[Parathyroid hypofunction after total thyroidectomy for differentiated thyroid carcinoma--perspectives after long term observation and treatment]. / Niedoczynnosc przytarczyc po tyroidektomii calkowitej z powodu zróznicowanego raka tarczycy--perspektywa wieloletniej obserwacji i leczenia.

Hypoparathyroidism remains a serious complication of total thyroidectomy for differentiated thyroid carcinoma (DTC). In Brachytherapy Department 952 patients affected with DTC were followed up in the years 1996-2000. Radical total thyroidectomy was performed in 235 (24.6%) of cases, while the other 717 patients underwent complete rethyroidectomy. The incidence of hypoparathyroidism following radical operation and after complete rethyroidectomy was 15.74% and 23.43%, respectively. In patients operated in our institution, blood for calcium was analyzed daily for five days following the surgery. If calcium level was normal the next measurement was performed 4-5 weeks thereafter. Hypoparathyroidism was diagnosed later in postoperative period in many patients operated elsewhere. Asymptomatic hypocalcemia during the first week after the operation requires oral administration of calcium. If hypocalcemia requiring intravenous calcium supplementation does not resolve in a few days, vitamin 1(OH)D3 is introduced. Vitamin 1(OH)D3 and calcium carbonate play the main role in management of persistent hypocalcemia. In case of marked hypercalciuria thiazid diuretics are instituted. Low-phosphate diet is recommended. The aim of treatment of hypoparathyroidism is to restore normal serum calcium level with calciuria not exceeding 5 mg/kg/24 h, so to avoid hypocalcemic complications as well as vitamin D intoxication.

The influence of hypoxia on the cytotoxicity of concomitant KW-2149 and ionizing irradiation in Chinese hamster fibroblasts.

7-N-((2-((2-(gamma-L-glutamylamino)ethyl)dithio)ethyl))-mitomycin C (KW-2149) is a newly synthesized water-soluble mitomycin C (MMC) analog. Preclinical testing showed an interesting activity profile and a superior hematological tolerance in murine models. The aim of this study was to investigate the interaction of this compound with ionizing radiation, both under normoxic and hypoxic conditions, in Chinese hamster fibroblasts (V79). V79 cells were irradiated both under normoxic conditions and after a 1 h period of hypoxia. Paired irradiation dose-response curves confirmed the significance of radioresistance under hypoxia with an oxygen enhancement ratio of approximately 3. In contrast to MMC, KW-2149 showed no increased cytotoxic effect on hypoxic V79 cells. The cytotoxic effect of KW-2149 increased with increasing concentration, irrespective of the ambient oxygen pressure. When KW-2149 was combined with irradiation under hypoxic conditions, cytotoxicity was significantly enhanced under these conditions. The difference in survival between normoxic and hypoxic conditions was statistically significant (p < 0.004). These data suggest a radiosensitizing effect of KW-2149, more pronounced under hypoxic conditions. This effect increases with radiation dose. It also corroborates earlier suggestions of a different mode of action of KW-2149 as compared to MMC.

[Elective (prophylactic) brain irradiation in small cell lung cancer patients treated with chemotherapy combined with surgery]. / Elektywne (profilaktyczne) napromienianie mózgu u chorych na drobnokomórkowego raka pluca leczonych chemicznie w skojarzeniu z chirurgia.

The incidence of brain metastases in small cell lung cancer patients in the group without prophylactic cranial irradiation (PCI) was compared with the incidence of brain secondaries after PCI. Out of 29 patients without brain irradiation 13 patients experienced brain metastases at 19 months (13/29). On the contrary, no one out of 17 patients who received PCI was found to have brain metastases at 4 years. The justification of prophylactic cranial irradiation is presented and criteria of patients selection are given. Elective brain irradiation is indicated exclusively in patients with "limited disease" achieving complete response.

[Radiotherapy of metastases to the brain by the method of high fractionated doses with planned intervals]. / Radioterapia przerzutów do mózgu metoda wysokich dawek frakcyjnych z planowana przerwa.

Results of treatment by irradiation with CO60 of metastases to the brain applying the high fractionated doses with planned interval method in the group of 32 patients, are presented. The treatment has been given in two stages; at the first stage 20 Gy has been given to the total brain in 5 fractions; after three weeks interval the response to treatment has been evaluated, and patients with positive response received second course of irradiation analogous to the first. Patients received as a total 40 Gy in 10 fractions with three weeks interval. The positive response to treatment has been obtained in 25 (78%) cases. Medium survival in the analysed group amounted to 7.5 months, 6 patients survived one year following the treatment (18.7%). Tolerance of the treatment has been good. No serious complications have been observed following the treatment.

[Evaluation of the results of radiotherapy of non-small cell lung cancer by the method of high fractionated doses with planned intervals]. / Ocena wyników napromieniania metoda wysokich dawek frakcyjnych z planowana przerwa w niedrobnokomórkowym raku pluc.

The number of new cases of cancer of the lung in Poland increases systematically in connection prevalence of the tobacco smoking and increase of the natural environment pollution. However the percentage of patients qualified for radical surgical treatment is not increasing since the diagnosis of pulmonary cancer is extremely late. Such situation causes a dynamically increasing demand for palliative treatment. Radiotherapy is a method of choice for such treatment. In order to provide the treatment for possibly large group of patients in the situation of restricted availability of adequate therapeutic equipment it is necessary to propose such method of radiotherapy as fulfils the requirement of palliative therapy, with short period of hospitalization, not overburdening the therapeutic equipment. The method of irradiation with high fractionated doses and planned interval in shortened time is a method fulfilling those demands applied in the Radiotherapy Clinic of the Oncology Center in Warsaw. Results of treatment in our Clinic and in other centers are at least comparable with other radiotherapeutic programmes, and the method is worth recommendation.