RESUMEN
During the last decade radiotherapy, in combination with chemotherapy, has become the treatment of choice in cure of anal carcinoma with preservation of anal function, and has replaced abdominoperineal resection (APR). From 1979-1990 54 patients with anal carcinoma were treated by radiotherapy. 24 patients received radiotherapy after APR (12 adjuvant, 12 after recurrence). 11 received palliative radiotherapy without prior APR. 19 patients were treated curatively, 17 of whom received a combination of external irradiation followed by interstitial iridium implantation in a split course regimen. 11 of the 19 patients received short simultaneous chemotherapy (mitomycin C and 5-fluorouracil). All 19 patients had a complete remission. 18/19 patients had no local recurrence after mean 14 months' follow-up. 2 patients developed regional recurrence. 3 patients died of other causes. Colostomy was necessary in 5/19 patients with anal necrosis which was dose-related. The maximum tolerated dose was 71.4 Gy. Our results support the recommendation in the literature of primary, curative, radiotherapy and chemotherapy of anal carcinoma with preservation of the anal sphincter.
Asunto(s)
Neoplasias del Ano/radioterapia , Braquiterapia/métodos , Carcinoma/radioterapia , Adulto , Anciano , Anciano de 80 o más Años , Canal Anal/efectos de la radiación , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias del Ano/tratamiento farmacológico , Neoplasias del Ano/cirugía , Carcinoma/tratamiento farmacológico , Carcinoma/cirugía , Terapia Combinada , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Various conventional and modern fluoroscope units had been examined with an anthropomorphic phantom to determine the applied average organ doses. The aim of our investigation was to compare these doses with those normally delivered to the patients during a conventional X-ray examination of the thorax. As was to be expected, the doses resulting from conventional fluoroscopic units are much higher than the doses from modern units. As shown by means of our measurements, the efforts of advanced technology permit to reduce the dose rate up to a factor of 30. I.e., the doses resulting from modern fluoroscopic units are even smaller than the doses received during a conventional thoracic X-ray examination, what means a great improvement for this examination technic.