[Combined radio-chemotherapy in solid tumour treatment of advanced bladder cancer (preliminary report)]. / Kombinovana radioterapija i hemoterapija kod bolesnika sa solidnim tumorima (prethodni izvestaj o lecenju napredovalih carcinoma mokracne besike).

Radiotherapy combined with platinum compounds in widely used despite unclear biological basis and mechanism of their potentiation. We started a prospective nonrandom study on January 1, 1991 with the aim to ameliorate local tumour control and possibility of curative treatment, and treatment of toxicyty. PATIENTS CHARACTERISTICS: 82 patients with locally advanced bladder cancer (stage T3 and localizet T4) were treated with radiochemotherapy. Median age was 62 years, and male female radio was 3.5:1. The whole group had transitpy cell carcinoma, grade III, with primary tumour in 56 patients and solitary tumour in 51 patients. TREATMENT: External beam radiotherapy was performed on linear accelerator with locoregional technique, conventional fractionating and tumour dose of 65 Gy. On the lifth day of radiotherapy a 20 mg i.v. bolus Cisplatin 1 hour prior radiotherapy was administered to 49 patients. Total dose of Cisplatin was 120 mg per course. Carboplatin was given (75 mg i.v.) to 12 patients in the same way like Cisplatin, with total dose od 450 mg. In 21 patients Carboplatin was administered in a dose of 150 mg (fifth day) during radiotherapy, and total dose was 900 mg. TOLERANCE: The toxicity was mild in both groups of patients: 2/49 patients in Cisplatin group experienced nausea and 2/49 experienced haematological toxicity grade II as wel as 5/33 patients from Carboplatin group. RESPONSE: Tumours complete regression was observed in 69.4% of patients in Cisplatin group and in 84.6% in Carboplatin group. Mean follow-up was 14 months in Cisplatin group and overall survival was 77% at a 2-year interval, these results are not-suphicicent for the binal conclusion conserning the late complications and the clinical benefit, but the treatment was well tolerated. We intend to increase Carboplatin dose in our fur ther study.

[Treatment-related complications after radiotherapy for testicular malignancies--seminoma stage I and II]. / Komplicacije radioterapije malignih tumora testisa (seminoma prvog i drugog stadijuma.

Significant improvement in survival of patients treated for testicular seminoma, particularly in early stages of disease, shows that combined treatment can cause both acute reactions and/or late adverse effects in some cases. These rare complications may have great impact on quality of life of long-term survivors. The aim of our investigation was to assess incidence and intensity of sequelae in a group of 113 patients receiving postoperative radiotherapy for testicular seminoma stage I and II over the period 1982-1988, as well as to determine possible risk-factors. The follow-up period was 24-84 months (Me = 68.4 m). Acute symptoms were noticed in 19.4% of patients, all of them being of a mild degree and no case required a delay of treatment. Long-term complications developed in 8.8% of patients. During the follow-up period two secondary cancers were detected and histologically proved. These results are acceptable and similar to other published data, and in relation to the good prognosis with combined treatment, it can be concluded that the infradiaphragmatic radiotherapy is the obliged part of management for testicular seminoma in early stages.

[The role of radiotherapy in combined treatment of chondrosarcoma of the bone]. / Uloga radioterapije u kombinovanom lecenju hondrosarkoma kosti.

A retrospective analysis of 32 cases of chondrosarcoma of the bone treated by radiotherapy between 1966 and 1986 is presented. In all cases the disease was histologically confirmed. With respect to the known prognostic factors this group of patients was infavourable (75% in the trunk and the head; 69.5% with high histologic grad; 87.5% of high local aggressiveness; the wean patients' age was 37.9 years). Thirteen patients were preoperatively irradiated, 8 postoperatively and 11 received radiotherapy after the biopsy. The treatment was radical (symptomatic relief only) in 9 cases. After the treatment 30 patients were on follow-up from 4-274 months (Me = 60.8m.). According to the local control 9 patients responded to therapy (30.0%). The survival rate was 26.6% and disease-free survival rate was 20.0%.

[Use of chemotherapy in brain tumors in children--possibilities and perspectives]. / Primena hemioterapije kod tumora mozga u dece--mogucnosti i perspektive.

In the past two decades a huge progress was achieved in the treatment of malignant diseases in children. The cyclical chemotherapy combined with surgery and radiotherapy gave very good results. However, the contribution of chemotherapy to paediatric neuro-oncology was not as great is it was to other branches of paediatric oncology (acute leukaemia, malignant lymphoma, Wilms' tumour). One of the reasons is that although brain tumours are usually solid in children the existence of different histological types contributes to the fact that they are not very frequent or are rare. Consequently, for many types the necessary number of representative controlled studies is lacking. On the other hand, the leading paediatric oncology associations in the world (Children's Cancer Study Group (CCSG), International Society of Paediatric Oncology (SIOP) and Paediatric Oncology Group (POG)) have applied the prospective clinical programmes of treatment of these tumours later than in other malignant diseases. On the basis of the analysis of these programmes and experience of individual oncological centres a certain experience was acquired in present-day possibilities of chemotherapy in children suffering from brain tumours.

[Intracranial malignant melanoma in childhood]. / Intrakrainjumski maligni melanom decjeg doba.

Malignant melanoma is a very uncommon tumour in childhood. Over the period from 1978 to 1987 998 children were treated with radiotherapy for different malignant diseases. Only two children were treated for melanoma. The authors present a 12-year-old boy with malignant melanoma of the central nervous system which appeared in the left parieto-occipital region. All clinical, laboratory, radiological and other examinations could discover no other lesion except the CNS (primary or metastatic). The boy was operated on (partial extirpation) and radiotherapy was performed with 60Gy/30f. The boy completely recovered for a short time. He died 14 months after the onset of symptoms and 12 months after the beginning of the treatment. This clinical course suggests a rapid progression of primary brain melanoma.

[Radiotherapy of esophageal cancer]. / Radioterapija karcinoma jednjaka.

In the Institute of Radiology in Belgrade, in 1960 to 1972 period, 115 patients with malignant tumors of eosophagus were treated only with radiation. Among them there were 89 men and 26 women. The tumors appeared most frequently in the seventh decade of life, and their localization did not have an essential influence on the course of the disease, respectively on the effects of medical treatment. Two of these patients survived 5 years, and 78 died in the course of the first year after radiation. Particularly we found improvement regarding the general condition and the better feeding possibilities (70 per cent of the cases). These patients spent their last days relatively well and in this we should see the significant of radiotherapy of these malignant tumors, because another choice of medical treatment and help does not exist for the present. From 1975 year we have been using the preoperative radiation in short courses in order to improve the surgical results.

[Treatment of acute lymphocytic leukemia in children with combination chemotherapy and irradiation of the central nervous system]. / Akutna limfocitna leukemija u dece lecene hemioterapijom i zracenjem centralnog nervnog sistema

From July 1972 until April 1975 51 children with acute lymphocytic leukemia had been treated with combination chemotherapy and central nervous system irradiation. First remission was induced in 46 patients. 13 patients died during the first and second year of treatment. Central nervous system leukemia developed only in 3 patients. In 9 patients chemotherapy had been stopped after 30 months of treatment. These results are very encouraging and we hope that majority of our patients will survive 5 years without relapse.