[Recurrence of gynecologic malignancies after combined and primary radiotherapy. Incidence and lapse of time until the diagnosis is made]. / Rezidive gynäkologischer Malignome nach kombinierter und primärer Strahlentherapie. Häufigkeit und Zeitraum bis zur Diagnosestellung.

A group of 1018 patients with gynecological malignancies after a combined or primary radiation therapy was studied for frequency and space of recurrence. In the first three years after therapy in cases with cervical cancer 95%, in cases with endometrial cancer 82% and in cases of ovarian cancer 98% of all recurrences were diagnosed. In cases of cancer of the vagina, the tube and vulva all recurrences were observed within the first three years. By results obtained it is put up for discussion to replace "five-years-rate" by "three-years-rate" in cases of gynecological malignancies with exception of mammary carcinoma. Thereby the value of a model of therapy could be realized earlier than hitherto.

Radiosensitizing effect of medroxyprogesterone acetate on endometrial cancer cells in vitro.

From clinical experience it is known that medroxyprogesterone acetate (MPA) can increase the radiosensitivity of adenocarcinomas of the corpus uteri. This study investigates this phenomenon in vitro. Primary explants of highly differentiated adenocarcinomas were irradiated with or without pretreatment with MPA and compared with an untreated control group and to a group treated with MPA only. Cell culture itself was performed on an agarose medium in order to prevent overgrowth by fibroblasts. Untreated samples formed 43 +/- 5 clones, explants treated with MPA only produced 39 +/- 5 clones, a difference which was not statistically different; samples irradiated without pretreatment produced 16 +/- 8 and samples after combined treatment 9 +/- 3 clones (all values means +/- SD). This numeric reduction of cell growth through preirradiation treatment with MPA was statistically significant. The effect of MPA as a radiosensitizer may be due to its potential to prolong the radiosensitive G2 phase of the cell cycle. This effect of MPA may be useful also in other hormone-dependent tumors.

[Lead detoxication effect of a combined calcium phosphate and ascorbic acid therapy in pregnant women with increased lead burden (author's transl)]. / Uber die entbleiende Wirkung einer kombinierten Therapie mit Kalziumphosphat und Vitamin C bei erhöhter Bleibelastung in der Schwangerschaft. 10. Mitteilung über Schadstoff-Belastung und -Vorsorgeuntersuchungen.

In former papers it was stated that the fetus can be exposed a considerable burden by traces of heavy metals and that a combined therapy with calcium phosphate and ascorbic acid has a good detoxifying effect. In fourty lead-burdened mothers who were treated in this way the excretion of 5-aminolevulinic acid in urine decreased by 65%, the lead content of placenta by 90% and the lead content of mother's milk by 15% compared with a control group without treatment. The cadmium content of the placenta was reduced to 4% of the content in untreated mothers.

[The possibilities of optimal therapy of corpus uteri cancer (author's transl)]. / Uber die Möglichkeiten einer optimalen Therapie des Carcinoma corporis uteri.

During the years 1960-1974 out of 1002 patients with endometrial carcinoma 256 underwent primary surgery and 846 primary irradiation. The evaluation of the results of 4 different surgical methods showed despite a different distribution of the stages of the cancer that Werthein's operation and abdominal hysterectomy and adnexectomy with simultaneous lymphnodectomy had statistically significant better results than abdominal hysterectomy without lymphonodectomy. By surgery a 5 years survival time was achieved in 83.6% (214 cases) with a primary mortality rate of 0.39% and an incidence of histologically proved lymphnode-metastases of 6.78%. Out of the 846 patients with generally or locally inoperable endometrial carcinomas, who underwent primary intracavitary irradiation 411 (48.6%) achieved a 5 years survival time. After irradiation in 9.9% reversible reactions (severe proctitis and cystitis) and in 2% irreversible complications (fistulas) were observed. After an observation period of 5 years 625 of the total of 1002 treated patients (62.4%) were alive and free of symptoms.

[Histomorphologic examinations of bone marrow of patients with gynecologic malignoma before, during, and after radiotherapy (author's transl)]. / Histomorphologische Untersuchungen des Knochenmarks von Patientinnen mit gynäkologischen Malignomen vor, während und nach Bestrahlungstherapie.

