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J Kutzner

Publications and source records attributed to J Kutzner.

At least 37 records · Page 2Linked to original sources
PubMed1992

[The percutaneous irradiation of osteolytic bone metastases--a course assessment].

Percutaneous radiotherapy is the most effective modality for treatment of metastatic bone cancer. Local irradiation improves overall quality of life by relieving pain in most patients. It also helps preventing complications as pathological fractures in lytic bone lesions by new bone formation. In a retrospective study on 100 patients, irradiated for lytic bone metastases, the radiotherapeutic effect on alleviation of pain and on recalcification rate was investigated. In our experience in 84% of the cases pain and disability associated with bone metastases could be decreased. 38% of the patients had complete relief of symptoms. A correlation between subjective therapy effect and histology of the primary tumor was not demonstrated. Remineralization was found in 67% of all irradiated skeletal areas (n = 137) (recalcification rate in breast cancer 77%, in bronchial carcinoma 27%, and in renal cell carcinoma 25%). After a total dose of 30 Gy reduction of the metastases-associated pain was achieved in 81% of the cases and remineralization was observed in 70% of the cases.

Adult↗
PubMed1991

MRI-assisted radiation therapy planning of brain tumors--clinical experiences in 17 patients.

A new and simple method for precise determination of lateral opposed treatment portals was developed and used in 17 patients. Compared to CT, MRI led to significant changes of portals in 59% (10/17) of cases. Individual shielding blocks could be precisely designed by use of our new method. MRI is the procedure of choice in local radiation therapy planning of brain tumors.

Adolescent↗
PubMed1991

Graves ophthalmopathy: role of MR imaging in radiation therapy.

Twenty-three patients with Graves ophthalmopathy who underwent radiation therapy were monitored by means of magnetic resonance (MR) imaging. T2 relaxation times of extraocular muscles and orbital fat, areas of extraocular muscles, and degree of exophthalmos were measured by means of MR imaging at the beginning, at the end, and 3 months after completion of radiation therapy. As a result, patients with primarily elevated T2 times of extraocular muscles showed a better therapy response regarding muscle thickening than patients with primarily normal T2 times. Elevated T2 times, which probably represent acute inflammatory changes, were markedly decreased at the end of therapy. Therefore, quantitative MR imaging favors the choice of anti-inflammatory therapy regimens in patients with elevated T2 times of extraocular muscles. However, the clinical response (activity scores) to the low-dose treatment protocol that was used did not correlate well with primarily elevated T2 times. Furthermore, T2 times increased again after cessation of therapy. Whether a higher radiation dose or a different fractionation scheme leads to better results must be clarified by means of further study.

Adult↗
PubMed1991

A novel combined operative and radiotherapeutic treatment approach for recurrent gynecologic malignant lesions infiltrating the pelvic wall.

Patients who have recurrent gynecologic malignant conditions infiltrating the pelvic wall still have a poor prognosis, although based on the biologic factor of the tumor, 50 per cent might be salvaged if local control is achieved. For patients with unilateral disease, we have designed a combined operative and radiotherapeutic treatment (CORT) that involves subtotal resection of the tumor, intraoperative placement of guiding tubes for postoperative high dose rate brachytherapy of the residual tumor and tumor bed at the pelvic wall and pelvic wall plasty with autologous tissue flaps. We use either flaps of the greater omentum and inferiorly based rectus abdominis muscle flaps from the abdominal route or (de-epithelialized) gluteal thigh flaps from the vaginal and perineal route to cover the tumor bed and overlying tubes. Thus, a protective distance between the radiation source and radiointolerant pelvic organs is created and the risk of local infection and hypoxia is reduced. With this combination of surgical and radiation treatment, the therapeutic ratio between tumor control and tissue damage in the pelvic area is thought to be improved. Higher local doses can be applied compared with conventional methods in instances in which surgical treatment has been performed and reirradiation with tumoricidal doses may be possible after primary or adjuvant radiation therapy. The encouraging first experience with the CORT concept in nine patients with a short follow-up period is reported.

Adult↗
PubMed1990

[The importance of preoperative chemotherapy and radiotherapy in 373 children with Wilms' tumor].

