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1.
Animal ; 12(11): 2434-2442, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29606159

RESUMO

The Meat Standards Australia (MSA) grading scheme has the ability to predict beef eating quality for each 'cut×cooking method combination' from animal and carcass traits such as sex, age, breed, marbling, hot carcass weight and fatness, ageing time, etc. Following MSA testing protocols, a total of 22 different muscles, cooked by four different cooking methods and to three different degrees of doneness, were tasted by over 19 000 consumers from Northern Ireland, Poland, Ireland, France and Australia. Consumers scored the sensory characteristics (tenderness, flavor liking, juiciness and overall liking) and then allocated samples to one of four quality grades: unsatisfactory, good-every-day, better-than-every-day and premium. We observed that 26% of the beef was unsatisfactory. As previously reported, 68% of samples were allocated to the correct quality grades using the MSA grading scheme. Furthermore, only 7% of the beef unsatisfactory to consumers was misclassified as acceptable. Overall, we concluded that an MSA-like grading scheme could be used to predict beef eating quality and hence underpin commercial brands or labels in a number of European countries, and possibly the whole of Europe. In addition, such an eating quality guarantee system may allow the implementation of an MSA genetic index to improve eating quality through genetics as well as through management. Finally, such an eating quality guarantee system is likely to generate economic benefits to be shared along the beef supply chain from farmers to retailors, as consumers are willing to pay more for a better quality product.


Assuntos
Bovinos/fisiologia , Comportamento do Consumidor , Carne Vermelha/normas , Animais , Austrália , Cruzamento , Culinária , Ingestão de Alimentos , Europa (Continente) , Músculos , Fenótipo , Paladar
2.
Animal ; 11(8): 1399-1411, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28190414

RESUMO

The beef industry must become more responsive to the changing market place and consumer demands. An essential part of this is quantifying a consumer's perception of the eating quality of beef and their willingness to pay for that quality, across a broad range of demographics. Over 19 000 consumers from Northern Ireland, Poland, Ireland and France each tasted seven beef samples and scored them for tenderness, juiciness, flavour liking and overall liking. These scores were weighted and combined to create a fifth score, termed the Meat Quality 4 score (MQ4) (0.3×tenderness, 0.1×juiciness, 0.3×flavour liking and 0.3×overall liking). They also allocated the beef samples into one of four quality grades that best described the sample; unsatisfactory, good-every-day, better-than-every-day or premium. After the completion of the tasting panel, consumers were then asked to detail, in their own currency, their willingness to pay for these four categories which was subsequently converted to a proportion relative to the good-every-day category (P-WTP). Consumers also answered a short demographic questionnaire. The four sensory scores, the MQ4 score and the P-WTP were analysed separately, as dependant variables in linear mixed effects models. The answers from the demographic questionnaire were included in the model as fixed effects. Overall, there were only small differences in consumer scores and P-WTP between demographic groups. Consumers who preferred their beef cooked medium or well-done scored beef higher, except in Poland, where the opposite trend was found. This may be because Polish consumers were more likely to prefer their beef cooked well-done, but samples were cooked medium for this group. There was a small positive relationship with the importance of beef in the diet, increasing sensory scores by about 4% in Poland and Northern Ireland. Men also scored beef about 2% higher than women for most sensory scores in most countries. In most countries, consumers were willing to pay between 150 and 200% more for premium beef, and there was a 50% penalty in value for unsatisfactory beef. After quality grade, by far the greatest influence on P-WTP was country of origin. Consumer age also had a small negative relationship with P-WTP. The results indicate that a single quality score could reliably describe the eating quality experienced by all consumers. In addition, if reliable quality information is delivered to consumers they will pay more for better quality beef, which would add value to the beef industry and encourage improvements in quality.


Assuntos
Bovinos/fisiologia , Comportamento do Consumidor/estatística & dados numéricos , Culinária/métodos , Carne Vermelha/normas , Adolescente , Adulto , Animais , Austrália , Demografia , Feminino , França , Humanos , Irlanda , Masculino , Pessoa de Meia-Idade , Polônia , Inquéritos e Questionários , Paladar , Adulto Jovem
3.
Animal ; 11(8): 1389-1398, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27829474

