RESUMEN
The radiosensitizing efficacy of iso-metronidazole, a 4-nitroimidazole derivative, was evaluated in a prospective clinical phase-II study. The results of combined radiotherapy of 25 patients with bladder cancer were compared with those of a control group of 25 patients treated with radiotherapy only. Tumor regression six months after radiotherapy was used as an endpoint. The surgical procedure was performed as double TUR. Evaluating the local tumor control after additional application of iso-metronidazole a gain factor of 1.2 is obtained.
Asunto(s)
Metronidazol/análogos & derivados , Fármacos Sensibilizantes a Radiaciones/administración & dosificación , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Neoplasias de la Vejiga Urinaria/radioterapia , Administración Intravesical , Terapia Combinada , Evaluación de Medicamentos , Femenino , Humanos , Masculino , Metronidazol/administración & dosificación , Metronidazol/efectos adversos , Metronidazol/farmacocinética , Cuidados Posoperatorios , Fármacos Sensibilizantes a Radiaciones/efectos adversos , Fármacos Sensibilizantes a Radiaciones/farmacocinética , Inducción de Remisión , Neoplasias de la Vejiga Urinaria/sangreRESUMEN
The possibility is investigated to use shielded vaginal applicators for "line-shaped" 192Ir-sources to irradiate cervical carcinoma. Using segment-shaped absorbers of heavy metal the dose can be reduced in ventro-dorsal direction in area of rectum and bladder with irradiation of cervical carcinoma up to a factor of 2 in dependence of rectum and bladder position. Selecting a suitable source position and source standing time a dose reduction can be realized in cranial direction up to two centimetres from the portio.
Asunto(s)
Braquiterapia/instrumentación , Radioisótopos de Iridio/uso terapéutico , Protección Radiológica , Neoplasias del Cuello Uterino/radioterapia , Femenino , HumanosAsunto(s)
Trasplante de Médula Ósea , Leucemia-Linfoma Linfoblástico de Células Precursoras/cirugía , Trasplante de Médula Ósea/efectos adversos , Niño , Terapia Combinada , Estudios de Evaluación como Asunto , Alemania Oriental/epidemiología , Humanos , Tablas de Vida , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamiento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/mortalidad , Trasplante Autólogo , Trasplante HomólogoRESUMEN
In a summary representation the therapeutic principles are shown applying radiotherapy in epithelial tumors of epi-, meso-, and hypopharynx on base of actual references in literature and own results. Especially by combination therapy a trend indicates improvement of therapeutic results.
Asunto(s)
Neoplasias Faríngeas/radioterapia , Terapia Combinada , Humanos , Neoplasias Faríngeas/mortalidad , Tasa de SupervivenciaRESUMEN
The dose distribution of a "line-shaped" 192Ir-source was measured in 1,152 measuring points in a water phantom. Using regression analysis the analytical description of dose distribution was obtained. Accomplished comparison measurings with a solid phantom of miramide in 45 measuring points show that the dose distribution can be reproduced well by solid phantom measurings. Taking an ideal line source distribution as a basis, the r-dependence of correction factor, obtained by regression analysis, refers to a dispersion effect. The angle-dependent deviation of dose distribution from the ideal line source can be described by cos-terms with the single and double angle between line source axis and measuring point.
Asunto(s)
Braquiterapia , Neoplasias de los Genitales Femeninos/radioterapia , Radioisótopos de Iridio/uso terapéutico , Femenino , Humanos , Modelos Estructurales , Dosificación RadioterapéuticaRESUMEN
For different fields of application in irradiation of gynecological tumors a comparison of isodose distribution is done with "point-shaped" and "line-shaped" 192Ir-source. With the oblateness of dose efficiency distribution towards the axis of source with the "line-shaped" 192Ir-source an improvement of dose distribution occurs in intracavitary irradiation with the lower and more balanced exposure of fundus uteri, especially in irradiation of the endometrial carcinoma. On the other hand the irradiation of vaginal stump renders problematic. In pure vaginal irradiation no differences are found in medically interesting range.
