[Comparative assessment of the five-year results of surgical, combined, radiation and chemoradiotherapy in laryngeal cancer (T3N0M0)].

Four modalities of specific treatment for laryngeal cancer were compared in 158 patients. Five-year survival after chemoradiotherapy using cisplatin, 5-FU and bleomycin plus irradiation (65-70 Gy) was 87% versus 69.7; 66.2 and 45.9% after surgical, combined and radiotherapy, respectively. Chemoradiotherapy failed in 22.4%, as compared with 28.9; 31.5 and 41.7% after the alternative modalities, respectively. Organ preservation was used in 30.3% of surgical cases and 58%--in combined treatment group.

[A comparison of two modalities of complex chemoradiotherapy for locally advanced nasopharyngeal carcinoma]. / Sravnitel'naia otsenka variantov kompleksnogo lecheniia nedifferentsirovannogo mestnorasprostranennogo raka nocoglotki.

Two modalities of complex chemoradiotherapy for locally advanced nasopharyngeal carcinoma stage III-IV were compared in the treatment of 52 patients. Thirty-four patients (group I) received polychemotherapy: cisplatin--100 mg/sq.m, i.v., dropwise, on day 4, plus ACOP (adriamycin 35 mg/sq.m, i.v.--4; cyclophosphamide 750 mg/sq.m, i.v.--4, day 1; vincristine 1.4 mg/sq.m, i.v.--4, and prednisolone 100 mg/sq.m, per os, days 1-5; group II (18)--cisplatin 100 mg/sq.m, day 4, plus 5-FU 1,000 mg, i.v.--4, injection, days 1-3. Full response was registered in 93.7% (group I) and 93.3% (group II). Overall 5-year and relapse-free survival was 85 and 63% (group I), and 83 and 56% (group II), respectively. There were no significant differences in radiation-related injury incidence in both groups. The best results were reported with chemoradiotherapy using two courses: an induction one and an adjuvant cisplatin drugs treatment concurrent with ACOP or 5-FU.

[Combined treatment of stage III laryngeal cancer with different schedules of radiotherapy and surgery. Evaluation of preventive methods of the treatment of regional areas (cooperative randomized study)]. / Kombinirovannoe lechenie raka gortani III stadii s razlichnoi posledovatel'nost'iu oblucheniia i operatsii. Otsenka preventivnykh metodov vozdeistviia na regionarnye zony (po materialam kooperirovannogo randimizirovannogo issledovaniia).

In 1980-1987, a cooperative randomized study of 363 patients with stage III laryngeal cancer (T1-3N0-1M0) was carried out. In 249 patients tumor was located in the vestibular space and in 114 in the vocal cord area; 78.5% of the patients had no regional metastases (N0) and 21.5% had metastases (N1). Combined therapy was applied to 251 patients, 135 of which were first exposed to radiotherapy and then to surgery and 116 were first exposed to surgery and then radiotherapy. In 71 patients, regional zones underwent preventive treatment (in 24 patients elective radiotherapy and in 47 preventive removal of the cervical fat were used). In 112 patients, the therapeutic protocol was modified due to different reasons (69 patients underwent only surgery and 43 radical radiotherapy). The therapeutic results were assessed in terms of three parameters: incidence of relapses and regional metastases, relapse-free time, and survival. This approach revealed no significant differences in the efficacy of the different protocols of the combined treatment. The 5-year survival rate of the patients with vestibular and cord space tumor was 77.9% and 80.7% respectively, when treated according to the radiotherapy + surgery protocol, and 82.8% and 89.2%, respectively, when treated according to the surgery + radiotherapy protocol. Comparison of preventive approaches showed that the 5-year survival rate increased by 92% as a result of removal of the subcutaneous fat from the neck area.

[Radiation therapy of stage III laryngeal cancer]. / Luchevaia terapiia raka gortani III stadii.

As a result of a marked effect of the 1st stage of radiation therapy of 44 patients with stage III (T3N0M0) laryngeal cancer it was followed by therapy after a radical program up to a summary focal dose of 65-70 Gy. Continued tumor growth and recurrences were diagnosed in 19 patients, of them radical operation was performed on 12, 25 patients (57%) have been followed-up for 3 years, without signs of either recurrence or metastases with the preserved larynx. The above results suggest the effectiveness of radiation therapy in locally advanced laryngeal cancer.

[Combined treatment of primary inoperable breast cancer]. / Kompleksnoe lechenie pervichno neoperabel'nogo raka molochnoi zhelezy.

