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[Plain abdominal film in neoplasms of the large bowel. - A comparative study with a population of normal subjects (author's transl)].

A comparative study was performed between plain abdominal films of 110 patients with neoplasms of the large bowel and 52 normal subjects for control. In neoplasms of the right colon the failed spontaneous visualization of caecum and ascendent colon or the direct recognization of lume's deformation allow us to suspect such a lesions in about 90% of the cases. Neoplasms of the other tracts of the large bowel may be suspected only when plain abdominal film demonstrates direct evidence of an obstruction: in about 25% of the cases.

Adult↗

Acute and late toxicity of patients with inflammatory bowel disease undergoing irradiation for abdominal and pelvic neoplasms.

PURPOSE: Little data exists in the medical literature describing the response of patients with inflammatory bowel disease (IBD) to abdominal and pelvic irradiation. To clarify the use of this modality in this setting, this study assesses the short- and long-term tolerance of 28 patients with IBD to abdominal and pelvic irradiation. METHODS AND MATERIALS: From 1970 to 1999, 28 patients with IBD (10 patients-Crohn's disease, 18 patients-ulcerative colitis) were identified and underwent external beam abdominal or pelvic irradiation. Mean follow-up time after radiation therapy was 32 months. Patients were treated either by specialized techniques (16 patients) to minimize small and large bowel irradiation or by more conventional approaches (12 patients). Acute and late toxicity was scored. RESULTS: The overall incidence of severe toxicity was 46% (13/28 patients). Six of 28 patients (21%) experienced severe acute toxicity necessitating cessation of radiation therapy. Late toxicity requiring hospitalization or surgical intervention was observed in 8 of 28 patients (29%). One patient experienced both an acute as well as late toxicity. For patients undergoing radiation therapy by conventional approaches, the 5-year actuarial rate of late toxicity was 73%. This figure was 23% for patients treated by specialized techniques (p = 0.02). CONCLUSIONS: Because of the potentially severe toxicity experienced by patients with IBD undergoing abdominal and pelvic irradiation, judicious use of this modality must be employed. Definition of IBD location and activity as well as careful attention to irradiation technique may allow treatment of these patients with acceptable rates of morbidity.

Abdomen↗

Surgical approaches and techniques in intraoperative radiotherapy for intra-abdominal, retroperitoneal, and pelvic neoplasms.

Eighty-five patients with locally advanced intra-abdominal, retroperitoneal, and pelvic malignant diseases have been treated at the National Cancer Institute (NCI) with electron beam intraoperative radiotherapy (IORT). In general, IORT was performed after resection to the tumor bed and to areas of locoregional spread. IORT was delivered directly to some unresectable tumors. The median survival for the entire NCI patient group was 13.9 months, with 34% of the patients projected to achieve local control of disease at 5 years. Multiple abutting IORT fields were used in 76% of the patients; they encompassed treatment areas as large as 569 cm2 and involved as many as five separate IORT applications. Multiple fields were matched along straight edges on the treatment applicators or provided by means of lead shielding strips. Areas of field overlap were prevented by the use of lead shields. Surgical approaches and radiotherapeutic techniques of multiple field matching have been developed and are detailed for carcinoma of the pancreas, carcinoma of the stomach, sarcomas of the retroperitoneum, carcinoma of the rectum, and tumors of the pelvic girdle.

Abdominal Neoplasms↗