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Biomedical subjects

R Kenda

Publications and source records attributed to R Kenda.

At least 37 records · Page 2Linked to original sources
PubMed1980

Second malignancies in Hodgkin's disease: a complication of certain forms of treatment.

A total of 764 patients with Hodgkin's disease treated with radiotherapy (RT) or chemotherapy or both were reviewed 3-186 months (median 43 months) after initial treatment to assess the incidence of second malignancies. Incidence of solid tumours and acute non-lymphoblastic leukaemia (ANLL) were calculated by a life-table method and percentages of patients affected derived from life-table plots. Within 10 years after initial treatment the overall incidence of second solid tumours was 7.3%, and over a comparable period 2.4% of patients developed ANLL. Solid tumours occurred only in patients given RT with or without adjuvant chemotherapy, and ANLL occurred only after treatment with MOPP (mustine, vincristine, procarbazine, and prednisolone) or modified MOPP regimens. Neither solid tumours nor ANLL occurred in patients given ABVD (adriamycin, bleomycin, vinblastine, and dacarbazine). The highest incidence of leukaemia (5.4%) occurred after treatment with extensive RT plus (5.4%) occurred after treatment with extensive RT plus MOPP; hence the benefits of this approach in Hodgkin's disease must be weighed against its carcinogenic potential.

Adult↗
PubMed1980

Radiotherapy alone and radiotherapy followed by radical mastectomy in T2 breast cancer.

Ninety-four patients with T2 NO, N1a, N1b, MO were treated with primary radiotherapy (RT) because of old age or poor general conditions. In 32 patients (34%), younger in age and in better general conditions, Halsted radical mastectomy could be performed 5-8 months from starting RT; surgery was not done at random, but decided case by case on the basis of a good response to RT and an improvement of general status. Relapse was documented in 42 patients. Relapse rate was 50% in the group treated with RT alone (high incidence of breast recurrences) and 33% in the group operated on after RT. Distant metastases had the same incidence in the 2 groups, with a median free interval of 14 months. Overall disease-free survival rates at 5 to 10 years were 46% and 35%, respectively; these results are not particularly different from the data of historical series of T2 breast cancer treated with surgery alone. The patients operated on after RT had a significantly better survival, but the results were clearly influenced by the selection of patients. For the future, a safe policy could be a conservative combined treatment consisting of tumorectomy followed by curative RT; adjuvant medical therapy could be scheduled for high-risk patients (N1b).

Adult↗
PubMed1980

Retroperitoneal metastases from ovarian carcinoma: reassessment of 365 patients studied with lymphography.

From 1973 through 1978, 365 patients with ovarian carcinoma were evaluated with lymphography. The extent of disease was assessed by clinical and conventional radiologic examinations, peritoneoscopy with visualization of diaphragmatic leaves, peritoneal cytology, and, in some patients, exploratory laparotomy. The highest incidence of metastases was found in advanced stages (31.1% in stage III and 60% in stage IV) and in recurrences (75.9%). In 87 patients with early disease, the incidence was 9.2%. In 36 pretreated patients with no evidence of disease, this incidence was 11.1%. Biopsies of the nodes were performed in 96 patients: radiologic accuracy was confirmed in 33 of 33 positive and in 55 of 63 negative cases. Of the patients, 33% had metastases only in the pelvic nodes, and 7.9% only in the paraaortic nodes; in 79.1%, both chains were involved simultaneously. These data confirm the importance of lymphography in diagnosis, treatment planning, and surveillance of ovarian carcinoma.

Adenocarcinoma↗
PubMed1978

Bronchial involvement by Hodgkin disease.

Two cases of Hodgkin disease, lymphocyte depletion type, with bronchial involvement are described. One patient revealed involvement of the right upper lobar bronchus, the other patient of the left main bronchus. The correct diagnosis was made by fiberbronchoscope examination with cytologic brushing and biopsy. That bronchial involvement by Hodgkin disease is very rare is confirmed by the literature, where only 20 cases have been so far reported.

