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R Hünig

Publications and source records attributed to R Hünig.

At least 19 recordsLinked to original sources
PubMed1992

The role of laminectomy in the combined treatment of metastatic spinal cord compression.

A retrospective analysis of clinical data concerning 140 patients with spinal cord compression is presented. Treatment consisted of a surgical decompressive laminectomy followed by radiation therapy in 127 cases. Primary radiation therapy supported by steroids was applied in only 26 cases. A dose of 30-40 Gy in 15-20 fractions was delivered to all patients. Treatment outcome was analyzed by comparing motor function (categories: no deficit, mild deficit ambulatory, paraparetic not ambulatory, paraplegic), sphincter function, and pain relief before and after treatment in both modalities. Following laminectomy and radiation therapy, 82% of paraparetic patients regained their ability to walk, sphincter function improved in 68%, pain relief was achieved in 88%. Following radiation therapy alone, 64% of paraparetic patients became ambulatory, 33% showed a normalization of sphincter function, and 72% became pain free. Our results indicate that laminectomy should play a major role in the treatment of patients with metastatic spinal cord compression. The decision as to the treatment of choice has to be made individually for each patient taking into consideration his general condition, life expectancy, and origin of the primary.

Adult↗
PubMed1992

[Diagnostic problems in local recurrence after breast saving treatment].

353 patients with stages pTis, pT1-2, pN0-1, cM0 breast cancer have been treated consecutively by breast conserving therapy in a prospective, nonrandomized study at the University Hospital Basel and the Women's Clinic Rheinfelden/Baden/Germany. The median age was 47 years, the median follow-up time 67 months, and 4% only of this collective were lost to follow-up after a median time of 42 months. In 79% of the cases the tumor was excised totally, while in 19% the resection margins were positive and in 2% only the margins were not available for histological judgement. The rate of local failure reached 8% with a median time interval of 53 months. 116 patients showed postactinic induration in the primary tumor region. 73 of these were given additional diagnostic examination: The postactinic induration was judget clinically suspicious in 51 cases and clinically nonsuspicious of local failure in 22 cases. All 73 patients received additional examination by mammography and biopsy. By comparison with the histological results the clinical results were correct in 59% and false in 41%, while the mammographic results were correct in 82% and false in 18% of the cases.

Biopsy↗
PubMed1991

[Health status and late complications following allogeneic bone marrow transplantation. A review].

Better results following bone marrow transplantation (BMT) have increased the number of patients in longterm follow-up. Health status and late effects are therefore of increasing interest. We discuss here the incidence and follow-up of late complications after allogenic BMT. Any conditioning regimen including TBI in postpubertal women introduces a postmenopausal status. In contrast, normal function is found after BMT without irradiation. In men, there is usually permanent azoospermia after TBI but not following chemotherapy alone. Thyroid dysfunction after BMT with TBI has been reported in about 40% of patients. In most of them compensated hypothyroidism with elevated TSH is found. BMT with TBI induces growth retardation in children. Decreased growth hormone levels are observed and substitution can induce normal height development. Interstitial pneumonitis (IP) is a major cause of death. It occurs on average three months after BMT but late onset IP's are increasingly reported. Cataracts are common after BMT. The risk of cataracts in patients given single dose TBI attains 80-100% after four years. Under treatment with cyclophosphamide alone, the risk of lens opacification is less than 20%. So far, patients treated with fractionated TBI have not developed more cataracts than those treated with chemotherapy alone. Impaired renal function is common early post-transplant. Risk factors include cyclosporine (CSA) nephrotoxic antibiotics and antifungal drugs. So far, few secondary malignancies have been reported in humans after BMT. However, actual observation time is still too short for final evaluation. Prevention or treatment is instituted for common complications. It is expected that other types of tissue damage will be recognized.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Conservation therapy for breast cancers other than infiltrating ductal carcinoma.

Pathologic review of 861 Stage I and II breast cancers yielded 152 patients (18%) with histologic types other than invasive ductal carcinoma. All patients had been treated by breast-conserving surgery and radiotherapy, including supplemental radiation to the tumor bed. For 67 patients with predominantly lobular carcinomas, the actuarial overall 5-year survival was 100% and 77% for node-negative and node-positive patients, respectively. The actuarial probability of recurrence in the treated breast (13.5% at 5 years) appeared to be somewhat greater than that observed after treatment of invasive ductal cancers (8.8% at 5 years, P = 0.11). Of 12 mammary recurrences in patients with lobular carcinoma, four occurred at a considerable distance from the original primary and seven were multifocal, involving more than one quadrant in five patients. Of 47 patients with strictly in situ carcinomas, one patient whose axillary nodal status had not been determined subsequently developed distant metastases. Three additional patients developed mammary recurrence, two at the primary tumor site and one in another quadrant. The actuarial 5-year mammary recurrence and overall survival rates were 4% and 98%, respectively. For 27 patients with true medullary cancers, overall survival at 5 years was 90%. One localized mammary recurrence was observed at the site of the original primary. Actuarial mammary recurrence rate was 4% at 5 years. No relapse was observed in ten patients with colloid and one patient with adenoid cystic carcinoma. The authors conclude that, in addition to its well-established efficacy in the treatment of infiltrating ductal carcinomas, the combination of tumor excision and radiotherapy appears to provide adequate local control for other histologic types as well. However, patients with lobular cancer appear to be at somewhat greater risk of mammary failure, and recurrences in such patients tend to be multifocal and multicentric.

