[Combined treatment of the diffuse form of XXXX ].

@entity2720 @entity1362 @entity1 @entity5
@entity1362 is a specific lesion of the synovial membrane of the @entity2720 . In recent years it is frequently regarded as @entity5 . The problem of therapy of the diffuse form of the disease is yet to be solved. Recurrence rates after partial synovial capsulectomy remain high (33-46%) as well as after operation combined with radiation therapy. The authors summed up their experience in combined therapy of @entity1362 . The method was used in 24 @entity1 with the diffuse form of the disease, ranging in age from 15 to 62. In 18 of 24 @entity1 the process affected the knee joint, in 6 @entity1 the articular bones were involved in the process. Partial synovial capsulectomy with subsequent development of recurrences was recorded in 14 @entity1 ' history. Total synovial capsulectomy was performed at the first stage; in knee joint involvement the operation was supplemented by meniscectomy. gamma-beam therapy followed operation in 3-4 weeks. Radiotherapy was necessitated by the fact that elements of the affected synovial sheath could not be completely removed even in total synovial capsulectomy. Irradiation was given from 2 fields, a single focal dose being 1.2-1.5 Gy, 5 fractions a week; a summary focal dose reached 16-20 Gy. A follow up period lasted from 6 mos to 6 yrs. Complete convalescence was noted in 23 @entity1 . Occupational rehabilitation was achieved in 21 @entity1 . In 2 @entity1 the functional outcome was considered to be satisfactory. The data obtained indicated to a high efficacy of combined therapy of the diffuse form of @entity1362 and the appropriateness of the use of radiotherapy in the postoperative period.
