Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]
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Comparative Study
[Does primary tumor affect the prognosis in postmastectomy locoregional recurrence in breast carcinoma?].
Prognosis following locoregional recurrence of breast cancer after mastectomy often is described as fatal. However, certain subgroups with better prognosis are supposed. We analysed established prognostic factors for their influence on post recurrence survival in order to discriminate favourable from unfavourable subgroups. ⋯ The mentioned prognostic factors may be useful in determining the adequate (local and systemic) therapy and the best time for it. Our data support previous findings, that certain subgroups with favourable prognostic features exist and they might still have a chance for cure by an adequate local treatment, whereas subgroups of patients with unfavourable prognostic factors have to receive systemic therapy immediately following local therapy because of the forthcoming systemic progression.
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Randomized Controlled Trial Clinical Trial
A prospective randomized study concerning the point A dose in high-dose rate intracavitary therapy for carcinoma of the uterine cervix. The final results.
High-dose rate (HDR) remote afterloading intracavitary therapy has been recognized as an effective and safe treatment modality for carcinoma of the uterine cervix. Since 1983, a prospective randomized study was started in order to investigate the more advantageous treatment schedule with keeping the local control rate. This paper reports the final results in terms of survival, local control and complications. ⋯ There were no statistically significant differences between 2 treatment schedules in survival rates, failure patterns and complications rates. This fact suggests that small number of fractions (7.5 Gy/fraction) may be advantageous because of short duration and a low load of treatment.
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Since volumetric dose distributions are available with 3-dimensional radiotherapy treatment planning they can be used in statistical evaluation of response to radiation. This report presents a method to calculate the influence of dose inhomogeneity and fractionation in normal tissue complication probability evaluation. ⋯ Combining NTD calculations and histogram reduction techniques, normal tissue complication probability can be estimated taking into account the most relevant contributing factors, including the volume effect.
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Treatment results were reviewed in a retrospective analysis and compared with literature data. Prognostic factors for freedom from relapse and overall survival were identified. ⋯ The optimal choice of treatment for patients with early stage Hodgkin's disease--combined modality treatment/radiotherapy alone/chemotherapy alone?--and for patients with advanced stages--consolidation radiotherapy?--remains an unresolved issue and needs further testing in large randomized trials considering acute and late complications. Staging laparotomy may be used only for a small group of patients who would receive radiotherapy alone as definitive treatment. Modifications of therapy clearly reduce the impact of negative prognostic factors.