RESUMO
Our purpose was to evaluate a pharmacological and dietary protocol of prophylaxis and treatment of acute actinic esophagitis during mediastinal radiotherapy. This phase II study was conducted on 29 patients affected by cancer not directly involving the esophagus. The irradiated volume included at least 10 cm of esophagus with a median dose of 46 Gy and the incidence of clinical acute esophagitis was scored with RTOG-EORTC tables. During the entire course of radiation therapy all patients were subjected to prophylaxis pharmacological therapy in addition to dietetic rules commonly used. All patients were evaluable, 9 (31%) had no acute esophageal toxicity, 20 (69%) had toxicity of degree 1, and no patient showed a toxicity of degree 2, 3, or 4, there were no toxicity-related related interruptions of the radiotherapy course. In conclusion, this low cost protocol seems to reduce the incidence and degree of acute radiation esophagitis (without added morbidity), compared with literature reports.
Assuntos
Esofagite/prevenção & controle , Lesões por Radiação/complicações , Doença Aguda , Esofagite/dietoterapia , Esofagite/tratamento farmacológico , Esofagite/etiologia , Humanos , Mediastino , Estudos ProspectivosRESUMO
Pelvic radiotherapy almost always induces intestinal symptoms. We investigated the radiation-induced damage to the small intestinal mucosa and evaluated its relationship with symptoms, using cellobiose/mannitol permeability test (CE/MA) and plasma postheparin diamine oxidase test (PHD) in 20 patients treated with pelvic radiotherapy. The symptoms developed during radiotherapy were noted. Intestinal permeability significantly (p=0.013) increased from 0.021 +/- 0.026 to 0.047 +/- 0.055 (mean +/- SD) after 15 days of radiotherapy, while it returned to normal values (0.010 0.015) at the end of radiotherapy. PHD values did not change. All patients developed intestinal symptoms. These findings indicate that pelvic radiotherapy induces an early small bowel mucosa damage followed by mucosal adaptation. Acute intestinal symptoms during pelvic radiotherapy may not depend only on small intestinal mucosal damage.
Assuntos
Enteropatias/etiologia , Intestino Delgado/efeitos da radiação , Pelve/efeitos da radiação , Lesões por Radiação/etiologia , Neoplasias Retais/radioterapia , Neoplasias do Colo do Útero/radioterapia , Idoso , Amina Oxidase (contendo Cobre)/sangue , Permeabilidade Capilar/efeitos da radiação , Celobiose/metabolismo , Diarreia , Feminino , Humanos , Enteropatias/enzimologia , Enteropatias/patologia , Mucosa Intestinal/enzimologia , Mucosa Intestinal/patologia , Mucosa Intestinal/efeitos da radiação , Intestino Delgado/enzimologia , Intestino Delgado/patologia , Masculino , Manitol/metabolismo , Pessoa de Meia-Idade , Náusea , Lesões por Radiação/enzimologia , Lesões por Radiação/patologia , Neoplasias Retais/sangue , Neoplasias Retais/urina , Neoplasias do Colo do Útero/sangue , Neoplasias do Colo do Útero/urinaRESUMO
We evaluated the effect of increasing doses of gamma-irradiation on the release of interleukin-4 (IL-4) and interferon-gamma (IFN-gamma) from lymphocytes, and interleukin 1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha) from monocytes. The most radiosensitive populations were the T lymphocytes which release IL-4 and IFN-gamma after irradiation alone. This release increased when the cells were activated by polyclonal activators such as Concanavalin A (Con A). Monocytes irradiated and stimulated with lipopolysaccharide (LPS) released TNF-alpha with values near those of the control cells. Con A produced no effect. The release of IL-1 beta decreased as the irradiation dose was increased, while stimulation with LPS and Con A caused a greater IL-1 beta increase after small irradiation doses. The results obtained show that minimum doses of irradiation can induce significant alterations in an amplified and unbalanced immunologic response through release of cytokines.
Assuntos
Citocinas/metabolismo , Linfócitos/metabolismo , Linfócitos/efeitos da radiação , Monócitos/metabolismo , Monócitos/efeitos da radiação , Sobrevivência Celular/efeitos da radiação , Concanavalina A/farmacologia , Humanos , Interleucina-1/metabolismo , Cinética , Lipopolissacarídeos/farmacologia , Linfócitos/efeitos dos fármacos , Monócitos/efeitos dos fármacos , Doses de Radiação , Fator de Necrose Tumoral alfa/metabolismoAssuntos
Patela/anormalidades , Feminino , Humanos , Pessoa de Meia-Idade , Patela/diagnóstico por imagem , RadiografiaRESUMO
The post-surgical radiotherapy of breast cancer and its problems are discussed and an account is given of recent trends in this field. The use of fast electrons is regarded as an optimal form of management for the chest wall, and the ipsilateral subscapular and internal mammary lymph gland chains.
Assuntos
Neoplasias da Mama/radioterapia , Elétrons , Neoplasias da Mama/cirurgia , Feminino , Humanos , Metástase Linfática/radioterapia , MastectomiaRESUMO
The anatomical and physiological premises of liver scintigraphy with radiocolloids as a useful study in patients suffering from various stages of breast cancer are analysed. A series of 111 cases is then reported. The technique was used on these cases one or more times and revealed the presence of a scintigraphic picture suggesting liver metastasis in 36% of cases (27.5% at first observation). These data proved higher than those previously reported in the literature by other workers. The technique is therefore proposed as a routine investigation in patients suffering from breast cancer.
