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Radiotherapy in Carcinoma of the Urinary Bladder 1993

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Cancer of the Urinary Bladder and indications for Radiation Therpay

Publié dans : Santé
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Radiotherapy in Carcinoma of the Urinary Bladder 1993

  1. 1. K^diafro Thelt 'fUni4atA 8I l31 3 lursnnl-J ? D v l-or-€st+- lrft oL ,"difio" 0' kiiaA fi,.,u*^ll*h nntyTib^^y
  2. 2. BLADDE x cARclNof"lA Lyrnphafics LympnoLie Vess"ls in ]h. rrtucosa' o'.tJ tr-"" tt,t'lt':r ct:all " o[ btidd., .' dvoin ia*o :2 r {qterior pe,' i vcsical r'oclt.t z L-rttex aL p<-; Yesical nocles ' Regiona.L nodes " +t-" blc.dAer z- " o' Fl777osE"ie 'od'>.,, b. Obt*taLot nod.s c' €"ttvno,L itiac nt"l.' d. Lcttenc^l Aacrc^l' no4 . ,... jrsxto veqionaL nodes a.= : ^, u c,orn,',on i[;".. r',ojn-- a' peri aotEic nod"t c' io6"i.'.-l fiades BLadder cancino.r-ra is . pri"no,r$z a t[i'uc.'" ",b thu V'n # 8'n du.o.du of t.;{" ' ,*ny jj ni ii,.," a/ " - *ri:#)?:,:; !3' b;iln"casc"/,,.,n6 ? l:;t."1il*r,,,[ !!ru!t'J"qi4'J ft, Arnioo-r,- noplnrp,r 4 Cc,tbl e. , ,1 e lLt^cu$onic A ( id ( <t co21^6^1 ea f octuct2 S,Abnovmol , ', - 7-,.j-1.) i^ s,,i.,. lp"oto.',.,.J."nLl' Lrypt+ptaa n.yla -'v fvc'-e'..IuJ in "'''" 1T:i;:gih^r..n 7. nitr.,l.vs s, ad{ee 3. aiFJi.,o( Ac,r".kncrs. lo. Anallesics. l/ tr- A Qunuh. f'.Jioprail'on tz. &t"od Qr"up- A. t3. FILA - 85 t+. HLA- CW+ 15. Cc',lcuJ,i I l. . at tivCy.tratrlr16 ' 5fasrs ro ( t7. $chisfo homiasis, I o
  3. 3. lv iqone U A nt eri or c":oll I Y A I./, 8/ Dcme ol tt'{e bbdrl^- 6 /'.- ) { too" neck l+ ffi*s 30 .ntK 4 eta eto B. Vyr:htu'7rr'n(no nyaErd z{ades, 71d fumaa, c/aaaloVt/ /arcraa.na in siLu. /6 ,PP//g r/*'- €oal thrasia') /hrastbn / lamr;za 4ryna Dr7 ;77a4c/e /'oYa sl'on invasrbn a/ Pt iYes ira/ 'f/ // f ry*r"/ Vt/ur orlans 2, ,P, /r"l A ful'z< stc*'oa// Sty*y'oa/ rTasek thYa*b.t invasrbo /atvatrz. o c A .8t 62 C Ts n T TL Zn Tss 4,+ zB. A NafuYaL Hist o'r'1 - pti", *r7 lrrno,,v sik*r?v syre) 4o La terdt r,-lall - 47./ -> intosn! g ex[e{o..l ilia< .,oJo" txte'(na.t ilic.. no{rt to TeLvo/...no"ol .,oJ." . J ' ur.Lr,'..l . t"{"*.Lo. ' Sec P/.lon*ph.ihs. l- t! // Yt U nt eo [oJ Ll./d,"' Conn, 5c,/ .li" 75 /. ,li" As *,^mour( pro7ress + /a ddc, Cartcet ?ta, r.s A c // trv dy';ca fi. c S.TrnrttfuVrrr2: eovcalucttlv/-'t S.d a' ()nl,.^l.A +h Ai' "h Uroae{ii' ;, Teo..l Jai"t.,"e ' r |r- J' I | ^.,t1 :,kk"^. Por,l;^4,;. "1, 7,"*tr . - -uy f +{ Aii- .r{ i^Iono''a"'" ' l-_'
