Radiotherapy of early stages Hodgkin's disease. 10 years experience of the Masaryk Memorial Cancer Institute.

Radiotherapy and chemotherapy, alone or in combination, are curative treatment methods in early stages of Hodgkin's disease (HD). The choice of treatment depends on the stage of the disease, histological type and localization of the tumor, as well as on other prognostic factors. A retrospective study was conducted including 145 patients with clinical Stages I and II of HD according to Ann Arbor classification, all treated in the Masaryk Memorial Cancer Institute in Brno during the years 1985 through 1994. 80 patients were males (55%) and 65 patients females (45%). The age of the patients ranged from 11 to 77 years, with an average of 34.8 years. 41 patients were diagnosed with Stage IA tumor, 1 patient with Stage IB, 75 patients with Stage IIA and 28 with Stage IIB disease. The histological types of the disease were lymphocyte predominant in 23 patients, nodular sclerosis in 49 patients, mixed cellularity in 65 cases and lymphocyte depletion in 8 cases. 91 patients were treated with radiotherapy alone. In this group 14 patients relapsed within the radiation field (15%) and 25 outside the radiation field (28%). 39 patients were treated with combination of radiotherapy and chemotherapy. In this group relapse occurred within the radiation field in 3 patients (8%) and outside the radiation field in 7 patients (18%). 15 patients were given chemotherapy alone, 7 patients from this group experienced a relapse. The five-year survival was 81% in patients with Stages IA and IIA disease, 65% in Stages IB and IIB disease. The five-year survival in the patients who relapsed was 56%. Radiotherapy remains the curative method of choice in highly selected group of patients with early stages of Hodgkin's disease. The results of radiotherapy alone are unsatisfactory in unselected clinical Stage I--II patients because of the presence of patients with adverse prognostic factors, particularly B symptomatology, mixed cellularity/lymphocyte depletion histology, higher age. These patients are candidates for combined treatment. Modern equipment and meticulous treatment are conditions crucial for the outcome of curative radiotherapy in patients with Hodgkin's disease. Combination chemotherapy is very effective in the treatment of relapse following the primary radiotherapy.

[Radiotherapy of carcinoma of the prostate--5 years' experience]. / Radioterapie u karcinomu prostaty--petileté zkusenosti.

Forty three patients were treated for cancer of prostate by irradiation at the Radiotherapeutic Ward of the Research Institute of Clinical and Experimental Oncology in the years 1976 to 1981. The five-year period of survival in patients with a localized tumorous disease was 45%. The authors analyzed causes of unsuccessful therapy and evaluated complications of the therapy, the latter being mostly early postirradiation reactions. Possibilities of improving the results of treatment in optimizing the radiotherapy of the localized prostate cancer are outlined.

A technical equipment for workroom with californium-252 used for the gamma-neutron brachytherapy.

A proposal for the 252Cf intracavitary brachytherapeutic workroom with the description of the technical equipment for the radioactive source storage and manipulation and the personal protection against the gamma-neutron radiation is provided.

Study of radiation dose fractionation in some tumor types.

In the presented work we have tested another fractionation schemes than simple fractionation in some so-called radioresistant tumors, i. e. in breast cancer and malignant melanoma. We have found the advantage of the irradiation with divided series (split irradiation) namely in malignant skin melanoma where we gained therapeutic results with 58% 5-year survival. Periodical irradiation especially with higher fractions once a week had encouraging success in advanced stages of the breast cancer where a single fraction of 8 Gy/tumor up to total dose of 40 Gy/tumor was determined as optimal. With the use of higher fractions more pronounced late postirradiation changes are to be expected. Fraction schemes were compared using NSD and TDF equations.

Possibilities of motion therapy using betatron.

Two modalities of motion therapy both with electron and bremsstrahlung irradiation are described. Both therapy modes were used in the therapy of 62 patients with tumors of the kidneys, 13 patients with tumors of the esophagus, 20 patients with tumors of the prostate and urinary bladder and 170 patients with tumors of the breast. The advantage of the described method is the possibility of simple, precise and easily reproducible irradiation in given localizations, good therapeutic effect and very good general tolerance as the patient concerns.

Chemo-radiotherapy of lung metastases of testicular tumors.

We studied the chemo-radiotherapy of testicular tumors in clinical stage III. Our study involved 54 patients with lung metastases of seminoma and nonseminoma, treated with a combination of radiotherapy and chemotherapy. The results obtained have not satisfied our expectations. While in the 16 seminoma patients only 43% overall response rate was obtained (probably due to the bad general condition of the patients who had mostly received previous treatment), in the 38 nonseminoma patients a 63% overall response rate was obtained, with 31% complete remission. In previously untreated patients a 73% overall response rate was obtained at 34% complete remission.