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86 Intralumenal brachytherapy in the treatment of bile duct carcinoma
s43 86
85 BRACHYTHERAPYOFORO-PHARYNGEALAREACANCER
Intralumenal of
A.V. Vazhenin, A.E. Klipfel Chelyahinsk Regional Oncologik
Ccntre,
Russia
During the last 10 years brachytherapy was carried out on 135 Patients with oral cavity cancer, 112 with tongue cancer, and 119 with cancer of the lips. Distant radiation was carried out in non-traditional fraction regimes with the Previous radiosensibiliwtion of metronidazol; intratumoural radiation - with sources “Cohalt-60”. Most of the Patients were in III tumour stage. 8X7-93.5% of Patients have reached resorhtion of neoplasms; 9.6-5.30/o of Patients - radiation ulcers; 5.9-O% of patients - radiation osteomyelitis. 3 years survival was reached at 87.5 f 1.9% in case of lip cancer, 70.5 f 1.8% in case of oral cavity tumour, and 59.7 f 1.9% in case of tongue cancer.
87 FOLLOW-UP RESULTS OF THE TREATMENT OF UTERUS CARCINOMA WITH REMOTE AETERLOADING USING “SELECTRON”
bile
brachytherapy duct
in
the
treatment
carcinoma.
B.Dolgushin, M.Nechushkin, M.Sushchikhina Cancer research Moscow. Russia.
Centre,
I patients with bile duct tumors unfit for radical surgery have been treated since 1988 by means of simple afterloading with %o - sources (the two first patients) or remote afterloading with high-active lgzIr source. Diagnostic and treatment processes included: 1. thranshepatic cholangiostomy insertion; 2. cytologycal or histologycal assay through cholangiostomy; 3. bile duct dilatation, more accurate determination of proxiand distal. tumor margins; 4. pretreatment mal topometry investigations with duct contrast and introduction of the catheter with dummy source into bile drain for the following implant reconstraction and treatment volume assessment; 5. dosimetry and radiobiological treatment planning. All the patients received only brachytherapy, one session during 100 hours in LDR-range or I fractions, 400 cGy daily, every day in HDR-range. The total dose of both regimes was estimated with a help of TDF-model as 4000 cGy. The target volume extention was from 40 mm to 80 mm, its diametr - from 20 mm to 40 mm. One of the main advantages of HDR-brachytherapy is the possibiliof forming the variable diameter treatment ty volume according to complex target margin by optimization. As a result one patient survided 4 years, one died in 1.5 years after treatment from there were no signs of bile duct heart desease, one patient died in 3.5 years tumor in autopsy, from metastases without local recurrence.
88 INITIAL EXPERIENCE WITH 125-I BRACRYTHRRAPY USING AN INTERACTIVR TRRATMSNT PLANNING SYSTEM FOR CHOROIDAL MALIGNANT MELANOMA IN TURKEY
L.Maryina, M.Niechushkin, R.Likhovetskaya Cancer Research Centre, Moscow, Russia.
6ZLER S.A.. ASTRARAN W.A.. LIGGETT P.R., ERYILDIRIM A., ALALIJF A., ~ZK~K s.. HAYDAMLU A.
SELECTRON gamma-units of Nucletron B.V. with ‘37Cs source has been in service in Russian Cancer Research Centre since 1983. The total number of patients with genital cancer who received intracavitary radiotherapy in radiological centres along the country with the use of SELECTRON units is 5146. In the course of the treatment on the basis of Quality Assurance programme dose control in points of interest was carried out for each irradiation procedure thus enabling necessary corrections to achieve required sum-up dose during the whole course. The immediate results showed clinically complete regression in 284 patients (88 s), partial regression in 12 (4%), no treatment effect in 14 (8%) cases. Analysis of recent treatment results for uterus cancer using SELECTRON in intracavitary radiotherapy showed 3-year survival in 240 cases (80%) without recurrence and metastases and 78%-survival for more than 5-year period. Tumours and near-by tissues showed effectiveness of 13’Cs irradiation to be no less than that of even more active ‘OCo. Ballshaped lslCs source used in combination with the inactive ones make it possible to produce optimal dose distributions depending on the tumour size. It is advisable to perform intracavitary irradiation for uterus cancer treatment, stages I-III, once a week with 12-15 Gy in point A whereby the number of cases of cistitis, rectitis, colitis and their severity degree went down. The SELECTRON properties enable easy programming, treatment control and necessary personnel protection without any special safety devices.
Uveal melanomas are most commonly managed by using enucleation and/or radiation therapy. Radiation therapy. Radiation therapy allows for retention of varying degrees of visual function, while yet maintaining local tumor control. Since 125-I is a low energy isotope, comparative dosimetry with more traditional isotopes demonstrates a trend toward increased radiation within the tumor and a decrease in radiation to normal ocular structures. We have used 125-I plaque therapy to treat 2 patients with choroidal melanoma first time in Turkey. The loading and treatment planning for radiation with multiple 125-I seeds was performed with Astrahan' s computerized interactive simulation system. Fundus photographs and CT scans were digitized to accurately locate the tumor. and the eye as well as the critical structures such as the optic disc. the fovea, and the lens crystallina. USC (University of Southern California) 10 ophthalmic plaques were selected to avoid excessive irradiation to the critical structures.Both patients had medium-sized melanomas of the choroid located posterior to the equator. Best corrected visual acuities were better than 2O/BO preoperatively. Both tumors demonstrated a decrease in size while eyes were maintaining the same visual acuities at three months after receiving 100 Gy irradiation to the apex at the time of surgery. No complications were encountered during surgery and shor-term follow-up.