RESUMO

Quantifying consumer responses to beef across a broad range of demographics, nationalities and cooking methods is vitally important for any system evaluating beef eating quality. On the basis of previous work, it was expected that consumer scores would be highly accurate in determining quality grades for beef, thereby providing evidence that such a technique could be used to form the basis of and eating quality grading system for beef. Following the Australian MSA (Meat Standards Australia) testing protocols, over 19 000 consumers from Northern Ireland, Poland, Ireland, France and Australia tasted cooked beef samples, then allocated them to a quality grade; unsatisfactory, good-every-day, better-than-every-day and premium. The consumers also scored beef samples for tenderness, juiciness, flavour-liking and overall-liking. The beef was sourced from all countries involved in the study and cooked by four different cooking methods and to three different degrees of doneness, with each experimental group in the study consisting of a single cooking doneness within a cooking method for each country. For each experimental group, and for the data set as a whole, a linear discriminant function was calculated, using the four sensory scores which were used to predict the quality grade. This process was repeated using two conglomerate scores which are derived from weighting and combining the consumer sensory scores for tenderness, juiciness, flavour-liking and overall-liking, the original meat quality 4 score (oMQ4) (0.4, 0.1, 0.2, 0.3) and current meat quality 4 score (cMQ4) (0.3, 0.1, 0.3, 0.3). From the results of these analyses, the optimal weightings of the sensory scores to generate an 'ideal meat quality 4 score (MQ4)' for each country were calculated, and the MQ4 values that reflected the boundaries between the four quality grades were determined. The oMQ4 weightings were far more accurate in categorising European meat samples than the cMQ4 weightings, highlighting that tenderness is more important than flavour to the consumer when determining quality. The accuracy of the discriminant analysis to predict the consumer scored quality grades was similar across all consumer groups, 68%, and similar to previously reported values. These results demonstrate that this technique, as used in the MSA system, could be used to predict consumer assessment of beef eating quality and therefore to underpin a commercial eating quality guarantee for all European consumers.


Assuntos
Bovinos/fisiologia , Comportamento do Consumidor/estatística & dados numéricos , Culinária/métodos , Qualidade dos Alimentos , Carne Vermelha/normas , Adulto , Animais , Austrália , Feminino , França , Humanos , Irlanda , Masculino , Pessoa de Meia-Idade , Polônia , Paladar , Adulto Jovem
4.
Animal ; 10(6): 996-1006, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26755183

RESUMO

European conformation and fat grades are a major factor determining carcass value throughout Europe. The relationships between these scores and sensory scores were investigated. A total of 3786 French, Polish and Irish consumers evaluated steaks, grilled to a medium doneness, according to protocols of the ���Meat Standards Australia��� system, from 18 muscles representing 455 local, commercial cattle from commercial abattoirs. A mixed linear effects model was used for the analysis. There was a negative relationship between juiciness and European conformation score. For the other sensory scores, a maximum of three muscles out of a possible 18 demonstrated negative effects of conformation score on sensory scores. There was a positive effect of European fat score on three individual muscles. However, this was accounted for by marbling score. Thus, while the European carcass classification system may indicate yield, it has no consistent relationship with sensory scores at a carcass level that is suitable for use in a commercial system. The industry should consider using an additional system related to eating quality to aid in the determination of the monetary value of carcasses, rewarding eating quality in addition to yield.


Assuntos
Ingestão de Alimentos , Gorduras/análise , Qualidade dos Alimentos , Carne Vermelha/normas , Matadouros , Animais , Austrália , Bovinos , Comportamento do Consumidor , Ingestão de Alimentos/psicologia , Feminino , França , Humanos , Irlanda , Masculino , Músculos/anatomia & histologia , Músculos/química , Polônia
5.
Animal ; 10(6): 987-95, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26750424

RESUMO

Delivering beef of consistent quality to the consumer is vital for consumer satisfaction and will help to ensure demand and therefore profitability within the beef industry. In Australia, this is being tackled with Meat Standards Australia (MSA), which uses carcass traits and processing factors to deliver an individual eating quality guarantee to the consumer for 135 different 'cut by cooking methods' from each carcass. The carcass traits used in the MSA model, such as ossification score, carcass weight and marbling explain the majority of the differences between breeds and sexes. Therefore, it was expected that the model would predict with eating quality of bulls and dairy breeds with good accuracy. In total, 8128 muscle samples from 482 carcasses from France, Poland, Ireland and Northern Ireland were MSA graded at slaughter then evaluated for tenderness, juiciness, flavour liking and overall liking by untrained consumers, according to MSA protocols. The scores were weighted (0.3, 0.1, 0.3, 0.3) and combined to form a global eating quality (meat quality (MQ4)) score. The carcasses were grouped into one of the three breed categories: beef breeds, dairy breeds and crosses. The difference between the actual and the MSA-predicted MQ4 scores were analysed using a linear mixed effects model including fixed effects for carcass hang method, cook type, muscle type, sex, country, breed category and postmortem ageing period, and random terms for animal identification, consumer country and kill group. Bulls had lower MQ4 scores than steers and females and were predicted less accurately by the MSA model. Beef breeds had lower eating quality scores than dairy breeds and crosses for five out of the 16 muscles tested. Beef breeds were also over predicted in comparison with the cross and dairy breeds for six out of the 16 muscles tested. Therefore, even after accounting for differences in carcass traits, bulls still differ in eating quality when compared with females and steers. Breed also influenced eating quality beyond differences in carcass traits. However, in this case, it was only for certain muscles. This should be taken into account when estimating the eating quality of meat. In addition, the coefficients used by the Australian MSA model for some muscles, marbling score and ultimate pH do not exactly reflect the influence of these factors on eating quality in this data set, and if this system was to be applied to Europe then the coefficients for these muscles and covariates would need further investigation.


