[Exclusive radiotherapy in bladder cancer]. / Radioterapia exclusiva en el cáncer de vejiga.

OBJECTIVE: The indications for treatment of superficial and infiltrating tumors of the urinary bladder by radiotherapy alone are analyzed. METHODS: The records of 468 patients treated at the Oncological Radiotherapy Department of the Clinica Puerta de Hierro in Madrid and data from the literature were reviewed. RESULTS: Radiotherapy continues to be a conservative alternative to radical cystectomy in infiltrating bladder cancer. Although the survival rates are slightly lower than those of the more recent series of patients treated by cystectomy, the cystectomy series report the results of retrospective studies in patients that were not randomized and with a bias in patient selection. The best results are obtained in young adult patients with T2-T3a tumors and no ureteral obstruction. In superficial bladder tumors, radiotherapy might be useful in recurrences of T1G3 managed conservatively. Its value as an adjuvant therapy has yet to be defined and is currently under study. Palliative radiotherapy for bladder cancer achieves satisfactory results in the control of hematuria and pain. CONCLUSIONS: Radiotherapy is a radical therapeutic option in infiltrating tumor of the bladder that must be considered as an alternative to radical cystectomy, perhaps within the context of current strategies of combination radio and chemotherapy.

[Prognostic factors in prostatic carcinoma treated with radical radiotherapy: stages A, B, and C]. / Factores pronósticos en el carcinoma de próstata tratado con radioterapia radical: estadios A, B y C.

Analysis of a series of 118 patients with histological diagnosis of prostate carcinoma, localized stages A2, B and C, treated with external radiotherapy with radical purpose between July 1964 and December 1991. The 5-year cause-specific survival was 69% years and 62% at 10 years. Disease-free survival was 56% and 48% at 5 and 10 years respectively. Local, locoregional and distant relapse-free survivals were 91%, 75% and 65% at 10 years respectively. Several factors characterize each tumour, influencing the therapy failure. In our series, non-differentiated, stage C tumours with pathological LDH levels at diagnosis and treated with AP-PA fields showed decreased survival and greater relapse ratios. Two separate factors influence on distant failure: LDH pathological levels at diagnosis and non-differentiated tumours. External radiotherapy is a therapeutical alternative in localized stages of prostate carcinoma, which offers little morbidity and good tolerance, similar results to those obtained with surgical treatment.

Individual risk of abdominal disease in patients with stages I and II supradiaphragmatic Hodgkin's disease. A rule index based on 341 laparotomized patients.

A multivariate analysis of the prognostic factors for clinical Stages I and II supradiaphragmatic Hodgkin's disease was carried out with a logistic regression model in 341 patients. The proportion of patients with positive staging laparotomy was greater in males, in individuals with several sites involved, mixed cellularity (MC) or lymphocyte depletion (LD) histologic types, systemic symptoms, or in patients with lower cervical involvement and higher erythrocyte sedimentation rate (ESR), serum copper, and LDH levels. Histology, presence of systemic symptoms (fever and sweats), and number of involved nodal regions were independent predictors of positive laparotomy. Mediastinal involvement is correlated to a significantly lower risk of positive laparotomy. Based on these observations, the individual risk for each patient of occult abdominal disease has been defined.