[Combined radiotherapy/hyperthermia in malignant tumors].
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Adenocarcinoma↗
Biomedical subjects
N Willich
Publications and source records attributed to N Willich.
[Indications for intraoperative radiotherapy].
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Combined Modality Therapy↗
[Intraoperative electron irradiation of malignant pancreatic tumors--initial experiences at Grosshadern].
15 patients with locally unresectable pancreatic carcinomas were treated by IORT and bypass surgery. 13 patients without distant metastases were additionally treated by external beam irradiation. Although only one patient had a local failure, the median survival was only eight months. Severe complications were seen in eight patients, gastrointestinal bleeding occurred in six patients and was the cause of death in three patients. The stop of weight loss and the impressive pain relief within ten days after IORT demonstrate the significance of this treatment modality with respect to palliative effects.
Adenocarcinoma↗
[The development of radiation caries after high doses of irradiation].
39 patients, who were irradiated with doses of 50 to 70 Gy for ENT-tumors over a period of 3.5 months to three years prior to the examination, showed a rapidly progressing caries of the teeth inside the target volume. The teeth outside the target volume developed a caries of less extent. Radiation induced xerostomia, effects of the irradiation of the soft tissues, nutrition habits and hygiene are discussed as causes for the damage of the teeth.
Adult↗
[Changes in the serum level of female sex hormones following radiocastration using different total doses].
We determined serum levels of estradiol, FSH and LH over a period of six to eight weeks after ovarian irradiation for castration with different doses (2 x 2.5 Gy/3 x 2.5 Gy/4 x 2.5 Gy) in 15 patients with metastatic breast cancer as compared to changes after ovariectomy in five patients. The time course of the changing estradiol-, FSH and LH-serum levels significantly depends on the ovarian dose. After radiological castration with a dose of 4 x 2.5 Gy = 10 Gy in four days the estrogen levels decrease within two to three weeks, and the FSH- and LH-levels increase after three to four weeks into the postmenopausal range. Therefore, the time course is not very different from changes after ovariectomy.
Adult↗
[Simultaneous radio- and chemotherapy of squamous cell carcinoma of the esophagus].
Between 1983 and 1986, 41 patients with a squamous cell carcinoma of the oesophagus without hematogenic metastases were treated with a combination of radio- and chemotherapy preoperatively. Treatment consisted of mitomycin C (10 mg/sqm/day 1) and continuous infusion of 5 fluorouracil (1000 mg/sqm/day-day 1 to 4) with a maximum of 1500 mg per day. On day 2 radiotherapy was started. After the administration of 36 Gy all patients were restaged. Nine patients were referred to surgery. In 13 cases surgery was refused, because of inoperability, due to local or distant metastases. In these patients radiotherapy was continued up to 50 to 60 Gy for palliation. Although the disease was confined to the oesophagus no surgery was performed in 19 patients, because of age, enhanced risk of anaesthesia or refusal by the patient. These patients were treated with radiotherapy alone (60 Gy) with curative intention. 32 patients treated without surgery were followed up. For the patients treated with curative intent, the one year survival rate was 62%, the two year survival rate was 42%. Compared to a group treated in 1970 bis 1982 with the same dosage of irradiation without the combination of chemotherapy the median survival could be raized from nine to 24 months, the two year survival rate improved from 18% to 42%. Patients treated for palliation only did not survive the first year after therapy.
Adult↗
[Results of interstitial radiotherapy using I-125 seeds in the treatment of prostatic cancer].
30 patients with localized adenocarcinoma of the prostate were treated with pelvic lymphadenectomy and I-125 interstitial implantation from 1980 to 1985 (21/30 T3-tumors and 14/30 with poor differentiation). The mean follow-up is 59.5 months (range 18 to 88 months). The crude, progression-free and local progression-free survival rates (Kaplan-Meier) for all patients are 68%, 61% and 71% respectively. But, the progression-free survival is 39% in patients with G3-tumors after five years and only 25% in patients with T3 G3-tumors after four years. The local progression rate was 33% in patients with T3-tumors. We did not observe any late intestinal side-effects, but 11/30 (37%) patients suffered from later urinary flow problems caused mainly by local tumor progression. Therefore, we regard interstitial implantation with I-125-seeds as an alternative treatment to radical prostatectomy in patients with T1, 2 G1, 2-tumors but as insufficient in patients with T3 G3-tumors.
