Cell proliferation in carcinoma in bilharzial bladder: Influence of pre-operative irradiation and clinical implications

Awwad, Hassan K.; Ezzat, Shahira Mohammed; Hegazy, M.D. Riham M. Abu Zeid Nedal A.; Dahaba, Nader; Bolkaini, Nabil El; Baki, Hoda Abd El; Moneim, H Abd El; Mansour, Mohammed; Ela, Moneer Aboul; Meguid, H. A.; Ismail, Saif

doi:10.1016/0360-3016(84)90232-3

Cited by 10 publications

(2 citation statements)

References 12 publications

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“…After surgery, microscopic tumor foci that escape resection undergo an accelerated proliferation [31,32]. Tumor repopulation is also enhanced by radiation therapy and this acceleration typically occurs after 30 to 40 days of treatment [3,33,34].…”

Section: Altered Treatment Schedulesmentioning

confidence: 99%

New Approaches to Postoperative Radiotherapy for Cancer of the Head and Neck

Prellop¹,

Ove²

2005

CCTR

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Historically, patients with resectable stage III and IV tumors were treated with combined surgery and radiation. Early attempts at improving results by incorporating chemotherapy in the postoperative setting have been largely unsuccessful or inconsistent. However, longer follow-up of recent landmark trials exploring concurrent chemotherapy and radiotherapy have clarified the issue, supporting concurrent cisplatin based chemotherapy for high risk patients. The survival benefit seen in the concurrent chemoradiotherapy trials appears to stem from improved locoregional control, as no reduction in systemic failure has been observed. Another evolving approach to post-operative head and neck radiotherapy is the use of altered fractionation schedules. There are several recent studies exploring either hyperfractionated or accelerated radiotherapy, as a response to the issue of accelerated tumor repopulation, providing evidence that such treatment is beneficial in selected patients. There are several questions worthy of further clinical research, and these will likely continue to follow the lead of nonsurgically managed head and neck cancer. Preliminary data suggests that IMRT can be tailored to postoperative patients, and target volumes defined such that morbidity can be minimized without jeopardizing tumor control. Biological modifiers of radiotherapy may allow selective radiosensitization without the morbidity of concurrent chemotherapy.

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Section: Altered Treatment Schedulesmentioning

confidence: 99%

New Approaches to Postoperative Radiotherapy for Cancer of the Head and Neck

Prellop¹,

Ove²

2005

CCTR

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“…Chan and Johnson [65] reported pelvic failures in 8/108 patients (7%) with T3 cancers following 5,000 cGy plus cystectomy without lymph node dissection. There is some evidence suggesting that regimens that employ a small number of large-dose fractions to a low total dose (e.g., two 650-cGy fractions separated by 1 week [66]) have little if any impact on local-regional control. Skinner and Lieskovsky [34] and Montie et al [67] gave no data regarding pelvic recurrence rates following cystectomy alone for clinical stage T3 cancer.…”

Section: The Effect Of Preoperative Irradiation On the Incidence Of Pmentioning

confidence: 99%

Role of planned preoperative irradiation in the management of clinical stage B2‐C (T3) bladder carcinoma in the 1980s

Parsons¹,

Million²

1989

Seminars in Surgical Oncology

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In recent years the role of planned preoperative irradiation in the management of clinical stage B2-C (T3) bladder cancer has been questioned by a number of investigators. Much of the confusion regarding the efficacy of combined therapy results from studies that compare the results of treatment of pathological stage B2-C patients treated by cystectomy alone versus clinical stage B2-C patients treated by preoperative irradiation plus cystectomy. Such comparisons are biased because of 1) the exclusion of a large number of pathological stage D patients from cystectomy-alone series and their inclusion in preoperative irradiation plus cystectomy series and 2) the inclusion in the cystectomy-alone series of patients whose clinical stages were less than or equal to T2. The purpose of this paper is to compare the results of treatment in patients with clinical stage B2-C bladder carcinoma following radical cystectomy alone versus preoperative irradiation plus cystectomy. This article reviews the rationale for administering preoperative irradiation, the effect of preoperative irradiation on the pathological specimen (including down-staging, the effect on regional lymph nodes, and radioresponsiveness according to tumor configuration, i.e., papillary vs. solid), the impact of preoperative irradiation on pelvic recurrence and 5-year survival, and the effect of preoperative irradiation on operative and postoperative complications. This paper cites all known literature on the subject in the English language. Data comparing 5-year survival results of radical cystectomy alone versus preoperative irradiation plus cystectomy are analyzed in three different ways: a) retrospective comparisons of historical results, b) comparison of contemporaneous "modern-day" (1960-1980) series comprising 1185 patients who received either radical cystectomy alone or preoperative irradiation plus cystectomy, and c) review of the results of six randomized trials. Preoperative results are also analyzed according to dose level (2,000 cGy versus 4,000 cGy vs. 4,500-5,000 cGy). The data presented indicate that the addition of preoperative irradiation to cystectomy for clinical stage B2-C (T3) bladder cancer adds approximately 15-20 percentage points to the 5-year survival, leading to a survival figure that is approximately half again that achieved by cystectomy alone.

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Analysis of the Growth Parameters of Human Tumours: Clinical Implications

Awwad¹

1990

Radiation Oncology: Radiobiological and Physiological Perspectives

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Cell proliferation in carcinoma in bilharzial bladder: Influence of pre-operative irradiation and clinical implications

Cited by 10 publications

References 12 publications

New Approaches to Postoperative Radiotherapy for Cancer of the Head and Neck

New Approaches to Postoperative Radiotherapy for Cancer of the Head and Neck

Role of planned preoperative irradiation in the management of clinical stage B2‐C (T3) bladder carcinoma in the 1980s

Analysis of the Growth Parameters of Human Tumours: Clinical Implications

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