[Results of radiotherapeutic treatment of malignant tumors of the tongue].
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Biomedical subjects
Publications and source records attributed to L Schertel.
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141 patients with endometrial cancer underwent radiation therapy at the department of radiology, University of Münster, between 1967 and 1979. The concept of the combined surgical and radiation therapy (intracavitary radium and percutaneous high voltage therapy) was adjusted to the stage (FIGO) and to the depth of penetration of invasive growth into the myometrium, this being ascertained by means of the excised tissues. Five-year survival for Stage-I patients amounted to 93.5%, for Stage II to 84.3% (ca. 80% were staged I or II). Radiation therapy of the aortic lymph nodes using monoaxial pendulum irradiation with 18-MV X-rays is discussed in detail, considering also the secondary radiation effects.
The specialist will expect diagnostic information on the spleen in particular with regard to its size. Well-tried examination methods are available. However, important arguments in favour of computer tomography in special cases are, among others, easy execution, reproducibility, accuracy of presentation, and an examination method which places practically no burden on the patient. In the author's opinion, the significance of CT representation of the spleen is undisputed with regard to radiation planning. The significance of computer tomography for the greater part of diagnostic problems -- tumors, inflammations, systemic diseases etc. -- , especially when compared with the ultrasound method, does not seem to be finally established, even on the basis of our studies.
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The authors are of the opinion that radiotherapy is always indicated for colorectal carcinoma patients: (1) Operable carcinomas should be given radiation treatment before operation; postoperative saturation of high-risk cases at the full tumor dose is recommended. (2) Inoperable or partially operated carcinomas should be treated with tumoricidal radiation dose. (3) Radiotherapy is also indicated for cases of local recurrence, especially in the floor of the pelvis, in view of the frequent lack of possible operative access. The necessary dose rate must take into account any prior radiation load. (4) The excellent palliative results are themselves a recommendation for radiotherapy.
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Using individual body cross-sections for purposes of irradiation (obtained by computed tomography with the Siemens-Somatom) in combination with a system for treatment planning (TPS, Phillips), a marked improvement of irradiation planning is achieved. Thus, an advance in the quality of radiation therapy may be expected. Some inconvenience with this combination of instruments, due to the necessity of enlarging the CT cross-sections up to life-sized cross-sections suitable for the TPS, is unavoidable so far.
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Radiographic appearances of tumours of the paranasal sinus are often equivocal. One must try to differentiate the main radiologic signs--shadow, and changes in the walls (tumour, inflammation?). A few important data are given. But examples also show the sources of error. The need for immediate diagnostic-surgical measures in all cases of even minimal suspicion of malignancy is obvious.
Comparison of film and xerographic examinations of arteries in the extremities has shown that it is possible to demonstrate vessels by using xerography with about half the usual concentration of contrast material. Advantages of this technique are: Less pain during the examination. No need for an anaesthetic. Less damage to the artery, with the possibility of repeating the examination. -There are still certain difficulties for the routine use of this method: the selenium plates cannot be used in the AOT changer. Limited format of the selenium plates.
We examine with phlebography usually a damaged vascular system. Radio-contrastmedia damage vascular endothelium. If we dilute them we may minimize the damaging effect. But when using the usual film-foliae combination, diagnostic results diminish the more we dilute. Results of 31 comparative investigations with film and xerphlebography show that dilution of contrast medium to 50 or even 25% will still produce phlebograms sufficient for evaluation with xerophlebography. It also has the advantage of a large picture: soft parts, veins and bony structures are visible of the same time. At present the method (chance of screening, gaps) renders routine use not advisable.
Bases on more than 2700 statistically evaluated, comparative filmradiographic thoracic organs, abdomen and vascular and lymphatic system, the value of xeroradiography was analyzed by a standardized process. We came to the conclusion that, in certain cases, xeroradiography is superior (example: head-neck-soft tissues), equal (example: cranial area) or inferior (example: abdomen) to conventional X-ray film techniques. The xeroradiographic procedure has advantages for the radiologist if he does not try to use it as a substitute for the conventional X-ray film technique.