ABSTRACT
Pagetoid reticulosis is a mycosis fungoides subtype. It is characterized by a prominent epidermotropism, localized lesions, slow progression and benign prognosis. We report on a 67-year-old patient with a history of classic mycosis fungoides, who developed pagetoid reticulosis on the right heel. Local electron beam therapy induced a complete remission, with no recurrence over three months of follow-up.
Subject(s)
Foot Diseases/radiotherapy , Mycosis Fungoides/radiotherapy , Neoplasm Recurrence, Local/radiotherapy , Neoplasms, Multiple Primary/radiotherapy , Pagetoid Reticulosis/radiotherapy , Skin Neoplasms/radiotherapy , Aged , Biopsy , Combined Modality Therapy , Electrons/therapeutic use , Follow-Up Studies , Foot Diseases/pathology , Heel , Humans , Male , Mycosis Fungoides/pathology , Neoplasm Recurrence, Local/pathology , Neoplasms, Multiple Primary/pathology , Pagetoid Reticulosis/pathology , Skin/pathology , Skin Neoplasms/pathologyABSTRACT
BACKGROUND: The localized prostate cancer can be treated curatively by radiation therapy. The combined treatment of external beam irradiation and HDR-Iridium 192 remote brachytherapy allows higher radiation doses within the tumor without increasing radiation sequelae. PATIENTS AND METHODS: Patients of our clinic have been treated with this combined procedure since 1991. Between 1991 and 1994 15 patients received 2 x 9 Gy of high-dose-rate brachytherapy, followed by 36 Gy external beam irradiation (group A). Because of the frequent local failures in group A, the reference dose of external beam irradiation was increased to 50.4 Gy after brachytherapy between 1994 and 1996. RESULTS: Seven of 15 patients (47%) in group A developed a local recurrence after a median of 17 (13 to 30) months. In group B (20 patients) local failure occurred in 3 patients (15%) after 11, 16 and 32 months. CONCLUSION: The combined radiation therapy of localized prostate cancer cannot substitute radical prostatectomy completely, but it is a promising alternative in the curative treatment in selected patients.
Subject(s)
Brachytherapy/methods , Iridium Radioisotopes/therapeutic use , Prostatic Neoplasms/radiotherapy , Aged , Aged, 80 and over , Brachytherapy/adverse effects , Disease-Free Survival , Humans , Iridium Radioisotopes/adverse effects , Male , Middle Aged , Neoplasm Recurrence, Local , Prostatic Neoplasms/pathology , Radiotherapy/methods , Radiotherapy Dosage , Treatment OutcomeABSTRACT
BACKGROUND: Although effectiveness of fractionated radiotherapy for painful bone metastases is well documented, there are unanswered questions regarding the adequacy of low-dose short radiation schedules for long-term pain control which give maximum benefit in patients with a short life expectancy. PATIENTS AND METHODS: Two consecutive non-randomized prospective follow-up studies were performed at a single institution to analyze pain response and duration of response in patients with a variety of primary tumors. Included were only patients with symptomatic nonvertebral bone metastases and without impending pathologic fracture. Forty-five patients received 1 x 4 Gy to 50 different sites (group I) while 86 patients received 4 x 4 Gy to 96 sites (group II). Pain relief to irradiation was evaluated according to patient interviews using a 4-point categorical scale. Follow-up was performed 7 and 90 days after radiotherapy. RESULTS: Pain relief after 4 x 4 Gy was significantly superior to 1 x 4 Gy with pain control rates being 86.5% vs 48% at day 7 (after end of treatment) and 80% vs 55% at day 90, respectively. A subgroup analysis of patients treated with 4 x 4 Gy demonstrated a more favorable outcome for breast cancer patients in comparison to patients with other primaries concerning pain relief (96% vs 81%), pain control after 90 days (93% vs 72%), median time to pain progression (9 vs 3 months), and median overall survival (14 vs 5.5 months). CONCLUSIONS: In this study 4 x 4 Gy proved to be clearly superior to 1 x 4 Gy in relieving pain from symptomatic nonvertebral bone metastases without impending pathologic fracture. Even if radiotherapy with 1 single fraction seems to be applicable in specific cases doses higher than 4 Gy should be chosen. In breast cancer patients pain control seems to be better compared to other primaries.
Subject(s)
Bone Neoplasms/complications , Bone Neoplasms/radiotherapy , Pain, Intractable/etiology , Pain, Intractable/radiotherapy , Aged , Bone Neoplasms/secondary , Dose Fractionation, Radiation , Dose-Response Relationship, Radiation , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prospective Studies , Survival Analysis , Time Factors , Treatment OutcomeABSTRACT
PURPOSE: In "high risk" breast cancer patients radio- and chemotherapy or hormonal strategies are applied after mastectomy. To reduce the risk of hot spots we developed an innovative irradiation technique using only 2 portals to encompass the chest wall and the regional lymph node areas. PATIENTS AND METHODS: In a retrospective analysis we evaluated 131 patients concerning late normal tissue reactions. We compared one group of combined treated patients (radio- and chemotherapy) with women who only had irradiation after surgery. RESULTS: The most frequent findings are telangiectasia in the chest wall (electron portal): grade 3 (1.5%), grade 2 (4.6%), grade 1 (35.8%), 58% no telangiectasia. A moderate lymphoedema of the arm was seen in 4.5%. There was no statistically significant difference between the 2 groups. CONCLUSION: Our treatment concept allows simultaneous application of radio- and chemotherapy without enhancement of late normal tissue reactions.
