Hyperfractionation of whole-abdomen radiation therapy: salvage treatment of persistent XXXX following chemotherapy.

@entity43 @entity1 @entity137 @entity390 @entity66 @entity882 @entity548 @entity5 @entity294 @entity900
Whole-abdomen radiation therapy has been utilized as primary adjunctive therapy in the management of epithelial @entity43 with encouraging results. The results reported when using standard fractionation protocols in @entity1 with recurrent or persistent @entity43 have been poor and treatment-related @entity137 have been severe. There are reported theoretical and clinical advantages of hyperfractionation of ionizing radiation in treating @entity5 . Fifteen @entity1 have been treated with a twice-a-day whole-abdomen, open-field radiation technique delivering 80 cGy per fraction, to a total dose of 3040 cGy in 19 treatment days. All @entity1 had @entity43 with persistent disease detected at pretreatment laparotomy after @entity900 -based chemotherapy. All @entity1 had moderately to poorly differentiated @entity5 with @entity66 less than 1 cm. Acute side effects of treatment included mild to moderate @entity390 and @entity294 . @entity882 (less than 50,000) was noted in five @entity1 . No @entity548 or infectious complications were noted, and no @entity1 required hospital admission for side effects. Disease recurred in nine @entity1 with two still alive 13 and 52 months after starting irradiation. Six @entity1 are currently alive without evidence of disease at follow-up, ranging from eight to 48 months. The mean survival to date is 20 months with four @entity1 alive more than 2 years, and two @entity1 alive for greater than 3 years from their radiation therapy. @entity1 tolerance has been acceptable, and both the short and long-term @entity137 are minimal. Late side effects of treatment have not been noted. This technique offers a chance for a long, disease-free interval and possible cure in well-defined cases of chemotherapy-treated @entity1 with persistent @entity43 .