Adenocarcinoma↗
[A ventral mantle technic with dorsolateral mediastinal saturation in the radiotherapy of Hodgkin's disease].
Between 1975 and 1981 69 patients suffering from Hodgkin's disease stage I to III were treated by radiotherapy exclusively. In contrast to the standard modalities the mantle was treated only through a ventral portal with dorsolateral boost to the posterior mediastinum. The geometrical treatment arrangement and the modalities of dose application yielded favourable dose distributions and single doses within the target volume. The analysis of failures showed no in field-failure, six marginal recurrences, and 17 distant failures, which are not related to the technique of irradiation. The described technique of mantle irradiation seems to be equivalent to the standard technique with regard to tumor control and side effects.
Cobalt Radioisotopes↗
[Irradiation of chemodectomas].
The rarely occurring, slowly growing glomus tumours of the inner ear, bulbus jugularis or carotis bifurcation, according to the site of the tumour, can be the cause of loss of hearing, tinnitus, vertigo, pain and cranial nerve destruction. As a result of radiotherapy, after having applied 45 Gy, the size of the tumour decreases only very slowly. Although radiotherapy yields very good results, chemodectomas are usually operated on. However, radiation can be applied as first choice of treatment because of its simplicity and because it is well tolerated by the patient. If surgery is used as first choice the rate of recurrence is higher and one should therefore always consider the use of radiotherapy. Our own results with eight patients confirmed that glomus tumours respond well to radiation. This is generally also known from the literature on this subject.
Brain Neoplasms↗
[Radiotherapy of medulloblastoma].
Between 1970 and 1985, 29 patients were postoperatively irradiated for medulloblastoma. Eight out of them received only a local irradiation and 21 a complete CNS irradiation. The posterior fossa was saturated up to a dose of 45 to 49 Gy in nine patients and 50 to 55 Gy in twelve patients. The patients treated by complete CNS irradiation show a three-year survival rate of 47% and a five-year survival rate of 40%. A nonsignificant increase of the three-year survival rate is found in patients whose posterior fossa was exposed to a higher radiation dose. Eleven recurrences were observed, and the posterior fossa was involved in seven out of these cases. Four recurrences confined to the spine were found after a dose of 20 to 30 Gy. Remote metastases, preferentially with a skeletal site, were formed in three out of 29 cases.
Adolescent↗
Vinblastine-ifosfamide-cisplatin treatment of bulky seminoma.
Eighteen patients with pure seminoma in advanced Stages IIC-IV of disease were treated with VIP combination chemotherapy consisting of vinblastine (6 mg/m2, days 1 and 2), ifosfamide (1.5 g/m2, days 1 to 5), and cisplatin (20 mg/m2, days 1 to 5). Eleven patients had Stage IIC, four had Stage III, three had Stage IV, and two had primary extragonadal seminoma. Primary histologic diagnoses were typical seminoma in 15 patients and anaplastic seminoma in three patients. Human chorionic gonadotropin (HCG) levels were elevated to 350 U/1 in eight patients; alpha-fetoprotein (AFP) levels were always normal. No primary lymphadenectomy was carried out. Seven of 18 patients had prior radiotherapy and were treated because of relapse or progression. There was one early death and one patient has not yet completed therapy. Of 16 evaluable patients, 14 reached complete remission (CR) (88%), which was documented surgically in six cases, whereas in the non-pretreated group, all nine patients reached CR and in the pretreated group, CR could be induced in five of seven patients (71%). The remission duration ranged from 6+ to 41+ months (median, 29+ months). No relapse has occurred. The bone marrow toxicity of VIP was remarkable. Because of leukopenia below 1000/mm3 and/or thrombopenia below 50,000/mm3, dose reduction and interval prolongation were necessary in 10 of 16 patients, especially in all those who were pretreated. Even though it is not superior to other platin-based regimens, VIP chemotherapy is highly effective in bulky seminoma with and without prior radiotherapy.
Adult↗
Sequential chemo-radiotherapy in locally advanced squamous cell carcinoma of the head and neck.
