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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.

Background and Objectives: The 1990s have established the contribution of multimodality therapy in the management of IIIb noninflammatory breast cancer (IIIb NIBC), by reducing the odds of recurrence and death., Methods: A total of 300 women with IIIb NIBC received a multimodality therapy. The treatment consisted of neoadjuvant chemotherapy [FAC (5-fluorouracil, Adriamycin, cyclophosphamide) regimen], radical (Halsted) mastectomy or modified (Patey mastectomy), postoperative radiotherapy, and adjuvant chemohormone therapy [FAC regimen + cyclophosphamide, 5-fluorouracil and methotrexate (CMF) regimen or Tamoxifen]., Results: Complete or partial clinical response (CR or PR) after neoadjuvant chemotherapy was obtained in 83% patients. Ninety-nine patients (33%) survived 5 years without evidence of disease (NED). The uni- and multivariate analyses factors that had significant influence on the treatment results were: clinical response to neoadjuvant chemotherapy, pathological tumor size, and microscopical status of the axillary lymph nodes., Conclusions: We conclude that neoadjuvant FAC regimen chemotherapy is very effective in producing objective tumor regression and offers the benefit of radical mastectomy to patients with previously unresectable IIIb NIBC.

Thirty-two patients with adenocarcinoma of the fallopian tube, treated between 1975 and 1990, were studied. Thirteen patients had stage I disease, 9 stage II, and 10 stage III. All patients underwent bilateral salpingo-oophorectomy, total abdominal hysterectomy, and subcolic omentectomy. All patients received postoperative primary whole abdominal external beam radiotherapy. Seventeen patients (53.1%) of the treated group survived NED for at least 5 years. Survival was 76.9% for stage I, 55.6% for stage II, and 20% for stage III. In the Cox multivariate analysis, two variables were independently related to survival: stage of disease and size of residual disease after surgery. Postoperative teleradiotherapy was totally ineffective in gross residual (>2 cm in diameter) disease (0% 5-year NED survivors) and not effective enough in small residual disease (<2 cm in diameter) (33% 5-year NED survivors). Despite postoperative whole abdominal external beam radiotherapy, 3 patients with microscopic, 4 with small, and 4 with gross residual disease did fail within the peritoneal cavity.

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.

Between 1970 and 1991, 22 patients with pure immature teratoma were treated at the Center of Oncology in Krakow. Sixteen (72.7%) patients had stage I, four (18.2%) stage II, and two (9.1%) stage III of disease, nine (40.9%) patients had grade 1, 11 (50%) grade 2, and two (9.1%) grade 3 tumors. Eight stage Ia, grade 1 patients were treated with surgery only, the remaining 14 (63.6%) received postoperative chemotherapy. Five-year NED (no evidence of disease) survival was achieved in 81.8% of patients. Out of 16 stage I patients, 15 (93.8%) survived 5-year NED, out of six stage II and III, three (50%) patients only survived this period. We cured all grade 1 patients, and 81.8% (9/11) grade 2; two grade 3 patients died because of tumors. We also cured all six stage Ia patients, treated with unilateral salpingo-oophorectomy (with or without chemotherapy), and all eight stage Ia grade 1 patients treated with surgery only.

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 fifty patients presenting with a stage I-II cancer of the supraglottic larynx were definitively treated with irradiation. The 5-year disease-free survival rate is 76%. Multivariate analysis reveals that the only statistically significant prognostic parameters are clinical stage (I versus II), and tumour site (epilarynx versus supraglottis).

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.

Between 1965 and 1988, 125 patients with primary invasive vaginal carcinoma were treated with radiation therapy at the Center of Oncology in Kraków. Twenty-two superficial stage I patients received radium or cesium intracavitary radiation alone. The remaining 11 patients with stage I disease whose lesions were either large or thick and 77 patients with stages II and III were treated with a combination of external irradiation followed by intracavitary brachytherapy. Fifteen patients with stage IVA received external irradiation only. Five-year NED survival was achieved in 42.4% of patients. In the Cox multivariate analysis three variable were independently related to beneficial survival: grade G1 + G2, stage I + II, and age below 60 years. Of 66 patients who died of vaginal cancer, locoregional failure was found in 51 (77.3%), locoregional and distant in 5 (7.6%), and distant only in 10 (15.1%) patients. Late radiation morbidity occurred in 16 (12.8%) patients.

Fifty-two women with typical medullary breast carcinoma, diagnosed according to criteria of Ridolfi et al. [Cancer 40:1365-1385, 1977] are described. At the time of diagnosis, 90% of the patients were stages I and II. The primary tumor size was < or = to 4 cm in 46 (88.5%) and > 4 cm in 6 (11.5%) patients. Axillary lymph nodes were microscopically negative in 35 (67.3%) and positive in 17 (32.7%) patients. All 52 women underwent the Patey operation. Seventeen patients with microscopically positive axillary lymph nodes received postoperative irradiation. Of the 52 treated patients, 44 (84.6%) survived 10 years NED. The only prognostic factor was the microscopical axillary lymph nodes status. In the group of pNO patients, 97.1% survived 10 years NED, pN+ 58.8% only. The sole causes of unsuccessful treatment were distant metastases to lungs, hepar, and bones. Typical medullary carcinoma is a favorable histological type of breast carcinoma with very good prognosis for pNO patients.

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).

Purpose: Presentation of the microscopical and clinical findings, prognostic factors and principles of treatment of the phyllodes tumor of the breast., Patients and Methods: This paper reviews the published data on this rare and intriguing tumor of the breast., Results and Conclusions: The main prognostic factor is the histotype of the phyllodes tumor (benign, borderline, malignant) assessed on the basis of the criteria proposed by Azzopardi [3] and Salvadori et al. [50]. Wide local excision with an adequate marg in of normal breast tissue is the preferred initial therapy for phyllodes tumor. Mastectomy is indicated only for very large tumors compared with breast morphologic size and for recurrences of borderline and malignant tumors.

