[Results of curative chemoradiotherapy in patients with carcinomas of the anus]. / Výsledky kurativní chemoradioterapie u pacientu s karcinomy anu.

BACKGROUND: Anal carcinoma is a rare cancer. Surgical treatment is applied for small superficial tumors of the anal margin, the more advanced disease is treated with concomitant chemoradiotherapy. The aim of our study was to evaluate treatment outcomes in patients treated at the Masaryk Memorial Cancer Institute in 2006- 2010. PATIENTS AND METHODS: We reviewed the clinical data of 29 newly diagnosed adult patients (aged 40- 84, average 60.7, median 60.6 years) treated between 2006- 2010. Demographic parameters, tumorrelated variables, toxicity of treatment, overall survival were analyzed. RESULTS: Acute dermal toxicity G4 was observed in two patients, G3 in nine patients. Acute intestinal toxicity G4 was not observed in any patient, G3 in four patients. Acute urologic toxicity G3- 4 was not observed in any patient. Acute hematologic toxicity was observed: leukopenia G3/ G4 in 7/ 1 patients, neutropenia G3/ 4 in 9/ 4 patients, anemia G3/ 4 in no patient and thrombocytopenia G3/ 4 in 10/ 0 patients. Severe acute toxicity G3- 4 was observed more frequently in patients treated with concurrent chemoradiotherapy. Chronic dermal toxicity G2 was observed in two patients, G1 in four patients, chronic intestinal toxicity G1 was observed in four patients. One patient had urethral stenosis and three patients had stenosis of anus without invasive solutions. One patient had osteoradionecrosis of the left pubic bone. The 5 years overall survival of all patients was 76%. We failed to demonstrate improved survival due to the small and heterogeneous file in the group of patients in clinical stage I and II compared with patients with clinical stage III disease, or better survival in the group of patients who received concomitant chemoradiotherapy compared with patients treated only with radiotherapy. CONCLUSION: Conservative treatment of locally advanced anal cancer is relatively well tolerated and safe treatment. Efficiency is comparable to surgical therapy, is also advantageous in terms of quality of life of patients due to the sphincter preservation.

Pilot study of sole conformal peroperative interstitial brachyradiotherapy of early stage breast carcinoma using high-dose rate afterloading.

In this study of high-dose-rate brachyradiotherapy to the lumpectomy site as the sole radiation are documented a three-dimensional treatment planning and preliminary results of accelerated partial- breast irradiation. From March 2002 to July 2004 25 patients were prospectively included in this study. Six patients were excluded becuase of definitive histology of lobular carcinoma or positive margin. The median age was 63.2 years (range: 44-77 years). Median follow-up of all patients is 11 months (range: 3-25 months) with a minimum follow-up of 3 months. Radiation was delivered using the high-dose-rate remote afterloader VariSource with [192]Ir source. The patients received radiation twice a day at least 6 hours apart for a total of 10 fractions over five days with a single dose of 3.4 Gy. The total dose was 34.0 Gy prescribed as a minimum peripheral dose to match or minimally exceed the volume defined by the surgical clips as seen on CT scans. Freehand technique allows conformal placement of the catheters to the shape of the lumpectomy cavity. We use the method of geometric optimalisation which allows the calculations of dose distribution in relation to target. At a median follow-up of 11 months none of patients developed in-field breast recurrences, one patient had out-of-field recurrences. There were no regional nodal recurrences. At each patient, there was calculated target volume size in cm3 (median 91.3 cm3) dose volume histogram (DVH), dose homogenity index (DHI). Median DHI was 0.42. Median volume of breast tissue getting 100% of the prescription dose, V(100), is 87%; and V(150) 48.5%. We have noticed two treatment complications: hematoma and abscess in the place of tumorous bed after exstirpation. At last follow-up, patients rated the overall cosmetic outcome excellent. This method is suitable just for patients with histologically confirmed small tumors (<3 cm in diameter) without negative prognostic factors for local recurrence (age at least 40 years, negative surgical margins, nodal involvement - maximum three positive nodes without extracapsular extension).

[Concomitant radiochemotherapy in solid tumors]. / Konkomitantní radiochemoterapie solidních nádoru.

The need for improved cancer control led to the investigation of combined-modality therapy for many cancers. This review is an attempt of analysis of possibilities to apply simultaneously both treatment modalities in treatment of cancer diseases and shows the possible mechanism of interaction between chemotherapy and radiotherapy. Further in this review is showed benefits of this method combined therapy and strategies of using chemotherapy and radiotherapy to treat different cancers.

[Abnormal placement of the testes]. / Polohové anomálie varlat.

The authors defined a uniform classification of abnormal positions of the testes. They recommend also a uniform therapeutic procedure: after the first year of life treatment with human chorionic gonadotropin in one or two curves, if orchiopexy fails.

[Neonatal levels of 17-hydroxyprogesterone--early diagnosis of adrenogenital syndrome]. / Neonatální hladiny 17-hydroxyprogesteronu--raná diagnostika adrenogenitálního syndromu.

The authors submit the results of 17-hydroxyprogesterone estimations in serum of healthy neonates after birth and during the first days of life. The 17-hydroxyprogesterone level declines markedly after birth to the fourth day after birth in infants of both sexes. The levels recorded in infants above 4 days (8.4 +/- 3.4 nmol/l) will serve as normal values in the diagnosis of adrenogenital syndrome caused by the block of 21-hydroxylase steroids. Estimation of 17-hydroxyprogesterone in umbilical blood cannot be used for the diagnosis of AGS in neonates.

[Effect of interruption on the prognosis of children from the following pregnancy]. / Vliv interrupce na prognózu detí z následujícího tehotenství

PIP: An analysis of the rates of neonatal fatility was made for the 10th district of Prague. Statistics showed that 50% of all neonatal fatalities occurred in newborns under 1000 gm of weight and that 60% of these fatalities occurred in women with artificial interruption of pregnancy in their history. On the basis of these statistics, abortion is considered to be 1 of the factors involved in the inability of women to carry pregnancies to full term. Perinatal mortality was also found to be worse in this district of Prague as opposed to rural districts. It was assumed that this is due to the higher number of abortions performed in the urban areas.^ieng