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Quality assurance in radiotherapy of neoplasms of the upper abdomen.

Neoplasms of the upper abdomen involve complex problems for radiotherapy. In fact, the anatomical structures are close to each other, lymphatic vessels are numerous and complex, there are organs of low radiation tolerance whose reciprocal position is of difficult assessment and finally there is high visceral mobility due to the diaphragmatic movements. Moreover most organs cannot be identified with the simulator and bone references are of little use. Therefore, treatment of these sites requires the routine application of quality assurance programs, checks of treatment reproducibility, in particular: In a number of clinical settings, CT study of the region (in treatment position) must be included in treatment planning and set-up with simulator and fluoroscopy. Before, during, and after radiotherapy, clinical exams and laboratory tests should be performed to assess the integrity of critical organs.

Abdominal Neoplasms↗
PubMed1977

Cerebral necrosis following radiotherapy of extracranial neoplasms.

We have examined 6 patients with delayed cerebral necrosis following irradiation of extracranial neoplasms. Four of the 6 patients received 1,760 rets (or less) tumor dose. The initial symptoms attributable to radiation necrosis appeared 4 to 31 months after irradiation and were those of a focal supratentorial mass. Cerebral angiography delineated an avascular frontal or temporal lesion in all 6 patients; in 1 case a magnification study revealed narrowing, irregularity, and occlusion of small cortical vessels. Four of our 6 patients underwent craniotomy with partial or complete surgical extirpation of necrotic brain tissue. Two operated patients are alive and without disabling neurological symptoms 30 and 25 months, respectively, after the operation. The characteristic neuropathological features of delayed radiation necrosis of brain suggest that vascular injury rather than neuronal or glial damage is of primary pathogenetic significance.

Adult↗
PubMed1958

RADIOTHERAPY.

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Neoplasms↗