RESUMO
PURPOSE: the study of the effect of Amifostine in reducing acute mucositis, xerostomia and late xerostomia emerging in the course of locally advanced head and neck cancer radio-chemotherapy. METHODS: Starting in 1999 we have conducted radio-chemotherapy treatment on 7 patients with or without Amifostine protection, each receiving 60 Gy (2 Gy a day/5 fractions a week) loco-regional irradiation. From the first to the fifth day and from the twenty-first to the twenty-fifth day prior to irradiation they were given a 70 mg/m(2) Carboplatin treatment. In the Amifostine group, on days 1-5 and 21-25 300 mg/m(2) and on days 6-20 and 26-30 200 mg/m(2) Amifostine therapy was given prior to the radio- and chemotherapy. RESULTS: In the course of the trial we did not find any haematologic side effects, or side effects directly connected to the Amifostine, which would have required suspension of the therapy. In the active phase, mucositis of Grade 1-2 was detected 1-2 weeks later than in the control group, in contrast to the mucositis of Grade 2-3 in the other arm. Global oral discomfort associated with acute xerostomia was of Grade 4-6 on a linear scale of ten, compared with Grade 7-8 on the active line. We had similar results when testing the symptoms directly connected with late xerostomia. Unstimulated and stimulated saliva production doubled following the Amifostine treatment. CONCLUSION: Despite the small pool of patients we have the impression that Amifostine can effectively reduce the severity of acute mucositis, xerostomia and late xerostomia.
RESUMO
The authors report the results of radiochemotherapy for bladder cancer, both advanced and early with a poor prognosis, on the basis of their own material as well as based on the literature. More than half of the patients received radioprotective madication at the same time. The short follow-up does not allow for far-reaching conclusions, but early results and limited complications appear hopeful. The authors emphasise that, if indicated, radiochemotherapy can serve as an alternative to cystectomy.
RESUMO
PURPOSE: Comparison of the effectiveness of preoperative and "sandwich" (preoperative and postoperative) radiation therapy in the treatment of midrectum and lower rectum carcinoma, based on a prospective clinical trial. MATERIAL AND METHOD: Over the period between 1990 and 1997, we treated 115 patients suffering from mid-rectum and lower rectum carcinoma at the Budapest Oncoradiological Centre, using sandwich therapy (22.5 Gy preoperative-27.5 Gy postoperative) in the case of 36 patients and 36 Gy preoperative radiation therapy in the case of 79 patients with external-beam megavoltage therapy with mostly telecobalt radiation and to a smaller number of cases 6 MV energy. The external-beam radiation therapy was nearly always applied with a 4-field box technique, and radical surgery was performed within 10 days following the preoperative radiation treatment. Effectiveness was evaluated in terms of a Log-Rank and Peto-Wilcoxon tests and the Kaplan-Meier survival curve. RESULTS: The effectiveness of the different therapies was compared in terms of the percentage of local failure and the rate of disease-free survival. The results show that when using the "sandwich" radiation therapy local failure is expected to occur in 13.8% of all cases, compared with 17.7%, when only preoperative radiation therapy is used. In terms of five-year disease-free survival, the sandwich therapy seems to be better, but for a higher number of years, namely 7.5, the preoperative radiation therapy yielded better results. CONCLUSION: In terms of local failure, the effectiveness of the preoperative and the "sandwich" radiation therapies for the treatment of mid-rectum and lower rectum carcinoma was nearly identical, while preoperative radiation therapy provided longer disease-free survival. Further trials using multivariation analysis need to be performed to evaluate the two types of radiation treatments, taking into account other parameters, such as grading, age and lymphatic spread.
