[Primary intraocular lymphoma--2.5 year follow-up]. / Pierwotny chloniak wewnatrzgalkowy--opis pacjenta w obserwacji 2,5-letniej.

PURPOSE: To present clinical manifestation, diagnosis and treatment of a patient with the primary intraocular lymphoma at 2.5 year follow-up. PATIENT AND METHODS: Phaco-PPV with silicone oil tamponade was performed in a 62 year old man with a diagnosis of recurrent bilateral uveitis of unknown etiology complicated by cataract. The creamy-yellow infiltrates were identified and aspirates were collected for immunocytochemical evaluation during the surgery--B-cell lymphoma was diagnosed. The results of additional tests--hematologic workup, head and orbit neuro-imaging--were within normal limits. The patient has been treated with regular intraocular injections of Methotrexate at a dose of 400 microg/0.1 ml to both eyes for 2.5 years. Regular routine ophtalmic examinations were performed during the said follow-up period. RESULTS: The lymphocyte infiltrations in both eyes regressed during therapy. The best corrected distance VA remained stable and was 0.2 in RE and 0.3 in LE (Snellen). The intraocular pressures and anterior segments in both eyes were normal. The new small lymphocyte infiltrates were observed in the fundi and were successfully treated with additional Methotrexate injections. Methotrexate treatment was augmented with a single laser endophotocoagulation in the LE and 2, 3-time argon laser photocagulation in both eyes. To date, there no systemic symptoms of the disease have been observed. CONCLUSIONS: Local chemotherapy with Methotrexate may be an effective and safe treatment of primary intraocular lymphoma. However, due to high potential for systemic and local spread, patients should be monitored on a regular basis by ophthalmologists and oncologists.

[Accelerated postoperative radiotherapy in patients with advanced larynx cancer]. / Przyspieszona pooperacyjna radioterapia u chorych na zaawansowanego raka krtani.

AIM: The aim of study was test efficacy of accelerated postoperative radiotherapy--concomitant boost in patients with advanced larynx cancer. METHODS AND MATERIALS: The prospective study included 112 patients with advanced larynx cancer after radical surgical treatment. Patients had postoperative radiation therapy, conventional (C) or accelerated (CB). RESULTS: The 3-year overall survival in CB was 59%, in C--58% (p = 0.2), 3-year locoregional control in CB--83%, in C--75% (p = 0.01), the 3-year disease free survival was in CB--72%, C--66% (p = 0.1). CONCLUSION: Concomitant boost postoperative radiation therapy did not improve overall survival, loco-regional control, disease free survival. Patients with close surgical margins, longer interval between surgery and radiation, high level of hemoglobin, T4 had benefit from accelerated radiotherapy.

[An analysis of factor influencing the outcome of patients with locally advanced larynx cancer]. / Analiza czynników rokowniczych u chorych z miejscowo zaawansowanym rakiem krtani.

PURPOSE: Results of treatment of locally advanced larynx cancer T3-4No-4 are unsatisfied. The aim of study is analysis of risk factors. METHODS AND MATERIALS: 112 patiens with larynx cancer after radical surgical treatment had postoperative radiotherapy (conventional or accelarated). RESULTS: The 3-year overall survival (OS) was 58%. Margin status and numer of risk factors had impast on OS. The 3-year locoregional control (LRC) was 80%. Number of risk factors, level of hemoglobin, overall tratment time and dose were significantly associated with LRC. Incidence of distant metastases was asssociated with G3 suamous cell carcinoma and index of nalignancy H. Glanz.

[Radiotherapy of age-related macular degeneration. Case reports]. / Radioterapia w starczym zwyrodnieniu plamki zwiazanym z wiekiem (AMD). Opis przypadku.

The radiotherapy is worth to remember in the most progression causes of AMD, when there is no possibility for application the modern methods of the treatment. We present cause of patient with bilateral advanced changes and low visual acuity in course AMD, who had applied rtg therapy and laser fotocoagulation. The right eye was radiated with foton beam energy 10 MeV using linear accelerator. Dosage of 9 Gy was delivered in 3 fractions through 5 days. In right eye we observed increase of visual acuity from 2/50 before treatment to 3/50 after 12 months, and 0.1 after the 48 months of radiation. The visual acuity in the left eye decreased from 0.2 to 2/50 after the 48 months. The improvement of acuity vision after rtg therapy allowed the patient self-dependence life.

Radiotherapy of skeletal metastases.

Radiotherapy plays an important role in treatment of bone metastases.
The mayor problem associated with bone metastases is pain, pathological fractures and a spinal cord compression. Radiotherapy is employed as a palliative treatment, mainly to relieve pain.
1.Radiotherapy with a single dose of 5-8 Gy/T is an efficient method of pain management especially in patients with bone metastases outside the vertebral column. This treatment can be provided as a day procedure.
2.Multi-fractionated irradiation - patients receive 20 Gy/T in 5 fractions or 30 Gy/T in 10 fractions. This is advocated for patients with metastases in the vertebral column or bones of the pelvis.
3.Half- body irradiation is designed for patients with multiple bone metastases. It's a single dose treatment. The upper half of body is irradiated with a dose of 6 Gy/T, the lower part with a dose of 8 Gy/T. Patients need a special preparation beforehand (steroids, hydratation) and hospitalization afterwards.