Radiation-induced breast cancer in women with Hodgkin's disease.

AIM AND BACKGROUND: The aim of this study is to analyze the main clinical and pathologic characteristics of radiation-induced breast carcinomas (BC) following treatment for Hodgkin's disease (HD) and to identify the risk factors for their induction. To create a mathematical model for the prediction of expected age at which a BC might develop based on the age at treatment for HD. MATERIALS AND METHODS: Thirty-nine cases of women with BC that developed after treatment for HD in puberty or adolescence were analyzed retrospectively. The median age at initiation of treatment for HD was 12.9 years (9-21). The median age at diagnosis of the second malignancy - breast carcinoma was 32.4 years (22.9-39). RESULTS: THE DISTRIBUTION OF PATIENTS ACCORDING TO THE CLINICAL T STAGE OF BREAST CANCER WAS AS FOLLOWS: 11 patients with T1 stage BC (28%), 22 with T2 stage (56%) and 6 with stage T3 (16%). Prevalent were tumors localized in the lateral breast quadrants. The observed 5 year survival was 95%. CONCLUSION: The risk of solid tumors, especially breast cancer, is high among women with HD disease who were treated with radiotherapy in their childhood. In this article, we propose a specific mathematical age formula which could be used as predictive equation when the age of the treatment for HD is in the range between 9 and 21 years. Systematic screening for breast cancer in these patients would be significantly important for their health and could improve their survival.

Degree of tumor regression after preoperative chemo-radiotherapy in locally advanced rectal cancer-Preliminary results.

AIM: The aim of this investigation is to determine the degree of tumor regression by histopathological evaluation of surgical specimen after neoadjuvant chemo-radiotherapy for patients with stage IIIB rectal cancer. BACKGROUND: The standard therapy for rectal carcinoma is surgical, however, preoperative radiochemotherapy will play an increasing role especially in locally advanced disease. To estimate the prognosis and the effect of radiochemotherapy the postradiochemotherapeutical pathological features are important to assess. MATERIALS AND METHODS: Ten patients with cT3-4, cN1 stage rectal cancer received preoperative chemo-radiotherapy. A total tumor dose of 50 Gy was applied to all patients, with a daily fraction of 2 Gy, 5 times a week, with concomitant Capecitabine 1650 mg/m(2). A pathomorphologic assessment of the therapeutic response of the residual tumor volumes and estimation of tumor control were performed using Dworak's system of tumor regression grading (TRD) from no regression (0) to a complete tumor control (4). RESULTS: Dworak's TRD for the examined patients is as follows: in 20% of the patients no tumor regression was observed - Grade 0, in 30% - Grade 1, in 20% - Grade 2 and in 30% a complete tumor regression was achieved - Grade 4. Four of the patients (40%) presented with borderline resectable tumors before the neoadjuvant chemo-radiotherapy. Nine of the patients (90%) underwent radical surgery. In one case (10%) a radical surgery was not possible. One patient (10%) developed severe radiation enteritis in both the early and late postoperative period, with her tumor regression evaluated as Grade 4. CONCLUSION: Accurate evaluation of local tumor control using Dworak's tumor regression grading scale after preoperative chemo-radiotherapy gives the basis for a larger investigation and search for a correlation with the prognosis of the disease and individual choice of adjuvant treatment.