[Total irradiation of the liver in treating patients with lymphogranulomatosis]. / Total'noe obluchenie pecheni v lechenii bol'nykh limfogranulematozom.

AIM: The study of efficiency of radiation in specific affection of the liver in lymphogranulomatosis (LGM). MATERIALS AND METHODS: 212 LGM patients were examined for hepatic lesions using x-ray, radiological, cytochemical and histological investigations of the biopsies. Coagulation, alkaline phosphatase, copper and ceruloplasmin in the serum were measured to evaluation the disease activity. All the patients received polychemotherapy (PCT). Irradiation of the liver in the total focal dose 36-44 Gy was performed in confirmed involvement of the liver as adjuvant to PCT. RESULTS: Specific liver lesions were detected in 6.1% of patients at primary examination and in 15.6%--at follow-up. Liver lesions occurred most frequently in mixed-cell variant of LGM and lymphoid depletion. Eradication of liver lesion after PCT was achieved in 15.4%. Subsequent radiation produced a complete remission in 100% of patients with diffuse and 80% of patients with large-focal liver lesion. In detection of liver involvement at the time of LGM progression eradication and remission were achieved in 70 and 50% of patients, respectively. From 30% of patients with liver lesions resistant to PCT and radiation, 15% had stable disease. The survival did not depend on eradication of liver lesion. CONCLUSION: In involvement of the liver its radiation is indicated for all the patients with new-onset LGM. In the recurrence, liver radiation is recommended for those in whom the liver is the only extranodal lesion.

[Late complications of combined therapy of lymphogranulomatosis]. / Pozdnie oslozhneniia kompleksnoi terapii limfogranulomatoza.

Basing on the results of follow-up of 212 lymphogranulomatosis patients in long-term remission, the authors have identified most frequent and serious complications. Contribution of different treatment components to development of these complications is specified. Signs of mono- and polyorganic lesions due to combined therapy are described, recommendations on the follow-up and prevention of the complications are provided.

[The functional status of the cardiovascular system in the late period after the combined therapy of patients with lymphogranulomatosis]. / Funktsional'noe sostoianie serdechno-sosudistoi sistemy v otdelennye sroki posle kompleksnoi terapii u bol'nykh limfogranulematozom.

The study included 127 patients with lymphogranulomatosis confirmed histologically. The patients were exposed to total or subtotal irradiation of lymph nodes and 6 cycles of polychemotherapy (COPP). Before the treatment and once a year after it all the patients were examined for defects in the cardiovascular function. Radiation pericarditis was found in 0.79% of the patients, acute coronary death occurred in 3 (2.8%) patients. At 3-11-year follow-up persistent changes in the cardiovascular parameters were noted only in older patients or those with cardiovascular disorders at the moment of the therapy. The authors think that feasibility of cardiac damage in lymphogranulomatosis patients is exaggerated and that reduction of radiation dose and COPP intensity is not valid in patients under 40.

[Radiologic detection of triombrast in liposomes of liver and spleen (first phase of clinical trial)]. / Triombrast v liposomakh dlia rentgenologicheskoi vizualizatsii pechenii selezenki (pervaia faza klinicheskikh ispytanii).

Clinical trials of the liposomal form of water-soluble x-ray contrast agent triombrast (90 mg of iodine in 1 ml) was carried out in 23 patients with Hodgkin's disease, 9 with liver cirrhosis, and 6 with malignant tumors of different localizations. Distinct images of the liver and spleen appeared 2-2.5 h after intravenous injection of the formulation. They could be observed during 4-6 h by plane radiography. Liposomal hepatolienography permits identification of the structural alteration sites 0.8-1.0 cm in size in these organs. Administration of higher doses of the formulation (more that 0.5 ml/kg) was associated with such side effects as fever and hyperthermia in 30% of patients parallel with the side effects common for iodine-containing x-ray contrast agents. These side effects could be eliminated by previous administration of prednisolone and pipolphen. These side effects were not observed after injection of lower doses of the formulation (less than 0.5 ml/kg) sufficient for an essential improvement of the image contrast during computer-aided tomography.

[Roentgenoradiological and ultrasonic diagnosis of liver and spleen involvement in patients with Hodgkin's disease]. / Rentgenoradiologicheskaia i ul'trazvukovaia diagnostika porazheniia pecheni i selezenki u bol'nykh limfogranulematozom.

A combined study including selective angiography of the liver and spleen, angioscintigraphy with 99mTc-TCK-5, polypositional scintigraphy with 99mTc-frosstimag-phytate, and ultrasonic scanning was conducted to detect specific liver and splenic involvement in 57 patients with Hodgkin's disease, CT was performed in 4 patients. A high diagnostic value of all methods was shown in macronodal liver involvement (node sizes over 3 cm); of ultrasonic scanning--in the detection of nodes in the liver (node sizes from 1 to 3 cm); of ultrasonic scanning, angiography and angioscintigraphy--in nodal splenic involvement. Signs of diffuse-infiltrative liver involvement detected in angiography and angioscintigraphy were described. The informative value of ultrasonic scanning and CT in this type of involvement was much lower.

[Radiodiagnosis of recurrences of lymphogranulomatosis]. / Luchevaia diagnostika retsidivov limfogranulematoza.

The authors discuss the role and place of chest x-ray tomography, scintigraphy with 67Ga-citrate, ultrasonic investigation, angiography, angioscintigraphy, computed tomography, scintigraphy of the liver and bones in the diagnosis of recurrences of Hodgkin's disease and in control of a progress of disease. Indications for a successive use of one or the other method have been defined.