[The current role of radiotherapy in immunogenic exophthalmos]. / Il ruolo attuale della radioterapia nell'esoftalmo immunogenico.

In this study, the value of radiation therapy was investigated in 41 patients with Graves' ophthalmopathy treated with orbital irradiation at the Radiotherapy Department of Mauriziano Hospital in Turin, 1986 through 1993. Our series consisted of 41 patients (32 women and 9 men), whose mean age was 53.6 years (range: 26-72 years). All patients had a high index of endocrine ophthalmopathy, based on the American Thyroid Association classification-NOSPECS classes III and IV. Irradiation was administered with two opposed convergent beams tilted posteriorly 5-10 degrees with 20 Gy/12 fractions/2 weeks. The total dose delivered to the lens was than 5%. The follow-up consisted of endocrinologic and ophthalmologic tests and, if possible, of pre/post-irradiation orbital US. A positive result was obtained in 31 patients, which was very good in 22 of them. Severe complications, i.e., 1 corneal ulceration and 3 cataracts, were observed in the patients with associated ocular conditions and were treated simultaneously with high-dose corticosteroids so that no direct and unquestionable correlation can be made between irradiation and complications. To conclude, our data show that radiation therapy can improve the signs and symptoms of Graves' disease, as many authors report.

[Neoplasia of the testis: surgical, radiological, and chemotherapeutic approach. Analysis and results of a retrospective study]. / Le neoplasie del testicolo: approccio chirurgico, radioterapico e chemioterapico. Analisi e risultati da un campione storico.

The Authors report the results of a retrospective study in patients with testicular cancer admitted to hospital between January 1979 and July 1991. A total of 59 cases of testicular cancer were treated: 42 seminomatous and 17 non-seminomatous. Radiotherapy was carried out with satisfactory results in patients with stage 1 and 2 seminoma (22 cases). A "wait and see" policy was adopted in 2 cases. The majority of non-seminomatous tumours underwent retroperitoneal lymphadenectomy followed by chemo- and/or radiotherapy (9 cases). Retroperitoneal lymphadenectomy plays a vital role in correct pathological staging and the evaluation of neoadjuvant chemotherapy.

[Prognostic factors in adenocarcinoma of the endometrium]. / Fattori prognostici nell'adenocarcinoma dell'endometrio.

We report the results of the combined use of surgery and radiation therapy in the treatment of endometrial carcinoma. From January 1974 to December 1989, 89 cases were treated by means of abdominal hysterectomy followed by external radiation therapy. Actuarial survival at 5 years is 100% for stage I, 75% for stage II, and 42.86% for stage III; stage IV patients could not be evaluated. Prognostic factors were statistically significant. In stages II and III survival rates were directly related to histological grading (G1: 90.91%; G2: 81.82%; G3: 25%) and to myometrial infiltration (M1: 85.71%; M2: 81.82%; M3: 70%). Generally, survival was related to age, and prognosis was better in younger patients (under 55) and depended on lymph nodal involvement (N-: 88.24%, versus N+: 25%). Vaginal and pelvic recurrences were 8 (10.1%), and deaths were 13. The identification of high-risk patients will make it possible to select an even more adequate treatment.

[Postoperative radiotherapy in endometrial adenocarcinoma]. / Radioterapia postoperatoria nell'adenocarcinoma dell'endometrio.

We present the results of the association of surgery and radiotherapy in endometrial adenocarcinoma. We have 151 cases of which we know FIGO classification, pTNM, histological grading and myometrium infiltration. Follow-up is considered between 6 months and 10 years. We report the survival graphic lines for a five year period relative to every single prognostic factor.

[Optimization of the radiotherapy dosage in vertebral metastases]. / Ottimizzazione della dose nella radioterapia delle metastasi vertebrali.

The authors describe the radiation therapy treatment planning used in the Department of Radiotherapy of Mauriziano Hospital, Turin, to treat bone metastases from various tumors. The study population consisted of 33 patients with vertebral metastases. Treatment with a 60Co therapy unit was performed following either a conventional or a concentrated schedule. The association of a direct posterior field and a rotational technique with the same center and swing angle varying from 120 degrees and 150 degrees is described. The dose percentage given with the two techniques, the field width and the arching angle variables related to depth and volume of the target are discussed. We present some examples elaborated with a dedicated computer by calculating the integral area dose to the whole body and to the target, towards the best treatment planning for every kind of treatment proposed in two groups of six patients with vertebral and sacral metastases. The technique allows a homogeneous dose distribution to the target, thus reducing the area dose to the whole body, which means good radiotherapeutic results.

[Role of radiotherapy in the treatment of carcinoma of the thyroid gland]. / Ruolo della radioterapia nel trattamento dei carcinomi della tiroide.

A series of 92 thyroid cancer patients treated in collaboration between the Nuclear Medicine and the Oncological Radiotherapy Departments of the Turin Mauriziano Hospital is reported. The age, sex, histotype and stage of the various groups of patients subdivided by therapeutic indications were analysed. In 17 patients, treatment was carried out for pain killing purposes on particularly painful secondary bone localisations with good results symptomatologically and from the point of view of functional recovery. In 21 patients with unfavourable histology who did not take up radioiodine, external radiation treatment was carried out for palliative reasons with, in some case, a lasting effect. In the other 44 patients although generally speaking, at advanced stages of the disease and often in the presence of invasive and anaplastic secondary manifestations, total survival with the two treatments combined was about 55% (24 cases) of whom 75% (18 cases) are alive 5 years later.

[Dosimetric study in vivo, using a computer, of Co-60 irradiation of patients with breast prosthesis made of silicone]. / Studio dosimetrico in vivo e a calcolatore di irradiazioni con 60Co di protesi mammarie in silicone.

This work studies the dose distribution through the chest wall in radiation therapy after mammary reconstruction with silicone prostheses. TLD experimental dosimetry has been done on patient with silicone prostheses, on patient without prostheses and on Alderson phantom. Various conditions of treatment have been theorically simulated on a computer. At least authors show the results evaluating the dose distribution through the chest wall, the skin and the local complications.

[Homogeneous dose distribution in the moving-strip technic]. / Omogeneizzazione della dose nella tecnica di moving-strip.

The moving-strip technique employing a 60Co beam, is used in radiotherapy for whole abdominal irradiation in ovarian tumours and lymphomas. With this technique the spread of received dose from single strip, around an average value, is very high. Our paper suggest a computerized method for a more homogeneous dose distribution in central strips and a lower dose in out-side tissues.