Assuntos
Bovinos/anatomia & histologia , Qualidade dos Alimentos , Carne Vermelha/análise , Carne Vermelha/normas , Caracteres Sexuais , Animais , Austrália , Cruzamento , Bovinos/classificação , Comportamento do Consumidor , Culinária , Feminino , França , Humanos , Irlanda , Masculino , Músculos/química , Fenótipo , Polônia , Paladar
6.
Animal ; 10(4): 718-28, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26687476

RESUMO

Ossification score and animal age are both used as proxies for maturity-related collagen crosslinking and consequently decreases in beef tenderness. Ossification score is strongly influenced by the hormonal status of the animal and may therefore better reflect physiological maturity and consequently eating quality. As part of a broader cross-European study, local consumers scored 18 different muscle types cooked in three ways from 482 carcasses with ages ranging from 590 to 6135 days and ossification scores ranging from 110 to 590. The data were studied across three different maturity ranges; the complete range of maturities, a lesser range and a more mature range. The lesser maturity group consisted of carcasses having either an ossification score of 200 or less or an age of 987 days or less with the remainder in the greater maturity group. The three different maturity ranges were analysed separately with a linear mixed effects model. Across all the data, and for the greater maturity group, animal age had a greater magnitude of effect on eating quality than ossification score. This is likely due to a loss of sensitivity in mature carcasses where ossification approached and even reached the maximum value. In contrast, age had no relationship with eating quality for the lesser maturity group, leaving ossification score as the more appropriate measure. Therefore ossification score is more appropriate for most commercial beef carcasses, however it is inadequate for carcasses with greater maturity such as cull cows. Both measures may therefore be required in models to predict eating quality over populations with a wide range in maturity.


Assuntos
Envelhecimento/fisiologia , Carne/normas , Animais , Composição Corporal/fisiologia , Bovinos/fisiologia , Colágeno , Feminino , Músculos , Paladar
7.
Wiad Lek ; 53(3-4): 142-5, 2000.
Artigo em Polonês | MEDLINE | ID: mdl-10946599

RESUMO

In the Clinic of Gastrointestinal Surgery at the Medical University in Wroclaw in 402 cases substernal oesophageal reconstruction was performed using different pedunculated oesophageal substitutes. 63 patients had to be operated on for the second time because of disorders in the oesophageal substitute. In 13 cases stenosis in the upper anastomosis and in 3 patients stenosis in the anastomosis with stomach were corrected. In 7 cases oesophageal ulcer was excised. 6 patients were operated because of substitute herniation into pleural cavity. In 3 cases huge diverticula in the neck were removed. 5 patients were operated because of stomach outlet stenosis. In 15 cases operation was necessary to correct the sequel of reflux oesophagitis. In 8 cases the surgery was performed to remove stenosis of the substitute. In 2 cases there was torsion of substitute and in the other 2 cases postoperative stenosis was caused by adhesions. One patient was operated because of the dumping syndrome. In 2 patients with the colon substitute polyps from the segment used for the oesophagus were removed endoscopically. The mortality after corrective surgery on the oesophageal substitute was less than 10% (6/63).


