RESUMEN
Radiation therapy is performed in many different lung cancer situations, often in combination with chemotherapy and surgery. The indications for radiotherapy are limited disease in small cell lung cancer, postoperatively in not completely operated non-small cell lung cancer, medically inoperable lung cancer and not resectable locally advanced disease. Combined-modality approaches using various permutations of three treatment modalities, namely surgery, chemotherapy and radiotherapy, are currently under investigation. Palliative radiation therapy is able to reduce life-threatening symptoms from intrathoracic tumor as well as from distant metastases.
Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/radioterapia , Carcinoma de Células Pequeñas/radioterapia , Neoplasias Pulmonares/radioterapia , Carcinoma de Pulmón de Células no Pequeñas/cirugía , Carcinoma de Células Pequeñas/cirugía , Terapia Combinada , Árboles de Decisión , Humanos , Neoplasias Pulmonares/cirugía , Cuidados Paliativos , Dosificación RadioterapéuticaRESUMEN
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.