Asunto(s)
Braquiterapia , Neoplasias de los Genitales Femeninos/radioterapia , Radioisótopos de Iridio/uso terapéutico , Femenino , Humanos , Dosificación RadioterapéuticaRESUMEN
The retrospective analysis of a radiotherapeutical material includes 452 patients with laryngeal carcinoma of the University Jena during the period from 1964 to 1981. The primary radiotherapy was done according to therapeutic protocol exclusively in glottal tumors of stage T1 and T2, exceptionally refusers of operation or inoperables. The portion of total laryngectomy is accordingly high with 47.6% of all patients. The 5-years-survival of all patients is 48% (217 of 452 patients). The results are compared with results of other therapeutic statements.
Asunto(s)
Neoplasias Laríngeas/terapia , Anciano , Terapia Combinada , Humanos , Neoplasias Laríngeas/radioterapia , Neoplasias Laríngeas/cirugía , Persona de Mediana Edad , Pronóstico , Estudios RetrospectivosRESUMEN
For the contact radiotherapy according to the afterloading-procedure of patients with cervical and endometrial carcinomas isodose plans are represented, that are standardized to the lengths of uterus probes and adapted to tumor stages and are determined by an applicator tube lying centrally within the uterine cavity. By an additional lead screening of the vaginal applicator a dose reduction can be attained by the factor 1.6 or 1.4 in the critical organs bladder and rectum, which are relevant for this therapeutic form. An uncritical inclusion of the vagina into the target volume of contact therapy, that is not justified by tumor invasion, should not be carried out, knowing the higher complication rate at the critical organs.
Asunto(s)
Braquiterapia/métodos , Neoplasias Uterinas/radioterapia , Braquiterapia/instrumentación , Femenino , Humanos , Dosificación Radioterapéutica , Neoplasias del Cuello Uterino/radioterapiaRESUMEN
Of 25 HLA-identical, MLC negative transplants 10 patients had acute lymphoblastic leukaemia (ALL), 8 acute nonlymphoblastic leukaemia (ANLL), 3 severe aplastic anaemia, 2 malignant histiocytosis, 1 patients neuroblastoma and 1 Fanconi anaemia. 3 HLA nonidentical, MLC positive transplants were performed, two children had malignant infantile osteopetrosis and 1 child had a severe combined immunodeficiency disease. Patients with ALL and ANLL received cyclophosphamide and single dose total body irradiation. 3 patients received fractionated TBI. The results for the allogeneic group overall indicate that the actuarial disease free survival rate is 0.62. 16 of 25 patients are in continuous complete remission (CCR) periods of 3-78 months posttransplant. All three transplanted children with severe aplastic anaemia alive disease-free for periods of 21-81 months. 10 patients with ALL were transplanted (2 in first remission for high risk ALL, 8 in second remission). 7 of 10 patients are alive and disease-free (CCR rate 0.67). 8 patients underwent BMT for ANNL while in first remission in 7 patients and in third partial remission in 1 patient. 4 of 8 patients are alive and disease-free for periods of 25-56 months (CCR rate 0.50). 1 patient with neuroblastoma stage IV survives 24 months, 1 child with Fanconi anemia died on day +25 of GVHD and septicaemia. 1 of the 2 patients transplanted for malignant histiocytosis relapsed 3 months posttransplant, 1 patient is alive and disease-free 5 months posttransplant. In none of the HLA-nonidentical and MLC positive transplantations T-cell depleted marrow engrafted.
Asunto(s)
Trasplante de Médula Ósea , Leucemia/cirugía , Adolescente , Anemia Aplásica/mortalidad , Anemia Aplásica/cirugía , Niño , Preescolar , Anemia de Fanconi/mortalidad , Anemia de Fanconi/cirugía , Femenino , Alemania Oriental , Enfermedad Injerto contra Huésped , Histiocitosis/mortalidad , Histiocitosis/cirugía , Humanos , Leucemia Mieloide Aguda/mortalidad , Leucemia Mieloide Aguda/cirugía , Masculino , Neuroblastoma/mortalidad , Neuroblastoma/cirugía , Leucemia-Linfoma Linfoblástico de Células Precursoras/mortalidad , Leucemia-Linfoma Linfoblástico de Células Precursoras/cirugía , Tasa de SupervivenciaRESUMEN
The elimination of erythrocytes by dextran sedimentation is a useful method to prevent haemolytic complications after AB0-incompatible bone marrow transplantation. The procedure presented here lasts only 1.5-2 hours, is high reproducible and safe in respect of infections. The mean recovery of nucleated cells amounted to 94%. The contamination with erythrocytes is low (recovery 1.1%). We have never seen haemolytic reactions during 7 AB0-incompatible bone marrow transplantations.
