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Biomedical subjects

R Ragona

Publications and source records attributed to R Ragona.

At least 19 recordsLinked to original sources
PubMed1992

Results of chemotherapy plus external reirradiation in the treatment of locally advanced recurrences of nasopharyngeal carcinoma.

Between 1982 and 1991, 16 patients with recurrent cancer of the nasopharynx were treated with chemotherapy (CT) and radiotherapy (RT). All patients had received prior RT (45-69, 30 Gy). According to rTNM there were three rT2, one rT3 and 12 rT4. 5 patients were N1. Reirradiation (12-46 Gy, mean: 28) started 3-4 weeks after CT (2-6 cycles of different combinations), but 2 cases involved concomitant therapy. Out of 16 patients 7 had complete response (CR) (43.7%), 7 partial response and 2 no response. Statistically significant prognostic factors for obtaining CR were time of relapse and response to initial CT. Median duration of CR was 22+ months (9-64+). Failures at primary site occurred in 3 patients, 2/2 of those receiving CT without platinum compounds and 1/5 of other ones, with statistically significant difference in local recurrence free-survival between the two groups. Two- and 3-year actuarial overall survival were 28% and 10%. Rates of disease-free survival were 17% and 8%, respectively. The acute toxicity was generally mild. No central nervous system damage or radiation-induced myelitis were observed in survivors.

Adult↗
PubMed1990

Hyperthermia alone in the treatment of recurrences of malignant tumors. Experience with 60 lesions.

Localized hyperthermia alone has been used for the treatment of cancer recurrences in which previous conventional therapies have failed. Since 1983 and 1988, 57 patients with 60 lesions have been heated by means of a microwave and radiofrequency system. Treatment protocol provided 45 minutes of heating at the intratumor temperature of at least 42 degrees C, twice a week, for a total number of six, eight, or ten heating sessions. Invasive intratumor thermometry was performed for all lesions. Complete response (CR) was obtained in ten cases (16.6%) and partial response (PR) in 14 (23.4%). Higher rates of CR were observed in the chest wall (38.5%) compared with the head and neck area (11.4%), trunk (10%), and limbs (none). Adenocarcinoma was the most responsive histologic type (40%). Squamous cells carcinoma had 7.7% CR. The only case of undifferentiated carcinoma showed CR; there were none on five sarcomas. Long-term local control (24 months) was approximately 7%. The multivariate analysis showed the statistical significance of the histologic variety (adenocarcinoma versus others, P less than 0.0001). Side effects and complications of the treatment were minimal.

Adult↗
PubMed1990

Serum thyroid hormone changes in head and neck cancer patients treated with microwave hyperthermia on lymph node metastasis.

Eleven patients with head and neck cancer (ten men, one woman; mean age, 65 years) (larynx, six; oropharynx, two; tongue, one; skin, one; thyroid, one) with regional lymph node enlargements either in contiguity or firmly adherent to the vascular structures of the neck have been treated by means of external microwaves (915, 434 MHz) applicators. All patients were treated by hyperthermia (42-45 degrees C) alone (ten sessions, twice a week, each lasting 30 minutes). Thyroid hormones (T4, T3, FT4, FT3, rT3, thyroid stimulating hormone less than obTSH]) were evaluated during sessions 1, 2, 3, and 8, just before the session (time [t] = 0) and at 10-minute intervals during the heating (t = 10, t = 20, t = 30). Blood was also taken 10 (t = 40) and 30 minutes (t = 60) after the end of each session. T4 showed a decreasing trend; T3 decreased significantly from t = 10 and reached the lowest values at t = 40 and t = 60; FT4 decreased at t = 40 and t = 60 at all sessions; FT3 and rT3 showed no change; TSH decreased at t = 10 until t = 40.

Aged↗
PubMed1990

Technique, dosimetry and results of total body irradiation in preparation to ABMT in Torino.

Twenty-five patients with haematologic malignancies received total body irradiation (TBI) as part of their conditioning regimen prior to autologous bone marrow transplantation (ABMT). TBI was delivered with an 18 MeV photon beam through AP-PA ports; the total dose was 13.2 Gy/8 fractions over 4 days; shields were used to limit the total dose to the lung to 8-10 Gy. Five relapses were observed; among 14 patients with ALL or advanced lymphoblastic lymphoma, 10 patients are currently alive and free of disease. Acute and late morbidity of TBI were low.

Adolescent↗
PubMed1990

[Total skin therapy with electron beams. I. Physical and geometric factors].

