Biomedical subjects

Igor Fajdiga

Publications and source records attributed to Igor Fajdiga.

3 recordsLinked to original sources

PubMed2006

Patterns of failure in patients with locally advanced head and neck cancer treated postoperatively with irradiation or concomitant irradiation with Mitomycin C and Bleomycin.

PURPOSE: The long term results and patterns of failure in patients with squamous cell head and neck carcinoma (SCHNC) treated in a prospective randomized trial in which concomitant postoperative radiochemotherapy with Mitomycin C and Bleomycin (CRT) was compared with radiotherapy only (RT), were analyzed. PATIENTS AND METHODS: Between March 1997 and December 2001, 114 eligible patients with Stage III or IV SCHNC were randomized. Primary surgical treatment was performed with curative intent in all patients. Patients in both groups were postoperatively irradiated to the total dose of 56-70 Gy. Chemotherapy included Mitomycin C 15 mg/m2 after 10 Gy and 5 mg of Bleomycin twice weekly during irradiation. Median follow-up was 76 months (48-103 months). RESULTS: At 5 years in the RT and CRT arms, the locoregional control was 65% and 88% (p = 0.026), disease-free survival 33% and 53% (p = 0.035), and overall survival 37% and 55% (p = 0.091) respectively. Patients who benefited from chemotherapy were those with high-risk factors. The probability of distant metastases was 22% in RT and 20% in CRT arm (p = 0.913), of grade III or higher late toxicity 19% in RT and 26% in CRT arm (p = 0.52) and of thyroid dysfunction 36% in RT and 56% in CRT arm (p = 0.24). The probability to develop a second primary malignancy (SPM) was 34% in the RT and 8% in the CRT arm (p = 0.023). One third of deaths were due to infection, but there was no difference between the 2 groups. CONCLUSION: With concomitant radiochemotherapy, locoregional control and disease free survival were significantly improved. Second primary malignancies in the CRT arm compared to RT arm were significantly less frequent. The high probability of post treatment hypothyroidism in both arms warrants regular laboratory evaluation.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed2005

Snoring imaging: could Bernoulli explain it all?

STUDY OBJECTIVES: To identify upper airway changes in snoring using CT scanning, to clarify the snoring mechanism, and to identify the key structures involved. PARTICIPANTS: Forty patients underwent CT examination of the head and neck region according to snoring habits; patients were classified into non-snoring (n = 14), moderately loud snoring (n = 13), and loud snoring (n = 13) groups. DESIGN: Comparative analysis. MEASUREMENTS: Using CT images, areas, the anteroposterior and transversal distances of the pharyngeal space at different levels, and the thickness and length of the soft palate and uvula and their angle against the hard palate were measured; evidence of impaired nasal passages was noted; the extent of pharyngeal inspiratory narrowing was the ratio between the area at the hard palate level and most narrow area; and expiratory narrowing was the ratio between the area behind the root of the tongue and the most narrow area. RESULTS: Greater pharyngeal inspiratory narrowing (p = 0.0015) proportional to the loudness of snoring (p = 0.0016), and a longer soft palate with uvula (p = 0.0173) were significant for snoring. Impaired nasal breathing was significantly related (p = 0.029) only to the loud snoring group. The body mass index and age of snoring persons were also significantly higher. CONCLUSIONS: Snoring is associated with typical changes that can be revealed by CT scanning. Greater pharyngeal narrowing is the most important factor. Given the "Venturi tube" shape of the pharynx, the Bernoulli pressure principle plays a major role in snoring. The key structure in snoring is the soft palate: it defines the constriction and is sucked into vibrating by negative pressure that develops at this site. Its repetitive closures present an obstruction to breathing, producing the snoring sound, and should therefore be the target for causal treatment of snoring. Obstacles in the upper airway that increase negative inspiratory pressure could not be confirmed as important for the development of snoring, although they may increase its loudness.

Biophysical Phenomena↗

PubMed2003

Postoperative concomitant irradiation and chemotherapy with mitomycin C and bleomycin for advanced head-and-neck carcinoma.

PURPOSE: In a prospective randomized clinical study, simultaneous postoperative application of irradiation (RT), mitomycin C, and bleomycin was tested in a group of patients with operable advanced head-and-neck carcinoma. It was expected that the planned combined postoperative therapy would reduce the number of locoregional recurrences and prolong survival. METHODS AND MATERIALS: A total of 114 eligible patients with Stage III or IV squamous cell head-and-neck carcinoma were randomized to receive postoperative RT alone (Group 1) or RT combined with simultaneous mitomycin C and bleomycin (Group 2). Patients were stratified according to the stage and site of the primary tumor and the presence or absence of high-risk prognostic factors. Primary surgical treatment was performed with curative intent in all patients. Patients in both groups were postoperatively irradiated to the total dose of 56-70 Gy. Chemotherapy included mitomycin C 15 mg/m(2) after 10 Gy and 5 mg of bleomycin twice a week during RT to the planned total dose of 70 mg. RESULTS: At 2 years, patients in the radiochemotherapy group had better locoregional control (86%) than those in the RT alone group (69%; p = 0.037). Disease-free survival and overall survival was also better in the radiochemotherapy group compared with the RT-alone group (76% vs. 60%, p = 0.099; and 74% vs. 64%, p = 0.036, respectively). Patients who benefited from chemotherapy were those with high-risk factors. CONCLUSION: The results of the present study indicate that concomitant postoperative radiochemotherapy with mitomycin C and bleomycin improves locoregional control and survival in patients with advanced head-and-neck carcinoma. The patients who benefited from chemotherapy were those with high-risk factors.

Adult↗