ABSTRACT
Between 1965 and 1981, 119 patients with squamous cell carcinoma of the esophagus were treated with radiation therapy with curative intent. Radiation was employed in combination with surgery and delivered pre- and/or postoperatively in 20 patients (17%). The remainder received radiotherapy alone. The overall survival rate was statistically higher in patients who had surgery and radiation compared to the group receiving radiation alone. The one-, two-, and five-year survival rates of patients receiving combined treatment vs radiotherapy alone were 65% vs 35%, 25% vs 14%, and 15% vs 6%. Age, total radiation dose, and inclusion of the supraclavicular areas in the radiation portals did not impact on outcome. Other prognostic factors are discussed. Long term survivors were noted to be at substantial risk for the development of a second epidermoid malignancy in the upper aerodigestive tract. Cumulative risk at five years was approximately 25%.
Subject(s)
Carcinoma, Squamous Cell/radiotherapy , Esophageal Neoplasms/radiotherapy , Adult , Aged , Carcinoma, Squamous Cell/mortality , Combined Modality Therapy , Esophageal Neoplasms/mortality , Female , Humans , Male , Middle Aged , Radiotherapy Dosage , Retrospective Studies , Time FactorsABSTRACT
One hundred-thirteen patients underwent Iodine-125 prostate implant and lymphadenectomy at Yale-New Haven Hospital from 1974 through 1980. The distribution by clinical stage was: 7 Stage A2, 86 Stage B, and 20 Stage C patients. Ninety-four patients had a negative lymphadenectomy (N-) and 19 patients (17%) had metastatic disease in the pelvic lymph nodes (N+). The actuarial 5-year survival for all 113 patients was 87% (+/- 6%: 95% confidence limits). Sixty-five percent of our 113 patients are disease free (NED) from 2 to 9 years following implant. Sixty-seven (N-) patients with clinical Stage B disease, whose tumors were either well differentiated or moderately well differentiated, have an actuarial 5-year NED survival of 84% (+/- 8%). Twenty (N-) patients with either clinical Stage C disease or poorly differentiated tumors have an actuarial 5-year NED survival of only 31% (+/- 20%). For the 19 (N+) patients, the actuarial 5-year NED survival is 38% (+/- 22%). Local tumor control was 85% for all Stage B patients and 75% for all Stage C patients. Only 10 patients (9%) have developed long-term gastrointestinal or genitourinary complications following their implant. Iodine-125 implant appears to be a reasonable alternate form of therapy in highly selected groups of patients with carcinoma of the prostate.
Subject(s)
Adenocarcinoma/radiotherapy , Iodine Radioisotopes/therapeutic use , Prostatic Neoplasms/radiotherapy , Brachytherapy , Humans , Lymph Node Excision , Male , Neoplasm Recurrence, Local , Prostatic Neoplasms/surgery , Radiotherapy DosageABSTRACT
The case of a husband and wife who both developed Hodgkin's disease of the same cellular subtype is reported. This represents only the fifth reported case of marital Hodgkin's disease that is well-documented histologically. The relevant literature and potential implications are reviewed.
Subject(s)
Hodgkin Disease/genetics , Adult , Female , Hodgkin Disease/pathology , Humans , Male , MarriageABSTRACT
One hundred ninety-eight patients received radiation therapy for carcinoma of the esophagus. Eight patients subsequently developed at least one other epidermoid carcinoma within the upper aerodigestive tract. Analysis by life-table method suggests a steadily increasing risk for second malignancies as survival lengthens. Implications with regard to the treatment and management of patients with squamous cell carcinoma of the esophagus are discussed and the relevant literature is reviewed.
Subject(s)
Carcinoma, Squamous Cell/pathology , Esophageal Neoplasms/pathology , Head and Neck Neoplasms/secondary , Carcinoma, Squamous Cell/mortality , Carcinoma, Squamous Cell/therapy , Esophageal Neoplasms/mortality , Esophageal Neoplasms/therapy , Female , Humans , Male , Middle AgedABSTRACT
Carcinoma of the extrahepatic bile ducts is uncommon, and the primary management has been largely surgical. Radiotherapy for this disease has received minimal attention, although recent innovations have prompted increased interest. We report a retrospective review of 34 patients treated with radiotherapy between 1967 and 1982. The five-year survival rate was 6%, and the median survival was 11 months. Patient characteristics, treatment techniques, and outcome for the entire group, as well as selected subgroups are discussed. Two patients treated by interventional radiographic techniques, external irradiation, and transcatheter intracavitary brachytherapy are presented in detail. The current surgical, radiotherapeutic, and chemotherapeutic literature is reviewed.
Subject(s)
Adenocarcinoma/radiotherapy , Bile Duct Neoplasms/radiotherapy , Adult , Aged , Brachytherapy , Female , Humans , Iridium/therapeutic use , Male , Middle Aged , Radioisotopes/therapeutic use , Radiotherapy, High-Energy , Retrospective StudiesABSTRACT
Sarcoidosis infrequently involves the larynx, but resultant airway obstruction will often prompt the need for therapeutic intervention. Systemic and intralesional corticosteroids as well as various surgical approaches have been advocated. We report a case of a 36-year-old man with biopsy proven laryngeal sarcoidosis. The patient became refractory to corticosteroids and was treated with megavoltage radiotherapy as an alternative to tracheostomy. A gradual and complete clinical recovery was observed. The radiation techniques are presented, and the literature regarding laryngeal sarcoidosis is reviewed. Megavoltage radiotherapy is a viable treatment option in this disorder.
