ABSTRACT
The decision to endorse and implement the BCRU recommendation has been taken after careful consideration and discussion amongst those currently active in brachytherapy treatment at the Christie Hospital, Manchester. We believe it to be both logical and scientifically sound. The practical measures discussed here outline how the Manchester System will operate with the new method of source specification, and we urge other users of the Manchester System throughout the world to adopt similar measures and accept the BCRU recommendations also.
Subject(s)
Brachytherapy/standards , Humans , Radiotherapy Dosage/standards , Weights and Measures/standardsABSTRACT
This paper describes the results of treating 74 patients with squamous cell carcinoma of the anal canal and perianal skin using interstitial radiotherapy as primary treatment. This technique does not involve irradiation of regional lymph nodes. The local control rate for patients with tumours smaller than 5 cm and with negative inguinal nodes was significantly better than for the remaining patients (64 versus 23 per cent). Only 3 of 41 patients with tumours less than 5 cm diameter had clinically significant nodes at presentation, while in 33 patients with tumours larger than 5 cm there were 6 with involved nodes at presentation. Local treatment using interstitial radiotherapy is suggested as useful primary treatment for small, node-negative carcinomas, with surgery held in reserve for failures.
Subject(s)
Anus Neoplasms/radiotherapy , Carcinoma, Squamous Cell/radiotherapy , Aged , Anus Neoplasms/pathology , Brachytherapy/adverse effects , Carcinoma, Squamous Cell/pathology , Female , Groin , Humans , Lymphatic Metastasis , Male , Neoplasm Recurrence, Local , Radiation Injuries/etiologyABSTRACT
108 patients with T2 or T3 carcinoma of the bladder were randomised to receive either photon therapy or low- or high-dose 15 MeV neutrons. Fifty-nine patients received photon treatment, 20 low-dose neutrons (LDN) and 20 high-dose neutrons (HDN). Eight patients received a combination of photon and neutron therapy, due to machine breakdown, and one patient received only one exposure, due to intercurrent illness. The three-year survival for all groups was 43% but there was no difference in survival between the treatment groups. The complication rate in the photon group was low--minor 3%, major 5%. The complication rates in the neutron groups were higher--LDN 30% and 15% respectively, HDN 15% and 10% and combined 25% and 37%. Only six patients died of complications related to therapy--photons 2, LDN 1, HDN 1, combined 2. No therapeutic gain for neutron therapy has been found in this study.
Subject(s)
Neutrons , Urinary Bladder Neoplasms/radiotherapy , Clinical Trials as Topic , Humans , Particle Accelerators , Prognosis , Radiotherapy, High-Energy/adverse effects , Random Allocation , Relative Biological EffectivenessABSTRACT
A fresh analysis of the data entered into the multicentre BIR fractionation trial of 3F/week versus 5F/week in radiotherapy of the laryngopharynx has been undertaken. Completed records of the 732 patients initially entered into the trial have now risen from 687 at the last report to 706. The data have been analysed in a manner similar to that adopted previously so as to measure the effects of the two regimes on both tumour and normal tissues, and some additional analyses have now also been made. There have been some modifications in the results in the various sub-groups which may be due to an inadequate number of patients having been followed up for long enough at the time of the previous analyses. More data for late radiation damage to normal tissues and new radiobiological findings have suggested possible explanations for the differences which have emerged between the two groups. The apparent differences between the sub-groups containing patients with highly localized tumours, which were reported in our previous report, are now less marked and not statistically significant.
Subject(s)
Laryngeal Neoplasms/radiotherapy , Pharyngeal Neoplasms/radiotherapy , Carcinoma, Squamous Cell/radiotherapy , Follow-Up Studies , Humans , Laryngeal Neoplasms/mortality , Laryngeal Neoplasms/surgery , Laryngectomy , Lymphatic Metastasis , Neoplasm Recurrence, Local/radiotherapy , Pharyngeal Neoplasms/mortality , Radiotherapy DosageABSTRACT
Analysis of 86 patients who underwent salvage cystectomy following a radical course of radiotherapy for bladder cancer and 37 patients who underwent primary cystectomy has shown a greater survival for women than men. The following factors were associated with a significant deterioration in survival: 1. Age at time of cystectomy: post-operative mortality and tumour recurrence are greater over the age of 70. 2. Non-function of one kidney on IVU. 3. Grade 3 tumour on cystectomy specimen. 4. pT3 or pT4 tumour on cystectomy specimen.
