.6% 5-year survival of Stage IV patients). Among the irradiation techniques currently available, curietherapy (intersitial applications or surface molds) presumably offers the best possibility of success, since the observed failures, both overall and stage by stage, are inferior. Radiotherapy alone may generally be of proven efficacy if the local or locoregional extension is limited. In more advanced cases a combined surgery-chemotherapy treatment method is recommended. The criteria for a combined therapeutic approach for these tumors are also discussed.

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PubMed1978

[Radiotherapy of oral cancer. Late results (author's transl)].

Radiotherapy of the primary site was employed between 1959 and 1965 in the treatment of 335 unselected cases of mouth cancer. The series is examined with regard to the long-term results and gross survival is evaluated in accordance with an actuarial method. Differences dependent on sex and age, and on the type of cancer involved and the treatment modalities are illustrated and discussed.

Adult↗
PubMedDate not supplied

Skin dose measurements for head and neck radiotherapy.

The use of immobilization plastic masks in head and neck radiotherapy can partially eliminate skin benefits derived from the utilization of megavoltage photon beams. Filters and blocks between the patient and the accelerator can further increase the skin dose value. In this study, the increase in surface dose due to 2 and 3.2 mm of plastic material utilized for patient immobilization was measured. Then, the effect of blocking trays, wedges, and blocks on skin dose in typical conditions for head and neck irradiation was evaluated. The measurements were obtained with a NE2534 chamber (Markus type) on a perspex phantom for 6 MeV x-rays from an accelerator.

Head and Neck Neoplasms↗
PubMedDate not supplied

[Cobalt therapy in the treatment of carcinoma of the oropharynx].

A clinical retrospective evaluation of 177 cases of carcinoma of the oropharynx treated with Cobalt therapy from 1959 to 1965 has been made. The analysis of long term results has shown that Cobalt therapy alone does not satisfactorily control carcinomas of oropharynx. In fact, less than 30% of the patients is still alive after 3 years. Survival is directly affected by the local extent of disease since, while the 5-year survival of T1 and T2 cases is respectively 26.8% and 21.5%, only 6.5% of patients with T3 carcinomas is still alive after 5 years. Particularly disappointing is the survival rate in cases with mono- or bilateral involvement of neck nodes, since none of these cases are alive 2 years after the initial therapy. In 69.4% of the cases, treatment failure has to be attributed to minimal response or early recurrence of primary tumor, while lymph node relapses have been observed in more than 25% of the cases. To allow a detailed clinical evaluation of the results, the different regions of the oropharynx should be considered separately, since differences in clinical evolution of various carcinomas would call for a different therapeutic approach. The results of this study in oropharyngeal carcinomas, indicate that improvement of long term results may only be obtained through a multidisciplinary therapeutic approach.

Cobalt Radioisotopes↗
PubMedDate not supplied

[Results of radiotherapy in a series of 250 carcinomas of the mucosal surface of the cheek (author's transl)].

This paper presents the results of a retrospective clinical study of 250 cases of monocentric carcinoma of the mucosal surface of the cheek, i.e. all the primaries treated by radiotherapy at our Institute between January 1948 and December 1965. Neoplastic lesions found at follow-up were regarded as marginal recurrences if in the proximity of the treated area and as secondary tumors in other cases. From 1948 to 1957 conventional radium therapy was the usual treatment for the primary tumor whereas from 1958 to 1965 cobalt teletherapy was given most frequently. Surgery was reserved for lymph node metastases when present on clinical examination. In our experience radiotherapy is effective in cancers of the mucosal surface of the cheek, for it checked local spread in 50.9% of cases, however treated and regardless of initial clinical appearance, whereas in the T1-T2 cases the local failure rate dropped to 35.8%. The higher the T level the greater are the difficulties confronting radiotherapy; for more extensive lesions appropriate combination therapy (radiosurgical) in line with the well-defined rules explained in the text is useful. In our experience radiotherapy yields good long term results regardless of T level and even in the more unfavorable cases. Our study confirms the low rate of lymph spread of these carcinomas: over half of the patients were N0 before treatment; only 56.7% of the patients receiving surgical treatment on the neck had histologically positive lymph nodes; there were very few neck recurrences at follow-up; the presence of suspect or frankly metastatic nodes on clinical examination, being movable and homolateral (N1), did not worsen the prognosis. However, considering the techniques used for irradiation of the primary, some patients received a substantial dose to the neck; hence radiotherapy probably played its part in the low rate of neck metastases.

Aged↗
PubMedDate not supplied

Clinical results of lymphography in cancer of the uterine cervix. A retrospective study of 542 consecutive, unselected patients.

From 1961 to 1976, 542 patients were evaluated with foot lymphography for cancer of the cervix at the Istituto Nationale Tumori of Milan. A group of 341 patients had lymphangiography as part of the initial diagnostic work-up. The overall incidence of positive examinations was 25% (9% stage I, 29% stage II, 46% stage III, 50% stage IV). In the 115 patients who had pelvic surgery the overall diagnostic accuracy of lymphography was 88%, with 2 false positive and 12 false negative reports. A second group of 90 patients was evaluated in the follow-up without clinical evidence of disease, and the incidence of metastases was 17%. Finally, group of 111 patients was studied for recurrence, and in this group the incidence of metastases was 51%. As regards site of involvement, the external iliac chains were involved in 93 to 96% of the cases, the common iliac in 34 to 79%, and the para-aortic in 17 to 36% in the different clinical conditions. The highest incidence of para-aortic metastases was found in the clinically initial stages (I and II) and in the recurrences. The lymphographic involvement of the retroperitoneal nodes was usually limited to a single region (41%) or two regions (37%). Only in 22% of the positive cases was a diffuse involvement of the retroperitoneal node chains evident.

False Negative Reactions↗
PubMedDate not supplied

Results of 60Co-teletherapy in oral cancer.

Our study reports 282 oral cancer cases treated with 60Co-teletherapy (TCT), taken from 736 oral carcinomas treated with radiotherapy on the primary tumor from January 1959 to December 1970. They were mainly locally advanced cases which often had regional node involvement. In fact, during that period, the more advanced cases were submitted to TCT. There were only 9 (3.2%) patients with T1 lesions, while there were 134 (47.5%) T2 and 139 (49.3%) T3, T4 cases; there were respectively 106 (37.6%) and 44 (15.6%) N1 or N2 and N3 cases. Almost half of the patients were greater than or equal to 66 years old at onset of the treatment (138/282 cases, or 47.2%); the women were a small minority (18/282, or 6.4%). There were 58 (20.6%) carcinomas of the mucosal surface of the cheeks, 60 cases arising from the retromolar areas, the upper-lower alveolar processes and the hard palate (21.3%), 72 carcinomas of the mobile portion of the tongue (25.5%) and 92 arising from the floor of the mouth (32.6%). All the patients considered in the study were treated with conventional techniques by doses, field dimensions and fractionation. The overall results were objectively disappointing, even though they should be evaluated keeping in mind the nature and the gravity of oral carcinomas submitted to TCT. Actuarial survival at 5 and 10 years from the onset of treatment was respectively 11.6% and 6.4%. None of the N1, N3 cases survived beyond the fourth year from onset of the treatment. Long-term survival differs very little in relation to the site of origin in the oral cavity. Nowadays, TCT alone may have only a palliative role in the treatment of oral cancer, reserving it for those cases which, due to their extreme gravity or the various contraindications, do not permit more aggressive treatments. In a combined therapeutic approach the aim of TCT today is to control the minimum disease foci. Its association with surgery appears to be most effective.

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