  4. 4. lliaLotoqit lc17e ,.Tvo^,'n;ho"J CelL x, Sar,t-tornoua Cel'l' l. Ade"^n ca'/ cinoft)a' 4 . $a'u co'nc^n 7{ 1-o ss- /. 5 +o la '/' | +- 4'/' ^Y atc . f"of,J"'-1" 'b*0^ .t n lvcu-,'rrto'-o'* ,!;:::'I#! Ce (t Ca.. lL.* l^16'ai"d :=/ SyF%t .,F-,...!6 -r so uAJ--a,iscs +",- ltn "JJ-:i+y'k4g'rEiltt .6 il - . - ^1.*l t^.J, '' CYslih s ' Y-'t- hz^'c' ^-r."r'4:24 Pao )//t'7 ta- . t./ ?"oqnos, s ( Maa+"1' ' -lt c.ll ca.: c; iavetleJ ?o!'rto-^' 6oll"rko-' ) t c,/. , I)Y' ----1'- X,J., - ?"f'twzc" - 7).n*t' a h I C2-,.tt!: ^) v32 e:::---:+Bn^^^/s nesls
  5. 5. (b-7 Proqnarh? /ch's th &tdan c' ' ( -- y'vcrall 5./* So,-viyal (/) Qrade /ap HtTA h_oo, Cha r c" /crr.s frc Daa i//aT ',/t/-/ 6a/ral /. 2. 3. S/a nan{ !rr hortno / /)6normo/ ?asac/ay /hrasrba {jilcc&tzr2 f-3.4 lorcs 2n/ ,Qasen I Vnw, 6ttca < y' c,r"s € aera./ r%arzaVaan/%,__4_-_ ,Sa.-7.-7 2>z,a,.dafraa le -56 / &cs -32 / /- z aa*,, 7/ -<tL" / 38 -s7;/. 7y' ;t B,s-- 3o'/ 77 ;/. 4s/ tc ;t *a ,1. 50/ .27 / &o-tfz-T/ -
  6. 6. Cornbio<d xloclaLtlg l-a] Padiahon the'.apy + Sur gexy 2- ' Lrr_l ,'i L ! a pe opercLhvc ','!if,-"^ol r.s"J'don r. Posf of^ohv" .:. sil'pie c uzJecl.ooy i :,. ; .o 1 Qc'-ol'ccr I CY"+"lo-Y [g] .'R di"".kA !9-"Jr ?!A^". frcse*uaEP1--1 .*-r 'w!''o ani,'ni'ti '" exLtn']al 6'o^ i vvc^dic"h cto lc1 -b. intevsh ha[ imPtaofs ' keseoach ole.ts .. rcdtatioo .no d-;f ie rs t. hign Li^e,a, eaer(1y -t"ons{." lnutc,py ( o.".l'",n ". concc>mitc$r idJ.sio,r .'hu^olh"-'Jp) *'*'') ,l hgn do'" i""..?.['on
  7. 7. ^;no€ , 4 nclir r.l"tl Ltt. 6t'84^' f o^.*"lo / p,"r.,r.^hon f+J'l"JJ'+ ) 2 i/"$*0 ; 1. .'^ C--t^ 7,,
  8. 8. D"finilr/. LxIe'+noL Jo""n t:::,4f!::: 3' ffi7'v'"--fa)--Inclicaf on s Ptt v$usinV o"'A",',fr meclicallY nolercble z. wAg ht-* v"' t^ d,, t"QoAt--J. 'a v' :tt' 'I. 2. 3. lo.allq ' .-lvonl"d cLisn".s'locallq < r)tvt'^t tcLs ee ' vnsuitSt@ #' ou'fl^{, ., ,,,, ctt c tol'-bon O^e aat<,/lo/ z Z LaL Vl.dXe p., Ls. Technia,ue- <;l c .l ., 'e bclvis ' -'r- r't t t t - 1,, i-rt,')e | r i l:uv )elcL.terho,1,Le. ta tnclude : e /fcaol lttac L)/ ttodc) obt wc^*ot Lv ,Node. v i"" +oo d.,su of ){oo.eyv ;;;;;,:;^";' ' '' lq 5 w'ee l<s .4.. 13oosl L o Lhc bl'..,4c. e -,i-> l l) ='-5O1 -{51 . . ,/.'se"t.s. bv' lr^tvee lalal technrt,r/Je b. c.