The study pf physical and geometrical factors influencing dose distribution is necessary in performing the Total Skin Electron Therapy. The authors examined some aspects. Photographic emulsions in humanoid phantom were used for dosimetry. The techniques uses 6 dual fields at 320 cm treatment distance, with a degrading lucite filter 100 x 200 x 0.6 cm3 at 20 cm from the patient. Absorbed dose and energy were determined according TG 30 and 21 AAPM. The position of degrading filter was recognized to be the main factor influencing dose rate, penetration depth and dose homogeneity.

Electrons↗
PubMed1990

[Total skin therapy with electron beams. II. Clinical results in mycosis fungoides].

Between 1985 and 1989, 19 patients with mycosis fungoides were treated by Total Skin Electron Therapy (TSET). Overall and disease-free survival at 3 years were 72% and 40%. The complete remission (CR) rate was 100% in patients with plaque and 33.3% in those with tumor masses; patients with negative nodes had a 90% CR rate whereas in those with adenopathy the rate was 55%. Overall and disease free survivals were also correlated with these factors.

Actuarial Analysis↗
PubMed1990

[5- and 10-year survival in carcinomas of the oral cavity (T1-2/N0-1) treated with external radiotherapy alone or associated with surgery and/or chemotherapy].

The authors report their results on the treatment of 211 T1-2/N0-1 carcinoma of the oral cavity treated with radiotherapy alone or associated with surgery and/or chemotherapy. Five- and ten-year survival rates are respectively 48 and 37%. Two groups were recognized: one with a better prognosis (T1 gum and cheek) and another with a poor prognosis (T2-N1 mobile tongue and floor of the mouth).

Adult↗
PubMed1989

Three new applicators for hyperthermia.

A computerized system with automatic treatment parameters control for radiological hyperthermia, called Sapic SV03, is presented. The system has been planned and built by the "Sezione Avionica ed Equipaggiamenti" of the Aeritalia in cooperation with the Radiotherapy Department of the University of Turin. The device is supplied with a multifrequency generator system (915, 433, 2-30 MHz) connected with many kinds of applicators, with a fiber optic system for temperature control and a previsional thermometry system. In this paper the authors presented three new applicators. The first one is a concave parallel microstrip applicator at 433 MHz, with a size 16 x 9 cm; the heating pattern is homogenous until 4 cm of depth. This antenna can be used for the treatment of chest wall recurrences of breast cancer. The second is a 27 MHz inductive ring and the third applicator is a pyramidal antenna ("TEM line") that operates at a frequency around 27 MHz.

Computer Systems↗
PubMed1988

Lateral high abdominal ovariopexy: an original surgical technique for protection of the ovaries during curative radiotherapy for Hodgkin's disease.

An original surgical method for gonadal protection in young women given pelvic radiation for Hodgkin's disease is presented. Lateral high ovarian transposition (LHAO) consists of the transposition of the ovaries into the paracolic gutter during staging laparotomy, after disconnecting the gonads from the fallopian tubes by dividing the tubo-ovarian vessels. The technique's effectiveness was assessed by a study using clinical investigation, radioimmunoassay (RIA) determination of sex hormones, and dosimetry; of 18 patients treated, 10 participated in the study. All but one have normal menses and hormone values, and one pregnancy occurred. We also calculated the doses absorbed by the ovaries and proved that, during inverted Y irradiation following LHAO, the ovaries are exposed to nearly one-half the dose they receive after traditional medial transposition. During subtotal nodal irradiation after LHAO, the irradiation dose is higher than after medialisation, but absolute values are minimal and castration is not induced.

Adolescent↗
PubMed1988

[Radiotherapy in the treatment of carcinoma of the major salivary glands].

The authors conducted a retrospective study on 99 patients with malignant tumors of the major salivary glands, who had been treated by radiotherapy between 1976 and 1986: 86 cases of parotid tumors and 13 cases of submandibular gland tumors. Only 28 tumors (28%) were T1-T2, N0-N1. Local control, 3-5 and 8-year survival rates, and complications were considered. Radiation therapy alone was performed on 19 patients (19%), while combined surgical and radiation therapy was performed on 80 patients (80%). The results of radiation therapy alone and combined with surgery are discussed. Loco-regional disease control was obtained in 9 out of 19 patients (47%) by irradiation alone, and by combined irradiation and surgery in 60 out of 80 cases (75%). Distant metastases developed in 23 out of 99 patients (23%). Loco-regional metastases were the most frequent cause of death (20 out of 55 cases: 36%). Severe complications were extremely rare. The results demonstrate not only the advantages of combined treatment but also the value of radiotherapy alone in the treatment of tumors of the major salivary glands.

