Postoperative radiotherapy in gastric cancer.

Surgeons in Poland are very skeptical about the positive role of adjuvant irradiation in patients with gastric cancer. A retrospective study of 21 patients with operable gastric cancer referred for irradiation to Cancer Centre in Warsaw between December 1984 and December 1991 was performed. Patients were qualified to receive adjuvant treatment because of bad prognostic factors--nonradical surgery (10 patients), infiltration of entire thickness of gastric wall (13 patients), and metastases in regional lymph nodes (9 patients). All patients were in good condition. They were treated by either telecobalt 60 unit or linear accelerator using 9-15 MeV photons. The total dose to the gastric bed and lymphatic was 46-50 Gy in 25 to 28 fractions, 5 days a week. The tolerance of treatment was good. None of these patients received 5-FU either during irradiation or as maintenance therapy. We have obtained more than 50% overall survival rate at 3 years. Median survival was 27 months and median recurrent-free interval 27 months. Local recurrence was found in four patients, distant metastases in five patients. In the group of 10 patients with nonradical surgery, 5 are alive without evidence of disease from 2 up to 7 years after treatment. Our preliminary results and good tolerance of treatment seem to support the beneficial role of adjuvant radiotherapy after gastrectomy in patients with risk factors of locoregional cancer recurrence.

[Evaluation of the results of combined treatment of patients with testicular seminoma in the II stage of clinical advancement]. / Ocena wyników skojarzonego leczenia chorych na nasieniaki jadra w II stopniu zaawansowania klinicznego.

An attempt to introduce combined therapy for patients with testicular seminoma in the II degree of clinical advancement was undertaken at the Centre of Oncology. Combined therapy consisted of 3 courses of PVB in the following daily doses: DDP 100 mg/m2 i.v. on the first day; VLB 10 mg i.v. on the first and second day; bleomycin 30 mg i.v. on the second, ninth and sixteenth day every 21 days, and 60Co on lymphatic glands area in which metastases were diagnosed prior to chemotherapy. Twenty three patients were treated that way between January 1985 and June 1989. Mean follow-up period after the treatment was 14 months. One patient died for the tumor, metastases to the lungs were diagnosed in one patient 9 months after completion of the treatment which ameliorated after "second" chemotherapy, and 22 patients (96%) are still free from the symptoms of active disease.

Supracystic urine diversion in patients with bladder carcinoma treated by cystectomy preceded by "short radiotherapy" (2000 R).

The authors assessed the results of supracystic urine diversion in 50 patients treated by cystectomy for bladder carcinoma who had "short radiotherapy" (2000 R) before the operation. It was found that preoperative radiotherapy caused no difficulties during subsequent cystectomy and the observed postoperative complications should be related rather to the surgical technique. It seems that indications to urine diversion by the method of Goodwin or Coffey should be considered with greater caution. In patients past the age of 65 years and those with more advanced neoplasms (T-3, T-4) bilateral ureterocutaneostomy should be performed more frequently for suprapubic urine diversion.