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Biomedical subjects

H Frommhold

Publications and source records attributed to H Frommhold.

At least 55 records · Page 3Linked to original sources
PubMed1988

[Radiotherapy of bronchial cancer].

Current radiotherapy is effective both in treating the non-small cell bronchial carcinoma and the small-cell anaplastic carcinoma. The spectrum of radio-oncologic methods requires on-target determination of indication. Curative treatment of non-small cell bronchial carcinoma may yield 5-year survival rates of 11% in case of radiotherapy; if onset of treatment is early, this rate may increase to 20%. Even in elderly patients (70-75%) the results are by no means inferior compared to younger patients. Adjuvant postoperative radiotherapy is indicated in N2 cases. Palliative radiotherapy is of undisputed value in non-small cell bronchial carcinomas. For treating the non-small cell anaplastic bronchial carcinoma, radiotherapy is an essential part of a multimodal interdisciplinary therapeutic concept. In combination therapy it ensures complete remission, reduces the relapse rate and results in remarkable long-term remissions because of its essential target areas in the region of the primary tumour and the cerebrum together with chemotherapy and surgery, and hence in an improvement of the survival time.

Carcinoma, Bronchogenic↗
PubMed1988

Transrectal ultrasonography as a follow-up method in prostatic carcinoma after external beam and interstitial radiotherapy.

Transrectal ultrasonography and ultrasonometrics were employed for follow-up in a total of 28 prostatic carcinoma patients subjected to external beam or interstitial radiotherapy. These two methods permit more accurate staging of prostatic carcinoma and have also proved to be valuable in the follow-up care of patients suffering from locoregional prostatic carcinoma. Of the 20 patients subjected to external beam radiotherapy four patients initially did not show capsular infiltration, 2B2, 2A2, whereas 16 patients presented with infiltration of the capsule and seminal vesicles. After external beam radiotherapy the ultrasonomorphologic findings of four patients revealed a sharply demarcated capsule and unremarkable seminal vesicles, which indicated tumour regression. Of five patients with infiltration of the pelvic floor and/or seminal vesicles, three showed definite tumour regression, whereas the ultrasonograms of the other two patients demonstrated tumour progression despite radiotherapy. In eight patients the greatest reduction in tumour volume was found one year after interstitial radiotherapy. Only one patient, initially presenting with slight infiltration of the capsule, was shown to have infiltration of the capsule and seminal vesicles after interstitial radiotherapy. At follow-up, evaluation of the echo patterns in these patients was inaccurate on account of the dense echoes reflected by the seeds implanted.

Brachytherapy↗
PubMed1987

[Radiotherapeutic aspects of the treatment of malignant gliomas].

In addition to surgery, curative radiotherapy is the most important mode of treatment for malignant gliomas. Radiotherapy makes it possible to significantly prolong the mean survival time. Since the majority of higher-grade gliomas recur in the area subjected to surgery or radiotherapy, radio-oncologists put the greatest possible emphasis on local tumour control. Increasing the dosage above 60 Gy raises the incidence of complications and in random studies has not been shown to bring definite therapeutic advantages. It appears important to reduce the size of the field while increasing the dose, especially when using stereotactic irradiation methods and intraoperative radiotherapy. The change in fractionating rhythm and the implementation of radiosensitizers have brought encouraging results in clinical trials, but their definitive therapeutic value remains to be proven by further research. Applied irradiation with high LET, as well as the use of radio-protectors and hyperthermic methods are still in the experimental stage.

Brain Neoplasms↗
PubMed1987

[Experience using bone marrow transplantation in the treatment of hematologic neoplasms and solid tumors].

