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Biomedical subjects

M Strietzel

Publications and source records attributed to M Strietzel.

At least 19 recordsLinked to original sources
PubMed1998

Fluconazole prophylaxis in patients with head and neck tumours undergoing radiation and radiochemotherapy.

The aim of the present study was to investigate the incidence of Candida stomatitis and resulting interruptions in radiation and radiochemotherapy in 50 patients suffering from squamous cell carcinomas of the head and neck region receiving fluconazole (100 mg d-1) in comparison with a historical control group (n = 50) without specific prophylaxis. Twenty of the control patients (40%) demonstrated Candida stomatitis, with seven of them (14%) requiring interruptions in anticancer therapy. In contrast, none of the patients with fluconazole had evidence of Candida stomatitis (P = 0.0000051) and subsequent interruption of anti-cancer therapy (P = 0.0061). Laboratory monitoring for the presence of Candida species was performed in 30 patients before and after therapy with fluconazole. Candida albicans was identified less frequently after therapy when compared with the pretreatment status. However, C. glabrata and C. krusei were isolated in some of the patients, probably because of drug resistance of these subspecies. The results demonstrate the clinical usefulness of prophylactic fluconazole applications in patients suffering from head and neck tumours with the aim of reducing Candida stomatitis and the resulting interruptions in radiation and radiochemotherapy.

Adult↗
PubMed1997

[Influence of reduction of radiation dosage on the incidence of radiation-induced pneumonitis, pulmonary fibrosis and pericarditis after mediastinal irradiation in the treatment of lymphogranulomatosis].

BACKGROUND: The amount of radiation dose applied in the treatment of Hodgkin's disease is associated with the incidence of complications including radiation-induced pneumonitis, lung fibrosis and pericarditis. Therefore, from the beginning of 1986, we have started to apply a radiation therapy approach with reduced doses in order to minimize complications while maintaining effective treatment. PATIENTS AND METHOD: From 1983 through 1992 141 patients suffering from Hodgkin's disease were included in the present study. All of them were treated by radiation of mediastinum. In 126 cases polychemotherapy was applied before radiation. From 1986 we used a reduced radiation dose in cases that were treated by radiation alone (affected nodal regions with 40 Gy instead of 45 Gy and unaffected nodal regions with 36 Gy instead of 40 Gy) as well as after application of chemotherapy (affected nodal regions 36 Gy instead of 40 Gy and unaffected nodal regions with 30 Gy instead of 36 Gy). Ninety-five patients were treated according to the new therapy protocol. Forty-six patients had been treated with the higher dosages and served as the historical control group. Radiation therapy included Co-60, 15-MV and 9-MV photons, and 15-MeV and 9-MeV electrons. Serial thoracic X-ray controls were performed. CT scans, echocardiographic and electrocardiographic investigations were added in selected cases. RESULTS: During the period from 1983 to 1992, we diagnosed radiation-induced pneumonitis in 31% of the patients who underwent radiation therapy of the mediastinum. In addition, 16% demonstrated lung fibrosis and 10% pericarditis. After implementation of the reduced radiation dosages, the incidence of pneumonitis decreased from 35% to 24% (nearly significant in the 5% range), lung fibrosis from 24% to 12% (p < 0.05) and pericarditis from 26% to 2% (p < 0.01). The efficacy of treatment remained unaffected by the new therapy approach as has been demonstrated for cumulative survival data and recurrence-free intervals. CONCLUSIONS: Reduction of radiation dose in patients with Hodgkin's disease who undergo mediastinal radiation leads to a decrease in the incidence of radiation-induced complications (pneumonitis, lung fibrosis, pericarditis) whereas treatment efficacy remains unchanged.

Evaluation Studies as Topic↗
PubMed1997

[Use of fluconazole as antimycotic prophylaxis in radiotherapy of patients with head and neck tumors].

The aim of the present study was to investigate the incidence of Candida stomatitis and resulting interruptions in radiation therapy in 50 patients suffering from squamous cell carcinomas of head and neck region receiving fluconazole (100 mg/d) in comparison to a historical control group without specific prophylaxis. 20 of the control patients (40%) demonstrated Candida stomatitis with 7 of them (14%) requiring interruptions of radiation therapy. In contrast, none of the patients with fluconazole had evidence of Candida stomatitis and subsequent interruption of anticancer therapy. Laboratory monitoring for the presence of Candida species was performed in 15 other patients before and after therapy with fluconazole. Candida albicans was identified less frequently after therapy when compared to the pretreatment status. However, C. glabrata and C. krusei were isolated in some of the patients probably due to decreased drug susceptibility of these species. The results demonstrate the clinical usefulness of prophylactic fluconazole applications in patients suffering from head and neck tumors with the aim to reduce Candida stomatitis and resulting interruptions in radiation therapy.

Antifungal Agents↗
PubMed1996

An adjuvant afterloading brachytherapy device for use after orbital exenteration in patients with orbital malignancies.

In cases of malignant diseases situated within the orbit and threaten to extend beyond it, removal of the orbit and periorbital contents may be indicated, followed by adjuvant chemotherapy or irradiation. An effective radiotherapy device for treatment of residual or suspicious cancer in the enucleated orbit consists of an external-beam radiation source (60Co) and an intraoperatively fitted mould as a guide for the flexible afterloading tubes using a 192Ir source. Considering the physical dose distribution and the local situation, this therapy permits a high dose with homogeneous dose distribution to the target area of the orbit but also allows significant dose reduction to adjunctive critical structures. Four patients with different orbital malignancies were treated by means of a combination of percutaneous radiotherapy with afterloading brachytherapy following orbital exenteration. The individual mould of the orbital cavity is modeled at the end of the operation. The technique of radiotherapy, dose distribution, and follow-up of the disease are demonstrated. Orbital malignancies with an extremely poor prognosis may profit from the application of this combined radiotherapy to avoid supraradical surgical intervention.

Adenocarcinoma↗
PubMed1989

[Intracavitary afterloading-therapy of cervicofacial tumors--results and experiences to date].

Since 1984 we have used the intracavitary afterloading brachytherapy also in therapy of cervicofacial tumors. We report on 21 patients, 12 of them with therapy of recurrences and 9 with a primary therapy. The patients represent an inhomogeneous selected group. With recurrences also long tumor-free survival periods (till now 44, 52, 53 months) can be attained by means of contact therapy alone or in combination with percutaneous irradiation. Also after primary intensive irradiation curative radiation doses are applicable again as therapy of recurrences. Procedure can likewise be applied in primary therapy of cervicofacial tumors as a boost-irradiation in percutaneous radiotherapy. It should be reserved to limited tumor situations in compliance with irradiation of small volumes.

Brachytherapy↗
PubMed1989

[The use of glass fiber endoscopy in afterloading contact therapy].

In afterloading contact therapy of cervico-facial tumors the control of position of the applicator has a special importance. Especially this applies the contact therapy in epipharynx. By means of a phantom of synthetic material the application can be simulated in epipharynx and the position of the applicator can be shown by means of computer-assisted tomography in all three planes. Estimation of distances by computer-assisted tomography allows correction in position and also control of corrected applicator position. Compared to it the glass fibre endoscopy requires longer working time and the topographical orientation is rendered more difficult with the technique being available in the same manner as post-rhinoscopic endo-photographic documentation of findings.

Brachytherapy↗