Bronchial Neoplasms↗
PubMed1976

Natural history and survival of inoperable breast cancer treated with radiotherapy and radiotherapy followed by radical mastectomy.

This retrospective study evaluates the time and site of relapse as well as the median survival of 454 consecutive patients with T3-T4 Nx Mo breast cancer treated with radiation therapy from 1968 to 1972. Radiotherapy was delivered with kilovoltage to the first 221 patients and with cobalt to 233 patients, respectively. A group of 133 selected patients was subjected to radical mastectomy 6-8 weeks after completion of the irradiation. The incidence of first relapse was 45% within the first 18 months from starting radiotherapy. The incidence of relapse was higher in presence than in absence of regional adenopathy, with no statistical difference between T3 and T4. Inflammatory carcinoma showed the highest percent of relapse during the first 12 months (48%). The relapse rate appeared independent from type of irradiation. The site of first relapse occurred more often (68%) in areas distant from irradiation fields. Sterilization of both primary tumor and regional nodes was obtained only in 10% of patients. The median survival for the whole series was 2.5 years, with no significant difference between roentgen therapy (3 years) and cobalt (2.5 years). Unfavorable survival was directly related to the presence of regional adenopathies (2.3 years), especially in the supraclavicular fossa (1.4 years) and of inflammatory carcinoma (1.2 years). Patients treated with radiotherapy followed by surgery showed a median survival of 3.9 years compared to 2.1 years for those given only irradiation. The importance of sequentially combining chemotherapy with radiotherapy is discussed.

Breast Neoplasms↗
PubMed1975

Endolymphatic radiotherapy in malignant lymphomas: its potential "prophylactic" value in cases with negative lymphograms.

From 1961 to 1969 426 patients (208 with Hodgkin's disease and 218 with non-Hodgkin's lymphoma) underwent endolympatic radiotherapy with Lipiodol 131I at the National Cancer Institute of Milano. For this study, only those patients with stage I, II, or III disease (with or without systemic symptoms), who were not previously treated, and who had a complete follow-up were reviewed. It appears that while in the cases where there is lymphographic evidence of involved lymph nodes, endolymphatic radiotherapy is not of value, in the cases with apparently negative lymphography, endolymphatic radiotherapy can reduce the incidence of relapse in the inguino-retroperitoneal nodes to a statistically significant degree.

Abdomen↗
PubMedDate not supplied

[Correlations between clinical control and histopathologic findings in breast cancer after irradiation and radical mastectomy (author's transl)].

154 cases of breast cancer (30 T1-52; 124 T3-54) treated by irradiation followed by radical mastectomy were subjected to histological revision in order to check the efficacy of radiotherapy in the local control of cancer and to seek correlations between the histological findings and the clinical course of the disease. The tumor disappeared completely only in 24% of cases, the percentage being higher in the initially smaller tumors; the axillary lymph nodes showed disappearance of the metastases in a still smaller proportion of cases, namely 15-20%. Only in 16 cases (10% of cases) were the histological findings negative both at mammary and axillary levels. X-ray therapy and cobalt therapy were of equal value in the local control of the disease, despite the higher doses of cobalt. The patients operated on after radiotherapy had a decidedly better survival rate than those treated with irradiation only, since the former were selected because of their better clinical course and operated on because of this. Of the operated patients those whose axillary histology was negative presented a higher survival rate (75% of patients living) than those whose findings were positive (53%). Factors of negligible importance prognostically were: complete sterilization at mammary and axillary level after radiotherapy, persistence of florid cancer tissue at mammary level and histiocytosis of the axillary lymph nodes. In short, the result of locoregional therapy, even when successful, was not crucial in the general control of the disease, especially in advanced locoregional breast cancer (T3-T4 with axillary metastases).

Adult↗
PubMedDate not supplied

[Cobalt therapy in the treatment of carcinoma of the oropharynx].

