Preoperative radiotherapy of rectal cancer--influence of fractionation and dose.

BACKGROUNDS/AIMS: We have been focused on patients with preoperative irradiation and compared two modes of radiotherapy, short-term (15 days) and long-term (45 days). METHODOLOGY: Monitored group of 183 patients who had undergone a preoperative irradiation between 01/01/1998 and 12/31/2002 were irradiated in two modes: with a dose of 45Gy applied in 25 fractions/1.8Gy per fraction (CFD45) and a dose of 34.5Gy in 15 fractions/2.3Gy per fraction (CFD34.5). RESULTS: No statistically significant difference in the occurrence of acute and postoperative complications, of locoregional recurrences and secondary dissemination, was mentioned in either group. In patients irradiated with CFD34.5 amputation of the rectum followed in 55%, and unlike the group irradiated with CFD45 the percentage of amputations was significantly lower (42%). We have recorded the average 5-year overall survival (OS) in those irradiated with CFD4.5 in 54% versus 61% in those irradiated with CFD45. More considerable conclusion was made comparing a 5-year disease-specific survival (DSS) versus the mode of irradiation, CFD34.5 57%, versus CFD45 71%. The significance level reached 10% (p = 0.057). CONCLUSIONS: Pre-operative irradiation of the rectal cancer with the dose of 45Gy in 25 fractions/dose of 1.8Gy per fraction is a standard recommended procedure.

[Paraneoplastic cerebellar degeneration associated with ovarian cancer: anti-Yo immunoreactivity in autoptic cerebellum and ovarian carcinoma]. / Paraneoplastische Degeneration des Kleinhirns bei Ovarialkarzinom Anti-Yo-positive Immunreaktivität der Kleinhirn- und Tumorzellen.

Paraneoplastic cerebellar degeneration is a rare disorder caused likely by autoimmune mechanisms in malignant oncologic diseases, and the most common tumors are ovarian, breast, lung cancer, and m. Hodgkin. An immune reaction is supposed to be directed against identical antigens of cerebellum and tumor, and paraneoplastic antibodies called anti-Yo, anti-Hu, anti-Ri, or anti-Tr are often detected in blood and cerebrospinal fluid. The course of paraneoplastic cerebellar degeneration as a complication of ovarian cancer is described. The relationship between the malignancy and pathologic changes in cerebellum was confirmed by positive immunohistochemical and immunofluorescence reaction between a patient's anti-Yo-positive serum and her own Purkinje's and ovarian cancer cells.

[Risk assessment of irradiation of tissue with metal implants]. / Odhad rizika ozarování tkáne s kovovými implantáty.

Authors examine the influence of metal implants on the distribution of ionizing radiation in tissue. In vivo measurements in a patient are seldom possible. The risk can be assessed with sufficient accuracy on the basis of various experimental dosimetric methods, histological changes in the irradiated volume and the tolerance to the physical stress, published in the available literature. The analysis shows that the risk of significant dose inhomogeneity or the treatment toxicity is minimal if mentioned principles are adhered to. Radiotherapy indications and dosage should not be markedly changed on the basis of the presence of metal in the irradiated volume.