[Radiotherapy in the combined therapy of limited stage pulmonary microcytoma. The experience of the Department of Oncologic Therapy at the Multiregional Hospital of Varese (1980-1989)]. / La radioterapia nel trattamento integrato del microcitoma polmonare a malattia limitata. L'esperienza della Divisione di Radioterapia Oncologica dell'Ospedale Multizonale di Varese (1980-1989).

From January 1980 to December 1989, 86 patients with limited small cell lung carcinoma (SCLC) were treated in our Institution. Sixty-eight of them were males, 18 females; mean age was 58 years (range: 40-74); Karnofsky index was 80 or higher. All patients received induction multiagent chemotherapy (CAV or CAVE), usually fractionated into 3/4 cycles. Radiotherapy was administered by means of a 10 MV Linear Accelerator, 2-3 Gy/day, 5 days/week. Radiation dose was 60 Gy for 39 patients, 50 Gy for 25 patients, and 30 Gy for 22 patients. Parallel opposed fields (AP and PA) were used for administering the 30-Gy dose, while higher doses were delivered by multiportal arrangement (3/4 fields). Overall survival (corrected Kaplan-Meier) was 21.3% and 13.4% at 2 and 3 years, respectively; 2 years' survival according to dose was 24.5% for 60 Gy, 19.9% and 11% for 50 and 30 Gy, respectively. Mean survival time (MST) was 14 months for 60 Gy, 13 months and 10 months, respectively, for 50 and 30 Gy. Survival and disease-free survival rates were similar in patients who received 50 and 60 Gy. No major complications related to irradiation were observed, not even in the group receiving the highest dose. Our data are similar to those reported in the literature.

Proposed evaluation scale for damage to healthy tissues as a result of radiotherapy of chest, head and neck cancers.

The authors present, as a criterion of side-effect damage, an evaluation scheme based on the qualitative grading of the acute, intermediate and late effects of the therapeutic irradiation of chest, head and neck cancers. The choice of individual qualitative clinical criteria is complex and arbitrary, although the parameters used are currently found in the literature on radiotherapy. Nevertheless the classifications they have proposed, applied clinically in cases of head and neck cancers, have proved useful in assessing the risk factors of acute and late radiation effects according to the doses delivered. The gradings here described constitute a useful tool for the preliminary assessment of radiation damage and will facilitate the comparative analysis of different case series.

[Radiotherapy as a single local regional treatment of non-oat cell carcinoma of the lung]. / La radioterapia come unico trattamento loco-regionale nei carcinomi polmonari non microcitomi.

The records of 168 patients treated by definitive radiation therapy for non-oat-cell-carcinoma of the lung in the Radiotherapy Department of the "Ospedale Regionale Multizonale" of Varese, Italy, from may 1979 to december 1984, were analyzed. Cumulative probability of survival from the beginning of radiotherapy were 48 +/- 4% at 12 months and 8 +/- 3% at 60 months. It appears to be no significant difference in survival according to TNM classes, UICC stages, histology and grading. Significant differences in survival were found grouping patients by performance status (I.K. less than 70 v.s. greater than or equal to 70), total absorbed dose (dose less than 56 Gy v.s. greater than or equal to 56 Gy), total isoeffect levels (CRE less than 17 reu v.s. greater than or equal to 17 reu), and response to treatment. The latter could be the most important prognostic factor. Median survival for CR, PR and NC categories were 48.5, 12 and 10 months respectively. We suggest that RT may be of value in improving quality of life and survival of patients affected by non operable non-oat-cell-carcinoma of the lung.

[Beam radiotherapy in treatment of thyroid carcinoma (author's transl)]. / La radioterapia a fascio collimato nella programmazione terapeutica dei carcinomi della tiroide.

There is a particular variety of therapeutic resources for thyroid carcinoma (surgery, radioiodine treatment, external radiotherapy, chemotherapy, hormonotherapy) with some peculiar characters for each of these. Just for this fact the clinic indications and the value of each of these therapies aren't easy. The authors study a group of 156 patients with thyroid carcinoma, selected among the patients treated with beam radiotherapy at the Istituto del Radio "O. Alberti" of Civil Hospitals of Brescia from 1960 to 1977. The aim of this paper is to give an help to the definition of the value of external radiotherapy given to thyroid carcinoma and to their spreading in regional lymph nodes. The analysis of the clinical findings has allowed to state some factors which affect the prognosis of these tumors: pathology, age, hormono-dependence, radioiodine trapping. According to these factors, separately evaluated for each pathological variety of thyroid carcinoma, has been possible to state the rules for which we can advice the use of external radiotherapy in the treatment of these tumors.