Assuntos
Estenose Esofágica/cirurgia , Gastroscopia/métodos , Anastomose Cirúrgica , Doenças do Esôfago/cirurgia , Refluxo Gastroesofágico/cirurgia , Humanos , Reoperação , Úlcera/cirurgia
8.
Health Phys ; 77(5): 571-8, 1999 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-10524511

RESUMO

The mass attenuation coefficients, mu/rho, for Clear-Pb for photon energies ranging from 10 keV to 10 MeV were determined using Monte Carlo methods and simple equations used to manipulate elemental mass attenuation coefficients. It was determined that the effectiveness of Clear-Pb as a radiation shielding material was greater than plain acrylic for all photon energies, especially those less than 150 keV, and for deep penetration problems where the differences in mu/rho between Clear-Pb and acrylic became more significant. Finally, the usefulness of Clear-Pb as a shielding material when compared with acrylic was determined for the following commonly used radionuclides: 125I, 103Pd, 99mTc, 192Ir, 137Cs, and 60Co.


Assuntos
Chumbo , Fótons , Proteção Radiológica/instrumentação , Proteção Radiológica/métodos , Radioisótopos , Radioisótopos de Césio , Radioisótopos de Cobalto , Radioisótopos do Iodo , Radioisótopos de Irídio , Método de Monte Carlo , Paládio , Polimetil Metacrilato , Tecnécio
9.
Med Phys ; 26(1): 87-96, 1999 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-9949403

RESUMO

Using Monte Carlo methods, neutron dosimetry for 252Cf Applicator Tube (AT) type medical sources available from Oak Ridge National Laboratory (ORNL) has for the first time been determined in terms of TG-43 formalism. This approach, as compared to previous "along-away" formalisms, demonstrates the relative angular independence of dose rate data, when the geometry factor has been removed. As the ORNL-made 252Cf AT type sources are considerably physically larger than most clinical sources used today, the radial dose function increases for radii less than 3.0 mm due to breakdown of the line source model. A comparison of the 252Cf neutron radial dose function with those for other medical sources revealed similarities with that from 137Cs. Differences with respect to previous 252Cf AT source neutron dosimetry data generally increased at increasing distances. This was attributed to differences in the various 252Cf AT source models and phantom compositions. The current status of 252Cf medical source fabrication and calibration procedures at ORNL is presented.


Assuntos
Braquiterapia , Califórnio/uso terapêutico , Nêutrons/uso terapêutico , Dosagem Radioterapêutica , Anisotropia , Califórnio/administração & dosagem , Simulação por Computador , Relação Dose-Resposta à Radiação , Transferência de Energia , Humanos , Método de Monte Carlo , Imagens de Fantasmas
10.
Wiad Lek ; 52(11-12): 559-62, 1999.
Artigo em Polonês | MEDLINE | ID: mdl-10745691

RESUMO

Early complications after partial pancreatic resections and benign pancreatic tumours were analysed. 276 patients with pancreatic tumours were treated in the years 1979-1997. In 77 cases radical operation was performed. 65 patients underwent Whipple and 12--Traverso-Longmire pancreatoduodenectomy. Malignant tumour was found in 55 cases and 22 were benign. In 4 patients tumour's resection along with invaded portal vessels and portal confluence reconstruction was performed. These were the first cases with vessels resection operated in Poland. There were 2 post-operative deaths observed in that group. Complications in our material were as follows: pancreatico-jejunal anastomosis fistulae, haemorrhage from ulcers in gastro-jejunal anastomosis, diffuse peritonitis, haemorrhage from pancreatic stump vessels, ileus, acute renal insufficiency, pneumonia and myocardial infarct. Mortality in whole group was 11%. In the last 5 years due to our growing experience and some technical modifications mortality fell to 4.4%.


Assuntos
Neoplasias Pancreáticas/cirurgia , Pancreaticoduodenectomia/métodos , Complicações Pós-Operatórias/mortalidade , Feminino , Humanos , Masculino , Polônia/epidemiologia , Estudos Retrospectivos
11.
Med Phys ; 25(11): 2197-9, 1998 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-9829245

RESUMO

Basic dosimetric parameters as recommended by the AAPM Task Group No. 43 (TG-43) have been determined for recently available IoGold 125I brachytherapy seeds. Monte Carlo methods (MCNP) were used in the calculation of these parameters in water, and results compared with soon to be published experimental parameters also for 125I IoGold seeds as well with parameters for model 6702 and 6711 125I seeds. These parameters were the radial dose function, anisotropy factor and constant, and the dose rate constant. Using MCNP, values for the radial dose function at 0.5, 2.0, and 5.0 cm were 1.053, 0.877, and 0.443, respectively. The anisotropy factor was 0.975, 0.946, 0.945, and 0.952 at 0.5, 1.0, 2.0, and 5.0 cm, respectively, with an anisotropy constant of 0.95. The IoGold dose rate constant was determined by excluding the low energy titanium characteristic x rays produced in the IoGold titanium capsule. Using this post TG-43 revised NIST air kerma methodology, the IoGold dose rate constant was 0.96 cGy h-1 U-1. These calculatively determined parameters for IoGold seeds were compared with those determined experimentally for IoGold seeds, and also compared with parameters determined for model 6702 and 6711 seeds as presented in TG-43.