Between October 1983 and October 1985, 12 allogeneic bone marrow transplantations from HLA-identical siblings were performed for treatment of malignant disease (11 haemopoietic malignancies) or severe aplastic anaemia (1 case). All patients showed prompt and complete engraftment of donor cells on average around day 17 after transplantation. 10 patients are alive and well 50-760 days after transplantation, without any signs of recurrence and partly without immunosuppressive therapy. Two patients died, one due to relapse of the leukaemia, and one as a result of CMV interstitial pneumonia. Graft versus host disease was seen in 6 of the 12 patients. Additional immunosuppressive therapy was necessary in 4 of them. The incidence of idiopathic interstitial pneumonia in our group of patients was low (two cases). Also tested was an experimental protocol for the treatment of chemotherapy-resistant metastatic solid tumours. After removal of all clinically detectable tumour tissue by maximal surgical therapy in 5 patients, residual systemic metastases were treated by means of total body irradiation and high-dose cyclophosphamide, followed by autologous bone marrow transplantation with curative intention. Relapse occurred in 4 patients between day 100 and 720 after BMT bone marrow transplantation. Only one patient remains without sign of relapse.

Adult↗
PubMed1987

Hyperfractionated, accelerated radiotherapy and concurrent chemotherapy in locally advanced bladder cancer.

A prospective study was performed on 11 patients with locally advanced transitional cell carcinoma of the bladder to evaluate the toxicity of an integrated treatment with cis-platinum (70 mg/m2 body surface), doxorubicin (10 mg/m2 body surface) and 8 meV photons. Local and systemic toxicity caused by this treatment schedule was minor. Late sequelae consisted of reduced bladder capacity in 2 patients and proctitis in 1 patient. Complete clinical clearance of the local tumor could be achieved in 9 of 11 patients after a mean follow-up of 8.1 months.

Aged↗
PubMed1987

Clivus chordoma in a 9-year-old child: case report and review of the literature.

Chordomas are bone tumors of the axial skeleton. They arise from notochordal remnants. In children these tumors are extremely rare and are predominantly located in the skull base. The authors report on a clivus chordoma in a 9 7/12-year-old girl. It presented as a nasopharyngeal mass with destruction of the clivus and paralyses of the ninth, tenth, and eleventh cranial nerves on the right side. After incomplete resection by a transoral transclival route, high-dose radiotherapy was added. This treatment was effective as demonstrated by follow-up CAT scans. A short review of the current literature is given. The local recurrence rate is extremely high, and distant metastases may occur. Complete resection is rarely possible, and combined management with postoperative radiotherapy is propagated. Permanent cure is rare, and at the present time, chemotherapy appears to be of no value in the primary treatment of chordomas.

Child↗
PubMed1987

[Intraoperative radiotherapy of malignant pancreatic tumors--initial results].

Thirteen patients suffering from adenocarcinomas of the pancreas were submitted to an intraoperative fast electron "boost" therapy with or without percutaneous photon irradiation. A duodeno-cephalo-pancreatectomy with subsequent irradiation of the tumor bed could be performed in three patients. Ten patients were inoperable because of advanced tumors and formation of metastases. The average survival is 6.5 months, at present six patients are alive without major troubles. An analgetic effect was obtained in ten patients. The first results are encouraging with respect to local control, the little acute and chronic morbidity, and palliation achieved in advanced stages.

Adenocarcinoma↗
PubMed1987

[Simplified HDR-afterloading and high-voltage therapy of cervical carcinoma].

In continuation of our long-term afterloading method applied in the treatment of patients with inoperable cervix carcinomas, we have introduced the ring and pin applicator system into the short term afterloading proceeding. The benefit of a standardized treatment method is especially relevant in HDR afterloading therapy. A time-consuming brachytherapy planning is not necessary because of the constant source distribution within the rigidly shaped ring and pin applicator and the unchanged dose to point A according to Manchester. Percutaneous radiotherapy planning is further facilitated by fixing a metal clip in the cervix at the first HDR insertion. With the aid of anterior-posterior localization radiography, the centre of the circular absorber used by us can be located on the metal clip. In case of an asymmetric position of the cervix, this allows to avoid a dose excess at one pelvis wall caused by superimposing target volumes of brachytherapy and percutaneous therapy as well as an insufficient dose at the opposite wall of the pelvis.

