[Radiotherapy and combined modality treatment of advanced gastrointestinal tumors. Analysis of morbidity in 101 patients].
Despite numerous reports about combined therapy of gastrointestinal tumours no detailed analysis of considerably manifold side effect has been established. In this study the therapeutic results and morbidity of irradiation in 64 patients are compared with 37 courses of combined therapy for recurrences and/or metastases. Modalities in combined therapy consisted of radiotherapy and hyperthermia or chemotherapy, or chemotherapy and hyperthermia respectively. Toxicity from combined therapy was seen more frequently and pronounced, requiring variations in therapy management up to 54% versus 17% in patients irradiated. Dose reductions (15% vs. 8%), intervals (30% vs. 14%) and its duration (14 vs. 6 days) extended the overall treatment times. In 21% combined therapy was interrupted totally (vs. 11% mainly caused by non therapy specific other diseases, respectively rapid tumour progression) or in another 13% continued sequentially. No improved results were seen following combined therapy, but an intolerably high risk of serious complications (up to 71% in combination of radio- and chemotherapy). With the dosages, fractionations and techniques used combined therapy can be performed only in a sequential course for palliation of advanced gastrointestinal tumours. We assume that morbidity of hyperthermia in most cases is considerably higher than its therapeutic gain.
D000368:Aged; D003131:Combined Modality Therapy / Q000009:adverse effects; D005472:Fluorouracil / Q000627:therapeutic use; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local
D005472:Fluorouracil
Strahlentherapie und kombinierte Behandlung fortgeschrittener gastrointestinaler Tumoren. Eine Morbiditätsanalyse an 101 Patienten.