RESUMEN
Ninety-two patients with resected adenocarcinomas of the rectum, rectosigmoid, or sigmoid, Gunderson Stages B2-3 and C1-3, received postoperative pelvic irradiation between 1976 and 1981. Thirty-three patients had gross or microscopic postoperative residual disease. Half were age 65 or older. Eighty-four patients (92%) completed therapy as planned with 71% given at least 5000 cGy. There were treatment interruptions in 26% but only two complications. The median follow-up was 32 months. Nineteen of 92 recurred in the pelvis (21%): 6/29 (21%), in Stages B2-3 (node -), 13/63 (21%), in C1-3 (node +), 7/50 (14%), in B2, C1-2 (mobile), and 12/41 (29%), in B3, C3 (fixed). There were 10/33 (30%) pelvic recurrences with postoperative residual disease compared to 9/59 (15%) recurrences in completely resected patients (p = 0.1). Among 51 patients who received greater than or equal to 4500 cGy pelvic irradiation, with no residual disease, only five recurred: 1/15 (7%) in B2-B3, 4/36 (11%) in C1-3, 4/38 (11%) in B2, C1-2, and 1/13 (8%) in B3, C3. In this cohort, the 5-year relapse-free survival rates were 83% in Stages B2-3, and 27% in Stages C1-3 (p = 0.023). High dose, postoperative pelvic irradiation is an effective and well tolerated adjuvant for local control of pelvic colon adenocarcinoma.
Asunto(s)
Adenocarcinoma/radioterapia , Neoplasias del Recto/radioterapia , Neoplasias del Colon Sigmoide/radioterapia , Adenocarcinoma/cirugía , Anciano , Terapia Combinada , Humanos , Recurrencia Local de Neoplasia , Radioterapia/efectos adversos , Dosificación Radioterapéutica , Neoplasias del Recto/cirugía , Neoplasias del Colon Sigmoide/cirugía , Factores de TiempoRESUMEN
One hundred and four computed tomography (CT) examinations were performed on 72 consecutive radiotherapy patients with pelvic malignancies. Prostate, bladder, rectosigmoid, gynecologic, and lymphomatous primaries were studied. Computed tomography demonstrated tumor volumes larger than clinically expected in 40% and tumor extension into unsuspected tissues in 43%. Based on CT, staging was revised upward in 25%. Computed tomography aided initial treatment planning in 61%. In 27 patients having post-therapy scans, changes in tumor volume were demonstrated in 59%. Modifications in therapy were made for 30% of the follow-up group. Computed tomography is recommended as an important adjunct in the workup and management of radiotherapy patients with pelvic malignancies.
Asunto(s)
Neoplasias Pélvicas/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Presentación de Datos , Femenino , Estudios de Seguimiento , Humanos , Linfoma/diagnóstico por imagen , Masculino , Metástasis de la Neoplasia , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Planificación de Atención al Paciente , Neoplasias Pélvicas/patología , Estudios Prospectivos , Neoplasias de la Próstata/diagnóstico por imagen , Neoplasias del Recto/diagnóstico por imagen , Neoplasias del Colon Sigmoide/diagnóstico por imagen , Cuidado Terminal , Neoplasias de la Vejiga Urinaria/diagnóstico por imagen , Neoplasias Uterinas/diagnóstico por imagenRESUMEN
By utilizing 61 lacrimal scans, 26 patients who had received radiotherapy for inner canthus and lid lesions were evaluated. Results indicate that the membranous lacrimal passages are relatively immune to radiation therapy. Although dacryoscintigraphy did not delineate the anatomical features quite as well as contrast dacryocystography, it yielded very useful information about flow mechanisms and tear transit times. The study is rapid, simple, non-hazardous, and particularly helpful in documenting the status of the lacrimal drainage system before and after radiotherapy to the inner canthus region.
