[Progress in radiotherapy of tumors: isobiodose curves].
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Biomedical subjects
Publications and source records attributed to F Bistolfi.
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Total body irradiation is today the main conditioning method for patients who have bone marrow transplantation. The most diffuse procedure, as proposed at the Fred Hutchinson Cancer Research Center of Seattle, has been employed in this study. Our clinical material comprises 16 patients; 5 with acute lymphoid leukemia; 5 with acute myeloid leukemia; 4 with chronic myeloid leukemia in accelerated fase; and 2 in blastic crisis. Clinical results and toxicity are discussed, with emphasis to interstitial pneumonia.
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Radiotherapy as the sole method of treatment or as a preoperative measure is an important tool against the inoperable tumours of the kidney in the adult. Several techniques of irradiation are possible, for all of which the CT is an invaluable means of efficiency. The author describes the case of a huge renal tumour in a patient aged 76, exclusively treated by cobalt therapy, who is alive and well at more than 3 years. Four main conclusions are drawn: 1) the treatment must be versatile and continuously adapted to the clinical, radiological and CT modifications; 2) in the first phase of treatment a large tumour must be irradiated through a grid (gamma or high energy X-rays); 3) the fractionation must be very slow (2 sessions a week or several cycles in an overall time of some months, with periods of rest); in order to getting a good re-oxygenation of the large anoxic parts of the tumour mass; 4) the involution of the tumour must be graphically evaluated, as the rate of shrinkage may be very slow, continuing many months after completion of the treatment.
The authors report their three-years experience on the use of CT in oncologic radiotherapy. They present 10 typical cases, using both brain and total body CT, in order to show the main relationships between CT and radiotherapy of deep tumors: 1) more careful oncologic diagnosis; 2) correct geometric approach to treatment planning; 3) good control of treatment, conforming the target-volume to the reduction in size of the tumor; 4) post-radiotherapeutic follow-up.
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The authors retrospectively analyzed the therapy results in a large group of children affected by rhabdomyosarcoma and treated from 1978 to 1988 with chemotherapy, radiotherapy and surgery. 39/58 patients (67%) achieved a complete response and 25/39 maintained the NED status. An individualized treatment was given to 13 patients who relapsed, but only 3 of them obtained a second response. Those with primary tumor in the orbit or in the genito-urinary tract had lower recurrence rate than patients with head and neck, extremities, pelvis and trunk diseases. Patients in clinical group I and II (according with I.R.S. stadiation) had a significantly better survival than those with more advanced disease (clinical groups III and IV). Relatively to the primary site of the disease, the late effects of combined treatment are mentioned.