Interstitial radiation therapy for carcinoma of the penis using iridium 192 wires: the Henri Mondor experience (1970-1979).

From 1970 to 1979, a group of 50 patients was treated for squamous cell carcinoma of the penis by interstitial irradiation using an afterloading technique and iridium 192 wires. The group included 9 patients with T1 tumors, 27 with T2 tumors, and 14 with T3 tumors. Forty-five patients presented with no metastatic inguinal nodes (N0), 3 patients with N1 nodes, and 2 patients had N3 nodes. After treatment, 11 patients (1 T1, 6 T2 and 4T3) developed local recurrences; 10 of these 11 patients underwent penile amputation which controlled the tumor in 7 of the patients. One patient refused amputation. Three patients developed post-therapeutic necrosis which necessitated partial amputation in 2 cases. Eight patients developed post-therapeutic urethral stenosis, which required surgical treatment in three of the cases. Overall, at their last follow-up examinations, 74% of the patients were free of disease with conservation of penile morphology and function. Most patients without metastatic nodes (37/45) at diagnosis did not receive prophylatic treatment of the groin. Two of these patients developed delayed metastatic nodes; one was successfully salvaged. All 5 patients presenting with metastatic nodes at diagnosis died, four with uncontrolled regional disease. Twenty-one percent of the patients died of their disease. We advocate interstitial irradiation using iridium 192 wires for the treatment of non-infiltrating or moderately infiltrating squamous cell carcinoma of the penis in which the largest dimension does not exceed 4 cm. Pre-implant circumcision and regular long-term follow-up are necessary. More extensive tumors are better managed surgically. When regular follow-up can be assured, it is reasonable to forgo prophylactic treatment of the inguinal nodes in patients presenting without groin metastasis.

The role of radiation therapy in the treatment of adenocarcinoma of the corpus uteri stage I. A ten year experience (1970-1979).

A series of 93 cases of endometrial adenocarcinoma stage I, of which 87 were treated by surgery in combination with pre- or postoperative irradiation, is analysed with respect to recurrence rate, survival and effect of preoperative irradiation on myometrial invasion. According to the authors, the treatment of choice remains a combination of surgery and radiation therapy in order to control the primary tumor and prevent vaginal recurrence. The authors recommend uterovaginal intracavitary irradiation followed by total abdominal hysterectomy and bilateral salpingo-oophorectomy with or without lymphadenectomy, and with adjunctive postoperative external irradiation reserved for the rare cases at high risk for locoregional failure (persistence of deep myometrial invasion, lymph node involvement).

Conservative management of breast carcinoma. The Créteil experience.

The results of conservative management of breast carcinoma are presented. The disease free survival for patients with T1 lesions was 84 per cent at 5 years, 76 per cent at 7 years and 65 per cent at 10 years, for T2 75, 71 and 64 per cent, and for T3 65, 51 and 45 per cent. The proportion of breast conserved amongst the patients free of disease at 10 years was 94 per cent for T1, 93 per cent for T2 and 80 per cent for patients with T3 lesions. The cosmetic results were very good for T1 lesions, good for T2 and quite good for T3 lesions. Up to 1981 a simple tumorectomy was carried out in most of the T1 lesions and some of the T2 lesions, followed by radical irradiation. Most of the T2 and T3 lesions were exclusively treated with radical irradiation. In an attempt to improve the cosmetic results, since 1981, the indications for tumorectomy were extended to include some of the T2 lesions, and when possible also some of the T3 lesions, where a tumorectomy is performed before or after irradiation, together with a limited axillary dissection.