Assuntos
Braquiterapia/instrumentação , Radioisótopos do Iodo/uso terapêutico , Imagens de Fantasmas , Planejamento da Radioterapia Assistida por Computador/métodos , Anisotropia , Braquiterapia/métodos , Braquiterapia/normas , Desenho de Equipamento , Humanos , Método de Monte Carlo , Controle de Qualidade , Dosagem Radioterapêutica , Água
12.
Med Phys ; 25(2): 245-6, 1998 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-9507487

RESUMO

Clinical observations have revealed that diode readings from 15 MV photon beams with small field sizes and small SSD values were consistently 5%-10% higher than doses calculated at the maximum depth. Dose at depth depends on the collimator scattering factor and the phantom scattering factor--both field size dependent. Diodes are placed on the skin surface, and therefore the phantom scatter factor is different than at depth. In addition, inverse square corrections should be calculated with respect to the location of the diode itself rather than the location of Dmax within the tissue. This may account for about 8% difference between calculated Dmax and diode readings for very small radiation fields and small SSDs, e.g., a prostate boost.


Assuntos
Fótons/uso terapêutico , Radiometria/métodos , Planejamento da Radioterapia Assistida por Computador/métodos , Radioterapia de Alta Energia , Fenômenos Biofísicos , Biofísica , Humanos , Masculino , Neoplasias/radioterapia , Imagens de Fantasmas , Neoplasias da Próstata/radioterapia , Radiometria/estatística & dados numéricos , Planejamento da Radioterapia Assistida por Computador/estatística & dados numéricos , Espalhamento de Radiação , Pele/efeitos da radiação
14.
Wiad Lek ; 50 Suppl 1 Pt 1: 344-7, 1997.
Artigo em Polonês | MEDLINE | ID: mdl-9446381

RESUMO

Endoscopic bouginage of benign esophageal and cardial strictures was compared with surgical treatment. Bouginage was performed by Celestin or Eder-Puestow bougies. Results obtained suggest usefulness of bouginage in many patients with benign stenosis of the upper gastrointestinal tract.


Assuntos
Estenose Esofágica/terapia , Esofagoscopia/métodos , Gastropatias/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Cárdia/cirurgia , Constrição Patológica/terapia , Dilatação/instrumentação , Dilatação/métodos , Esôfago/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
15.
Wiad Lek ; 50 Suppl 1 Pt 2: 154-7, 1997.
Artigo em Polonês | MEDLINE | ID: mdl-9424865

RESUMO

Since 1993 during pancreatic resection routine intraoperative portography has been employed. Thus we are able to establish infiltration engaging portal vein and its branches. Facilitating decision making about resectability of the tumor. 29 portographies were performed. In eight cases malignant infiltration on portal vein was established. Because of that in seven cases no radical resection was undertaken.


Assuntos
Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/cirurgia , Portografia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Intraoperatória , Veia Porta/diagnóstico por imagem , Veia Porta/cirurgia
16.
Wiad Lek ; 50 Suppl 1 Pt 2: 158-61, 1997.
Artigo em Polonês | MEDLINE | ID: mdl-9424866

RESUMO

Results of the operative treatment of Vater's papilla carcinoma in fifteen cases were analysed. Eleven patients had pancreatoduodenectomy according to Whipple, four had only local excision of Vater's papilla along with the tumour. All four had early recurrence and were re-operated by Whipple method. In our experience only radical pancreatoduodenectomy with regional lymphadenectomy, preferably Whipple type, gives chance of achieving the radical cure.


