RESUMO
Removable Iridium-192 implants provided a dose of 10 Gy/day or 41.5 cGy/hr at 0.5 cm from the center of 1.0 cm diameter tumors. The total radiation (x) alone was 20, 40 or 60 Gy, representing 2, 4, or 6 days of continuous radiation. The doses used for the combined treatments at elevated temperatures were 10, 20 or 30 Gy. The local tumor hyperthermia (LTH) treatment (43.6 for 35 min, water bath) was administered once for each 10 Gy of dose. The combined radiation + LTH was clearly superior to that achieved with radiation or LTH alone and yielded Thermal Enhancement Ratios (TER) of 3.4-3.9. Local tumor control rate was 67% and 89% for the 20 and 30 Gy x + LTH groups, respectively. A comparison of the results obtained in this study with those of earlier studies on the same tumor system indicate that the effects of Iridium-192 alone on this rapidly proliferating tumor were comparable to similar total doses of fractionated external beam radiation. Iridium + LTH produced a tumor response comparable to that achieved with external fractionated radiation + LTH. Combined treatment effect of elevated temperature appears to be less dose rate dependent in the range of 40 cGy/hr to 100 cGy/min and more dependent upon total dose accumulation.
Assuntos
Braquiterapia , Fibrossarcoma/radioterapia , Hipertermia Induzida , Irídio/uso terapêutico , Animais , Relação Dose-Resposta à Radiação , Fibrossarcoma/induzido quimicamente , Masculino , Metilcolantreno , Camundongos , Camundongos Endogâmicos BALB C , Transplante de Neoplasias , Radioisótopos/uso terapêuticoRESUMO
Gonadal dosimetry and spermatogenic activity was monitored in patients given radiation therapy (RT) after unilateral orchiectomy for seminoma. The RT given was, with minor variations, 3200 rad in 16 fractions in four weeks to the para-aortic and ipsilateral pelvic inguinal lymphatics in order to include the orchiectomy scar. The incidental amount of radiation to the remaining testicle averaged 78.4 +/- 7.4 rad and ranged from 32-178 rad as determined by thermoluminescent dosimetry. Induction of aspermia was documented in ten out of 14 patients who received over 65 rad to the gonad. At lower doses, aspermia may not have occurred or was of short duration. Recovery of sperm in the semen occurred in 12 patients within 30-80 weeks after start of treatment. The data suggest that the time of recovery may be dose dependent within the range of 19-148 rad. During the period of recovery, patients with oligospermic semen may be fertile and should be so advised.
Assuntos
Disgerminoma/radioterapia , Oligospermia/etiologia , Espermatogênese/efeitos da radiação , Neoplasias Testiculares/radioterapia , Testículo/efeitos da radiação , Adulto , Disgerminoma/cirurgia , Humanos , Masculino , Radioterapia/efeitos adversos , Dosagem Radioterapêutica , Contagem de Espermatozoides , Neoplasias Testiculares/cirurgia , Fatores de TempoRESUMO
The 11 patients in this study who received incidental gonadal irradiation from clinical therapy all became aspermic within 8-34 weeks following treatment. The estimated gonadal dose was 118-228 rads. Five of these patients have shown recovery of spermatogenesis; 3 of these have reached fertilizable concentrations. Recovery of semen sperm was noted at 44-77 weeks following treatment. The other 2 patients, after 110-176 weeks, have sub-fertile concentrations of semen sperm. Five patients have not been followed for a sufficient length of time to permit recovery to be noted.