85 BRACHYTHERAPYOFORO-PHARYNGEALAREACANCER
Intralumenal of
A.V. Vazhenin, A.E. Klipfel Chelyahinsk Regional Oncologik
Ccntre,
Russia
During the last 10 years brachytherapy was carried out on 135 Patients with oral cavity cancer, 112 with tongue cancer, and 119 with cancer of the lips. Distant radiation was carried out in non-traditional fraction regimes with the Previous radiosensibiliwtion of metronidazol; intratumoural radiation - with sources “Cohalt-60”. Most of the Patients were in III tumour stage. 8X7-93.5% of Patients have reached resorhtion of neoplasms; 9.6-5.30/o of Patients - radiation ulcers; 5.9-O% of patients - radiation osteomyelitis. 3 years survival was reached at 87.5 f 1.9% in case of lip cancer, 70.5 f 1.8% in case of oral cavity tumour, and 59.7 f 1.9% in case of tongue cancer.
87 FOLLOW-UP RESULTS OF THE TREATMENT OF UTERUS CARCINOMA WITH REMOTE AETERLOADING USING “SELECTRON”
bile
brachytherapy duct
in
the
treatment
carcinoma.
B.Dolgushin, M.Nechushkin, M.Sushchikhina Cancer research Moscow. Russia.
Centre,
I patients with bile duct tumors unfit for radical surgery have been treated since 1988 by means of simple afterloading with %o - sources (the two first patients) or remote afterloading with high-active lgzIr source. Diagnostic and treatment processes included: 1. thranshepatic cholangiostomy insertion; 2. cytologycal or histologycal assay through cholangiostomy; 3. bile duct dilatation, more accurate determination of proxiand distal. tumor margins; 4. pretreatment mal topometry investigations with duct contrast and introduction of the catheter with dummy source into bile drain for the following implant reconstraction and treatment volume assessment; 5. dosimetry and radiobiological treatment planning. All the patients received only brachytherapy, one session during 100 hours in LDR-range or I fractions, 400 cGy daily, every day in HDR-range. The total dose of both regimes was estimated with a help of TDF-model as 4000 cGy. The target volume extention was from 40 mm to 80 mm, its diametr - from 20 mm to 40 mm. One of the main advantages of HDR-brachytherapy is the possibiliof forming the variable diameter treatment ty volume according to complex target margin by optimization. As a result one patient survided 4 years, one died in 1.5 years after treatment from there were no signs of bile duct heart desease, one patient died in 3.5 years tumor in autopsy, from metastases without local recurrence.
88 INITIAL EXPERIENCE WITH 125-I BRACRYTHRRAPY USING AN INTERACTIVR TRRATMSNT PLANNING SYSTEM FOR CHOROIDAL MALIGNANT MELANOMA IN TURKEY
L.Maryina, M.Niechushkin, R.Likhovetskaya Cancer Research Centre, Moscow, Russia.
6ZLER S.A.. ASTRARAN W.A.. LIGGETT P.R., ERYILDIRIM A., ALALIJF A., ~ZK~K s.. HAYDAMLU A.
SELECTRON gamma-units of Nucletron B.V. with ‘37Cs source has been in service in Russian Cancer Research Centre since 1983. The total number of patients with genital cancer who received intracavitary radiotherapy in radiological centres along the country with the use of SELECTRON units is 5146. In the course of the treatment on the basis of Quality Assurance programme dose control in points of interest was carried out for each irradiation procedure thus enabling necessary corrections to achieve required sum-up dose during the whole course. The immediate results showed clinically complete regression in 284 patients (88 s), partial regression in 12 (4%), no treatment effect in 14 (8%) cases. Analysis of recent treatment results for uterus cancer using SELECTRON in intracavitary radiotherapy showed 3-year survival in 240 cases (80%) without recurrence and metastases and 78%-survival for more than 5-year period. Tumours and near-by tissues showed effectiveness of 13’Cs irradiation to be no less than that of even more active ‘OCo. Ballshaped lslCs source used in combination with the inactive ones make it possible to produce optimal dose distributions depending on the tumour size. It is advisable to perform intracavitary irradiation for uterus cancer treatment, stages I-III, once a week with 12-15 Gy in point A whereby the number of cases of cistitis, rectitis, colitis and their severity degree went down. The SELECTRON properties enable easy programming, treatment control and necessary personnel protection without any special safety devices.
Uveal melanomas are most commonly managed by using enucleation and/or radiation therapy. Radiation therapy. Radiation therapy allows for retention of varying degrees of visual function, while yet maintaining local tumor control. Since 125-I is a low energy isotope, comparative dosimetry with more traditional isotopes demonstrates a trend toward increased radiation within the tumor and a decrease in radiation to normal ocular structures. We have used 125-I plaque therapy to treat 2 patients with choroidal melanoma first time in Turkey. The loading and treatment planning for radiation with multiple 125-I seeds was performed with Astrahan' s computerized interactive simulation system. Fundus photographs and CT scans were digitized to accurately locate the tumor. and the eye as well as the critical structures such as the optic disc. the fovea, and the lens crystallina. USC (University of Southern California) 10 ophthalmic plaques were selected to avoid excessive irradiation to the critical structures.Both patients had medium-sized melanomas of the choroid located posterior to the equator. Best corrected visual acuities were better than 2O/BO preoperatively. Both tumors demonstrated a decrease in size while eyes were maintaining the same visual acuities at three months after receiving 100 Gy irradiation to the apex at the time of surgery. No complications were encountered during surgery and shor-term follow-up.