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Clinical observations indicate that the utility of classical prognostic factors in the assessment of probability of disease free or overall survival of lung cancer patients is not completely satisfactory. This is the cause for search of indices which results would contribute to optimization of this estimation. Of potential value in this aspect may also be the results of laboratory determinations which characterize patient's performance status. Dependencies between the times of overall survival in respect to chosen hematological and biochemical factors from the pretreatment period were analyzed in a group of 233 patients with lung cancer (adenocarcinoma - 44, squamous cell lung cancer - 156, small cell lung cancer - 33 patients) in different stages of disease. Apart from stage of disease and histological type of tumor, independent prognostic factors turned out to be the actual ideal body mass ratio and the number of leucocytes. In patients with less advanced stages of disease, such independent factors, apart from histological type are alpha-1 globulin and gamma globulin.

Small-cell lung cancer is characterized by an aggressive clinical course with high tendency for early dissemination. At presentation, patients are usually symptomatic and with hilar or mediastinal mass at radiography. Staging should be focused on identifying any evidence of distant spread. Chemotherapy including cisplatin and etoposide is a cornerstone of treatment for all patients. Limited-stage disease should be managed by chemotherapy combined with concurrent chest irradiation. All patients who achieve complete response should be considered for elective cranial irradiation. Surgical treatment may be used in highly selected patients with TNM stage I disease, and surgery should always be combined with chemotherapy. Extensive-stage disease should be managed by multi-agent chemotherapy alone. Long-term survivors should undergo careful monitoring for development of a second primary tumour.

Objectives: The aim of study was to analyse results of treatment patients with uterine-confined endometrial cancer which underwent surgery and postoperative radiotherapy in Center of Oncology in Kraków between 1985 and 1997., Material and Methods: The research included a group of 650 women. All patients undergo total abdominal hysterectomy with bilateral salpingo-oophorectomy and postoperative radiotherapy. 155 patients with intermediate-risk of recurrence (IA-G3, IB-G1, G2) received postoperative whole pelvic irradiation only. In the group of 495 patients with high-risk of recurrence (IB-G3, IC, II) 210 patients received brachytherapy vaginal cuff only and 285 patients whole pelvic and vaginal cuff irradiation., Results: In the group of patients with intermediate-risk of recurrence five NED survival was 93.5%. In the group of patients with high-risk of recurrence five NED survival was statistically lower in patients treated with brachytherapy vaginal cuff only (83.2% vs. 71.9%)., Conclusion: In uterine-confined endometrial cancer patients, with intermediate-risk of recurrence treated with surgery and postoperative whole pelvis irradiation, 5-year NED survival is above of 90%. In the group of patients with high-risk of recurrence the adjuvant treatment of choice is whole pelvic and vaginal cuff irradiation.

Objective: The aim of the study was to determine prognostic factors in the group of the patients with uterine--confined endometrial carcinoma treated with surgery and postoperative radiotherapy., Material and Methods: The authors analyzed 102 patients (mean age 58 years) with stage 1 (74 patients) and stage 11 (28 patients) endometrial carcinoma. All patients were treated with surgery (abdominal hysterectomy and bilateral adnexectomy) and postoperative radiotherapy: external beam pelvic irradiation (20 patients), vaginal cuff irradiation (33 patients) and combination (49 patients). Analysed were prognostic factors as follows: age, stage, tumor grade, depth of myometrial invasion, hormone receptors, expression of the tumor suppressor gene p53, Her 2/neu and MIB-1 (ki-67 paraffin)., Results: In our group of patients, multivariate analysis has identified tumor grade, progesterone receptors status and MIB-1 as independent significant prognostic factors.

Objectives: Follow-up in 65 patients with stage III-IV ovarian cancer after negative second-look laparotomy. Prognostic factors and causes of failure were also discussed., Material and Methods: 65 patients with ovarian cancer stage III-IV were treated with surgery and at least six courses of chemotherapy (cisplatin, adriamycin, cyclophosphamide) and second-look laparotomy. Results of the treatment are presented in a form of 5-year NED (no evidence of disease) survival. Dependence between analyzed factors and survival was assessment based on proportional hazard Cox model., Results: In 30 patients (46.1%) recurrence during 5 year follow-up was observed. In 28 patients out of them (93.3%) it was loco-regional failure and in 2 patients distant metastases were the sole reason of unsuccessful results of the treatment. Adverse prognostic factors found in statistical analysis were: advanced primary stage, residual infiltrations after first laparotomy exceeding 2 cm and low grade of differentiation., Conclusions: 1. In about 50% of patient with advanced ovarian cancer loco-regional recurrence was observed, 2. Adverse prognostic factors were: advanced primary stage, residual masses after first laparotomy above 2 cm and low grade of differentiation.

