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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A clinical application of the NSD-concept using iso-ret plans for the recording of radiation pneumonitis is reported. The conditions of an ascertainment of tolerance values for single organs by help of the Ellis formula are discussed. Of the examined patients with Hodgkin's disease who had been exposed to irradiation of the unaffected mediastinum, 42% suffered from radiogenic lung complications. The calculated iso-ret plans reveal a limitation of the pneumonitic shadow zone identical to the 1200-ret isoline. The data in literature are in accordance with these results.
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PMID:[Application of the NSD-concept for the ascertainment of tolerance doses in the region of the lung (author's transl)]. 76 Feb 69

In 1978-1980, inclusive, all breast cancer patients referred for postmastectomy irradiation were treated by 2 fractions per week (73 patients) but due to a high incidence of late complications this fractionation schedule was changed from early 1981 to 5 fractions per week (66 patients) with dose adjustment according to the nominal standard dose (NSD) concept. The dose aim in both regimens was 1345 ret minimum target dose. This allowed a comparison of acute and late complications in the two patient groups treated to the same NSD value, but with different fractionation. The patients have been analysed with respect to acute and late reaction in the skin, subcutaneous tissue, lung and bone, as well as related complications, such as arm oedema and impairment of shoulder movement. Except for the acute skin reactions, all other endpoints could not be adequately predicted by the NSD formula. Thus, telangiectasia greater than or equal to grade 1 and skin fibrosis greater than or equal to grade 2 were found to be 75% and 67% in patients treated with the 2-fraction scheme versus 39% and 5% in patients treated with the 5-fraction scheme. In the 2-fraction regimen, a higher frequency of impairment of shoulder movement and arm oedema was found compared to the 5-fraction regimen, 38% versus 11% and 44% versus 33%, respectively. The acute lung reaction as well as late lung reaction were significantly more pronounced in the 2-fraction regimen than in the 5-fraction regimen (pneumonitis greater than or equal to grade 2, 43% versus 23%, and lung fibrosis greater than or equal to grade 2, 32% versus 17%, in the photon fields, respectively). Further, radiation-induced osteonecrosis in the ribs was significantly more frequent in patients treated with large dose per fraction (19% versus 2%). The data clearly demonstrates the danger by using the NSD formula in equation of two different fractionation schedules. This formula as well as other mathematical models can only be used with caution within the limitations defined by the underlying clinical and experimental data on which they have been derived.
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PMID:The value of the NSD formula in equation of acute and late radiation complications in normal tissue following 2 and 5 fractions per week in breast cancer patients treated with postmastectomy irradiation. 360 25

Forty-nine patients with very advanced locoregional lung cancer, metastatic in 41% of the instances, were treated with 5 Gy once weekly to a total dose of 50 to 60 Gy (1826-2050 ret). The overall tumor response rate was 68% (27% complete response and 41% partial response). The largest number of responders and the majority of complete responses were seen with the higher doses (60 Gy). The response rates of the major histologic variants were 100%, 75%, and 47% for small cell, large cell, squamous, and adenocarcinomas. The time to achieve more than 50% reduction in tumor size was 2, 2, 6, and 9 weeks for these histologic variants, respectively. The overall incidence of local failures was 22%, with only 10% of the patients demonstrating exclusive in-field local failures. There are 13 long-term survivors and the main cause of patient deaths was metastatic disease. The technique was extremely well tolerated, and, in fact, practically no acute radiation-induced complications were observed during the 10 to 12 weeks' treatment duration. Only one patient developed a symptomatic but transient radiation pneumonitis. Radiation fibrosis of various degrees has occurred, but it has been mostly asymptomatic and analogous to what is normally seen using conventional continuous schedules delivering similar doses. Once-a-week irradiation emerges as a practical and convenient alternative for the treatment of lung cancer, and appears to achieve similar results to conventional continuous schedules.
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PMID:Once-a-week radiation therapy for locally advanced lung cancer. Final report. 674 5

42 patients with metastases to the lung and 7 patients with metastases to the liver received a combined treatment with polychemotherapy and local gamma-irradiation simultaneously. Radiation doses to the lung were mostly 15 Gy in 12 days up to 18 Gy in 2 1/2 weeks (657 to 731 ret). Right and left lung were never treated at the same time. Thus, treatment results could be compared and severe side effects were avoided. Regression of metastases occurred more often after a combined treatment, and remission lasted longer. Pneumonitis was seen in 1/3 of all cases but could be managed satisfactorily by antiphlogistics. Metastases to the liver, too, responded well to a combined treatment.
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PMID:[Combination of chemotherapy and local radiation therapy for metastases to the lung or liver: indication and results (author's transl)]. 742 64