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.

Two cases of primary small cell neuroendocrine carcinoma of the larynx (SCNLC) are presented. One patient is alive at 5 years without evidence of disease, after the combined therapy (surgery, radiotherapy and chemotherapy), the either treated without adjuvant chemotherapy died at 22 months because of lung and liver metastases.

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.

Teleradiotherapy is the treatment of choice for stage I testicular pure seminoma. In this study of 130 patients, we compared the dose of 35 and 30 Gy given prophylactically. No statistically significant difference in survival was observed between the groups.

Between 1970 and 1985, 500 patients with urinary bladder carcinoma received external beam radiotherapy with curative intent at the Centre of Oncology in Kraków. The 5-year survival without evidence of cancer for T1 patients was 100% (5/5), for T2 48.7% (19/39), for T3 32% (128/400), and for T4 7.1% (4/56). In our patients the clinical T category was the only pretherapeutic prognostic parameter of statistical significance confirmed in uni- and multivariate analysis. The tolerance of therapy was poorer in patients who had partial transurethral resection of the bladder tumour performed prior to radiation therapy, and in those whose bladder volume was less than 200 ml. The additional irradiation of regional (pelvic) lymph nodes seemed to improve survival of patients with T3 bladder carcinoma.

Between 1983 and 1990, 332 patients with non-small cell lung cancer (NSCLC) were referred to short-time, split-course palliative thoracic radiotherapy. The group consisted of patients with locally advanced (III degrees), unresectable cancer, not suitable for curative radiotherapy, asymptomatic or having only minimal symptoms related to intrathoracic tumor. The therapeutic plan involved two series of irradiation. Tumor dose delivered in each series was 20 Gy given in five daily fractions over five treatment days. There were four weeks interval between series. Of 332 patients initially qualified to thoracic radiotherapy only 170 patients received the treatment; the other 162 patients were not irradiated because of treatment refusal or logistic problems concerning therapy. They made the control group of the study, receiving the best possible symptomatic care. Twelve-month survivals in the radiotherapy and control groups were 32.4% and 9.3%, respectively; 24-month survivals 11.2% and 0%, respectively. Improvement of survival after palliative thoracic radiotherapy was observed only in patients with clinical stage IIIA and Karnofsky's performance status (KPS) > or = 70.

Between 1970 and 1985, 130 patients were irradiated with curative intent at the Center of Oncology in Kraków. The histological diagnosis was squamous-cell carcinoma in 60.8% of patients, adenocarcinoma in 25.4% of patients and other non-small cell cancer in 13.8% of patients. Out of 130 irradiated patients 21.5% refused surgery, 26.2% were inoperable for medical reasons, and 52.3% had unresectable tumors. According to the UICC TNM 1987 classification, 62 (47.7%) patients had early (stages I and II) disease. The remaining 68 (52.3%) patients had stage III A cancer. Additional criteria for patients selection to radiotherapy with curative intent were: Karnofsky performance status > or = 50, and no respiratory insufficiency. All patients were treated with megavoltage radiation. Patients with stage I were treated by three isocentric beams. Tumor dose was 6000 cGy in 24 fractions over five weeks. In patients with stage II and III A disease the radiotherapy was started with two parallel opposed beams encompassing primary lesion and mediastinum. The dose of 4000 cGy was given in 20 fractions over four weeks, followed by a "boost" dose of 2000 cGy in the fractions over two weeks, delivered with three isocentric beams. 54% of patients were disease-free at the twelfth month, 24.6% at the 36th month, and 18.5% of patients survived five years without evidence of cancer. A significantly better survival has been observed in patients with stages I and II, with Karnofsky performance status > or = 70, and with complete radiological regression eight weeks after radiation therapy. The main cause of failure of the treatment were distant metastases.

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.

Treatment results of combined radiotherapy and polychemotherapy in a group of 38 patients with advanced squamous cell of the head and neck cancer are presented. The radio-chemotherapy schedule included 60Co irradiation with 20 Gy in 10 fractions over two weeks followed by multidrug chemotherapy with vincristine, bleomycin, methotrexate and leucovorin. Three series of radio-chemotherapy were given. In 14 patients the total dose of irradiation was increased to 70-105 Gy. The probabilities of overall and symptom-free survival at 2 years were 32% and 20%, respectively. Treatment results correlated with stage of the disease. Patients who received higher doses of radiation seemed to have better chances of symptom-free survival.

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.

The neutron therapy facility based on the cyclotron installed in the Institute of Nuclear Physics in Kraków, Poland, is described. Fast neutrons are produced by bombarding a beryllium target with 12.5 MeV deuterons. The unit has been used for treatment of cancer patients by the medical team of the Institute of Oncology in Kraków since September, 1978. Fifty-three patients were treated; most of these patients had advanced head and neck cancer. On the basis of the radiobiological experiments, a standard tumor dose of 1320 radn,gamma in 20 fractions over 4 weeks was established. From among 34 patients with advanced head and neck cancer, treated with neutrons only, and observed for at least one year, 10 patients, (29%) are living free of cancer.

Treatment results in a group of 70 patients with salivary gland tumors were analyzed. Prognosis appeared to correlate with both clinical stage and malignancy of tumors. In patients irradiated postoperativey because of nonradical operation, a higher 5-year survival rate was achieved than in patients after radical surgery. It is suggested that postoperative radiotherapy improves treatment results in patients with T2 and T3 lesions. In unresectable cases (T4) a 13% 5-year survival was achieved. In patients with highly malignant cancers a high incidence (41.9%) of distant metastases was observed during the 5-year follow-up.