Between 1980 and 1988, in a prospective study of 373 children with Wilms' tumour throughout the Federal Republic of Germany, the results of various pre- and postoperative treatment schedules were analysed. There were 184 boys and 189 girls, mean age 3 11/12 (0-27) years. One third each was in group I, II or III-V, respectively. In 52% of cases the tumour volume, measured by ultrasound, was more than 400 ml. 218 of the children were called protocol patients, the remaining 155 served as observation patients, because the latter had histological variants or there had been marked treatment deviations. The stage-adapted treatment always included operation, in 30% of children after pre-operative chemo- or radiotherapy. Radiotherapy was given in selected patients in stage II and always to those in stages III, IV or V. Chemotherapy consisted of Actinomycin D and vincristine, adriamycin was added for stages III-V and cyclophosphamide or ifosfamide for histologically highly malignant variants. Of the 218 protocol patients 196 (90%) were alive without recurrence, after a mean observation time of more than 7 years. Radiotherapy was given to only 105 of the 218 protocol patients. The prognosis of the 155 observation patients differed according to the histology: those with clear-cell type had a better prognosis than previously reported. Among the total group of 373 patients 305 (81.8%) have remained without recurrence after more than 6 years.

Adolescent↗
PubMed1990

[Radiotherapy in HIV positive patients].

HIV-positive Patients often suffer from the symptoms of accompanying diseases. Palliative radiation therapy of associated tumors leads to an improvement of the patient's condition. Particularly skin tumors, which give rise to pronounced itching and ulcerating, are eliminated fast and safe by radiation therapy. Between 1984 and 1988, 6 HIV patients with Kaposi's sarcoma at different sites, and one HIV-patient with non-Hodgkin's lymphoma were treated by radiation therapy. Depending on tumor site, photons or fast electrons were used. Cosmetic results were satisfying or even excellent in all patients. With one exception complete local tumor control was obtained. Side effects leading to a peace of treatment did not occur.

Combined Modality Therapy↗
PubMed1990

[Sonography of bone metastases--its place in comparison with computed tomography and conventional x-ray diagnosis].

The value of CT, conventional radiography and ultrasound was compared in 40 patients with 52 skeletal metastases. For superficial lesions, the combination of sonography and conventional radiography was equivalent to CT in showing the extent of bone destruction and soft tissue involvement. As expected sonography was unsatisfactory for deeper lesions. Sonography can provide useful information for planning radiation therapy for superficial lesions, but it does not replace conventional radiography.

Bone Neoplasms↗
PubMed1990

[A simple method for MRI-assisted radiotherapy planning in brain tumors].

A simple method for radiation therapy planning of brain tumors is presented. Therapy portals of midline tumors can easily be determined by comparing sagittal MRI scans with the lateral simulator radiograph. By addition of appropriately processed MR-tomograms a similar planning is possible for parasagittal tumors. Digital data exchange between different operating systems is not necessary with our simple method, problems with varying input/output standards and expensive hardware requirements are thus avoided.

Adult↗
PubMed1989

[A new experimental method for the treatment of pelvic wall recurrencies of gynecological malignancies].

Pelvic side wall recurrences of gynecological malignancies subsequent to primary or adjuvant radiation therapy have a bad prognosis, although in almost half of the cases, distant metastases are not present at the time of diagnosis of the local tumor progression. A radical operative resection of the pelvic wall recurrence is rarely possible and a second conventional percutaneous or intracavitary irradiation with a tumoricidal dose is no longer feasible, because of the limited radiation tolerance of the surrounding pelvic tissue. The different forms of chemotherapy applied at present are not curative. Based on considerations of tumor and radiation biology, we propose a new experimental treatment mode after subtotal tumor resection. Intraoperatively, guiding tubes for afterloading HDR brachytherapy are fixed equidistantly on the tumor bed resp. residual tumor at the pelvic side wall. Coverage of this area by a rectus abdominis muscle flap or de-epithelialized myocutaneous flap improves fixation and creates a protective distance between radiosensitive pelvic structures and the radioactive source inserted postoperatively. In addition, improved vascularization by the flap might reduce the potential of hypoxia induced radioresistance of the residual tumor. Under these circumstances it appears possible, to deliver a second tumoricidal radiation dose of a small volume to a precisely defined area of the pelvic side wall.

Abdominal Muscles↗
PubMed1988

[The value of radiation therapy in the management of adenoid-cystic carcinoma of the head and neck].

