RESUMEN
After intubation for advanced, inoperable squamous carcinoma of the oesophagus, a prospectively controlled randomized trial was done to investigate the effect of radiotherapy (41 patients) or mono-chemotherapy (40 patients) or no further treatment (46 patients). Treatment had no significant effect on either palliation or survival (p < or = 0.7) and did not alter the natural history of the disease.
Asunto(s)
Carcinoma de Células Escamosas/terapia , Neoplasias Esofágicas/terapia , Esófago , Intubación , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma de Células Escamosas/tratamiento farmacológico , Carcinoma de Células Escamosas/mortalidad , Carcinoma de Células Escamosas/radioterapia , Neoplasias Esofágicas/tratamiento farmacológico , Neoplasias Esofágicas/mortalidad , Neoplasias Esofágicas/radioterapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cuidados Paliativos , Estudios Prospectivos , Tasa de SupervivenciaAsunto(s)
Misiones Religiosas/historia , Historia Moderna 1601- , Misioneros , Sudáfrica , Estados UnidosRESUMEN
Between 1978 and 1982, 88 patients were treated with radiotherapy at the University of the Witwatersrand Hospitals for carcinoma of the bladder. They were followed up for evidence of cystitis (i.e. frequency, urgency, nocturia, dysuria, haematuria). Those with persistent symptoms underwent cystoscopy. Biopsies were taken of areas suspicious of residual or recurrent tumour. The total incidence of late bladder complications was 11 (12,5%). Of these 11 patients, 6 had persistent or recurrent tumour. The implications of this are discussed.
Asunto(s)
Cistitis/etiología , Traumatismos por Radiación/etiología , Neoplasias de la Vejiga Urinaria/radioterapia , Femenino , Humanos , Masculino , Radioterapia/efectos adversosRESUMEN
Thirty patients, thought clinically to have ovarian tumours, were studied prospectively by pre-operative computed tomographic (CT) scans of the abdomen and pelvis. In six patients (20%) small metastases in mesentery, omentum and on subdiaphragmatic peritoneum were not detected by the scans. CT did not improve the accuracy of staging or assist the surgeons by drawing their attention to disease which they might otherwise have missed. Although CT gives an elegant demonstration of anatomy, it is not an alternative to extended laparotomy in patients with ovarian tumours.
Asunto(s)
Neoplasias Ováricas/patología , Tomografía Computarizada por Rayos X , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias Ováricas/cirugía , Estudios ProspectivosRESUMEN
A study to assess the role of computed tomography (CT) in the management of testicular seminoma showed that CT was of value in defining the extent of bulky abdominal disease at initial staging. After radiotherapy for Stage IIc disease, relapse by 1 year was common and predominantly extra-abdominal. Mediastinal relapse was detected by CT in the absence of raised serum tumour markers or changes on the chest radiograph. It was concluded that CT should be used at initial staging only to assess the volume of bulk disease shown by lymphangiography, that no benefit seemed to accrue from CT scanning of Stage I and IIa patients and that the follow-up of Stage IIb and IIc patients requires regular CT surveillance in the first year, irrespective of clinical status.
Asunto(s)
Disgerminoma/diagnóstico por imagen , Neoplasias Testiculares/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Terapia Combinada , Disgerminoma/patología , Disgerminoma/terapia , Humanos , Masculino , Estadificación de Neoplasias , Neoplasias Testiculares/patología , Neoplasias Testiculares/terapiaRESUMEN
A comparison has been undertaken between conventional radiographic imaging and computed tomography (CT) in 35 patients with testicular teratoma as part of an audit of our investigative approach to staging and follow-up. The CT examination included alternate cuts from the carina of the trachea to the lung bases as the thoracic assessment as well as the standard examination of the abdomen. Lymphangiography appeared to detect Stage IIa lesions better than did CT; however, CT was able to define the volume of abdominal disease more accurately. During the follow-up of Stage I patients, CT detected progressive disease in the absence of tumour marker elevation. Such progressive disease presented within 4 months in the majority of cases. The selective thoracic CT scanning conferred no advantage over whole-lung tomography, only one additional lesion being detected in 123 examinations. It is recommended that CT should be reserved for examining the area above the renal hila, for cases where lymphangiography is equivocal or positive, and that CT scanning of the abdomen in Stage I patients not receiving therapy should be repeated every 3 months following orchidectomy for the first year, irrespective of clinical status.
Asunto(s)
Teratoma/diagnóstico por imagen , Neoplasias Testiculares/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Humanos , Masculino , Métodos , Estadificación de Neoplasias , Tecnología Radiológica , Teratoma/patología , Teratoma/terapia , Neoplasias Testiculares/patología , Neoplasias Testiculares/terapiaRESUMEN
Thirty-five patients with Hodgkin's disease were staged with the aid of chest radiographs, bipedal lymphograms and computed tomography (CT) scans. Computed tomographic findings altered management in only two patients (6%) by indicating enlargement of their radiotherapy fields. After lymphography, five patients (14%) were changed from Stage II (clinical and CT staging) to Stage III, so altering their management. Because either technique may show more extensive disease, CT and lymphography are complementary. Computed tomography should be performed initially. If it reveals no abnormality in the lymphogram area, lymphography, too, should be undertaken. Inverted Y fields are easier to visualise and design from lymphograms than from CT sections.