Brachytherapy↗
PubMed1987

[Rectal shielding for a Selectron-ring applicator system (HDR- and LDR-afterloading)].

In order to decrease the morbidity rate after combined radiotherapy of the cervix carcinoma, a tungsten shield 3 and 5 mm thick for the rectum has been developed by the authors which is applied with the ring and pin applicator of the Selectron unit (LDR- and HDR-afterloading). The isodose curves were measured in a plexiglas phantom, and the radiation dose at the reference points was determined by means of a ionization dosimeter. The phantom measurements were performed with the same arrangement of sources as applied in radiotherapy. The measurements showed a dose reduction at point Rmax of 33% (HDR) and 44% (LDR) with the tungsten shield 5 mm thick.

Brachytherapy↗
PubMed1986

[Intraoperative radiation treatment of carcinoma of the pancreas. Initial clinical results].

Intraoperative radiotherapy (IORT) was administered to 13 patients with carcinoma of the pancreas, using high-velocity electrons of a LINAC accelerator in a single dose of maximally 25 Gy applied directly to the tumour or tumour bed with the abdomen open. There were no disorders of wound healing or other serious early complications which could be ascribed to the radiation. Stomach and intestines were excluded from the radiation field to avoid late radiation damage, such as stenoses or ulcers. The method is particularly indicated for locally non-resectable, non-metastasized pancreatic carcinoma, possibly also as tumour-bed radiation during radical surgery. Patients with distant metastases were not given radiation. First results point to IORT providing lasting improvement of pancreatic pain. It is too early to know whether survival time is favourable influenced.

Aged↗
PubMed1986

[Value of surgery in the treatment of small-cell bronchial cancer].

As a result of strict cooperation between oncologists, surgeons and radiotherapists we developed a comprehensive combination therapy for small cell lung cancer (limited disease): Stage I, II: radical tumour resection; chemotherapy (Cohen); cerebral radiation prophylaxis; locoregional radiotherapy; Stage III: Chemotherapy; cerebral radiation prophylaxis; lung resection in an extension required by the initial tumour; radiotherapy (local). The preliminary results in 15 patients are encouraging.

Adult↗
PubMed1986

The role of surgery in the combined management of small cell bronchial carcinoma.

Even after the introduction of modern chemotherapeutic regimens and radiotherapeutic approaches in the treatment of small cell bronchial carcinoma (SCLC), the results are still disillusioning. Long-term remissions are rare even in patients with limited disease. We review 66 patients with SCLC (limited disease) which we treated either by single therapies (chemotherapy, radiotherapy, surgery n = 16), or by different combinations of the possible therapeutic measures. Favorable results were achieved by a comprehensive treatment including operation, chemotherapy and prophylactic cranial and local irradiation: 11 of 15 patients survived 3 to 97 months after the onset of therapy, 4 of those more than 24 months. Based on our own experience and the results of other authors we feel that surgical resection should be again included as an essential part of treatment: tumor resection is the rational primary therapeutic approach for cases without lymph node metastases in the mediastinum and for tumors of uncertain histological type. If there is evidence of lymph node involvement in the mediastinum (N2), surgery should be performed after a remission has been successfully induced by chemotherapy (so-called adjuvant surgery).

Adult↗
PubMed1986

[Simplified standardized afterloading therapy of cervical cancer using a new applicator system (modeled after the Munich method)].

In order to be able to continue to benefit from the Munich method - fixed applicator geometry - even after changing from radium therapy to low dose rate afterloading therapy, our department has developed a standardized treatment program for the ring applicator. Its prerequisites are the dose specified on the Manchester point A and the distribution of sources specified for the ring applicator. The make-up of the source flow in the ring catheter is chosen in such a way as to reduce the maximum rectal dose to more favourable levels.

Brachytherapy↗