Radiotherapy of XXXX with a three field combination: feasibility, tolerance, and survival.

@entity1 @entity1310 @entity3117 @entity4318 @entity66 @entity353 @entity5 @entity391 @entity448 @entity99 @entity356 @entity1487
From 1980 to 1984, forty-five @entity1 suffering @entity356 were irradiated with curative intent. Twenty-three were considered at high risk of recurrence after complete surgical resection (invasion of the serosa, lymph nodes and/or surgical margins); eleven were treated after partial resection, and for eleven others, the local extension precluded surgery. Radiotherapy combined two lateral fields (usually with wedge filters) and an anterior field. The planned dose was 40 to 50 Gy, according to the amount of @entity66 and doses delivered to the major part of the liver and the right and left kidneys did not exceed 30, 5, and 18 Gy, respectively. For @entity1 aged less than 71 and whose general condition was acceptable, one cycle of chemotherapy (FAM for 20 @entity1 and @entity1487 for 10) preceded irradiation, followed if possible by 6 other cycles. Adverse effects, essentially @entity448 , @entity391 , and @entity353 , led to definitively stopping irradiation in 8 cases, and were present in 21 other @entity1 . Mean @entity353 was 2.5 kg. Apart from one @entity1 who developed a @entity3117 and died after reoperation, there was neither chronic complication, nor radiation @entity99 or @entity1310 . For 34 @entity1 , the observation time was superior to 3 years: 23 died of their @entity5 , 1 of a @entity3117 , and 2 of an intercurrent disease. Eight were disease-free at 3 years (three of these were irradiated for @entity66 ). For the overall series, the 4-year survival rate @entity4318 %. There is a significant survival advantage for females versus males (p less than 0.01), a non-significant tendency in favor of microscopic @entity66 versus macroscopic, and no advantage for the combination with FAM compared with no chemotherapy (non-randomized). This technique appears feasible with an acceptable tolerance and can control local @entity5 in a few cases. The planned dose of 40 Gy was probably too small and we are now testing 45 Gy delivered over the large initial volume, and boosts of 10-15 Gy to @entity66 .
