ABSTRACT
PURPOSE: To determine if Biafine compared to Best Supportive Care (BSC) is effective in minimizing or preventing radiation-induced dermatitis in women undergoing breast irradiation. METHODS AND MATERIALS: Patients were randomized between Biafine (n = 83) vs. BSC (n = 89). The institutions identified preference for BSC at the time of randomization. A no-treatment arm was allowed (16% received no treatment). Patients were instructed to apply randomized product three times a day, but not within 4 h of their daily RT session. Application began following their first radiation treatment and continued 2 weeks postradiation. Skin dermatitis was scored weekly utilizing the RTOG and ONS (Oncology Nursing Society) skin toxicity scales, a weekly patient satisfaction and quality-of-life questionnaire. RESULTS: Using the RTOG toxicity scale there was no overall difference for maximum dermatitis during RT between Biafine and BSC (p = 0.77). There was no difference in maximum toxicity by arm or breast size. There was an interaction between breast size and toxicity, with large-breasted women exhibiting more toxicity. Large-breasted women receiving Biafine were more likely to have no toxicity 6 weeks post RT. CONCLUSION: There was no overall difference between BSC and Biafine in the prevention, time to, or duration of radiation-induced dermatitis.
Subject(s)
Aloe/therapeutic use , Breast Neoplasms/radiotherapy , Dermatologic Agents/therapeutic use , Phytotherapy , Plants, Medicinal , Radiodermatitis/drug therapy , Adult , Aged , Aged, 80 and over , Chemotactic Factors/therapeutic use , Female , Gels , Humans , Macrophages , Middle AgedSubject(s)
Physician's Role , Professional Autonomy , Suicide, Assisted , Humans , Personal AutonomyABSTRACT
The versatility of the omentum has led to its use as a surgical adjunct in the total oncological management of primary and recurrent colorectal carcinoma. The omentum is used as a transposition pedicle flap, broadly based on the left gastroepiploic vascular supply. Following abdominoperineal resection or low anterior resection of the rectum, the small bowel is elevated out of the pelvis by the omental bulk. The pelvic defect is reperitonealized and the risk of pelvic small bowel adhesions is diminished. With the increasing use of postoperative radiation to the pelvis for rectal carcinoma, the tolerance to therapy may be improved and the incidence of radiation enteritis and enteropathy should be reduced. Surgical complications such as leakage from low anterior anastomoses and pelvic abscesses, which may delay or contraindicate necessary postoperative radiation, are dramatically decreased. Reconstruction of the perineum with omental flap provides adequate soft tissue bulk and contour when a radical resection has been performed. The omentum has the potential for neovascular proliferation and can act to prevent anastomotic dehiscence of intestinal anastomoses involving previously irradiated bowel. Furthermore, covering unresectable recurrent carcinoma in the pelvis and retroperitoneum with the omentum as a palliative measure provides a thick anatomical barrier against potential ureteral, bladder, and small bowel invasion and obstruction. The omental flap has been used in 24 patients with colorectal carcinoma; one flap was lost as a result of distal omental infarction in a patient with recurrent rectal carcinoma and radionecrosis of the perineum. The safety and ease of this procedure has allowed increased surgical innovation, especially in the prevention and treatment of radiation complications.
Subject(s)
Colonic Neoplasms/therapy , Omentum/surgery , Radiation Injuries/prevention & control , Rectal Neoplasms/therapy , Surgical Flaps , Colonic Neoplasms/radiotherapy , Colonic Neoplasms/surgery , Combined Modality Therapy , Humans , Methods , Radiotherapy/adverse effects , Rectal Neoplasms/radiotherapy , Rectal Neoplasms/surgerySubject(s)
Eye Neoplasms/radiotherapy , Retinoblastoma/radiotherapy , Vision, Ocular/radiation effects , Adolescent , Adult , Aged , Child , Child, Preschool , Eye Neoplasms/genetics , Eye Neoplasms/pathology , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Male , Middle Aged , Neoplasm Metastasis , Neoplasm Staging , Prognosis , Retinoblastoma/genetics , Retinoblastoma/pathology , RiskABSTRACT
Twenty-nine patients with stage II endometrial carcinoma were reviewed and the possible risk factors involved in state II disease are presented. Twenty-four patients received external irradiation as part of their treatment with or without intracavitary or intravaginal radium and/or TAH BSO. The 5-year actuarial survival in our series was 81.4%. The data showed that preoperative external irradiation can be effectively administered without undue complication. A strong argument against the traditional use of preoperative intracavitary radium is presented. Preoperative external irradiation administered with a 4-field box technique to deliver a minimum dose of 5000 rad in 5--6 weeks to all the structures at risk is the recommended treatment for stage II endometrial carcinoma.
Subject(s)
Uterine Neoplasms/radiotherapy , Adult , Aged , Female , Humans , Lymphatic Metastasis , Middle Aged , Radioisotope Teletherapy , Radiotherapy, High-Energy , Radium/administration & dosage , Time Factors , Uterine Neoplasms/surgeryABSTRACT
We studied 38 patients with prostatic cancer who received breast irradiation before oral estrogen administration. Our data are combined with those from other institutions to determine the effectiveness of pre-estrogen breast irradiation in minimizing gynecomastia and/or pain. Based on our review the incidence of estrogen-induced breast changes is 70%. Irradiation given before estrogen administration can prevent or minimize these changes in 89.3% of the treated patients. Histologic changes of gynecomastia are reviewed and recommendations for optimum radiation therapy technique are included.