The paper is devoted to the clinical characterization and results of therapy of 45 patients with locally advanced, primary inoperable cancer. Most of the women were at the age of 40-60, of them 64% had preserved menstrual ovarian function. Multimodality therapy included radiation therapy combined with chemotherapy (UAM and CMF schemes). The breast and all zones of regional metastasis were irradiated at a single focal dose of 2 Gy, the total focal doses were 67-70 Gy to the breast, 50 Gy to the axillary and supra- and subclavicular areas, and 34-40 Gy to the parasternal area. This therapy was followed by radical mastectomy on 30 patients. A degree of expression of a clinical effect and therapeutic pathomorphosis was emphasized. Proceeding from 2-year long-term results, multimodality therapy including surgical intervention was found appropriate.

[Experience with thermoradiotherapy of malignant tumors]. / Opyt termoradioterapii zlokachestvennykh opukholei.

The authors analyzed immediate, short-term results of thermoradiotherapy of 112 patients and radiotherapy alone of 91 patients (control group). All had tumors of different sites. Local hyperthermia used as an adjuvant to radiotherapy made it possible to increase the frequency of complete tumor regression from 0 to 11% in rectal cancer patients, from 86 to 100% in head and neck cancer patients, from 0 to 14% in the patients with soft tissue sarcomas and from 40 to 71% in children with rhabdomyosarcomas. These results suggest a possibility of raising the efficacy of radiotherapy combined with local electromagnetic hyperthermia.

[Criteria for evaluating the efficacy of treatment of breast cancer metastases to the bones]. / Kriterii otsenki éffektivnosti lecheniia pri metastazakh raka molochnoi zhelezy v kosti.

Roentgenography of the cranium, ribs, vertebral column, pelvis and scintigraphy of the skeleton were performed every 3-4 mos in 39 patients with breast cancer metastases to the bones. Criteria of therapeutic efficacy were the following: a complete therapeutic effect, a partial therapeutic effect, stabilization and progression. In osteolytic metastases a complete therapeutic effect was obtained in 72% of the cases. Sixteen patients have been in remission during 16-36 mos.

[4-component chemotherapy and radiation therapy of breast cancer]. / Chetyrekhkomponentnaia khimioterapiia i luchevaia terapiia pri rake molochnoi zhelezy.

The treatment schedule for disseminated breast carcinoma has been developed. It includes the use of adriamycin (30 mg/m2, days 1, 8, 15), methotrexate (30 mg/m2, day 1), 5-FU (600 mg/m2, day 8), and cyclophosphamide (400 mg/m2, day 15 i. v. by jet injection). A complete response was obtained in 50 to 56% of the patients, with remissions lasting for an appreciable period of time. The use of chemotherapy according to the described schedule combined with radiation of the bones of the pelvis and lumbar part of the spine brought about complete or partial reparation of the osteolytic, osteoblastic and mixed metastatic foci in 76.2% of the patients.

[Proton irradiation of bone metastases]. / Obluchenie protonami kostnykh metastazov.

A proton beam with the energy of 100-130 Mev, the range up to 40-100 mm and diameter up to 6 cm was used for radiation therapy of breast cancer metastases to the bones adjoining the vital organs or normal tissues with low tolerance (the skull, sternum, ribs, jaw, etc.). Medium fractionation regimens were used for the single doses of 4-10 Gy. The number of fractions was from 1 to 7, the summary dose 17-28 Gy that corresponded to 35-46 Gy of classic fractionation designed by the TDF factor. The first experience of the irradiation of bone metastases has shown that general and local reactions to proton irradiation correspond to a dose delivered and irradiation regimen and do not differ from those in conventional radiation. A marked therapeutic effect was obtained in all the patients. The formation of bigger diameter proton beams and of a deeper range is required for the irradiation of large zones of bone metastases.

[Radiotherapy of metastases of malignant neoplasms into the lungs]. / Luchevaia terapiia metastazov zlokachestvennykh opukholei v legkie.

The results of radiation therapy in 800 patients with lung metastases of different malignant neoplasms are reported. Metastases were multiple--in 53 cases, single--in 7, solitory--in 14. In 6 patients metastatic nodes were noted in the pleura. Total irradiation was employed (of one lung in 36 patients, of both lungs--in 44). In 15 patients an additional local irradiation of separate metastatic foci was performed. As a result of the treatment an immediate objective effect was gained in 44 of 80 patients (55%), metastases completely disappeared in 12 cases (15%). The period of remission ranged from 1 month to 2.5 years, making 8 months on the average. The data obtained indicate the rationality to further improve the technic concerned and to study simultaneously the opportunities of using radiotherapy, supplemented with the use of different antitumor drugs, taking into account the sensitivity of some or other malignant tumor to them.