Assuntos
Adenocarcinoma/cirurgia , Ampola Hepatopancreática/cirurgia , Neoplasias do Ducto Colédoco/cirurgia , Adulto , Idoso , Feminino , Humanos , Excisão de Linfonodo , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/cirurgia , Pancreaticoduodenectomia/métodos , Reoperação , Resultado do Tratamento
17.
Appl Radiat Isot ; 48(10-12): 1567-70, 1997.
Artigo em Inglês | MEDLINE | ID: mdl-9463877

RESUMO

The Gershenson Radiation Oncology Center of Wayne State University (WSU), Detroit, Michigan, is using 252Cf medical sources for neutron brachytherapy. These sources are based on a 20-year-old design containing < or = 30 micrograms 252Cf in the form of a cermet wire of Cf2O3 in a palladium matrix. The Radiochemical Engineering Development Center (REDC) of Oak Ridge National Laboratory has been asked to develop very compact, high-activity 252Cf neutron sources for use with remote afterloading equipment in order to reduce treatment times and dose to clinical personnel and to expedite treatment of brain and other tumors. To date, the REDC has demonstrated that 252Cf loadings can be greatly increased in cermet wires and with much smaller diameters. Equipment designed for hot cell fabrication of these wires is being tested. A parallel program is under way to relicense the existing source design for fabrication at the REDC.


Assuntos
Braquiterapia/métodos , Califórnio/uso terapêutico , Nêutrons/uso terapêutico , Califórnio/química
18.
Cancer Biother Radiopharm ; 12(5): 355-62, 1997 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-10851487

RESUMO

METHODS: A model of strontium biodistribution similar to the one created by the International Commission on Radiological Protection (ICRP) was applied for activity and absorbed dose calculations in a patient with bone metastases treated with Sr-89 strontium chloride. Metastases are represented just like all other organs and tissues collecting strontium. Data from the ICRP's standard Reference Man were used. RESULTS: Results include calculated time-activity data for all model compartments and for relevant target organs. Absorbed doses per unit administered activity were calculated for blood (0.036 cGy/MBq), soft tissues (0.046 cGy/MBq), bone marrow (1.15 cGy/MBq), bone surface (1.45 cGy/MBq), upper large intestine (ULI) (0.13 cGy/MBq), lower large intestine (LLI) (0.38 cGy/MBq), bladder (0.12 cGy/MBq), and metastases (37.5 cGy/MBq). CONCLUSIONS: Results of the absorbed dose calculations are comparable with results presented in references for specific clinical cases. Discrepancies in dose values may be effected by the size of metastases and the patient's condition.


Assuntos
Neoplasias Ósseas/radioterapia , Radioisótopos de Estrôncio/uso terapêutico , Neoplasias Ósseas/secundário , Humanos , Dosagem Radioterapêutica
20.
Int J Radiat Oncol Biol Phys ; 29(3): 529-34, 1994 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-8005811

RESUMO

PURPOSE: To evaluate the feasibility and toxicity of 252Cf neutron brachytherapy combined with hyperaccelerated chemoradiotherapy for Stage III and IV cervical cancers. METHODS AND MATERIALS: Eleven patients with advanced Stage IIIB-IVA cervical cancers were treated with 252Cf neutron brachytherapy in an up-front schedule followed by cisplatin (CDDP; 50 mg/m2) chemotherapy and hyperfractionated accelerated (1.2 Gy bid) radiotherapy given concurrently with intravenous infusion of 5-Fluorouracil (5-FU) (1000 mg/m2/day x 4 days) in weeks 1 and 4 with conventional radiation (weeks 2, 3, 5, and 6). Total dose at a paracervical point A isodose surface was 80-85 Gy-eq by external and intracavitary therapy and 60 Gy at the pelvic sidewalls. RESULTS: Patients tolerated the protocol well. There was 91% compliance with the chemotherapy and full compliance with the 252Cf brachytherapy and the external beam radiotherapy. There were no problems with acute chemo or radiation toxicity. One patient developed a rectovaginal fistula (Grade 3-4 RTOG criteria) but no other patients developed significant late cystitis, proctitis or enteritis. There was complete response (CR) observed in all cases. With mean follow-up to 26 months, local control has been achieved with 90% actuarial 3-year survival with no evidence of disease (NED). CONCLUSION: 252Cf neutrons can be combined with cisplatin and 5-FU infusion chemotherapy plus hyperaccelerated chemoradiotherapy without unusual side effects or toxicity and with a high local response and tumor control rate. Further study of 252Cf neutron-chemoradiotherapy for advanced and bulky cervical cancer are indicated. We found chemotherapy was more effective with the improved local tumor control.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Braquiterapia , Califórnio/uso terapêutico , Nêutrons/uso terapêutico , Neoplasias do Colo do Útero/terapia , Adulto , Idoso , Cisplatino/administração & dosagem , Terapia Combinada , Feminino , Fluoruracila/administração & dosagem , Humanos , Pessoa de Meia-Idade , Dosagem Radioterapêutica , Neoplasias do Colo do Útero/mortalidade
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