[Metastasizing cystosarcoma phyllodes].
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Adult↗
Biomedical subjects
O Esik
Publications and source records attributed to O Esik.
Bone marrow (reticuloendothelial system) scintigraphy for haematological follow-up of radiochemotherapy-treated patients.
To assess the bone marrow capacity before a new treatment decision, 99mTc-human serum albumin bone marrow scintigraphy (with qualitative and quantitative evaluation) was performed in 32 patients with solid tumours or malignant lymphomas previously treated with radiochemotherapy. In the group with a normal bone marrow capacity, the blood counts were normal (14/16 cases) or became normal (2/16 cases) in the follow-up period, and the examined marrow samples exhibited normal haemopoiesis. In the group with a reduced bone marrow capacity, one or more blood counts were low in 14/16 cases. Decreased haemopoiesis was observed in only 4 of 8 examined marrow samples. The following conclusions were drawn. (1) A scintigraphically normal bone marrow capacity relates to normal haematological parameters, and therefore treatment plans could be decided on. (2) Although a reduced bone marrow capacity indicates pathological haematological conditions in the majority of cases, further studies are needed to evaluate its precise significance. (3) Application of this non-invasive, inexpensive, repeatable, non-immunizing method is recommended before a therapeutic plan is decided on for patients at considerable haematological risk.
Adult↗
Prophylactic external irradiation in differentiated thyroid cancer: a retrospective study over a 30-year observation period.
Following surgery which left no microscopic residue, 114 patients with differentiated thyroid cancer (58 papillary, 56 follicular) were subgrouped on the basis of the dose of externally applied prophylactic postoperative radiation: group 1 received an adequate dose of radiation (> or = 4,500 cGy of telecobalt, > or = 4,000 R of orthovoltage therapy), while group 2 received an inadequate dose of radiation (this group included non-irradiated patients). Local/regional-relapse-free survival (LRRFS), distant-metastatic-relapse-free survival (DMRFS) and total-cause-specific survival (TCSS) were calculated by means of life-table analysis for each histologic type. TCSS and LRRFS were significantly (p < 0.001) better for group 1 in papillary cancer. No difference was found in DMRFS. LRRFS was significantly (p < 0.001) better for group 1 in follicular cancer. No differences were found in TCSS and DMRFS. We conclude that (1) prophylactic postoperative external irradiation is an effective method for survival prolongation in papillary cancer, reducing local/regional recurrences, and (2) external irradiation should be considered in the postoperative management of follicular cancer, to diminish local/regional relapse.
Adenocarcinoma, Follicular↗
Second malignancies after treatment for Hodgkin's disease.
The occurrence of treatment-related second malignancy following Hodgkin's disease (HD) has now been recognized as a major problem. The purpose of this study was to review our experience with second malignancies in patients treated for Hodgkin's disease, comparing the results with the international literature data. Six hundred and sixty five patients with HD were treated in our department, between 1978 and 1996. Second neoplasm developed in 32 cases (4.8%). Seven secondary hematological malignancies were observed: four acute nonlymphocytic leukemias, two non-Hodgkin's lymphomas and one chronic myeloid leukemia. Among patients with second hematological malignancies, the mean age at diagnosis of HD was 44 years and the mean interval until the development of second malignancy was 6.1 years. Five patients received chemo- and radiotherapy and in two cases chemotherapy was used. Three of the seven patients are alive. Twenty-five patients have had solid tumors, affecting lung (5), breast (3), colon (3), stomach (2), urinary bladder (2), head-and-neck (1), thyroid gland (1), esophagus (1), liver (1), pancreas (1), furthermore, three sarcomas and two malignant melanomas were observed. Their mean age at the diagnosis of HD was 46 years and the mean period of latency was 8.3 years. Chemotherapy was applied to nine patients, 16 patients received both chemo- and radiotherapy. Eleven patients had solid tumors in the region irradiated earlier. Ten out of the 25 patients are alive, three patients' present state is unknown. Since alkylating agents increase the risk of leukemia and irradiation contributes mainly to other malignancies, future treatment protocols should attempt to reduce the most serious consequence of therapy without compromising the survival. It is necessary to investigate the impact of additional risk factors. Careful, lifelong observation is indicated for patients with HD, with special attention given to new clinical signs and symptoms.
Adult↗