  9. 9. -- | 60 tn --;' -J-SOCLOSl L U 1q-fioctv {*1,"1 teJ $F"li"? @lntqfu--L 'rrla) DOO6E- l+ .Lo" ,k+o / l. -llwee Ji-tJ-. 1),Ia I J ,-p.eo/.u6', llxt{- rocltht ,bo./ 3. ooe AnY E nB't . 7'{* Io* loo y'. ,tL ta)o La aedln' z{;7.irl6-->-/ b6'f loot. A.AP:PA c. boast fietd 3o" t, -Tec L. 1rl0L^ cl xlOc-. lTt' tr L.aT )10 pl I oo'l ' <i. t.'t".7. b. olyovA lalwi) 6a{t tob/. xli*'
  10. 10. Res.^l"fs .r-t.1" ntkve iv{aAtatton 'i' i' ' 5 /, r-rnvtvo.J ; 26 +.73 /. 13 / +" 3(./ 5 6[o91e- cl A,3 t B-zuC Autho" Sey^*o" cI o1 r4illr.,'r *f'hason }.{orrison 6{,,"t.[ ol Ccrrr-rn io7 eU o, P. P,'-/l '/2_ C 33/ 25/ A Br B2 C_ A, B, Bt, c b2 C 5c>'/. t 26/. zt /. ___ r 1l:_ 4t/ 2s /. 3s/ 9 r-r ,,/ z.-v /' ' B. b/ C -7 3'/ 36) rLl BlandY A A*sociaavt 70/ . s+/ 5_6_ / | 7.5/ alro jo"'tl ' vc.Aia*t o n 5 v" St^nvival $. $a {
  11. 11. Ilt''atlb'a L .fmp1..n1.'l'on I., .l i. ..tio'., > IoLc. L t.^-o"Yt Jo'ra 6ooo <qy lo 65oo c G1Y t" € ra 7 daYs' tumouv - urell l.r.o I is "J stc^Xe B1 (r-) : i..i:u3:,f".b1;,ond d*p",|uiJ rnas'le r-otJt a:rre q not rnc're )a" c-s clionetct' T-!tgv: " S,-^".,,.-[ oPeo;^, { *r' t bl..tld"'- ,. "rr?,h.'n otlh'v f.-o"' +: 'ft bRi:l -5,,.',':;, 3. Tavrqe[ /o1.,.". - 1(nPtc^nt<cJ oo'fh^ rrqvraan= ; ;J;:," ,-y''"1" I"-'"'7 r';a':.: a r:'-t'l'-' o qol;"'n Pet mr^n"ol i-yv'4s Au t " , T '' "h 6. b. 1
  12. 12. r-rl Ke-s. tts e In! JrnPlants Vaode^ we,rM.ss;V A CT,) 117 toy @ aode, wer ,tuntil b 1612 3z-o 61 /. Io7" ' vanAu a".$ o',",a;.fi "?, , a_ : 4 | 7t t 5y,. s.-,1"-!.u U lt3pz t i g,,taa- ' I / / btoo.n Tt'r,;"^'- on 7a./ {7' B,rbri'',19]6 4o/ 5/'' tlottioefat- ' A(t,) 16 f1 5y,. f,., . :. , r VanA^ l,Je, 5le^qz aT[ rl o .".j,+rr,-,".J. Inlr-"h'L'J l-yl^.1-/,o" +n h / Lo.o "t"nti oh'un' airrlo.'," s.-r::4:ll f::!.------, - Zgl- ---891- ";*J.*- +' t*r-,-folEyrv - 2>/. -2-7- -4,.. olMrf".ok"is al to7" 4lt 85 /' ^t k"Xl I btA t et"lq,n' " 7 s-y'. I g'/' ,-Jh'pll r e cr-l::u:r Qn c'< lS./. | '/' s"hk'iL'+ ToK 76 /. 2o/. d gxv#::l*itu 6o/.-_tt/ in'Ecn"t-|1',:"! --E;r.^ ij1r- =1t1r -- --a;t* a' Pt *'F =-T17-
