[Radiotherapy of non-neoplastic diseases: the situation in Piedmont]. / La radioterapia delle affezioni non neoplastiche: la situazione in Piemonte.

The authors report the results of a census among the Piedmont region radiation therapy departments during the period 1980-1991 concerning non antineoplastic radiotherapy. Eight out of eleven centers respond to the questionnaire. During the period considered 36,480 patients were treated, with an annual mean of 4056; the number of treated patients varies from 1.2% to over 71.3% in the different centers when compared to the number of neoplastic patients. Arthrosis, osseous angioma, cheloides and verruca were the most treated diseases. Plesioroentgentherapy and roentgentherapy were normally employed; telecesium and telecobalt therapy were also used; only two centers used electron beams or brachytherapy. The doses of radiotherapy were not uniform; also patients' information and follow-up criteria were quite different in the various centers. The authors conclude with a guidelines for future radiotherapy in benign diseases.

[The importance of using computed tomographic scanning in breast irradiation after conservative treatment]. / L'importanza dell'utilizzazione delle scansioni con Tomografia Computerizzata nell'irradiazione della mammella dopo trattamento conservativo.

Conservative surgery followed by radiotherapy is the current treatment of choice for primary breast cancer: indeed, this protocol ensures local control, relatively good cosmetic results and NED survival values similar to those of more invasive surgery. Radiotherapy requires the optimization of the irradiation technique to minimize the dose to the organs at risk. To this purpose, 30 patients submitted to quadrantectomy for breast carcinoma and then to radiotherapy on the residual breast were examined, January through December, 1994, at the Radiotherapy Service of the Ivrea Hospital, to investigate if CT can help optimize treatment planning, sparing as much of the pulmonary tissue underlying the residual breast as possible. Our series of patients was then compared with a literature series whose treatment had been planned only on the mapping of body outline. Some interesting considerations follow from our results: 1) With CT, larger fields can be used than those used with the body outline, so that the planned target volume can be more closely approached; 2) Larger fields can be used because the critical organ included in the irradiation field is more correctly and precisely defined; 3) The comparison with the literature shows that in the past the fields were larger, because the target volume and the critical organ were more difficult to define. The use of larger fields means a higher dose to the lung and thus maybe a higher risk of radiation pneumonia.

[Injury of the large vessels of the neck caused by radiation of neoplasms of the otorhinolaryngologic region: a study using Doppler echography]. / Danno indotto sui grossi vasi del collo da irradiazione di neoplasie del distretto O.R.L.: studio mediante eco-Doppler.

Twelve patients undergoing radiotherapy for pharyngo-laryngeal neoplasms were compared to a control group by means of duplex-Doppler US in order to evaluate early and late radiation-induced damage to the main arterial vessels in the neck region. On first examination the case distribution regarding the presence/absence of preexisting vascular lesions was: no lesions (8.3%), mild (33.3%), moderate (16.6%), and severe (41.6%) atherosclerotic lesions. The subjects included in the control group presented with similar characteristics, so that they had similar features to the patients undergoing radiotherapy. While no early complications were demonstrated, development and/or progression of parietal lesions were detected 1 year after the first examination in 58% of patients. No variations were observed in the control group. Radiation-induced damage to the arterial wall was subdivided into 2 groups: moderate (42%) and severe (16%). Damage to neck vessels, though allowing for the small number of patients and the short follow-up, has to be referred to radiotherapy, since no changes were detected in the control group. In the authors' opinion, follow-up by means of hematochemical exams and duplex-Doppler US of the neck is advisable to evaluate general risk factors and to select those patients who can fruitfully undergo surgical treatment.

[Radio-chemotherapy of inoperable malignant brain gliomas]. / La radio-chemioterapia dei gliomi cerebrali maligni inoperabili.

Numerous studies have proved the benefit of the use of postoperative radiotherapy in the treatment of malignant cerebral gliomas. The data concerning the efficiency of the treatment of unoperated gliomas are rather scarce. The data obtained in 28 cases of malignant cerebral gliomas, defined as inoperable and treated with radio-chemotherapy, are reported. The diagnosis was obtained through radiological and bioptic examination (21 out of 28). Using a proper treatment with cortisone "dexamethasone" at a dose of 8-16 mg/day, with telecobaltotherapy, we have reached in almost all cases (26 out of 28) doses of 60 Gy, without significant side-effects. All patients were given BCNU as chemotherapy at a dose of 80 mg/m2 every 8 weeks. The resulting average survival rate of 36 weeks, verified through CT, confirms the validity of radio-chemotherapeutical treatment. This type of treatment has been proved useful not only for prolonging the life of these patients, but also improving the quality of their life.