Pathologic findings in total esophagectomy specimens after intracavity and external-beam radiotherapy

Article Abstract:

Esophageal cancer has a poor prognosis, and most treatments are designed to ease the patient's discomfort rather than affect a cure. The rationale for combining intracavity and external-beam radiotherapy is to maximize the exposure of the tumor to the effects of radiation. The portions of the tumor which are exposed to the inside of the esophagus are likely to be low in oxygen, and consequently less responsive to radiotherapy. Placing the radiation source inside the esophagus, close to this side of the tumor will increase the tumor's susceptibility to radiotherapy. External radiation treats the tumor in the esophageal wall and in the tissues adjacent to the esophagus. Pathologic findings following surgical removal of the affected area permit the direct measurement of the penetration of radiation damage into the tumor. Twenty-one patients were treated with intracavity and external-beam radiotherapy at varying doses. Pathologic examination revealed that 7 of 21 tumors showed poor penetration of the radiation damage. Tumor sterilization was observed in 7 of 21; 6 of these were from the highest radiation dose of 4,000 cGy (a Gray, or Gy, is defined as 1 joule of radiation energy absorbed per kilogram of tissue). Lymph node metastases were found in 12 of the 21 patients, but 19 of the 21 did not undergo thoracic surgery, and the involvement of mediastinal lymph nodes was not determined. (Consumer Summary produced by Reliance Medical Information, Inc.)

Surgery, Cancer, Cancer treatment, Esophagus, Esophageal cancer, Esophageal surgery

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Combined hepatic artery 5-fluorouracil and irradiation of liver metastases: a randomized study

Article Abstract:

Colorectal cancer is second only to lung cancer as a cause of cancer deaths in the United States. Of the 20,000 annual deaths from colorectal cancer, 25 to 33 percent are due to metastases which have spread to the liver. Chemotherapy using 5-fluorouracil is generally the treatment of choice for colorectal hepatic metastases. Some investigators have used a combination of 5-fluorouracil and radiation in the treatment of other forms of cancer; this combination therapy was used in a randomized study of 37 cancer patients over a three-year period. Overall, the patients receiving 5-fluorouracil and radiotherapy had a lower survival rate than patients given 5-fluorouracil alone, but this difference was not statistically significant. However, if one considers various subpopulations of patients, there may be distinct advantages of the combined treatment for some cases. Patients with well-differentiated tumors and highly vascular tumors did significantly better with the combined treatment regimen. Careful selection of patients for 5-fluorouracil and radiotherapy treatment may result in improved survival. Further research on the timing and dosage of this regimen may optimize results. (Consumer Summary produced by Reliance Medical Information, Inc.)

Colorectal cancer, Liver cancer

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Primary carcinoma of the gallbladder: adjuvant postoperative external irradiation

Article Abstract:

Gallbladder cancer has a dismal prognosis; only between 5 and 30 percent of patients with cancer of the gallbladder survive beyond five years. In an uncontrolled study of seven patients, postoperative irradiation was used after surgical removal of the cancer. A dose of 4,600 cGy (a Gray, or Gy, is equal to 1 joule of energy absorbed per kilogram of tissue) was delivered to the local region of the gallbladder, and a booster dose of 900 cGy was given to the gallbladder bed itself. One patient died at 12 months and another at 26 months because of tumor recurrence. The remaining five patients are alive with no evidence of disease at 5, 9, 11, 31, and 58 months. Although this study did not include a group of control patients (who did not receive postoperative radiotherapy), comparisons with historical data of gallbladder cancer suggest that postoperative irradiation is an advantageous treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Gallbladder cancer

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