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  14. 14. l. L. ' , - t, r. ^,on^r)tfu-1 .'- I n - Pc,volive lwc.dto+ion I | ,, v -J, Kes"lts oj f'{e u .i;:^t"P;):T#,?;2:,""fJ":;';;!l?r,I!^;?4;* cxl6oe.7 -',t,.'. ', | , r. .1. ln i"-*, b:A":J :tff" U' (r) ' th"u' h'a b'"n clnfin'|''< 'T,:;";:; ):,::;"-,."' h"^';' a, pnocruc'r p'^.L'.^!tg lhc - 6omY slcl;ults I I -^::,!"i'j"|."tr:"r,"!::'":'r"."-^,7)^l^'^21u'iiln" "n::: l;" Z,-.','|"..l"l I Do^' su6t'67 ;*F'lt "ltd*);' i# T,:n*i;,1;^ + 5 r{
  15. 15. fuo ol ,vtadtuhon slg:j_)rp .[ T,s .1-' ,'t, Or* ' +' sI'?f 57" s"'r"r; Aulhon _:y 4k o,;ls, 6+ / f,art.t--z""c}'qt +P o-'^t bt f.e)a q *" _ Xq ./. phihno,r '{ J ooo'7 zo+ "^ Z^r' B ' - 5c''/' .),ooc7st i : 2rr/, Skinn* el oL leoo cQ7 i|- 6,4 - 7-1/. B, , Bs- s6 /' -*--- -7; sE:E4!3 , -;.4ille4,,lohn;o. St"i,t1, zil B-' C - 1-'/'Y r' ,. t^^.)!, ta'r. A- . - 36/ tc) L,- >-. a b, *-q af , u, a-.,. -7'r{. D,,JiJ 4{oo'47 zsf bz''' - o./ Pyl'J "i .7^, iz::2r l,J': 'E:. - 't'o', S h inna" ct- d ) irii).'i"u u,*,- )ooo cQ7 zof', B2-^,' - :: I r..rhif -"," uf ^l l1ooo Q7 zo'f 2- - - ".3t Looo.q, +f b2,..'33/ v,,n,)* a"jmeX'g /ooo..7 ,o! b,c. -. se'/ lo I l 1-
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  18. 18. .r rr I YaTcetYn s o h U / u.tl;o' Mille,r laoclu wc-:l rn"s',o7 posL V l)osu -fcrlLri,.ing W toc-l 0? RT s s*ffJ D isl"'al-- Nekttlttntt: i" / 2't / Ls/ 3s/ Jcubnt- -i;t,,^u r..lod,U Pt lLo. SoP cy f wt' ' l1ooo.9/t't,. /c>oa c7 f uu' 4ooo cQ, f ut 2{ ,19 ta 183 I e '/. le / t+ / t+
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  20. 20. Tethoi q,cte I v Dose' tory" t+ @* /,'l R"r,^lts ' LocaL =(sz'/) ffiur;:W4yeo,,,crtte n c e-o aafe,o rPr" -b "un t^D^@(rc/) l1
  21. 21. | -,1 Pattenn oP f at r v'r< LocaL {ailuv< t al- ' Pve of Rr t- 2. lvrc,,oliahoo 4 3. lost oP l2 T 7t^.".) AalvaTe 1. RT alooe I 5. Cct sle.lo^'t 4Loaz -d t5 -t I( YJ tz (--fo.D Y /1 <-q!t..L",- v o1 . O'/ to t6'/. , l+/ : 33/. . so/. , 2_A'/. D;"bnI f,.;lu'._ 'o['y;lu'"t"fr"^,-l a; lE .',"'l"'llJ' "f, L'^L *u l-"'tt CY sti ..*o'nY alo'o._ | / Pl"" oP Rt '+ Plc.nnuA 7"e'/ ' 28 t- 35 I tnc- | y' J,tn'.v;'t'' - C" 'B locl'len ^ ,o"'q ,'lli. -^ and, C2 /. of cun'n- A"ulT;' 'h'"A J''" {o lc'co[ {'rluae