A clinical retrospective evaluation of 177 cases of carcinoma of the oropharynx treated with Cobalt therapy from 1959 to 1965 has been made. The analysis of long term results has shown that Cobalt therapy alone does not satisfactorily control carcinomas of oropharynx. In fact, less than 30% of the patients is still alive after 3 years. Survival is directly affected by the local extent of disease since, while the 5-year survival of T1 and T2 cases is respectively 26.8% and 21.5%, only 6.5% of patients with T3 carcinomas is still alive after 5 years. Particularly disappointing is the survival rate in cases with mono- or bilateral involvement of neck nodes, since none of these cases are alive 2 years after the initial therapy. In 69.4% of the cases, treatment failure has to be attributed to minimal response or early recurrence of primary tumor, while lymph node relapses have been observed in more than 25% of the cases. To allow a detailed clinical evaluation of the results, the different regions of the oropharynx should be considered separately, since differences in clinical evolution of various carcinomas would call for a different therapeutic approach. The results of this study in oropharyngeal carcinomas, indicate that improvement of long term results may only be obtained through a multidisciplinary therapeutic approach.

Cobalt Radioisotopes↗
PubMedDate not supplied

Small size T4 breast cancer. Natural history and prognosis.

The clinical records of 66 patients with T4 (for skin infiltration or ulceration) breast cancer not larger than 5 cm treated with primary radiotherapy at the Istituto Nazionale Tumori of Milan from 1968 through 1977 were reviewed. The tumor measured no more than 3 cm in 19 patients and 3-5 cm in 47 patients. In the first group axillary involvement was lower (32% vs 55%) and mean age was older (68 years vs 58). Thirty-four patients were irradiated with orthovoltage and 32 with cobalt, at full doses. In 22 of 66 patients (33.3%) a Halsted radical mastectomy was carried out after completion of radiotherapy. No medical treatment was planned. The incidence of locoregional and distant metastases was the same in both groups of patients, but that of patients with smaller T4 (up to 3 cm) demonstrated a better prognosis in terms of absolute survival at 5 years (71.3% vs 34.7%). T4 breast cancer of 3-5 cm had very poor results quite similar to those of historical large series of T4 carcinomas of any size; therefore they should be treated by the same aggressive combined modality approach adopted for locally advanced breast cancer. On the contrary, small T4, up to 3 cm, in older women could be treated by tumorectomy followed by radiotherapy at full doses; systemic medical therapy (hormonal manipulation or chemotherapy) should be decided according to endocrine receptor investigation and general conditions.

Adult↗
PubMedDate not supplied

Adult granulosa cell tumor of the ovary: a clinico pathologic study of 35 cases.

AIMS AND BACKGROUND: Adult granulosa cell tumor has a low malignant potential but requires an extensive follow-up of more than 5 years to accurately assess tumor activity. The aim of the present study was to evaluate the clinical characteristics, the treatment and the outcome of this rare ovarian tumor. STUDY DESIGN: A retrospective review of 35 cases treated at primary onset of disease during a 23-year period from 1971 to 1993. RESULTS: The disease-free survival rate for stages IA-B-C at 5 and 10 years was 90% and 84%, respectively; for stages III-IV the 5-year freedom from progression rate was 16%. CONCLUSIONS: The most important prognostic factor appears to be the extent of tumor involvement outside of the ovary.

Adolescent↗
PubMedDate not supplied

Radio-chemotherapy of anal cancer.

Conventional treatment of anal cancer has been the demolitive Miles operation for decades. Radiotherapy has been utilized in a limited number of centers for early cancers only. Radio-chemotherapy has become the treatment of choice for all stages of anal cancer after the first experiences by the group of Detroit and after the confirmation of successful results by many other centers. Infusional chemotherapy (5-FU and Mitomycin C or CDDP) and concurrent irradiation are able to achieve local control in more than 80% of patients. Surgery currently represents a rescue treatment for partial responders or in relapsing patients. A brief review of the literature and the experience at the Istituto Tumori in Milano are presented.

Anus Neoplasms↗