The efficiency of treatment in patients with uterine-confined endometrial cancer.

AIM: To present our experience regarding the efficiency of treatment in patients with uterine-confined endometrial cancer. PATIENTS AND METHODS: 775 patients with uterine-confined endometrial cancer (UCEC) were treated between July 1985 and June 2000 in the Krakow Branch of Sklodowska Memorial Institute. RESULTS: Among the 775 patients, 5-year disease-free survival was observed in 82.8% patients; 96% patients with low risk of disease recurrence, 93.6% patients with intermediate risk and 78.3% patients with high risk survived five years with no evidence of disease. In the group with a high-risk disease recurrence rate, 5-year disease-free survival was statistically higher among patients treated with adjuvant brachytherapy plus external beam radiotherapy (EBRT) in comparison to patients treated with adjuvant brachytherapy (BRT) alone (82.4% vs 72.1%). CONCLUSIONS: The recommended treatment in patients with high and moderate differentiation of UCEC with FIGO Stage IA is surgery alone. Surgery with adjuvant EBRT in the group of patients with intermediate risk of cancer recurrence allows over 90% of patients to be cured. In the group of patients with a high risk of disease recurrence adjuvant BRT with EBRT is statistically more efficient in comparison to BRT alone.

[Radiotherapy for stage III, inoperable, asymptomatic small cell lung cancer. Final results of a prospective randomized study (240 patients)]. / Radiothérapie du cancer bronchique non à petites cellules de stade III, inopérable, asymptomatique. Résultats définitifs d'un essai prospectif randomisé (240 patients).

PURPOSE: To report the results of a prospective randomized study concerning the role of radiotherapy in the treatment of stage III, unresectable, asymptomatic non-small cell lung cancer. MATERIAL AND METHODS: Between 1992 and 1996, 240 patients with stage III, unresectable, asymptomatic non-small cell lung cancer were enrolled in this study, and sequentially randomized to one of the three treatment arms: conventional irradiation, hypofractionated irradiation and control group. In the conventional irradiation arm (79 patients), a dose of 50 Gy in 25 fractions in five weeks was delivered to the primary tumor and the mediastinum. In the hypofractionated irradiation arm (81 patients), there were two courses of irradiation separated by an interval of four weeks. In each series, patients received 20 Gy in five fractions in five days, in the same treatment volume as the conventional irradiation group. In the control group arm, 80 patients initially did not receive radiotherapy and were only observed. Delayed palliative hypofractionated irradiation (20-25 Gy in four to five fractions in four to five days) was given to the primary tumor when major symptoms developed. RESULTS: The two-year actuarial survival rates for patients in the conventional irradiation, hypofractionated irradiation and control group arms were 18%, 6% and 0%, with a median survival time of 12 months, nine months and six months respectively. The differences between survival rates were statistically significant at the 0.05 level. CONCLUSION: Although irradiation provides good palliation, the results are disappointing. The comparison of conventional and hypofractionated irradiation shows an advantage for conventional schedules.

Altered therapy schedules in postoperative treatment of patients with malignant gliomas. Twenty year experience of the Maria Sklodowska-Curie Memorial Center in Kraków, 1973-1993.

Results of altered therapy schedules obtained in postoperative treatment of 294 patients with malignant gliomas over last 20 years are presented. During this period 135 patients received Conventional Irradiation and Chemotherapy (CICH), 61 patients received Conventional Irradiation (CI), 59 patients received Split Course High Fractional Dose Irradiation (SCHFDI), and 39 patients received Twice a Day Accelerated Irradiation (TDAI). Actuarial survival rates at 2, 3 and 5 years were 19%, 7%, 0% respectively for patients treated with CICH, and they were 21%, 10%, 0% for CI group, 24%, 12%, 0% for SCHFDI option and 15%, 8%, 0% for TDAI schedule. According to the Cox proportional hazard model, only age was significant factor in prognosis.

[The prognostic significance of impaired vocal cord motility in patients with stage II glottic cancer treated with radiotherapy]. / Prognostyczne znaczenie ograniczenia ruchomosci faldów glosowych u chorych na raka glosni w II stopniu zaawansowania leczonych napromienianiem.

Eighty-five patients with stage II glottic laryngeal cancer were treated with radiotherapy in Center of Oncology in Kraków between 1973 and 1989. Fifty-five patients were irradiated with 60Co unit, 30 with mixed photon--electron beam. The 5-year survival rates without evidence of disease after the radiotherapy only were 65.9%, after the radiotherapy and surgery for recurrences--76.5%. The sex, age, local extension of primay tumour and vocal cord mobility were evaluated in a uni- and multivariate analysis of prognostic factors. For the end-point of 5-year survival without evidence of disease no statistically significant relationship was found between results and analysis variables, especially between survival and impaired cord mobility.

[Is gender a prognostic factor in early stages of laryngeal cancer treated by radiotherapy?]. / Czy plec jest czynnikiem prognostycznym w niezaawansowanym raku krtani leczonym napromienianiem?

Six hundred and thirty patients with stage I and II glottic and supraglottic laryngeal cancer were treated with radiotherapy in Center of Oncology in Kraków between 1973 and 1989. The 5-year NED survival rates after the radiotherapy only were 79%, after the radiotherapy and surgery for reccurrences--87.1%. Gender is not a prognostic factor in early stage laryngeal cancer treated with radiotherapy.

[Prognostic factors in patients with early stages of supraglottic cancer treated by radiotherapy]. / Czynniki prognostyczne u chorych na niezaawansowanego raka górnego pietra krtani leczonych napromienianiem.

Three hundred patients with early stage supraglottic cancer were treated with radiotherapy in Center of Oncology in Kraków between 1973 and 1989. The 5-year NED survival rates after the radiotherapy only were 82.9% in stage I, and 70%in stage II cancer, after the radiotherapy and surgery for recurrences--90% and 75% respectively. The stage and tumor site were an important prognostic factors in the treated group of patients.

[Radiation therapy in glottic laryngeal carcinoma stage. I. Results and analysis of prognostic factors]. / Teleradioterapia raka glosni w I. zaawansowania. Wyniki leczenia I analiza czynników prognostycznych.

Two hundred and forty-five patients with stage I glottic laryngeal cancer were treated with radiotherapy in Center of Oncology in Kraków between 1973 and 1988. One hundred and fifty-five patients were irradiated with Co-60 unit, 90 patients with mixed photon-electron beam. The 5-year NED survival rates after the radiotherapy only were 85.3%, after the radiotherapy and surgery for recurrences--95.1%. The sex, age, local extension of primary tumor (T1a vs. T1b), location of the tumor on true vocal cord and involvement of anterior commissure were evaluated in a uni- and multivariate analysis of prognostic factors. For the end-point of 5-year NED survival no statistically significant relationship was found between results and analysis variables.

Validation of a method of treating menorrhagia by endometrial ablation.

Menstrual blood loss was measured by intravenous injection of radioactive iron (59Fe) and whole-body counting in 19 women complaining of menorrhagia due to dysfunctional bleeding. Fifteen patients were then treated by radiofrequency endometrial ablation, after which blood loss was re-measured. The majority of the patients were bleeding excessively before treatment (mean 281 (SD 156) ml per cycle averaged over two cycles, range 49-665 ml, n = 19). In the 15 treated patients, average blood loss was reduced to 52 (SD 39) ml per cycle and the mean reduction in blood loss was highly significant (P < 0.001). These quantitative data correlate well with the patients' subjective reports.