Continuous accelerated 7-days-a-week radiotherapy for head-and-neck cancer: long-term results of phase III clinical trial.

PURPOSE: To update 5-year results of a previously published study on special 7-days-a-week fractionation continuous accelerated irradiation (CAIR) for head-and-neck cancer patients. METHODS AND MATERIALS: One hundred patients with squamous cell carcinoma of head and neck in Stage T(2-4)N(0-1)M(0) were randomized between two definitive radiation treatments: accelerated fractionation 7 days a week including weekends (CAIR) and conventional 5 days a week (control). Hence the overall treatment time was 2 weeks shorter in CAIR. RESULTS: Five-year local tumor control was 75% in the CAIR group and 33% in the control arm (p < 0.00004). Tumor-cure benefit corresponded with significant improvement in disease-free survival and overall survival rates. Confluent mucositis was the main acute toxicity, with the incidence significantly higher in CAIR patients than in control (respectively, 94% vs. 53%). When 2.0-Gy fractions were used, radiation necrosis developed in 5 patients (22%) in the CAIR group as a consequential late effect (CLE), but when fraction size was reduced to 1.8 Gy no more CLE occurred. Actuarial 5-year morbidity-free survival rate was similar for both treatments. CONCLUSIONS: Selected head-and-neck cancer patients could be treated very effectively with 7-days-a-week radiation schedule with no compromise of total dose and with slight 10% reduction of fraction dose (2 Gy-1.8 Gy), which article gives 1 week reduction of overall treatment time compared with standard 70 Gy in 35 fractions over 47-49 days. Although this report is based on the relatively small group of patients, its results have encouraged us to use CAIR fractionation in a standard radiation treatment for moderately advanced head-and-neck cancer patients.

[Primary multiple tumours in patients treated in Otolaryngological Department of Voivodenship Hospital Number 4 in Bytom]. / Pierwotne nowotwory mnogie u pacjentów Oddzialu Laryngologii Wojewódzkiego Szpitala Specjalistycznego Nr 4 w Bytomiu.

The authors presented a specification of seven cases of multiple primary tumors treated in the Otolaryngological Department of Voivodenship Hospital No. 4 in Bytom (in the years 1991-2004). One case above-mentioned was described more closely. The presented case shows criterions for recognizing the malignant multiple primary tumors. The case describes a case of 42 years old patient treated for 3 primary tumors, metachronic--larynx, oral cavity and pharynx during 12 years. Two tumors have been radicaly removed in surgical treatment, the third one was cured by irradiation. The authors show more frequent appearance of malignant multiple primary tumors and their not clear etiology and emphasizing the significance of systematic follow up examinations after the treatment of primary tumors.

[Efficacy of primary and combined radiotherapy in locally advanced cancer of oropharynx and nasopharynx in III and IV stage]. / Ocena skutecznosci radioterapii i leczenia skojarzonego u chorych na raka czesci nosowej i ustnej gardla w stopniu III i IV klinicznego zaawansowania.

Aim of the study is evaluation of radiotherapy treatment in cancer of oropharynx and nasopharynx. Retrospective analysis was based on 283 patients in III and IV clinical stage of disease without distant metastases who were treated between 1989-2001. 201 patients were treated radiotherapy alone and 82 by combined modality: radiotherapy and chemotherapy. Induction chemotherapy and radiotherapy was used in 34 cases, concomitant chemoradiotherapy--25 and adjuvant chemotherapy and radiotherapy in 23 cases. Following methods of radiotherapy fractionation were used: accelerated in 35 cases, conventional--26, hyperfractionation--21. Accelerated treatment mainly was used in concomitant combined modality. Log-rank statistical analysis revealed better results of treatment for combined modality: radiotherapy and chemotherapy. Most effectiveness method of combined modality was concomitant radiochemotherapy. Locoregional control in 3 years observation interval was better for concomitant mode about 18% comparing to induction chemotherapy and radiotherapy and 30% to adjuvant chemotherapy and radiotherapy. Based on this data, the optimal mode of treatment in III and IV stage of oropharyngeal and nasopharyngeal cancer, especially with extensive nodal disease and extranodal involvement is concomitant treatment with accelerated fractionation dose of radiotherapy.

[Lung dissemination of giant cell tumor of femur. The case report]. / Rozsiew do pluc guza olbrzymiokomórkowego kosci udowej. Opis przypadku.

The case of 32 years old patient suffering for giant cell bone tumor of left femur was reported. After surgery (curettage and filling of tumor bed with bone cement followed by arthroplasty), a dissemination to lungs was found. Patient was treated by palliative lungs radiotherapy (10 x 1.1 Gy) and six cycles of chemotherapy (every four weeks) based on cisplatin (35 mg/m2) and doxorubicin (30 mg/m2) obtaining significant regression of metastases. Because of four persistent lung metastases, the extracranial radiosurgery using one fraction of 16 Gy was done.