ABSTRACT
PURPOSE: Specific information about radiation therapy in nonagenarians is limited. In order to shed more light on the feasibility of radiotherapy in this challenging subgroup, a retrospective study was performed. METHODS: The data of 93 consecutive patients receiving irradiation treatment at the Department of Radiation Oncology, Ordensklinikum Linz Barmherzige Schwestern between June 2005 and December 2016 were analyzed. Patient- and treatment-related factors were extracted from the patient records. Overall survival (OS) was defined as time from irradiation to death or last follow-up. The survival rates were analyzed using the Kaplan-Meier method and log-rank test. RESULTS: The study population of 93 patients was between 90 and 99 years old (median 91 years). It included 59 women (63%) and 34 men (37%). Of these, 38 (41%) received definitive radiotherapy, 14 (15%) received neoadjuvant or adjuvant radiotherapy, whereas a palliative regimen was prescribed in 44% of the cases (nâ¯= 41). In all, 79 patients (85%) were able to complete their prescribed course of radiotherapy. While 16 (17%) patients reported grade 2 toxicities or higher, 4 had ≥grade 3 side effects (4%). The median survival was significantly higher in patients treated with adjuvant, neoadjuvant or definitive radiotherapy (13.8 months) compared to patients treated with palliative radiotherapy (3.6 months; pâ¯< 0.001). CONCLUSION: Even in patients managed without preradiotherapy comprehensive geriatric assessment, carefully planned fractionated radiotherapy was feasible and resulted in acceptable rates of acute toxicities.
Subject(s)
Neoplasms/radiotherapy , Age Factors , Aged, 80 and over , Dose Fractionation, Radiation , Feasibility Studies , Female , Follow-Up Studies , Geriatric Assessment , Humans , Kaplan-Meier Estimate , Male , Neoadjuvant Therapy , Neoplasms/mortality , Palliative Care , Radiotherapy, Adjuvant , Survival RateABSTRACT
In three years' period 80 trombendarteriotomies on iliacae and femoralis arteris were made in our department. The decision for surgical measures was made on the basis of clinical state as well as aorto--graphies. With us, the basic principal of obliteration removing, was the initial gangren extremities and stronger rest pains. Analyzing our results we found out that 60 per cent of patients were good and in the 6 per cent cases the surgical measures didn't give the expected result. The aim of this exposition is to represent the way of our work, experience and encouraging results trombendarteriotomy which propose further efforts in the field of vascular surgery.
Subject(s)
Endarterectomy , Thrombosis/surgery , Adult , Aged , Female , Femoral Artery/surgery , Humans , Iliac Artery/surgery , Leg/blood supply , Male , Middle Aged , Popliteal Artery/surgeryABSTRACT
Success in surgical intervention depends primarily on the general practicioner who makes the early diagnosis, who also makes the temporary bandages against clotting and who quickly transports the patient to the nearest surgical hospital. The arrival of patient in the shortest time period; within 6 hours after the injury, could give a guarantee for a successful surgical intervention. At a combined injury of veins and arteries, it is necessary to give, besides the minuteness surgical technic, an anti-coagulative (anti-clotting therapy during the post-operative period. We are of the opinion that every surgical department should be able to handle injuries on the outer blood vessels, which means they should have a good knowledge of basic principles on the vascular surgery.