The histomorphological changes in the bone marrow were investigated in 9 patients treated by primary irradiation for cervical cancer. Bone marrow specimens were obtained by the Yamshidi puncture technique from the spina iliaca posterior superior after radiotherapy with different radiation dosages, as well as four months after termination of radiotherapy. All patients showed disappearance of almost all the haematopoietic cells in the irradiated area and, with the exception of one patient, no repopularization of the bone marrow or fibrosis. The possible mechanisms leading to these results are discussed and comparisons with the international literature are drawn.

[Electronic data processing in irradiation of gyneocological cancer (author's transl)]. / Elektronische Datenverarbeitung in der Strahlentherapie gynäkologischer Malignome.

For statistical processing of data resulting from irradiation of gynecological cancer a system of EDP working off-line is presented. Not only healing and survival rates will be evaluated but also data about the morbidity of irradiated patients. Thereby the employed therapy should be improved. Moreover, the patient follow-up can be supervised by a special program with automatical summoning of negligent patients.

[Epidemiology of breast cancer in Austria (author's transl)]. / Zur Epidemiologie des Mammakarzinoms in Osterreich.

In cooperation with the Austrian National Institute for Statistics the incidence-rates of breast cancer in Austria in the period of 1971-1975 were investigated. The incidence-rate of breast cancer (50 new cases/year/100,000 women) is higher than the incidence-rate of cervical or endometrium carcinoma. The increasing risk of the higher age-groups, which is especially expressed by the incidence-rate of 145 in the age-group of 70 or more years, is pointed out. This findings are of great consequence to the system of preventive medical care. In urban areas the incidence of breast cancer seems to be higher than in rural district.

[Epidemiology of cervical cancer in Austria]. / Zur Epidemiologie des Gebärmutterhalskrebses in Osterreich.

In cooperation with the Austrian National Institute for Statistics the incidence rates of cancer of the cervix uteri in Austria in the period of 1971--1975 were investigated. Not only the different federal countries but also the political districts were concerned by this study. The main findings were a relative high rate of women less than 40 years of age and severe regional differences. Problems in the registration of incidence rates of cancer are pointed out.

[High dose gestagen therapy following primary radiation therapy of endometrial carcinoma (author's transl)]. / Hormonprophylaxe bei der Strahlenbehandlung des Korpuskarzinoms mit hochdosierten Gestagenen.

By a high dose gestagen therapy following primary radiation therapy of endometrial carcinoma it was possible to reduce the recurrence-rate 12 months after therapy in comparison with a control-group without gestagen therapy by more than 50%. Therefore this method is recommended not only for treatment of far advanced carcinoma of the endometrium but also as prophylactic therapy in cases of early endometrium cancer.

[Geriatric gynecology with special reference to malignant tumors]. / Geriatrische Gynäkologie unter besonderer Berücksichtigung maligner Tumoren.

After the enumeration of every single problem encountered in the geriatric gynecology, it has been proved, that the malignant tumors of such cases are of a special significance. according to the epidemiological facts of the Austrian Cancer-Registration-Statistics between the years 1971--1975 (even if the cancer of cervix uteri is excluded) more than 60% of the cases are still seen in the geriatric group. Increasing risk (by rate of incidence) of malignant tumors of internal genitals or the breast in aged women is also known and is proved to be very specific. Inspite of the progress won in geriatric surgical gynecology, the post-operative complications are still the negative factors, which limitate the success. Therefore today radiotherapy of the malignant tumors especially in geriatric-gynecological patients is gaining more and more importance.

[The significance of primary radiotherapy in cervical carcinoma in older women]. / Zur Bedeutung der primären Strahlentherapie des Zervixkariznoms älterere Frauen.

In spite of the increasing interest in geriatric-operative therapy primary irradiation therapy still has its important place in the treatment of cervical cancer in cases of higher age. About every third patient with cervical cancer belongs to the age group over 60 years, which is more or less excluded from operative therapy. The advantage of irradiation therapy is to be seen in the low post-therapeutic mortality and the remarkable survival and healing rates.

[Epidemiology of corpus carcinoma in Austria (author's transl)]. / Epidemiologie des Korpuskarzinoms in Osterreich.

