Sophisticated imaging techniques allow the identification of radiation effects in partial volumes of the kidneys. A dose-response relationship in relation to the volume of kidney irradiated can thus be established for scintigraphic changes. As in a number of other organs, such changes do not relate directly to loss of renal function due to the reserve capacity of unirradiated kidney tissue.
In the present study, the clinical manifestation of intestinal side effects according to RTOG/EORTC criteria was reflected by neither the vitamin B(12) nor by the D-xylose resorption test. Hence, these tests cannot be regarded as useful for objective quantitation of intestinal radiation injury.
Background: In an open pilot study we tested a program of reduced combined radio-chemotherapy in Hodgkin’s disease in limited stages with risk factors and in advanced stages. Aim of the study was to reduce the delayed complications of full-dose combined modality treatment while preserving its effectiveness. Material and Methods: From May 1985 to December 1988 43 previously untreated consecutive patients entered the study. Treatment consisted of CVPP/ABVCy hybrid chemotherapy and low-dose (25 Gy) involved-field radiotherapy. Results: All patients could be evaluated for response to treatment. Primary complete remission (CR) reached 35/43, partial remission 5/43 (12%), and 3/43 (7%) did not respond. After a median observation period of 64 months 28/35 (80%) are in first CR. The survival data are as follows: relapse-free survival 3 years 86%, 5 years 78%, overall survival 3 years 91%, 5 years 83% (Kaplan-Meier estimation). So far 7 patients relapsed and 7 patients died. The acute toxicity of the treatment program was acceptable and up to now we have not observed secondary neoplasms. Conclusions: We regard our treatment approach as useful; it matches the reports of other groups using similar treatment policies.
The D-xylose test is an important and simple method for determination of radiogen induced carbohydrate malabsorption in proximal small intestine. By means of it radiation side effects on small intestine can also be determined in patients who are otherwise free of complaints.
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