Between 1982 and 1983, 32 patients were treated for locally advanced inoperable squamous cell carcinoma (SCC) of the head and neck in a prospective pilot study. Patients received two to five courses of chemotherapy consisting of methotrexate, bleomycin and cis-dichlorodiammine-platinum (II). Radical radiotherapy was performed two weeks after administration of chemotherapy. Despite the high initial response rate to chemotherapy of 62.5%, long-term results remained poor. After a median follow-up of 10.5 months (3-39 months), 15 patients were still alive, but only 4 were clinically free of disease. Aggressive chemotherapy does not prevent delivery of full-dose radiotherapy for SCC of the head and neck. Furthermore, our study does not suggest that chemotherapy has a great influence on long-term results.
Adult↗
[Postoperative radiotherapy of supratentorial anaplastic glioma].
Between 1970 and 1983, 149 patients with high grade anaplastic supratentorial gliomas received a postoperative irradiation during primary treatment. 118 out of these patients had an anaplastic astrocytoma, 18 an anaplastic oligodendroglioma, and 13 an anaplastic ependymoma. Most of these patients were treated by irradiation of a great volume with 50 Gy within five weeks, the others by irradiation of the total brain with 50 Gy within five weeks and saturation with 10 Gy within one week. The one-year survival of the total group was 35.5% and the two-year survival 10.6%. Patients at an age of less than 40 years show a significantly longer survival than older patients (one-year survival rates 40% and 30.7%, respectively). Patients suffering from anaplastic tumors with astrocytic and oligodendrocytic differentiation have a comparable prognosis. Patients suffering from anaplastic tumors with ependymal differentiation, however, have prolonged survival times. The therapy results of different treatment methods are discussed using the communications of literature.
Adult↗
[Two-year clinical experience with Mevamatic 3--development of a verification and protocol system for irradiation units].
Since 1983 the computerized record and verify system Mevamatic 3 was tested in connection with the linear accelerator Mevatron 77 (Siemens Company). In consequence of the software development the handling of the system was improved for the clinical routine with the result of a fully utilizable system. The topics of this report are the description of the hardware, the functions of the system, the software development and some possibilities for improvements in the future.
Germany, West↗
[Radiotherapy of seminoma: small-volume irradiation at the stage pT1N0M0--prophylactic irradiation of the mediastinum].
122 patients suffering from seminoma were irradiated between 1971 and 1981 at the Radiotherapy Department of the University of Munich. 113 patients were available for retrospective analysis. The ten year actuarial survival for all patients was 93%. The survival rate in stage pT1N0M0 (UICC classification) was 100%, in stage pT2-4-xN0M0 97%, in stage pT1-4-xN1-3M0 93%, and in stage pT1-xN4M0/pT1-xN1-4M1 69%. Using a stage adapted target volume, the exclusive irradiation of the paraaortic nodes in the stage pT1N0M0 led to a cure-rate of 100%. Because of this result, and due to the improved tolerance and lower exposure to the remaining testis we recommend this method. The effectiveness of radiotherapy, also in advanced seminomas, the benefit of prophylactic mediastinal irradiation and the therapeutic modalities for treatment of extragonadal seminomas are discussed.
Cobalt Radioisotopes↗
[Radiotherapy in the treatment of malignant diseases].
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Humans↗
[Radiotherapy of precancerous conditions in the ENT area].
Precancerous lesions of the oral cavity and the larynx are usually treated by surgery, because a complete histological examination for detecting an invasive carcinoma is important and, on the other hand, modern surgery procedures yield very satisfactory functional results. High-dose irradiation of inoperable high-risk precancerous lesions of the larynx may be taken into account. Experiences in the irradiation of inoperable low-risk lesions with different doses are very rare. The carcinoma in situ should be treated like an invasive carcinoma. 10 years of experience in radiotherapy of precancerous lesions of the larynx in 23 patients are reported.
Carcinoma in Situ↗
[Individual face masks as aids in quasi-3-D planning and completion of irradiation of tumors of the head and neck].
Apparatus for immobilizing the patient's head in an identically reproducible position is required, if the advantages of exact quasi-3-D-therapy planning are to be fully exploited for the irradiation of irregular target volumes in the head and neck area. The topics of this report are the production and application of individual thermoplastic masks in connection with special head supports for CT planning scans, simulation and irradiation.
Head and Neck Neoplasms↗