Biomedical subjects
Publications and source records attributed to G Mandoliti.
The authors describe an afterloading brachytherapy to treat oral cavity carcinomas. Catheters for arterial/venous catheterization are inserted percutaneously in the target volume. The internal needles are then removed and replaced with iridium wires inside tubes to form wire loops. This technique has proven to be simple, quick and safe.
The authors investigated the effects of radiation therapy on the immune system by studying lymphocyte subsets and other parameters in 32 patients undergoing radiation therapy for solid cancer. With monoclonal antibody techniques, we studied both T- and B-lymphocytes; cell suspensions were analyzed by means of a Facs Spectrum III Ortho (Ortho-Diagnostic) unit. The first control was performed right after the beginning of radiotherapy, when the dose to the patients was 50 Gy or higher. The second control was performed at 40 Gy because all patients received this dose. 30% of the patients exhibited lymphopenia from the beginning of the study; at 40 Gy the number of T-lymphocytes was low and helper/suppressor ratio was altered. A variable response of B-cells was observed, although all patients exhibited restoration of normal values at 6 months. Four patients only suffered from side-effects: a patient with tongue cancer presented oral mycosis, and a woman--treated for breast cancer--presented vaginal mycosis. Two cases of cystitis were also observed, after 18 Gy, in patients with uterine carcinoma undergoing pelvic irradiation. Disease progression was observed in 2 patients with head and neck cancer, while 3 patients died from lung cancer progression. Another one, with head and neck cancer, died because of heart failure.
Electron beam therapy is the superior modality of treatment for advanced skin cancer or in specific anatomical situations. The authors report the results for the electron beam therapy of 31 patients with advanced skin carcinoma. There were 15 squamous cell carcinomas, 11 basal cell carcinomas and 5 mixed, basosquamous cell carcinomas. All lesions were 3 cm or greater in maximum diameter. With follow-up ranging from 1 to 6 years, 28 patients have not evidence of disease, 1 is dead with disease, 1 is alive with suspicious residual disease and 1 is alive with recurrence. Acute and late complications are acceptable; bone, cartilage and soft tissue necrosis are not reported. The treatment results are similar to those in the literature and show the advantages of the electron beam irradiation for advanced skin carcinomas.
The treatment of anal canal carcinoma is very difficult and great care must be taken in planning therapy because this type of cancer is potentially curable. From 1982 through 1989 we treated 16 patients with carcinoma of the anal canal. All patients were evaluable for toxicity and 14/16 for response after treatment. Of the 12 patients who underwent irradiation alone and were N0 M0, 8 are alive with no evidence of the disease, 4 had a recurrence which was treated with radical surgery, and 2 underwent palliative treatment alone. Therapy toxicity was not relevant in most cases and our results are in agreement with those reported in the literature.
Recently, high-dose rate intracavitary irradiation has been used as a boost therapy or a palliative therapy in the treatment of the esophageal carcinoma. The new intraesophageal device is based on a modified Sengstaken-Blackemore tube. On the surface of the esophageal balloon of the S-B tube Cyponil tubes are fixed as iridium containers. The device is placed at the level of the neoplastic lesion. Treatment tolerance is good.
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Flexible 192Ir wire implants are commonly used for the treatment of some types of cancer in the oral cavity. A modified technique of plastic tubes is here presented which aims at correctly positioning the active wires with thin plastic templates. Possible sources of error are examined and their consequences on the dose distribution around the implant are analyzed. In most cases control dosimetry matches the provisions satisfactorily. It may be thus concluded that the use of templates allows good and reproducible results to be obtained in the brachytherapy of the oral cavity.
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