Total Focal Dose Research Articles

Whether the intraoperative irradiation influences the life quality of lung cancer patients?

The life quality of patients with lung cancer after the intraoperative irradiation with a dose 15 Gy during the surgery (loband pneumonoectomies) for the period of two years has been studied. The form developed by the European Organization for Research and Treatment of Cancer EORTC QLQ-C 30 and the QLQ-LC 13 module were used. It is shown that the life quality of patients with lung cancer after combined therapy is determined mainly by the volume of surgery made, rather than by the adjuvant therapy conducted. Of great importance for patients was the period needed for the adaptation of the organism to new living conditions. In general, no significant differences in the main life quality indices were revealed among patients of both groups. Based on the results obtained, one can say that the addition of surgery with intraoperative radiotherapy with a total focal dose 15 Gy does not lead to the considerable worsening of life quality of patients and can be recommended for clinical application.

High-activity samarium-153-EDTMP therapy followed by autologous peripheral blood stem cell support in unresectable osteosarcoma

Despite highly efficacious chemotherapy, patients with osteosarcomas still have a poor prognosis if adequate surgical control cannot be obtained. These patients may benefit from therapy with radiolabeled phosphonates. Six patients (three male, three female; seven to 41 years) with unresectable primary osteosarcoma (n = 3) or unresectable recurrent sites of osteosarcomas (n = 3) were treated with high-activity of Sm-153-EDTMP (150 MBq/kg BW). In all patients autologous peripheral blood stem cells had been collected before Sm-153-EDTMP therapy. No immediate adverse reactions were observed in the patients. In one patient bone pain increased during the first 48 hrs after therapy. Three patients received pain relief. Autologous peripheral blood stem cell reinfusion was performed on day +12 to +27 in all patients to overcome potentially irreversible damage to the hematopoietic stem cells. In three patient external radiotherapy of the primary tumor site was performed after Sm-153-EDTMP therapy and in two of them polychemotherapy was continued. Thirty-six months later one of these patients is still free of progression. Two further patients are still alive. However, they have developed new metastases. The three patients who had no accompanying external radiotherapy, all died of disease progression five to 20 months after therapy. These preliminary results show that high-dose Sm-153-EDTMP therapy is feasible and warrants further evaluation of efficacy. The combination with external radiation and polychemotherapy seems to be most promising. Although osteosarcoma is believed to be relatively radioresistant, the total focal dose achieved may delay local progression or even achieve permanent local tumor control in patients with surgically inaccessible primary or relapsing tumors.

Application of Irradiated Bone Replants in Surgical Treatment of Osteogenic Sarcoma in Children

Ten children, aged 8-16, with osteogenic sarcoma received complex treatment which included distant gammairradiation in total focal dose of 36 Gy with chemotherapy (Pt drugs) and subsequent surgical intervention. Operation was performed 3-6 months after chemotherapy in case of stabilization of local tumor process and absence of metastases. Peculiarity of surgical tactics consisted in the following: in the operating room the resected bone with tumor (often it was the distal articular end of the femur) was subjected to single electronic bunch irradiation in 60 Gy dose and after that it was replanted. X-ray control showed that the reconstruction of irradiated replants implanted into irradiated tissues developed slowly and did not complete by the 3rd observation year. However, it did not prevent the replant from functioning as a prosthesis. In 30% of patients postoperative complications, i.e. suppuration, were noted. Four patients died. Six patients are alive, 4 out of them have follow-up period over 2 years and 2 patients over 3 years. Authors conclude that in appropriate indications and simulataneous irradiation autobone-replants can be used for the substitution of bone defects.