Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
4
pubmed:dateCreated
1991-11-6
pubmed:abstractText
Patients who have recurrent gynecologic malignant conditions infiltrating the pelvic wall still have a poor prognosis, although based on the biologic factor of the tumor, 50 per cent might be salvaged if local control is achieved. For patients with unilateral disease, we have designed a combined operative and radiotherapeutic treatment (CORT) that involves subtotal resection of the tumor, intraoperative placement of guiding tubes for postoperative high dose rate brachytherapy of the residual tumor and tumor bed at the pelvic wall and pelvic wall plasty with autologous tissue flaps. We use either flaps of the greater omentum and inferiorly based rectus abdominis muscle flaps from the abdominal route or (de-epithelialized) gluteal thigh flaps from the vaginal and perineal route to cover the tumor bed and overlying tubes. Thus, a protective distance between the radiation source and radiointolerant pelvic organs is created and the risk of local infection and hypoxia is reduced. With this combination of surgical and radiation treatment, the therapeutic ratio between tumor control and tissue damage in the pelvic area is thought to be improved. Higher local doses can be applied compared with conventional methods in instances in which surgical treatment has been performed and reirradiation with tumoricidal doses may be possible after primary or adjuvant radiation therapy. The encouraging first experience with the CORT concept in nine patients with a short follow-up period is reported.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:status
MEDLINE
pubmed:month
Oct
pubmed:issn
0039-6087
pubmed:author
pubmed:issnType
Print
pubmed:volume
173
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
297-302
pubmed:dateRevised
2009-11-11
pubmed:meshHeading
pubmed:year
1991
pubmed:articleTitle
A novel combined operative and radiotherapeutic treatment approach for recurrent gynecologic malignant lesions infiltrating the pelvic wall.
pubmed:affiliation
Department of Obstetrics and Gynecology, University of Mainz, Germany.
pubmed:publicationType
Journal Article