Biomedical subjects

R Ragona

Publications and source records attributed to R Ragona.

59 records · Page 4Linked to original sources

PubMedDate not supplied

[Results of interstitial curietherapy and combined transcutaneous radiotherapy-curietherapy in 150 patients with carcinoma of the tongue and/or mouth floor].

The authors report their experience on the treatment of carcinoma of the oral tongue and floor of the mouth with interstitial brachytherapy, alone or in combination with external irradiation. One hundred and fifty patients were treated; among these, 116 with brachytherapy alone, 34 with combined treatment. The five years local control in those patients treated with brachytherapy alone was 72.5% in T1, 61.2% in T2 and 35% in T3; in those patients treated with external irradiation and brachytherapy the global five years control was 42.5%. The global five years survival was 64% in the patients treated with brachytherapy alone and 48% in the patients treated with combined therapy.

Adult↗

PubMedDate not supplied

[Percutaneous treatment of hilar cholangiocarcinoma completed by high-dose rate brachytherapy. Experience in the first 5 cases].

Cholangiocarcinoma at the confluence of the hepatic ducts (Klatskin tumor) is a slowly growing malignancy with early onset of symptoms and poor outcome since surgery allows radical resection in only a minority of cases. Percutaneously placed biliary stents offer a good palliation, but tend to obstruct after 6-8 months; then, retreatment requires exchange of the endoprosthesis or establishment of a permanent external-internal biliary drainage which offers, in some patients, a relatively long survival. Percutaneous intraluminal HDR brachytherapy might be a valid alternative as a definitive therapy or as a method to keep metallic stents patent for a long time. Five patients with hilar cholangiocarcinoma, diagnosed by means of ultrasound, Computed Tomography, percutaneous transhepatic cholangiography and transluminal biopsy, underwent double percutaneous external-internal biliary drainage. Dummy sources were introduced into the drainage catheters to allow dose distribution planning. The stepwise progression of the miniaturized high activity Iridium source inside the applicators, introduced into the drainage catheters, was controlled and monitored by a computer equipped with dedicated software. In the radiotherapy bunker, using the remote loading technique, percutaneous intracavitary high dose rate brachytherapy was delivered at the rate of 750 cGy per fraction, prescribed at 1 cm from the center of the catheter, once a week, for 4 weeks. Nevertheless, only 4 of 5 patients underwent the complete treatment. In one case, radiation treatment was discontinued after the first session because of digestive bleeding from a duodenal ulcer, supposingly as a consequence of the decubitus of a catheter tip. CT demonstrated rapid progression of the disease with neoplastic spread to the omentum and gallbladder wall thickening; a gallbladder malignancy was then suspected and the patient was no more eligibile for brachytherapy. Subsequently, Carey-Coons endoprostheses were inserted to prevent post-actinic strictures and removed after three months. After completing radiation therapy, control cholangiograms demonstrated in all cases improvement of neoplastic strictures. The first two patients we treated show no signs of tumor recurrence at 4 and 1 months, respectively, after endoscopic removal of the stents. The third patient is still bearing 2 Carey-Coons endoprostheses to be removed after 3 months. The last patient with supposingly partial success of bracytherapy, was treated with two Strecker nitinol stents.

Aged↗

PubMedDate not supplied

[High-dose-rate brachytherapy. The indications, technic and preliminary results].

The authors report their experience of high dose brachytherapy technique (HDR), relative to the first period of work, especially regarding treatment indications and preliminary clinical results. Twenty eight patients were examined, 12 of them with esophageal carcinoma, 7 biliary tract carcinoma, 6 skin of the face and 3 head and neck carcinoma. HDR brachytherapy was the first treatment in 20 cases; the other 8 cases were recurrences after previous irradiation. The HDR treatment had a curative purpose in 15 patients and was palliative in the other 13. Brachytherapy doses ranged from 20 to 30 Gy for curative treatments, with 4-8 fractions; 1 fraction was used for palliative radiotherapy, with doses from 5 to 10 Gy. The results were satisfactory. Local control was achieved in 5/6 patients affected with cholangiocarcinoma of the biliary tract and in 6/6 patients with skin neoplasia. In esophageal cancer, 9/12 patients treated with palliative, disobstructive purpose, showed dysphagia remission in 89% of the cases; the remission was maintained in 7 patients (78%), with 9 months median follow-up. HDR brachytherapy was then proved, during this first period of clinical application, as a valid and safe therapeutic method. It also allowed to extend the application field of brachytherapy, with new indications, as in esophageal neoplasias and biliary tract carcinomas.

Adult↗

PubMedDate not supplied

[Absorbed doses in dental radiology].

The growing use of dento-maxillo-facial radiographic examinations has been accompanied by the publication of a large number of studies on dosimetry. A thorough review of the literature is presented in this article. Most studies were carried out on tissue equivalent skull phantoms, while only a few were in vivo. The aim of the present study was to evaluate in vivo absorbed doses during Orthopantomography (OPT). Full Mouth Periapical Examination (FMPE) and Intraoral Tube Panoramic Radiography (ITPR). Measurements were made on 30 patients, reproducing clinical conditions, in 46 anatomical sites, with 24 intra- and 22 extra-oral thermoluminiscent dosimeters (TLDS). The highest doses were measured, in orthopantomography, at the right mandibular angle (1899 mu Gy) in FMPE on the right naso-labial fold (5640 mu Gy and in ITPR on the palatal surface of the left second upper molar (1936 mu Gy). Intraoral doses ranged from 21 mu Gy, in orthopantomography, to 4494 mu Gy in FMPE. Standard errors ranged from 142% in ITPR to 5% in orthopantomography. The highest rate of standard errors was found in FMPE and ITPR. The data collected in this trial are in agreement with others in major literature reports. Disagreements are probably due to different exam acquisition and data collections. Such differences, presented comparison in several sites, justify lower doses in FMPE and ITPR. Advantages and disadvantages of in vivo dosimetry of the maxillary region are discussed, the former being a close resemblance to clinical conditions of examination and the latter the impossibility of collecting values in depth of tissues. Finally, both ITPR and FMPE required lower doses than expected, and can be therefore reconsidered relative to their radiation risk.

Adolescent↗

PubMedDate not supplied

Angiogenesis: prognostic significance in laryngeal cancer.

The aim of this study was to evaluate the role of angiogenesis in the progression of laryngeal squamous cell carcinoma (LSCC). We correlated disease-free survival with microvessel count (MC) in the hot spot areas of 97 randomly selected caucasian males with LSCC followed for 60 to 90 months after surgery with or without radiotherapy. The results obtained indicate that: a) MC higher than 130 microvessels/mm2 is a cut-off value that distinguished patients who relapsed during the follow up period; b) multivariated analysis indicates that MC (p < 0.00001) is an independent predictor of disease free-survival; c) multivariated analysis selectively done on cases with relapse demonstrates that MC correlates with the presence of metastasis (or/and M) with local relapse (T). We suggest that MC is useful in the assessment of prognosis in LSCC and probably will permit selection of patients that could benefit from anti-angiogenic therapy associated with chemotherapy and/or radiotherapy.

Adult↗