Asunto(s)
Sistema del Grupo Sanguíneo ABO , Incompatibilidad de Grupos Sanguíneos , Células de la Médula Ósea , Trasplante de Médula Ósea/inmunología , Separación Celular/métodos , Dextranos , Eritrocitos/citología , Sistema del Grupo Sanguíneo ABO/inmunología , Anticuerpos/análisis , Niño , Eritrocitos/inmunología , HumanosRESUMEN
Since 1984 bone marrow from 42 children with acute lymphoblastic leukaemia, non Hodgkin's lymphoma and neuroblastoma was cryopreserved. In 5 cases (c-ALL, NHL and B type) the marrow was purged by using a cocktail of three monoclonal antibodies (VIL A1, VIB C5, VIB-E3). Up to now 13 children (ALL/10, neuroblastoma/3) were autografted (one of them after purging) after supralethal chemoradiotherapy. Except one child with early death all patients had engraftment: a level of 1.0.10(9)/l leukocytes was reached at days 10-33 (median, 19); platelet level over 60.10(9)/l at days 32-60 (median, 41). 2 children died on treatment related complications, one on infection after full haematological restitution, 2 patients alive with relapse, 8/13 alive in CCR and well.
Asunto(s)
Trasplante de Médula Ósea , Criopreservación , Conservación de Tejido , Anticuerpos Monoclonales , Médula Ósea/patología , Separación Celular , Niño , Preescolar , Granulocitos/patología , Células Madre Hematopoyéticas/patología , Humanos , Lactante , Leucemia/patología , Leucemia/cirugía , Linfoma no Hodgkin/patología , Linfoma no Hodgkin/cirugía , Macrófagos/patología , Neuroblastoma/patología , Neuroblastoma/cirugía , Rabdomiosarcoma/patología , Rabdomiosarcoma/cirugía , Trasplante AutólogoRESUMEN
The value of serum neopterin as tumour marker was verified on 104 breast cancer patients. Based on the results, neopterin cannot be recommended either for deciding treatment after primary therapy or for monitoring of breast cancer.
Asunto(s)
Biomarcadores de Tumor/sangre , Biopterinas/análogos & derivados , Neoplasias de la Mama/sangre , Adulto , Anciano , Anciano de 80 o más Años , Biopterinas/sangre , Estudios de Evaluación como Asunto , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , NeopterinRESUMEN
With 282 autopsied patients with bladder carcinoma, that were treated by combined operation and radiotherapy, conclusions are given for tendency in tumor spreading as well as for complications and late-effects of radiotherapy. In 24.5% of the cases tumor tissue was found within the bladder and in 30.5% of the cases within the minor pelvis. Metastases were found in 24.1% in iliac lymph-nodes, in 21.3% of the autopsy cases in abdominal lymph-nodes. Liver, lungs, bones, and kidneys are main organs for hematological metastasizing. Little or undifferentiated carcinomas and squamous cell carcinomas show a greater tendency to metastasize than highly and medium-differentiated ureteral carcinomas. The least radiotherapeutical complications and late-effects were found in a fractionation with daily 1.5 Gy and a total dose of 60 Gy (necrotising urocystitis 17.9%, proctitis 3.6%).
Asunto(s)
Carcinoma de Células Escamosas/radioterapia , Carcinoma/radioterapia , Neoplasias de la Vejiga Urinaria/radioterapia , Carcinoma/patología , Carcinoma/secundario , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/secundario , Humanos , Metástasis Linfática , Neoplasias de la Vejiga Urinaria/patologíaRESUMEN
In 294 patients with bladder carcinoma, in which after transurethral or transvesical operation a high-voltage irradiation with daily 1.5 Gy and a total target dose of 60 Gy (four fields cross firing technique) was done, the influence of quality of physical-technical irradiation planning is studied on survival rates, portion of recurrences, side-, and late effects. The group of patients with individually computer-based optimizing of irradiation parameters based on a patient's cross-section, ascertained on therapy simulator, significantly shows better results with regard to above-mentioned criteria than the groups of patients with standard irradiation technique without and with definition of bladder topography.
