[Quadrantectomy and tumorectomy followed by radiotherapy in early tumors of the breast]. / Quadrantectomia e tumorectomia seguita da radioterapia nei tumori iniziali della mammella.

The authors examined 235 patients with early breast cancer treated by radiotherapy after conservative surgery during a 10-year period (1974-1984). Disease-free survival and incidence of local recurrences, in agreement with the data reported in literature, did not differ from those of patients with early breast cancer treated with radical surgery. As for local recurrences in the breast only (7/235), a slightly significant difference was observed in favor of quadrantectomy (3/62 for tumorectomy versus 4/173 for quadrantectomy). On the contrary, a significant difference was observed in the breast recurrence rate of premenopausal (5/7) and postmenopausal women (2/7). Complications occurred in 7.2% of the cases. Satisfactory esthetic results were generally obtained, with 78% good and excellent results. Doses greater than 50 Gy to the whole breast and irradiation of the axilla both worsened the esthetic results and increased complication rate. Chemotherapy does not worsen the esthetic results, while that is often the case when the removed volume is excessive in comparison to the whole breast volume.

[Cardiomyopathy due to adriamycin: the possibility of its prevention. Monitoring by noninvasive technics]. / Cardiomiopatia da adriamicina: possibilità di prevenzione. Monitoraggio con tecniche non invasive.

To prevent delayed cardiomyopathy induced by adriamycin and subsequent severe congestive heart failure, a monitoring schedule with noninvasive techniques to measure cardiac performance (CPK-MB, electrocardiographic, systolic time intervals, echocardiography and quantitative radionuclide angiography) has been used. 15 patients, 33 to 65 years old, with metastatic breast carcinoma, previously treated with a polychemotherapy protocol not including adriamycin have been studied. Monitoring at 0 time allowed to exclude one patient with previous asymptomatic cardiomyopathy and to treat patients at risk with cardiovascular pathology, up to reach and even exceed the dosage of 550 mg/m2. Four of the treated patients showed positive findings of cardiomyopathy at different adriamycin dosage levels: 2 asymptomatic dilatative cardiomyopathies, 1 symptomatic and 1 with congestive heart failure remitted with medical therapy. No patient died because of cardiovascular complications. The results obtained show that of all noninvasive techniques used, only quantitative radionuclide angiocardiography allowed, when employed following an adequate monitoring schedule, to detect reliable findings of moderate and reversible cardiomyopathy thus indicating the appropriate time for drug discontinuation.

[Radiotherapy techniques of the mediastinum (author's transl)]. / Tecniche di radioterapia del mediastino.

The principal techniques of mediastinal irradiation are discussed with reference to the need for rational space distribution of the dose, one reason being to respect healthy tissues (particularly the bone marrow); numerous examples are presented.

[Radiotherapy of lymphomas. Clinical classification, radiotherapy planning and indications]. / Radioterapia dei linfomi. Classificazione clinica, programmazione e indicazioni radioterapiche.

The staging of Hodgkin's disease and non-Hodgkin lymphomas is discussed with reference to the treatment plan indicated for each stage and the problems associated with radiotherapy.