Prevention of radiation enteritis by an absorbable polyglycolic acid mesh sling: a 60-case multicentric study
Article Abstract:
Radiation is often used in conjunction with surgery in the treatment of cancer. When the primary cancer is removed, radiation is applied to the region of the malignancy to destroy any tiny nests of tumor cells that may have escaped detection and removal. Invariably, the dose of radiation is limited by the damage that might be inflicted upon normal, health tissues. This is especially true in the treatment of cancer in the pelvic region. The small intestines are particularly susceptible to the deleterious effects of radiation. When the dose of radiation exceeds 4,000 to 5,000 cGy, small intestine damage occurs in 5 to 25 percent of cases. This dose range of radiation is not small, but is significantly smaller than that given for many tumors, and is smaller than would be preferred for best results. One way of reducing the risk of radiation damage to the small intestine would be to hoist it out of the way, so that it is no longer in the direct path of the radiation beam. This would require the surgical placement of a sling within the patient's abdomen to hold the small intestine. Furthermore, a second surgical procedure would be necessary to remove the sling after radiotherapy is complete. Researchers have now simplified this procedure by developing a sling composed of an absorbable material. This avoids a second surgical procedure by eliminating the requirement for removing the sling. An absorbable mesh sling composed of polyglycolic acid was tested in the treatment of 60 cancer patients requiring irradiation of the pelvic region. Surgical complications occurred in five patients, and four developed radiation-induced inflammation of the bowels despite the preventive measure. Magnetic resonance imaging was used to observe the resorption of the mesh material, which was complete three to five months after the operation. The results suggest that the polyglycolic acid mesh sling is safe, and should be considered for patients at high risk for the recurrence of pelvic cancer who may benefit from increased doses of radiation therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Cancer
Subject: Health
ISSN: 0008-543X
Year: 1991
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Endolymphatic chemotherapy in gynecologic cancer
Article Abstract:
The chances for the recurrence of many types of cancer are increased significantly when cancer cells have already migrated into the lymph nodes. This is true for cancer of the genital tract, where tiny lymphatic metastases provide the source of cancer recurrence. Unfortunately, these cancer cells nesting in the lymph nodes are somewhat protected from the onslaught of chemotherapeutic drugs. In order to circumvent the natural protection afforded to these cancer cells, a technique was devised to suspend chemotherapeutic agents in oil and infuse them directly into the lymphatic system. The feasibility of this technique was evaluated on 18 patients with cancer of the uterine cervix, vulva, or endometrium who were scheduled for surgery. Bleomycin sulfate, the chemotherapeutic agent, was suspended in sesame oil and infused into the lymphatic drainage of each leg. In two cases, successful infusion could not be accomplished. On surgery, five cases were found to have lymph nodes positive for cancer cells. A total of eighteen positive nodes were removed and examined histologically. All had evidence of necrosis (cell death) which may be attributed to the chemotherapeutic treatment. In some cases, necrosis could also be observed in the primary tumor. Examination of the healthy lymph nodes showed no signs of necrosis or impaired viability of cells. The rationale for this treatment is that the environment of the lymphatic system is somewhat hydrophobic: water-soluble agents will freely pass from the lymphatic system back into the veins. By dissolving the bleomycin in oil, a greater concentration will remain where it can do the most good. Clearly more research will be needed to determine if this technique should be added to the anti-cancer armamentarium. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Cancer
Subject: Health
ISSN: 0008-543X
Year: 1990
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Simultaneous versus sequential combined technique therapy for squamous cell head and neck cancer
Article Abstract:
Squamous cell cancers of the head and neck are generally responsive to chemotherapy, radiation, or both. However, not all schedules of treatment work equally well. To evaluate the relative effectiveness of two schedules of combination radiation and chemotherapy, 48 patients with locally confined squamous cell carcinoma of the head and neck were randomly assigned to one of two experimental groups. The first group received chemotherapy and radiotherapy simultaneously, followed by another course of simultaneous chemo- and radiotherapy. The second, or sequential, group, received chemotherapy first, followed by radiotherapy. Chemotherapy consisted of cycles of 5-fluorouracil and cisplatin; radiotherapy consisted of a total of 6,000 cGy (a Gy, or Gary, is 1 joule of energy absorbed per kilogram of tissue). Patients who achieved complete remission after the first treatment cycle did not receive surgery; in addition, five patients either had unresectable tumors or refused surgery. The data indicate an improved relapse-free survival rate for the patients who received simultaneous treatment. However, it is too early to determine if the relapse-free survival will translate into significantly improved overall survival. The toxicity of the two treatment schedules was comparable, although the simultaneous chemo- and radiotherapy group had more inflammation of the mucous membranes and greater weight loss. The study demonstrates that simultaneous chemo- and radiotherapy may provide an advantage for treating squamous cell carcinoma of the head and neck. Furthermore, the study found that the appropriate scheduling of treatment can reduce the need for surgery without affecting the patient's relapse-free survival. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Cancer
Subject: Health
ISSN: 0008-543X
Year: 1990
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