The rates of endometrial carcinoma incidence in Austria were investigated for the period between 1971 and 1975 by the authors in cooperation with the Austrian National Institute of Statistics. The incidence of corpus carcinoma has increased also in Austria over the past decades, as may be seen from the ratio between corpus carcinoma and cervical carcinoma which is 1:1.9 at present. Age related incidence was studied, as well, with continuous growth in incidence having been observed along with growing age. In women aged between 60 and 69, corpus carcinoma was almost as frequent as cervical carcinoma, and it was predominant among women of 70 and above. The findings obtained from age group surveys have also suggested that irradiation therapy rather than primary surgery was required for more than 50 per cent of the patients reviewed.

Investigations on general immune reactivity in untreated cervical cancer patients.

74 patients with untreated cervical cancer (FIGO II and III) were skintested with a battery of recall antigens, and also sensitised and challenged with DNCB. A significant reduction of reaction to Tuberkulin, Varidase and also to DNCB was found in patients with stage III in comparison to healthy females of the same age group. Significant changes in immunoglobulin levels, increase of IgA and decrease of IgG were observed in the cancer patients. Serum lysozyme values were the same as in the control group.

[Multiple malignant tumours in gynaecology (author's transl)]. / Zur Multiplizität maligner Tumoren in der Gynäkologie.

At the radiotherapy unit of the Ist Department of Gynaecology, University of Vienna, 8500 malignant tumours were observed in the years 1950-1975. Multiple primary neoplasms were recorded in 204 of these cases (2.4%). In 76 women (37.2%) the double neoplasms were situated in the genital region (local multiplicity), whilst in 128 cases the second neoplasm was situated in a distant organ, with cancer of the breast predominating (61 cases = 29.9%). A third of the multiple neoplasms were diagnosed simultaneously, whilst in the remaining two thirds a peak occurrence in the first year before or after the diagnosis of the gynaecological neoplasm is observed. Seven cases of triple neoplasms are presented as a separate group. Our observations are compared with the appropriate literature.

[Radium treatment of primary vaginal carcinoma (author's transl)]. / Zur Radiotherapie des primären Vaginalkarzinoms.

Between 1951 and 1970, 263 cases with primary carcinoma of the vagina were observed at the Irradiation-Department of the Ist University Clinic of Obstetrics and Gynecology in Vienna. As method of choice the individual, fractioned and protracted Radium-Röntgen-Telekoalt-therapy is recommended. Of the 263 primary vaginal carcinomas 112 (42,5%) were cured. During the time mentioned in this report, we did not have any primary mortality; 24 women, however, could only be subjected to a palliative therapy, 20 patients died from an intercurrent disease and 20 women succumbed to a second carcinoma. Conclusively, the authors present a survey about the results in vaginal carcinoma.

[Primary radiation therapy of sarcoma of the uterus (author's transl)]. / Die primäre Radiotherapie des Uterussarkoms.

We report 24 cases of sarcoma of the corpus uteri treated by sole irradiation. The 5-year-survival-rate was 20,8%. The prognosis seems to be poor in this group treated by sole irradiation. Only inoperable cases of sarcoma of the corpus uteri ought to be treated by radiotherapy alone.

[Therapeutic results in sarcoma of the uterus (author's transl)]. / Behandlungsergebnisse beim Uterussarkom

60 cases of sarcoma of the uterine body were treated at the Ist Department of Obstetrics and Gynaecology, Vienna University, during the period 1960 to 1971. Treatment consisted of combined surgery and irradiation (37 cases), surgery alone (8 cases) and irradiation only (14 cases). The 5-year survival rate was 53.3%.

[Efficiency of primary radiotherapy in generally or locally inoperable carcinoma of the endometrium]. / Die Leistungsfähigkeit der primären Strahlentherapie beim allgemein oder lokal inoperablen Endometriumkarzinom.

The usual method of irradiation in the therapy of the carcinoma corporis uteri is described. It is stressed, that none but inoperable carcinomas were irradiated: this means, of course, a negative selection in disfavor of the radiotherapy. A report is given of 802 cases of carcinoma of the corpus uteri, treated by primary radiotherapy in the 1st University Clinic of Obstetrics and Gynecology in Vienna in the years 1950-1970. The 5-years-survival rate in this period was 50.4%. In the last half decade of this period the 5-years-survival rate of 300 patients went down to 48.6%. The reduction of this survival rate may be caused by the increasing age of the patients, who underwent therapy and is corresponding to world-wide experiences. Additive therapies like the "second-look abrasio" for early diagnosis of a local recidivation and the gestagen therapy for the prevention of metastatic carcinoma of the corpus uteri are discussed.