Asunto(s)
Planificación de la Radioterapia Asistida por Computador , Radioterapia Asistida por Computador , Neoplasias de la Vejiga Urinaria/terapia , Anciano , Terapia Combinada , Humanos , Persona de Mediana Edad , Neoplasias de la Vejiga Urinaria/radioterapia , Neoplasias de la Vejiga Urinaria/cirugíaRESUMEN
Overall 1,021 patients with endometrial carcinoma were treated between 1965 and 1982 at the Department of Obstetrics and Gynecology and the Department of Radiology, Friedrich-Schiller-University, Jena. The 5-year-survival rate of all patients amounted to 63%. The 5-year-survival probability with primary surgery was 76.1%, with primary irradiation 34.4%. The frequency of risk factors in the patient group was compared with an age adjusted group of patients who underwent a D & C due to irregular bleeding of benign causes. Overweight and infertility were evaluated as significantly more frequent risk factors in cancer patients. There was no significant difference between the two groups concerning the factors hypertension, diabetes, heart-diseases, irregular bleeding and history of carcinoma in the family.
Asunto(s)
Neoplasias Uterinas/terapia , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Persona de Mediana Edad , Pronóstico , Factores de Riesgo , Neoplasias Uterinas/radioterapia , Neoplasias Uterinas/cirugíaRESUMEN
From radiobiological model investigations it is deduced that hyperfractionated irradiation can render possible a better tumor regression than conventional fractionation with the same complication rate in tumors growing not too quick.
Asunto(s)
Neoplasias/radioterapia , Dosificación Radioterapéutica , Supervivencia Celular/efectos de la radiación , Humanos , Técnicas In Vitro , Células Tumorales Cultivadas/efectos de la radiaciónRESUMEN
A prospective randomized clinical study is made on patients with uterine cervix and endometrium carcinomas treated only by radiotherapy. The fractionation schemes of 4 times 10 Gy, and 5 times 8 Gy, and 8 times 5 Gy at the reference points A and My, respectively, of a short-term afterloading therapy combined with percutaneous telecobalt therapy with 45 Gy at the pelvic wall are investigated. A tendency is shown towards better tumor control and less radiogenic effects with an increased number of fractions. The results are discussed on the basis of the NSD and LQ models. The problems caused by the equipment type and dosage specificity hampering the applicability of the results on other afterloading therapy units are pointed out.
Asunto(s)
Braquiterapia/métodos , Neoplasias del Cuello Uterino/radioterapia , Neoplasias Uterinas/radioterapia , Anciano , Ensayos Clínicos como Asunto , Femenino , Humanos , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Dosificación Radioterapéutica , Distribución AleatoriaRESUMEN
On the basis of an evaluation of different isoeffect correlations for normal tissue reactions supported by a clinical study, a number of correlations for the dose-time optimization of irradiations with equal fractionation intervals are derived from a simple approach for the survival rate of irradiated tumor cells based on a linear quadratic dose-effect function for an exponential cell proliferation. This allows to determine optimum single doses for every given fractionation interval which, applied with the number of fractions tolerated by normal tissue, lead to a maximum reduction of tumor cells. The values of these optimum fractionation parameters depend from cell proliferation and radiosensitivity of the tumoral tissue and vary with respect to a normal tissue tolerance for early and late reactions. The results are described for several fractionation examples. It is shown that, within the tolerance limits of normal tissue, a greater tumor remission is achieved by hyper-fractionated irradiation than by a small number of high-dose irradiations.
Asunto(s)
Relación Dosis-Respuesta en la Radiación , Neoplasias/radioterapia , Humanos , Matemática , Dosificación Radioterapéutica , Radioterapia de Alta EnergíaRESUMEN
Two cases of radiation-induced sarcomas are presented. Osteosarcomas developed in the frontal bone after a latency period of 36 years following operation for brain tumor with post-operative irradiation (48 Gy) in one patient and in the region of the right sacro-iliac joint after ablation of testis for seminoma with post-operative irradiation (60 Gy) in another patient. In the literature, the risk of developing an irradiation-induced sarcoma is considered to be low (0.05-0.2%). Both cases, however, underline the necessity of an exact indication for irradiation to avoid such complications.