[The radiotherapy satellite in Kristiansand--a model for Norwegian regional hospitals?]. / Stråleterapisatellitten i Kristiansand--en modell for norske regionsykehus?

BACKGROUND: During the first decade of 2000, significant increase of radiotherapy capacity in Norway will take place, as the number of linear accelerators will increase from 24 to 36. In Norway, radiotherapy departments are traditionally located only in university hospitals. However, six of the new accelerators will not be installed in existing radiotherapy centres, but in small, new radiotherapy units, set up in selected county hospitals and organized as satellites of the university hospitals, in order to secure the treatment quality. The university hospital is responsible for both medical and technical standards in the satellite, while the county hospitals have the financial responsibility. RESULTS: The satellite model combines two important aspects of hospital management; treatment is geographically decentralized, while treatment quality is centralized. The first radiotherapy satellite was established in the town of Kristiansand in January 2001. We report our experience with this new concept in radiotherapy. INTERPRETATION: The satellite model should be evaluated also for other medical specialties within the university hospitals.

Retinopathy after low dose irradiation for an intracranial tumor of the frontal lobe. A case report.

A 32-year-old man underwent an operation for an oligodendroglioma of the left frontal lobe. Postoperatively he was irradiated to a target dose of 54 Gy. One year later he developed bilateral retinopathy quite similar to diabetic retinopathy. There were no clinical or biochemical signs of diabetes or hematological disease. The calculated maximum dose to the retina was 11 Gy. This is to our knowledge the lowest retinal dose of ionizing radiation reported to produce retinopathy.

Post-treatment fertility in patients with testicular cancer. III. Influence of radiotherapy in seminoma patients.

Sperm analysis and serum hormone measurements (LH, FSH, testosterone) were performed in 29 patients after orchiectomy for seminoma before and after irradiation. Before radiotherapy 14 of 20 orchiectomized patients were azoospermic or had impaired spermatogenesis. A minimum sperm count was found 1 year after radiotherapy with gradual improvement up to 2 years. The recovery of sperm cell production was impaired most in patients with pre-treatment sperm counts less than 3 million/ml. Serum testosterone remained at low normal levels throughout the observation period. The mean serum FSH was increased 1 year after radiotherapy but returned to normal in 50% of patients within 3 years after treatment. This post-treatment increase in FSH was significantly correlated with increased pre-treatment FSH but not with the gonadal dose, which was 1 to 3% of the target dose. Severe disturbances in spermatogenesis, observed 2 to 3 years after radiotherapy for early seminoma, are likely to be the expression of a highly impaired pre-treatment sperm cell production and only to a lesser degree dependent on the irradiation of the remaining testicle.

Paternity after irradiation for testicular cancer.

According to the Medical Birth Registry (MBR) of Norway, 69 of about 430 patients irradiated for testicular cancer (stage I + II) during 1966-1978 fathered at least one child after radiation therapy (median observation time 136 months, range 36-191 months). A total of 95 children were born. Between 10 and 122 months elapsed between discontinuation of irradiation and the birth of the first child born after radiation therapy. Though the total doses to the abdominal irradiation field were higher in patients irradiated by a linear accelerator (1971-1978), than in those treated by a betatron (1966-1970), the gonadal doses were generally lower in the former group due to better gonadal shielding. In the children, the sex ratio and the median weight and length at birth were comparable to those values seen in a control group from the MBR. No increased frequency of malformations was observed. It is concluded that modern radiation therapy techniques allow post-irradiation fathership in a significant number of patients, without increased risk of neonatal problems or malformations in the children.