Between 1992 and 1999 at the Oncology Centre in Cracow 138 NSCLC patients after complete resection of the tumour with mediastinal/hilar node involvement were included in the prospective clinical trial. The analysis of the results did not show any improvement of survival in the postoperatively irradiated group. Three-year survival rates with no symptoms of disease in postoperative radiotherapy patients compared to surgery alone group were 30% and 29% respectively. In this study adjuvant radiotherapy significantly improved local recurrence rate from 28% in surgery only group to 9% in postoperatively treated patients.

In a retrospective analysis of 150 incompletely resected NSCLC patients treated with adjuvant external beam radiotherapy 32 (21.3%) survived 3 years with no symptoms of disease. Ipsilateral mediastinal/hilar lymph node involvement and macroscopic incomplete surgery were the prognostic factors that unfavourably influenced survival in Cox's proportional hazards model. Postoperative external beam radiotherapy was the efficient adjuvant treatment method in microscopically incompletely resected NSCLC, predominantly with no nodes involvement, but had no benefit in those with macroscopic incomplete surgery.

A case of fourfold cancer: of the vulva and larynx diagnosed synchronously and the breast and lung diagnosed metachronously is presented.

In the period 1965-1988, 125 women with primary invasive vaginal carcinoma were treated with radiotherapy. 53 (42.4%) survived 5-year without evidence of disease. In the Cox multivariate analysis three variables were independently related to survival: age of the patients, grade of differentiation of tumor and the clinical stage of illness.

The role of teleradiotherapy in the treatment of patients with thyroid cancer is presented. The indications for external irradiation include patients with: primary inoperable disease or inoperable recurrence, microscopic or gross residual disease after surgery, high risk of local regional failure, and metastatic thyroid cancer, especially with skeletal, brain and mediastinal metastases.

A retrospective analysis of 7 patients with adenoid cystic carcinoma of the breast operated at Center of Oncology in Kraków is presented. Ten years without evidence of disease survived 6 (85.7%) patients. One patient only, with poorly differentiated carcinoma, presented axillary metastases and died of metastases to the lungs and hepar.

Four cases of solitary extramedullary plasmocytoma of the larynx (3 men, 1 women) treated with radiotherapy are presented. Laboratory and X-ray examinations showed no evidence of systemic plasmacytoma. One patient was treated with conventional X-ray therapy and 3 patients with telegammatherapy Co-60. All patients survived 10 years with no evidence of disease.

An analysis of 80 patients with infiltrating lobular carcinoma of the breast treated at Center of Oncology in Kraków is presented. All patients underwent radical mastectomy. The evaluation of treatment results showed stage, pathological tumor size, and involvement of axillary nodes as the prognostic factors. The ten-year survival rate NED in all group was 38.8%; for stage I, II, and III it was 62.5%, 48.8%, and 19.4% respectively.

A case of a primary synchronous bilateral lung cancer is presented. Tumor of the left lung was treated with lobectomy, tumor of the right lung with radiotherapy. Patient survived 5-years without evidence of disease recurrence.

Eighty-five patients with stage II glottic laryngeal cancer were treated with radiotherapy in Center of Oncology in Kraków between 1973 and 1989. Fifty-five patients were irradiated with 60Co unit, 30 with mixed photon--electron beam. The 5-year survival rates without evidence of disease after the radiotherapy only were 65.9%, after the radiotherapy and surgery for recurrences--76.5%. The sex, age, local extension of primay tumour and vocal cord mobility were evaluated in a uni- and multivariate analysis of prognostic factors. For the end-point of 5-year survival without evidence of disease no statistically significant relationship was found between results and analysis variables, especially between survival and impaired cord mobility.

We analysed 170 women with carcinoma of the breast who survived 20 years after local or loco-regional therapy, without adjuvant chemo-hormonotherapy. Patients with axillary lymph nodes metastases constitute thirty-six percent of this group.

Six hundred and thirty patients with stage I and II glottic and supraglottic laryngeal cancer were treated with radiotherapy in Center of Oncology in Kraków between 1973 and 1989. The 5-year NED survival rates after the radiotherapy only were 79%, after the radiotherapy and surgery for reccurrences--87.1%. Gender is not a prognostic factor in early stage laryngeal cancer treated with radiotherapy.

Three hundred patients with early stage supraglottic cancer were treated with radiotherapy in Center of Oncology in Kraków between 1973 and 1989. The 5-year NED survival rates after the radiotherapy only were 82.9% in stage I, and 70%in stage II cancer, after the radiotherapy and surgery for recurrences--90% and 75% respectively. The stage and tumor site were an important prognostic factors in the treated group of patients.

A retrospective analysis of 32 patients with primary fallopian tube carcinoma treated at Center of Oncology in Kraków is presented. In all cases therapy consisted of primary total abdominal hysterectomy with bilateral salpingo-oophorectomy followed by adjunctive radiotherapy. Five year without evidence of disease survived 53.1% of the patients. Stage of disease was the only prognostic factor: survival at 5 years was 76.9% for stage Io, 55.6% for stage IIo, and 20% for stage III.