Adolescent↗
PubMed1987

[Technic and dosimetry in total body irradiation with 18 MeV photons].

Total body irradiation (TBI) is used in our Institution in the conditioning regimen for bone marrow transplantation. The fractionation pattern consists of two daily fractions of 1.65 Gy repeated for 4 days (total dose 13.20 Gy in 8 fractions). Lung dose is reduced by means of lead custom shaped shields directly strapped to the patient surface. TBI is delivered by a THERAC 20 linear accelerator with two opposing AP-PA photon beams with a maximum energy of 18 MeV. Treatment distance is 340 cm and the patient is treated in a semi-standing position. Dosimetry studies in a homogeneous phantom were performed in the treatment geometry and consisted in the determination of: tissue maximum ratios (TMR) at different depths, absorbed dose along the median axis and the diagonal of the field, variation of the absorbed dose in the prescription point with different volumes of scattering material, and transmission of shielding and compensating material. A semi-empiric formula for the calculation of absorbed dose in a point has been obtained. A subsequent study in a Rando phantom with termoluminescent dosimeters (TLD) has shown a +/- 5% agreement between calculated and measured values and a +/- 7% homogeneity.

Humans↗
PubMed1987

[Total cutaneous irradiation with low energy electrons and mycosis fungoides. Technic and dosimetry].

Mycosis fungoides initially involves the epidermis and the superficial layers of derma at a depth of about 1 cm. Wide field irradiation with low energy electrons is therefore the treatment of choice in the initial stages of the disease. In our Institute, total skin electron beam irradiation is delivered with Therac 20 linear accelerator: the lowest available energy is 6 MeV. A lucite sheet of 0.6 cm thickness is used to decrease the energy of the beam. We used film dosimetry to evaluate the homogeneity of dose distribution in an Alderson-Rando phantom with different arrangements of the fields and the lucite sheet: 4 and 6 fields techniques have been compared with different positions of the lucite filter, near the phantom and near the collimator. Six fields yield a better dose distribution: homogeneity is within +/- 3.7%, while with four fields it is within +/- 6%. X-rays contamination is less than 2%. "In vivo" dosimetry has been performed using thermoluminescent dosimeters: homogeneity is within +/- 15%.

Electrons↗
PubMed1987

[Results of radiotherapy in the treatment of 218 carcinomas of the tonsillar area].

After a brief review of the literature, the results of the treatment by radiation therapy in 218 patients with tonsillar region carcinoma are reported. The patients were treated at the Turin University Radiotherapy Department (131 cases) and at the Radiotherapy Department of the Ospedale Maggiore, Novara (87 cases) from 1976 through 1984. The series included 29 T1, 88 T2, 64 T3 and 37 T4; 86 patients (40%) were N0. Only 49 patients were stages I and II (1/4 of the total). The local control (T) rate at the end of therapy was 63.5% for the overall series (139/218) ranging from 100% in T1, 72.6% T2, 54.6% T3 to 30% T4; the regional control (N) for patients with cervical lymphadenopathy was 66% (88/132). The overall 5-year survival was 38%; the 5-year disease-free survival was 35%. The 5-year survival according to T-stage was 52% for limited cases (T1-T2) in comparison to 22% for advanced ones (T3-T4). The 5-year survival for N0 stage was 55%; when neck nodes were present (N # 0) the survival was 29% after 5 years. Complications included 6 cases of trismus and 2 osteonecroses of the mandible. Second primary malignant diseases were seen in 17 cases (7.8%). The most common cause of death was failure in primary tumour control (80% of cases). In this series the results of radiotherapy of early stage tonsillar carcinomas are quite good; patients with large tumour masses fare less satisfactorily. Better results should be obtained in the future by identifying prognostic factors, monitoring potential causes of treatment failure and optimizing the radiotherapeutic treatment plan and technique.

Adult↗
PubMed1986

[Comparison of dosimetric protocols for beams of photons and electrons].

In this work we utilize different methods for the calculus of the absorbed dose at different photon and electron energies and we evaluate the difference between their yields. One of these methods is based on the consideration of the factors C lambda e CE (ICRU, HPA, AAPM protocols before 1980); by means of the others (AAPM-Task Group 21, NACP) we seek to obtain a better accuracy introducing new conversion factors. Our measurements were performed using cylindrical and flat ionisation chambers. In the considered energy range we obtained the following results: the new conversion factors have a higher value than C lambda and always smaller than CE.

Electrons↗