Is there a best management for localized adenocarcinoma of the prostate?
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Biomedical subjects
Publications and source records attributed to B L Hintz.
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Surgery has been the mainstay in the management of anal carcinoma. However, anal carcinomas are reasonably sensitive to ionizing radiation. By appropriate combinations of external radiation beams and interstitial implantation techniques, curative therapy with preservation of anal continence can be rendered by radiation alone. Sufficient radiation dose to the draining lymph nodes, both intraabdominal and inguinal, along with intensified dose to the primary lesions, is required for high cure and low complication rates.
Forty-seven patients with soft tissue sarcomas were analyzed retrospectively. Treatment was non-randomized between surgery alone, preoperative radiation of 5,000 rads/5 weeks, postoperative radiation of 6,000 rads/6 weeks following total gross tumor removal, and postoperative radiation (variable dosees) for residual gross or unresectable tumor. Preoperative radiation was not statistically better for local control or survival compared to postoperative radiation after local excision of gross tumor. Wide excision, higher postoperative radiation dosage, and/or enlarged radiation portals perhaps would improve results. Additional adjuvant therapies, such as chemotherapy or immunotherapy, needs to be investigated.
The results of postoperative radiotherapy in 151 patients with malignant epithelial tumors of the ovary are presented. Actuarial survival at five years for patients in FIGO Stage I was 76%; in Stage II, 56%; Stage III, 16%; and Stage IV, 0%. Survival also varied with histopathological type, the best prognoses occuring in the serous (malignant) and endometrioid types (NED survival of 35% and 50%, totalling all stages, respectively). The presence of ascites or intraperitoneal surgical spillage did not adversely affect survival. The role of lymphangiography in staging is discussed. New approaches to diagnosis, staging and treatment are required for improving the prognosis of patients with ovarian carcinoma.