Between 1970 and 1986, 252 women under 36 years of age with cervical carcinoma were treated in the Center of Oncology in Cracow. The five-year disease-free survival for all patients was 52.8%. In the multivariate analysis tumor stage IIB and III and the age under 30 years were adverse prognostic factors.

Two hundred and forty-five patients with stage I glottic laryngeal cancer were treated with radiotherapy in Center of Oncology in Kraków between 1973 and 1988. One hundred and fifty-five patients were irradiated with Co-60 unit, 90 patients with mixed photon-electron beam. The 5-year NED survival rates after the radiotherapy only were 85.3%, after the radiotherapy and surgery for recurrences--95.1%. The sex, age, local extension of primary tumor (T1a vs. T1b), location of the tumor on true vocal cord and involvement of anterior commissure were evaluated in a uni- and multivariate analysis of prognostic factors. For the end-point of 5-year NED survival no statistically significant relationship was found between results and analysis variables.

Forty-one patients with teratoma of the ovary were operated in the Center of Oncology in Kraków. The five-year disease-free survival for all patients was 68.3%. The histological grading appear to be an important prognostic factor. The five-year disease-free survival for patients with grade 0 was 100%, grade I--80%, grade II and III--14.3%.

Between 1972 and 1985, 25 patients with ovarian pure dysgerminoma were treated in the Center of Oncology in Cracow. In twenty-two (88%) patients total abdominal hysterectomy with bilateral salpingo-oophorectomy and postoperative radiotherapy was undertaken. Unilateral salpingo-oophorectomy alone was undertaken in 3 patients in stage IA. The five-year disease-free survival for all patients was 84%, for patients in stage IA degrees -- 100% (11/11), I degree -- 94.4% (17/18), II degrees and III degrees -- 57.1% (4/7).

A retrospective analysis of a group of 102 women younger than 36 years is reported. All patients were treated initially only surgically by Halsted or Patey mastectomy. Disease-free 10-year survival was noted in 39.2% of the patients. The effectiveness of the treatment proved to be the same in the group of women under and over the age 35. For all patients with breast cancer, despite their age, identical prognostic factors were observed.

On the basis of the literature the clinical picture, treatment and prognosis of the small cell laryngeal cancer has been discussed. The authors presented two own cases.

350 patients with ovarian cancer were operated and irradiated postoperatively in the Center of Oncology in Kraków. 5-year survival with no recurrence was 41.7% (I.--77.3%, II.--44.1%, III.--7.7%). Stage, histological grade and residual volume tumor appears to be an important prognostic factors.

An analysis of 75 patients with non-small cell lung cancer that underwent post-surgical teleradiotherapy was carried out. The authors have shown it to be of little value in stage III B patients and in patients with metastases to regional lymph nodes and in whom the surgical procedure was not radical. 17.9% of stage III A patients were cured, 61.1% of stage II. Postsurgical radiotherapy was very efficient in patients without metastases to regional lymph nodes (61.5%--3 year survival).

For estimating the effectiveness of combined treatment of cases of anaplastic gliomas of the cerebral hemispheres retrospective analysis was undertaken of 83 patients treated only surgically and prospective analysis of 81 patients treated by the combined method. In the group treated only surgically 47 patients had glioblastoma multiforme, and 36 had anaplastic oligodendroglioma. The general condition and the neurological status were evaluated using the score of Karnofsky. In the group of combined treatment the patients were given telegammatherapy from Co-60 cobalt source by the method of Skołyszewski and CCNU (Belustine) every 6-8 weeks for 1 year in doses of 100 mg/m2. In about 25% of patients transient leucopenia was observed, and 20% had transient thrombocytopenia. In about 30% of cases transient increase of intracranial pressure occurred. In the compared groups it was possible to establish, using the statistical method of representation probability of Kaplan-Meier and statistical analysis of Gehan as modified by Wilcoxon, that the mean survival time in the surgically treated patients was 6.25 months, while in the patients treated by combined method it was 13.97 months.

Recent opinions concerning the role of radiotherapy in the treatment of patients with non-small-cell lung cancer are presented, particular attention being called to the problem of independently applied radical irradiation, adjuvant postoperative irradiation and palliative irradiation.

11-year experience of the Cracow Branch of the Oncology Center concerning the applicability of electron radiation for the radiotherapy of patients with malignant neoplasms is presented. It has been found that 9% of all patients receiving external radiation required the application of electron beam. On 81% of cases the energy of electrons applied did not exceed 11 MeV, and in 99%-15 MeV. 30% of patients have been irradiated with electrons only the remaining 70% in combination with different kinds of radiation. The electron been has been applied mainly in the group of patients with cancer of the head and neck area, breast cancer, skin and lip cancer and in patients with metastases to the peripheral lymphatic nodes.

Details of clinical and technical problems connected with the irradiation of a total abdominal cavity, applying the "moving strips" method are discussed. In connection with the analysis of clinical data concerning 10 patients, preliminary estimation of results indicates that the discussed technique is an efficacious and safe method of postoperative irradiation of patients with ovarian cancer.