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At least 91 records · Page 5Linked to original sources

Conservative management of breast carcinoma. The Créteil experience.

The results of conservative management of breast carcinoma are presented. The disease free survival for patients with T1 lesions was 84 per cent at 5 years, 76 per cent at 7 years and 65 per cent at 10 years, for T2 75, 71 and 64 per cent, and for T3 65, 51 and 45 per cent. The proportion of breast conserved amongst the patients free of disease at 10 years was 94 per cent for T1, 93 per cent for T2 and 80 per cent for patients with T3 lesions. The cosmetic results were very good for T1 lesions, good for T2 and quite good for T3 lesions. Up to 1981 a simple tumorectomy was carried out in most of the T1 lesions and some of the T2 lesions, followed by radical irradiation. Most of the T2 and T3 lesions were exclusively treated with radical irradiation. In an attempt to improve the cosmetic results, since 1981, the indications for tumorectomy were extended to include some of the T2 lesions, and when possible also some of the T3 lesions, where a tumorectomy is performed before or after irradiation, together with a limited axillary dissection.

Brachytherapy↗

[Radiation late damage of the thoracic marrow after irradiation in the thoracic region (author's transl)].

A report is given about radiation late damage on the thoracic marrow, basing on the case histories of 100 patients irradiated in the mediastinal region with telegamma from a 60 Cobalt or 137 Caesium source between 1959, January 1st and 1972, december 31st. 77 patients were followed up during 18 months after the radiotherapy was ended; in 3 of them (equal to 4 p.c.) a radiation-induced myelopathy was found. These 3 cases were suffering from Hodgkin's disease, whereas in none of the patients with bronchial carcinoma--in spite of markedly higher radiation doses--any late damage was observed. Therefore, in irradiation of the mediastinal region, the exposure of the spinal marrow should be reduced, although the dose alone is not decisive for the development of a radiation myelopathy.

Adolescent↗

[New experiences in primary radiotherapy for vaginal carcinoma with notes on a multistage refined target volume concept].

Based on an analysis of a small new series of carcinomas of the vagina, observed in St. Georges General Hospital, Hamburg, a five year cure rate of more than 59% as a result of radiotherapy alone in 27 cases has been stated. Compared with former statistical information this effect represents a highly significant improvement. This improvement can be attributed to an individualized use of localised curie therapy. Performed with the flexible application of 127 Cs vaginal cylinders adapted to the individual anatomic extention of tumours. Apart from this individual adaption to the tumour size and site the method of curie therapy includes full utilisation of the space available within the genital tract. It is combined with a telecobalt treatment performed as a 4-axis-180 degrees-rotation directed the lateral parts of the true pelvis. The study gives a chance to discuss the target volume concept for combined radiotherapy of gynecological cancers. It is distinguished between target volumes of 1st, 2nd and 3rd order. The difficulties arising when the different components of combined radiotherapy of gynecological tumours have to be summed up, cannot easily be overcome. Further research with this field seems to be desirable.

Adult↗

[Criteria for an optimal isotope in gynecologic radiotherapy].

With regard to the evident disadvantages of radium, nowadays an artificial radiation source always should be considered, since it may be much more favorable for any intracavity application. The most usual ones are Cs-137, Co-60 and Ir-192. Each of these isotopes has its advantages and disadvantages; therefore the choice of the isotope must take into account the criteria and requirements for each intracavitary radiation technique.

Cesium Radioisotopes↗

[Technics and radiophysics of Buchler's afterloading device].

Informations are given upon a newly developed afterloading apparatus. It works by means of a point-shaped Iridium-192 source which is oscillating within the applicator during irradiation. The motion of the source is regulated by exchangeable cams. A great variation of isodose curves can be obtained in this way. The safety devices of the installation yield optimal radiological protection. The compact construction system of the basic equipment allows flexible use within existing therapy rooms.

Female↗

Radioisotopes in treatment of stage Ia ovarian cancer.

The role of radioisotopes in the treatment of ovarian carcinoma is discussed. The University of Iowa experience with prophylactic treatment of stage Ia ovarian cancer with radiogold is presented. Cumulative survival in 56 patients with epithelial cancers was 94.3%. In a prospective study, we compare the use of radiogold and total abdominal irradiation in the treatment of stage Ia ovarian carcinoma.

Adolescent↗

[Cryotherapy, polychemotherapy and radiotherapy in the treatment of oral carcinoma. Preliminary note].

Following a short introduction to outline the therapeutic approach to primary carcinoma of the oral cavity, technical modalities, and the techniques of using this new type of cryo-polychemo-radiotherapeutic association are reviewed. The extremely interesting and flattering results obtained in 30 cases of patients suffering from this form of cancer must, however, be considered fairly modest if allowance is made for the time limits (insignificant). Results will be reviewed when a longer period has gone by.

Adult↗

Combined intraoperative and postoperative irradiation for soft tissue sarcomas.

A major problem in the management of soft tissue sarcomas is the high rate of local recurrence postoperatively, regardless of whether the surgery performed was radical or conservative. The addition of irradiation to the tumor bed has decreased this risk significantly. In an attempt to achieve maximal local tumor control, a number of patients were treated by means of excisional surgery combined with an intraoperative implant and postoperative external irradiation. A new type of intraoperative irradiation procedure was used, in which iridium (192Ir) is inserted into afterloading nylon catheters which are implanted in the tumor bed at the time that the tumor is surgically excised.

Brachytherapy↗

[Side effects of postoperative irradiation of uterine cancer with high dose rate iridium and low dose rate radium].

A report is given about reversible and irreversible complications following postoperative irradiation in cases of endometrial carcinoma. Intravaginal brachytherapy was performed. In advanced cases or in cases with poor prognosis (tumor grading) percutaneous irradiation was added (Co60). In 156 cases low-dose-rate irradiation (Ra226) and in 143 cases high-dose-rate irradiation (Ir192) was applied intravaginally. Reversible complications (cystitis, proctitis) could be observed following Radium in 7%, following Iridium in 14%. Irreversible complications (fistulas, stenoses): 1.9% following Radium and 3.5% following Iridium. When high-dose-rate irradiation was combined with percutaneous Co60 therapy, reversible complications occurred in 22.8%. After changing the Iridium-therapy scheme (reduction of dose from 10 to 7 Gy and irradiation only of the upper two thirds of the vagina) complications only could be observed in the same level as in Radium-therapy. High-dose-rate irradiation does not need hospitalization of the patients.

Brachytherapy↗