[Endoscopic laser recanalization in the chemo- and radiotherapy of stenosing cancer of the esophagus]. / Endoskopicheskaia lazernaia rekanalizatsiia v khimioluchevom lechenii stenoziruiushchego raka pishchevoda.

The authors analyze the results of endoscopic laser recanalization in 11 patients with stenosing esophageal carcinoma, whose mean age is 61 years. The tumor was located in the upper thoracic portion of the esophagus in 3 patients, in the middle thoracic portion in 6, and in the lower thoracic portion in 2 patients. The diagnosis of carcinoma was morphologically verified. The length of the esophagus involvement was estimated by x-ray data and varied from 5 to 12 cm and longer. Endophytic form predominated--it was diagnosed in 5 patients. The technique of endoscopic laser recanalization by means of Raduga-1 unit with neodymium alumo-yttrium garnet laser as the source of irradiation is described. The method was specified with consideration for the type of tumor growth. The patients were kept on parenteral nutrition during the treatment session. Three-five days after endoscopic laser destruction long-distance open-field gamma-beam therapy was administered to 10 patients and polychemotherapy to 9 of these. After laser destruction dilatation of the stenosed portion of the esophagus from 0.2-0.6 to 1.0-2.0 cm was recorded in 10 patients. Complete regression of the tumor resultant from laser destruction and chemoradiotherapy was achieved in 5 patients, partial regression in the rest 5. The patients were followed up for 5-12 months. No recurrences were recorded in patients with complete regression of the tumor; the process progressed in 3 cases with partial regression. Studies on improvement of recanalization technique, specification of indications for and contraindications against this treatment modality are in progress.

[Postradiation pericarditis in lymphogranulomatosis patients]. / Postluchevye perikardity u bol'nykh limfogranulematozom.

Postradiation pericarditis was diagnosed in 11 of 52 patients treated for lymphogranulomatosis with radiation applied to enlarged mediastinal lymph nodes. The risk of postradiation pericarditis is greater in cases of high radiation doses (more than 45 Gy) and in patients with postradiation pneumonitis. Postradiation pericarditis can develop both during the exposure and long after radiation therapy; therefore long-term follow-up is required for these patients.

[Recurrences of lymphogranulomatosis after radical radiotherapy and their treatment]. / Retsidivy limfogranolematoza posle radikal'noi luchevoi terapii i ikh lechenie.

Radical radiation therapy provided complete remissions in 152 out of 166 patients with Hodgkin's disease, stages I-II-IIIs. During 3 to 17 years of observation, the relapses occurred in 67 patients (44%). A half of all the relapses were recorded during the first year of remission. In 88% of the cases the relapses were seen over the diaphragm, in 61% at the sites exposed to radiation and in 60% of the cases they were local. The rate of the relapses did not correlate with the stage, histological type, site of the lesion or with the radiation dose. Repeated complete remissions were attained in 48 patients (72%). The best effect was reached after cyclic polychemotherapy in combination with local radiation. In nodular sclerosis, the repeated remissions appeared far more lasting as compared to those in patients with the mixed-cell version.

[The 5- and 10-year survival and long-term effects of radical radiotherapy in patients with stage I-III Hodgkin's disease]. / Piati-, desiatiletnie rezul'taty lecheniia i otdalennye posledstviia luchevoii terapii po radikal'noi programme bol'nykh limfogranulematozom I-III stadii.

Radical radiation treatment was given to 152 patients suffering from stage I-III Hodgkin's disease in 1967-1977. Exposure was limited to the lymph collectors above the diaphragm in cases of stage I tumor. Exposure was extended to para-aortal lymph nodes and spleen (or splenic base) in cases of stage II tumor. All three levels were irradiated in cases of stage III. Mean five-year survival rate in the entire group was 89% (stage I-93: IIA-92.8 and IIIA-82.3%); ten-year rate-66.6%. Recurrences were detected in 43.5%; 75% of them were identified within the first two years after radiation. Relapse was more frequent in cases of mixed cell pattern of tumor and lymphoid depletion. Radiation-induced injuries of varying degree were found in 28%, changes in the lungs and soft tissues were prevalent. A relationship between radiation injury frequency and the extent of exposure was established: radiation injury was observed in 4% of stage I cases and in 63% of patients with stage III tumor. Radiation-induced malignancies (breast cancer and fibrosarcoma of ilioinguinal soft tissues) were found in two cases out of 152 at different periods of the study.

[Second tumor in lymphogranulomatosis]. / Vtoraia opukhol' u bol'nykh limfogranulematozom.

The study was concerned with second malignancies which arose from non-hematopoietic tissue in 6 Hodgkin's disease patients. The malignancies were detected within 15-150 months and appeared to be the immediate cause of the death of the patients. The clinical course of Hodgkin's disease and second malignancy, the terms of second malignancy detection v. previous treatment, morphological features of Hodgkin's disease and the effect of splenectomy are discussed. It is concluded that the rise of second malignancy development should be taken into consideration when procedures for treatment of Hodgkin's disease are selected, particularly, in cases with favorable prognosis.