[Morphine--myths and facts]. / Morfina--mity i rzeczywistosc.

Morphine in the form of opium tincture accompanies the mankind for several thousands years. At the beginning of the twentieth century morphine has been isolated from opium and it was used initially to treat ... opium addicts. At present it plays an important role in the treatment of severe pain of different origins and (more seldom) in the premedication for general anaesthesia. Despite its side effects it is irreplaceable especially in the treatment of cancer pain. Nowadays the chronic use of oral morphine preparations has been supported by medical authorities who at the same time warn against incorrect dosage and combination with other drugs. Many clinical data concerning oral morphine show that it is safe and effective even in the patients with advanced cancer and poor performance status. Our paper lists myths and common mistakes connected with morphine use and confronts them with well established facts confirming its effectiveness in cancer pain treatment.

[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.

[A case of Hodgkin's disease with an uncommon clinical course. Predominant localization in the liver]. / Przypadek ziarnicy o nietypowym przebiegu klinicznym. Przewazajaca lokalizacja w watrobie.

A 26 year old woman with systemic symptoms typical for Hodgkin's disease was admitted to The Oncology Clinic of the Medical Academy in Cracow in may 1988. Markedly elevated values of hepatic enzymes were observed. Infectious and autoimmune diseases were excluded. Although the diagnosis was not confirmed by histopathologic examination, MOPP chemotherapy was administered "exiuvantibus". Complete remission was obtained for two years. In 1991, when the patient relapsed for the second time, FNA biopsy of a hypogenic focus in the liver revealed Hodgkin's disease. In the sixth year of observation an enlarged supraclavicular lymph node appeared. Histopathologic examination of the node confirmed Lymphogranulomatosis-typus mixtus. The patient completed treatment in 1993 and since then she remains disease-free, with the overall observation period of 8 years.