  22. 22. I Saqr.relo.e ol, fvzot-ntoF )6 6:lz:l'l:;.:a rc";' :iili:';;:;"''; :'k' t. oiit'^'hut orolo[/ ', l'""')*,,,:)"":f: d oec"of'. {,-,'.',o.-^', 4 ' I' o'-Ve- UlceMo'11v Acrt[. Sqv'l ;^" z- -.atc,a'g.^el"' tu r,.n,"r rlinut-r'''| ' -;rJ *h",J kliP"ffi y btuddr'! vk* .t , , z co^Ltackdt blc't?LAJib;; . Rc.{".I ruo'fo- <JT'ili";; ; i;;::dfiffi::+:!* 4. Qn,,l,.l ulee't A. ;;va,"io''61 +l-"i -,ri e. r)'rcm;o' ,:;1fi'";Ti-?"'s- ' ^"1{ .^:llJi;!"Hir . ffil.f#5 ^,* {#,,*,1::hfrInm " "ffiTi" ffi,+*S
  23. 23. l2ros w.hve ,.-.o,'Jornis.A -triol bv B{oo..n I cAlluqq*^ s[,ru' Bz a c (rs) , stvc,'$.-y'hA nt- sho'2A o' Al;:,+'cc.nb J1eil^'{"b;' 'tu(: ' {'"'t"''1u n'v {Jrru'" U i goYt' SYY 5*n vivo'J" / ' 43 / -f" fuc of aT + %"+"1-W Z5 '/ +' Yt^-,oL'to-[ R'T ol'ont' t7 d P*"f aftshcolt, /I 3{/ +3/ +, f,oo? PI + C7|..'l-1r 1o" rooli.J Rr olo.e. ",,-' ,c.^tr,, funA^ Pt atre' b's F * e p" 6P RT P+s ovetr 6{,1,' sh';ld be nv'o ': oThon "i Pr e yad)c,ltoa fu^fy + sobLg- ad'l'J"*/ I C1sk"J"*7 Radica-[ 5
  24. 24. Sand c,r,i h *urhnlal*< Mtoh iadcL'n A olk*s l6 Clrni^tSb-f,. B d c U 5oo e Q 7,; t f , * Vr* v nol b+ ; t"i'Y,,: ;,r:,1" :#:.^-: x, Ifu rSmrK 3y,ststv'troJ - rc/ w B' rn"FEJ 'i 5^1L''' n o ?U d-otttbyenl l,o-t Yeu'Ltrren(i-' t t1
  25. 25. G**nJ . Sh;ptuy p oltcns s-z p& stagz T. +.1-q ,rot con.[id..l.r {a bolu'> Cisptafi n . e ve*1 3'rr.. 70,nV,1.nL (zi n,/oJ,'4.) .s8. on cl7 oo" RT' io 33 +'d Se f ';, | 5 prs. ., 73'/. alive c'* I +o foJa "4k-F ,ne r^^ b,,stui rJ z4 '-l.i^ + 'i IJ C+lhtecto,nV u'v R To R. , i,^t) ,lo"_ ,"r.^l.ofi'on .E Coo.o,nit...nl g cot nse a* r. Dt thL, rt " o ' i ^r,h2z,ntb */u 8z I .g Te- Ts dt"u"-" Plt L h^d c,,mpl"Le y(spon5e. 5o,/ "k Tq 6ti>eonu. J - *- 'l Do^nsk^Lo M.J;,J C"nIr, N.X - l') '-- '' ( lnlu'r;on 5FU,rn'tlomycin C tY bolua + c,.n*^il^^l "-l;.,lun t6 ' inuoriuu h,yt',- 2rJl., hiXl, l+'^nz Cc' 6lotkJ"v ' mosL h..d tu%".,rl a P*, ?,,nnodt''' {"oi"a'a' Confinut* 1e ; inJ,,^^;on o srtt ).quii^cd A.leeks l,+F7 cn Zr5 + rnik m,6r'in lV bolo,''"o lon6 i'-,- ToFa) Dose 6ooo rQy h 65oo,97 6t/a+o7,'rk-r. "'2"
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