There are different opinions about the importance of radiotherapy in the treatment of adenoid-cystic carcinomas. A report is given on the experiences gained with highdose radiotherapy in twelve patients suffering from adenoid-cystic carcinomas. In spite of the unfavorable composition of the group of patients (6/12 were classified stage T3 or T4, 5/12 were only irradiated after a local recurrence had appeared), local tumor control was achieved in all patients by percutaneous irradiation with a focal dose of 80 Gy or interstitial irradiation with a focal dose of 70 Gy. On the basis of these results as well as of recent communications in literature, it is concluded that adenoid-cystic carcinomas can be locally cured by radiotherapy.

Carcinoma, Adenoid Cystic↗
PubMed1988

[Adenoid cystic carcinomas of the head and neck. Results of treatment with high-dosage radiotherapy].

Different opinions exist about the role of radiotherapy in the treatment of adenoid cystic carcinoma of the head and neck. In this paper the results of 14 patients with high-dosage irradiation are reported. Radiotherapy with local curative intent was performed in all patients. 10/14 patients were irradiated post-operatively. 4/14 patients received radiation therapy alone. By percutaneous irradiation (n = 13) focal doses of 80 Gy were applied, by interstitial irradiation (n = 1) 70 Gy. Despite the less favourable patient group - 8/14 patients had either a T3- or T4-tumour; 5/14 patients were referred because of recurrent disease - local tumour control could be achieved in all cases after a mean observation time of 3.5 years. Together with newer reports of literature we consider adenoid cystic carcinomas of salivary gland origin as locally curable by postoperative high-dosage radiotherapy.

Adult↗
PubMed1986

[Changing of organ distribution of radioactive yttrium in rats by varying amounts of carrier].

There is little change in the organ distribution of yttrium citrate complex after addition of 0.01 mg/kg BW as carrier. Adding increasing amounts of inactive yttrium up to 1 mg/kg BW caused a considerable reduction in bone uptake and an increasing accumulation in the liver and spleen by transformation to colloid. Uptake in the lung indicates formation of macro-particles. The transformation into colloid can be varied by changing the citrate concentration. The 90Y-citrate complex for therapy should be used either without or with very little carrier of inactive yttrium.

Animals↗
PubMed1986

[Results of radiation therapy in cervix carcinoma with reference to side effects].

The analysis of 770 patients after irradiation of cervix-carcinoma from 1968 to 1976 with Cobalt 60, radium or operation or only irradiation therapy shows five-year survival rates of 78% for stage I, 61% for stage II, and 23% for stage III. Bowel reaction was seen in 27%, 4% developed stenoses, 1.3% a recto-vaginal fistula. A complication of the bladder was seen in 18%, 2.7% had an ureteral stricture and 0.8% a bladder-fistula.

Cobalt Radioisotopes↗
PubMed1986

[Lymphoepithelial carcinoma of the nasopharynx: the treatment results following radiotherapy].

Data of 17 patients with lymphoepithelial carcinoma of the nasopharynx treated with telecobalt were reviewed. The follow-up period was five to nine years. 16/17 patients had lymph node metastases at the initial presentation. Cervical lymphadenopathy was the only tumor symptom in seven patients. The overall five-year survival was 70% (12/17 patients), the disease-free survival 47% (8/17). 2/10 patients survived seven years. Local recurrence in the nasopharynx was seen in 5/17 patients, recurrence at neck sites in 7/17. 5/7 lymph node recurrences developed outside the radiation field. Half of the recurrences appeared late (three to six years after radiotherapy). In 8/9 patients recurrence preceded the hematogenous spreading of the carcinoma. Therapy of lymphoepithelial carcinoma of the nasopharynx should always include radiation of the primary tumor and bilateral cervical lymph nodes with 60 to 70 Gy.

Carcinoma, Squamous Cell↗
PubMed1985

[Palliative bile duct irradiation].

Carcinoma of the common hepatic bile duct or common bile duct were treated by interstitial irradiation with gold seeds using the percutaneous transhepatic drainage partly boosted by external irradiation. The interstitial dose of 50 Gy was given in two applications and 40 Gy by linac. Twice histological examination showed wide tumor destruction of local irradiation, but also much more tumor extension than seen before by diagnostic investigation. Mostly the therapy is only palliative because of the infiltration of liver and lymph nodes.

Aged↗