Adenocarcinoma, Mucinous↗
PubMed1978

[Radiotherapy of esophageal neoplasms. Review of the 1st post-therapeutic year].

The first post-therapeutic year in 33 patients with esophageal cancer treated by radiotherapy alone is analyzed. Effectiveness of treatment was measured by clinical symptoms, radiological findings, and autopsy results. Out of a group of 33 patients, 36.4% showed no subjective or objective symptoms 1 year after commencement of therapy. Based on our own experience and the literature, the concept of therapy in esophageal cancer is discussed.

Adrenal Gland Neoplasms↗
PubMed1978

[Tonsillar neoplasms].

While it is generally accepted that the treatment of choice in carcinoma of the tonsil is transcutaneous radiotherapy (including lymphatic drainage), opinion on additional surgical interventions is still divided. The possible operations are extended tonsillectomy followed by radical neck dissection or the composite operation with partial mandibulectomy. The importance of the composite operation for T3 stage tumors is emphasized. Chemotherapy (bleomycin) was rarely used in our patients, and only initially in extensive carcinoma.

Bleomycin↗
PubMed1978

[Tridimensional irradiation planning with Philips TPS and ultrasound gray-scale tomography in the course of routine work (author's transl)].

Extent and location of the target volume as well as the optimum choice of radiation and field and the use of wedges or compensation filters are critical parameters with respect to the quality of a treatment plan. The latter should always take into account the individual topography, even if standard concepts can be applied in some cases. We feel that treatment planning in each patient would require too much of the staff's time. Therefore equipment that helps to save planning time is welcome, particularly if it increases the reliability of the final results. In this respect ultrasonic tomography is a useful tool for solving many problems. These will be described, discussed and compared with the advantages of computerized tomography, which is just being introduced.

Mathematics↗
PubMed1977

[Diagnostic laparotomy in Hodgkin's disease: indication, management, results (author's transl)].

Till December 31st 1976, diagnostic laparotomy was carried out in 58 patients with Hodgkin's disease. Of these, 23 cases (40%) revealed abdominal involvement. The tumor stage found by conventional diagnostics before surgical treatment had to be altered in 16 patients (27%). It had to be increased in ten and lowered in six cases. Of 13 splenic Hodgkin infiltrations twelve had not been supposed preoperatively; four out of 43 sound organs had been suspected preoperatively because of splenomegaly. Subdiaphragmatic histological findings involving a rather unfavorable prognosis were seen in nine patients (16%). In Hodgkin's disease, risk groups cannot be selected with confidence, as no definite correlation between the frequency of subdiaphragmatic affection and the primary manifestations, histology or general symptoms was observed. Since operation risk of diagnostic laparotomy is low, operable stage I-III cases with Hodgkin's disease should undergo diagnostic laparotomy prior to treatment planning.

Adolescent↗
PubMed1977

[The diagnosis of intracranial tumors by CT (computerized tomography) from a practical point of view (author's transl)].

In a historical abstract the mathematical basis of image reconstruction techniques and CT is reviewed. The enhancement of iodine contrast media is essential in CT diagnostic of space occupying intracranial lesions. Intracranial tumors usually show relatively characteristical but mostly non-specific absorption patterns. Additional clinical information is necessary for differential diagnostic evaluation. The development of tables with various tumor patterns is recommended. Absorption feature of primary and secondary brain-tumors with the surrounding edema is explained. Glioblastomas as well as metastases often show a distinct cerebral edema which has been observed in 64% of our patients with metastases and distinctly localized high dense foci in 69%. 6000 patients were investigated by CT and 1708 examinations were performed with contrast enhancement of other intravenously applicated contrast media.

Adolescent↗
PubMed1975

[Radiotherapy of mammary cancer related to tumor size, tumor localization and surgical management (author's transl)].

Postoperative irradiation of the regional lymphatics is indicated when suspected positive lymph nodes remain after mastectomy. Postoperative chest wall irradiation is carried out in cases where staging of the tumor is T-3 and T-4. A local tumor control can be achieved with irradiation as the only means of therapy. Preoperative radiotherapy seems to lead to favorable results and should be encouraged in cases of advanced breast cancer.

Breast Neoplasms↗