RESUMEN
To improve the results of treatment of locally advanced malignant tumors we performed different types of combined radio- and chemotherapy, which are mostly applied in neo- and/or adjuvant or parallel regimens, and have significant toxic effect on hemopoiesis. For the last years we have used dicarbamin, a natural hemoprotector from the group of pseudopeptides. Good outcomes have been achieved in its ability to reduce frequency of hematological complications in patients with locally advanced lung cancer and Hodgkin's disease treated by combined radio- and chemotherapy.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Imidazoles/uso terapéutico , Neoplasias/tratamiento farmacológico , Sustancias Protectoras/uso terapéutico , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Caproatos , Quimioterapia Adyuvante/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias/patología , Radioterapia Adyuvante/efectos adversos , Estudios RetrospectivosRESUMEN
One hundred-thirty seven patients with recurrences and metastases of skin melanoma (stage II-III) were divided into four groups in a retrospective study. In group I, there was no adjuvant therapy (47); it was given for 35 +/- 5 days after surgery in group II (31); for 1-2 days after surgery in group III (31). In group IV, neoadjuvant therapy (NAT) was administered by way of preparing for surgery and adjuvant therapy (41). During both procedures, standard CVD regime of cytostatics pre-incubated in patients' autoblood was used: it involved distant gamma-therapy with single focal dose of 3Gy-total dose of 40 isoGy per primary focus and areas of regional metastasizing spread. The rate and nature of tumor progression being similar, signs of skin melanoma generalization correlated with terms of adjuvant therapy administration: in group I, cell dissemination was detected after 8.7 +/- 2.3 months; group II - 9.5 +/- 1.5 months; group III - 18 +/- 3.1 months (p < or = 0.05 groups I and II); group IV - 28 +/- 2.3 months (p < or = 0.05 for all groups), respectively. Use of NAT and urgent adjuvant therapy is expedient at advanced stages of skin melanoma.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Melanoma/patología , Melanoma/terapia , Terapia Neoadyuvante/métodos , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/terapia , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Quimioterapia Adyuvante , Ciclofosfamida/administración & dosificación , Dacarbazina/administración & dosificación , Progresión de la Enfermedad , Fraccionamiento de la Dosis de Radiación , Femenino , Humanos , Metástasis Linfática , Masculino , Melanoma/tratamiento farmacológico , Melanoma/radioterapia , Melanoma/cirugía , Persona de Mediana Edad , Recurrencia Local de Neoplasia/diagnóstico , Recurrencia Local de Neoplasia/epidemiología , Estadificación de Neoplasias , Neoplasia Residual/diagnóstico , Neoplasia Residual/epidemiología , Radioterapia Adyuvante , Estudios Retrospectivos , Neoplasias Cutáneas/tratamiento farmacológico , Neoplasias Cutáneas/radioterapia , Neoplasias Cutáneas/cirugía , Procedimientos Quirúrgicos Operativos/efectos adversos , Resultado del Tratamiento , Vincristina/administración & dosificaciónRESUMEN
Data on sonographic features of different variants of skin melanoma are presented. Relationship between skin to tumor thickness ratio and invasion depth (Clark) or tumor thickness (Breslow) were found. Tumor extent was effectively identified by ultrasound tomography of primary focus preoperatively. Such patterns of melanoma blood supply as "avascular" (superficial tumor) and "vascular" (node-like tumor) were established. A "tree-like" vascular pattern was typical of melanoma in color Doppler imaging. Tumor with such pattern had poor prognosis.
Asunto(s)
Melanoma/irrigación sanguínea , Melanoma/diagnóstico por imagen , Neoplasias Cutáneas/irrigación sanguínea , Neoplasias Cutáneas/diagnóstico por imagen , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ultrasonografía Doppler en Color/métodosRESUMEN
The role of radiotherapy in multiple modality treatment of Wilms' tumor is evaluated in 225 children aged 3 months to 11.5 years (mean age 3.5 years) with stage III-IV. 184 (81.8%) patients presented with stage III, 93.7% with typical nephroblastoma. Intervention was combined with drug and radiotherapy in 99.6% patients. Exposure of the abdominal cavity in total focal doses of 10.5-50.2 Gy (mean dose 28 Gy) was carried out in 219 (97.3%) of 225 patients. Special attention is paid to the incidence of relapses, remote metastases, and survival of patients in relation to prognostic factors (sex, age, stage of tumor process, terms of exposure, and total focal doses). All patients were followed up for 2-203 months (median 32 months). During this period relapses and/or metastases were observed in 34.2% patients; 30.2% died because of disease progress. 35.1% children live without signs of disease for more than 5 years, 14.7% for more than 10 years. Relapses were more incident during the first year of treatment (in 65% children) and outside the exposed field (72.5% cases). 33.2% patients with stage III developed metastases after 1-49 months; the lungs were involved most often. Prolongation of the period between surgery and exposure of the abdominal cavity led to increase in the incidence of relapses in the abdominal cavity from 6.7% (up to 2 weeks) to 21.9% (more than 1 month), p = 0.02. Relapses were the most frequent in children aged over 4 years. This parameter virtually did not depend on the total focal dose. The absence of relationship between the incidence of local relapses and life span after exposure to a total focal dose of up to 21.6 Gy in comparison with higher doses recommends reduced doses for therapy without notable deterioration of the survival of patients with nephroblastoma.