1. Long term outcome after combined modality treatment for anal cancerIrena Oblak, Primož Petrič, Franc Anderluh, Vaneja Velenik, Albert-Peter Fras, 2012, original scientific article Abstract: Background. The aim of the retrospective study was to evaluate the effectiveness and toxicity of radiochemotherapy in patients with squamous cellcarcinoma of the anal canal treated at a single institution. Patients and methods. Between 1/2003 and 9/2010, 84 patients were treated with radical radiochemotherapy at the Institute of Oncology Ljubljana, Slovenia. The treatment consisted of 3-dimensional conformal external beam radiotherapy with concurrent chemotherapy (5-fluorouracil and mytomycin C), followed by brachytherapy or external beam boost. The toxicity of therapy and its effectiveness were assessed. Results. The treatment was completed according tothe protocol in 79.8% of patients. The median follow-up time of 55 survivors was 53 months (range: 16-105 months). The 5-year locoregional control(LRC), disease-free survival (DFS), disease-specific survival (DSS), overall survival (OS) and colostomy-free survival (CFS) rates were 71%, 68%, 81%, 67% and 85%, respectively. No treatment-related mortality was observed. The most frequent acute side-effect of the treatment was radiodermatitis (grade 3-4 in 58.2% of patients). LENT-SOMA grade 3-4 late radiation side effects were observed in 15 (18%) patients. In patients with brachytherapy boost a trend of less late side effects was observed compared to patients with external beam boost (P=0.066). On multivariate analysis, complete clinicaldisease response was identified as an independent prognostic factor for LRC, DFS and DSS, the salvage surgery for LRC and DFS, whereas Hb below 120 g/l retained its independent prognostic value for OS. Conclusions. Radiochemotherapy provides an excellent disease control and the survival with preserving anal sphincter function in majority of patients. Surgical salvage with abdominoperineal resection for persistent or recurrent disease has curative potential.
Published in DiRROS: 21.03.2024; Views: 794; Downloads: 255
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2. Adenocarcinoma skin metastases treated by electrochemotherapy with cisplatin combined with radiationGregor Serša, Maja Čemažar, Zvonimir Rudolf, Albert-Peter Fras, 1999, original scientific article Abstract: Background. The aim of this study was to determine the interaction between electrochemotherapy as a means of facilitated cisplatin delivery into the cells and irradiation of adenocarcinoma skin metastases. Case report. A patient with progressive disease presenting skin metastases of tubal dedifferentiated pappilary adenocarcinoma was enrolled in the study. Skin metastases were treated by electrochemotherapy with intratumoral injection of cisplatin. Its antitumor effectiveness was compared to that of combined treatment of irradiation with electrochemotherapy. After a two week observation time, the response to treatment was comparable between the electrochemotherapy and electrochemotherapy combined with irradiation. Both ofthese treatments were more effective than irradiation alone. Furthermore, antitumor effectiveness of the combined electrochemo- and radiotherapy was found to be quicker than that of electrochemotherapy alone. Comment. This study shows that electrochemotherapy with cisplatin is also effective in the treatment of adenocarcinoma skin metastases. Inspite of the short observation time, positive interaction between radiotherapy and electrochemotherapy with cisplatin was found.
Published in DiRROS: 22.01.2024; Views: 756; Downloads: 193
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3. Cryosurgery combined with radiotherapy of tumors in miceAlbert-Peter Fras, Simona Kranjc Brezar, Maja Čemažar, Gregor Serša, 1999, original scientific article Abstract: Tlle aim of this study zuas to determine antitumor effectiveness of cryosurgery alone and in comhination with radiotherapy. Cryosurgery of subcutaneous fibrosarcoma SA-1 tumors in A/J mice was moderately effective trcatmcnt. Tumor growth delay was 10.3 * 3.8 days after 5 minute treatment with nitrogen filled cryo-prohe. Shorter treatment times induced less, but dose dependent antitumor effect. In combined treat- ment, tumors were either first treated by cryosurgery for 3 minutes and then locally irradiated with 10Gy for 5 minutes, or irradiated first and thereafter treated by cryosurgery.The antitumor effectiveness of com- bined treatrnent was sequence dependent; the irradiation of tumors before cryosurgery resulted in better antitumor effect than the irradiation after cryosurgery. These results indicate that radiosensitization may not be always expected, in spite of some reports demonstrating that cryosurgery may have radiosensitizing effect in vivo, and that some other mechanisms may be involved contributing to radiationdamage when cryosurgery follows irradiation.
Published in DiRROS: 22.01.2024; Views: 845; Downloads: 200
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6. High rate of complications in patients with carcinoma of the cervix surgically treated after radical radiotherapyAlbert-Peter Fras, 1995, original scientific article Abstract: With the aim to improve the results of treatment of patients who had advanced carcinoma of the uterine cervix and were radically irradiated, a group of 49 patients underwent hysterectomy two to 24 months after completion of radiotherapy, among whom for only 43 patients data were available. Radiotherapy consisted of 40 Gy external beam irradiation to true pelvis, low dose intracavitary treatment to a total dose 40 Gy to point A, and parametrial irradiation 16 to 20 Gy, shielding the place where radioactive sources were positioned during intracavitary therapy. Necrosis, persistent cervical carcinoma, recurrent carcinoma, and in patients younger than 50 years no evidence of disease (NED) with dysplasia were indications for the surgical treatment. Hysterectomy with bilateral oophorectomy was as conservative as possible but severe complications, such as ureteral stenosis (five cases), recto-vaginal fistula (three cases), vesico-vaginal fistula (two cases), recto-vesico-vaginal fistula (one case) occurred. Asymptomatic frozen pelvs as a mild complication occurered in 10 cases. One patient died postoperatively because of dehiscence and abdominal wall necrosis. In 17 (39.5%) of 43 patients complications occurred, although asymtomatic frozen pelvic was not taken in account. We believe that such a combined treatment is only for selected cases.
Keywords: Complications
Published in DiRROS: 15.01.2024; Views: 613; Downloads: 165
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