ABSTRACT
PURPOSE: To evaluate the overall and disease-free survival of patients with advanced cervical carcinoma (FIGO stages IIB-IIIB) treated with external beam radiotherapy (EBRT) and medium dose rate brachytherapy (MDR-BT) plus/minus surgery. PATIENTS AND METHODS: One hundred and seven patients received preoperative RT (group A) and 154 were treated with definitive RT (group B); 73 patients in both groups also received cisplatin as radiosensitizer. EBRT delivered as preoperative reached a total dose of 44-46 Gy/pelvis, whereas the definitive RT reached a total dose of 62-64 Gy with standard fractionation. MDR-BT was performed with a LDR/MDR Cs-137 Selectron machine; 10 Gy/point A were delivered in the preoperative group A and 14 Gy/point A/, 1-2 fractions in group B. Cisplatin as radiosensitizer was administered during EBRT at a dose of 20 mg/m(2)/day for 5 days with 21 days interval between cycles. RESULTS: With a median follow-up of 44.4 months (range 3.4-61.6) the overall survival at 3 years in group A was 92% vs. 68% for group B (p<0.01). According to FIGO stages 3-year overall survival was 88% in stage IIB, 79% in IIIA and 60% in IIIB (p<0.01). Three-year local control was 73.5% (192 patients). Thirty-three (13%) patients developed locoregional recurrences, and another 8 (3.07%) locoregional recurrences plus distant metastases. CONCLUSION: The association of EBRT with MDR-BT represents an effective treatment in advanced cervical carcinoma. A significant difference in 3-year overall survival was found, favoring preoperative RT, with a very good rate of local control.
Subject(s)
Brachytherapy , Carcinoma/radiotherapy , Uterine Cervical Neoplasms/radiotherapy , Adult , Aged , Carcinoma/pathology , Disease-Free Survival , Dose-Response Relationship, Radiation , Female , Follow-Up Studies , Humans , Middle Aged , Neoplasm Recurrence, Local , Radiotherapy Dosage , Survival Rate , Uterine Cervical Neoplasms/pathologyABSTRACT
A 2-year-old child is presented with irregular frequent vomiting leading to a very severe marasmus. Only repeated radiological investigations revealed the hepatodiaphragmatic interposition of the colon. Two years after surgery she has nearly doubled her body-weight.
Subject(s)
Colon/abnormalities , Diaphragm/abnormalities , Liver/abnormalities , Female , Humans , Infant , Protein-Energy Malnutrition/etiology , Syndrome , Vomiting/etiologySubject(s)
Diseases in Twins , Hypercalcemia/genetics , Humans , Hypercalcemia/etiology , Infant , Male , Pyelonephritis/complicationsABSTRACT
From the 253 infants admitted to the praemature unit of the Department of Pediatrics, University of Pécs in 1971 87 showed signs of respiratory tract infection. 44 of these babies suffered from otitis media diagnosed by means of tympanal suction-drainage. This reliable diagnostic method is completely harmless and less traumatic than paracentesis. We have isolated Gram negative bacteria from the tympanal secretion in three quarters of the cases Bacterial culture proved to be negative in only two infants. We should like to stress that tympanal suction drainage--apart from its good therapeutic effect--is also beneficial to the anatomical development of the ear: the early embryonal tissues sucked out in this way could disturb the transformation of embryonal tissue to normal mucoperiosteum. The persistent embryonal tissue thickens the tympanal mucosa. This is a factor promoting inflammation.
