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Basing on a study of the results of therapy of 47 pediatric patients with thyroid cancer metastases to the lungs the authors worked out methods of hormono- and radiotherapy, specified indications for a volume of operations in locally spread primary tumor or regional metastases. The use of multimodality hormono- and radiotherapy of distant thyroid cancer metastases in children resulted in the 5-year survival rate of 90.9%.

Teletherapy or radiotherapy combined with 131I for thyroid cancer metastases to the bones caused the development of bone reparation in 70%, in 17% the picture remained unchanged; signs of further tumor growth were observed in 13%. An early x-ray sign of therapeutic efficacy was the decreased soft tissue component of a metastatic tumor 3-5 mos after the initiation of therapy. Disease stabilization was observed in 2.5-3 yrs. X-ray manifestations of bone reparation looked as sclerotic changes along the periphery of a focus of lesion and depended on the sizes of a metastasis and its localization in the skeleton.

General principles of management of localized small-cell lung cancer were developed using the experience of treatment of 300 cases of the disease. Tumor extent should be assessed according to the TNM classification. The effectiveness of surgery + radiation as a first component of complex treatment was evaluated in a randomized study which included 71 patients. Patients with T1-3 primary tumor and metastatic involvement of bronchopulmonary lymph nodes, those of the lung root and a group of tracheobronchial lymph nodes (NI-2) should be radically treated with either surgery or radiation. Unless contraindicated, surgery should be preferred at the first stage. However, treatment should start with irradiation in cases of lymph node involvement. The second stage should include combination chemotherapy.

The paper presents a review of up-to-date literature on the problems of morphological heterogeneity of small cell lung cancer, clinico-morphological parallels, main prognostic factors and rationale for application of radiation therapy in the complex treatment of the disease. The authors also discuss their own findings on 208 cases, with 170 of them having localized tumor. Superfractionated irradiation of a locoregional zone with 1.2 Gy thrice a day was conducted at the initial stage of treatment (total dose--46.8 Gy). As a result, complete regression was obtained in 65.5% and partial regression in 34.5%. All patients with localized tumor survived six months after radiation chemotherapy, 58.5%--12 months, and 57.1%--24 months.

In this paper the analysis of immediate results of clinical material is given which has been accumulated by participants of the joint investigation in some CMEA member countries (Project 3-9.1.1 of the Lung Cancer Program; Bulgaria, Hungary, Poland, USSR, Czechoslovakia) with the aim to study the effectiveness of one of the variants of combined treatment of patients with differentiated forms of lung cancer. Combined treatment received 286 patients, 231 patients (control group) were treated surgically. It is concluded that the preoperative radiotherapy using the method of the intense concentrated course does not complicate the operation itself and is not reflected in the nature and frequencies of intraoperative complications. However, in combination with the subsequent surgical intervention, it significantly elevates the number of postoperative complications, particularly of those of purulent nature (bronchial fistula, intrapleural empyema) and also the lethality. The difference between the groups in this respect is particularly significant at State III of the disease. Late results were studied in 379 patients (in 221 of them after a combined treatment and in 158 after surgical treatment). For more than 1, 3 and 5 years survived 76.5, 49.4 and 34.48% (combined treatment) and 77.2, 41.2 and 20.7% (surgery), respectively. The differences between the groups in favor of the combined treatment are due to patients with Stage III planocellular carcinoma.

The results of a cooperative study on combined treatment and preoperative radiotherapy in 478 lung cancer patients were analyzed. Intensive fractionated radiotherapy was given at doses of 4 Gy for 5 days, the total dosage thus attaining 20 Gy. 218 patients received combined treatment, 260 patients were treated only surgically. A comparison of the 5-year survival rates of Stage I and II patients did not show any advantage in favor of the used therapeutic modality. The combined treatment with preoperative radiotherapy, however, improved the survival rates of Stage III patients with non-small cell lung cancer. The 3-year rate in these patients was 49.4% and the 5-year rate was 29.2%, while those found in the patients treated only surgically were 28.1% and 15.8%, respectively. In all patients with regional metastases the effectiveness of the treatment was higher when the combined method was employed.

In some cases radiodiagnosis of osteogenic sarcoma is associated with some difficulties resulting from a variety of its x-ray picture. The main factor that influences the x-ray manifestations of osteogenic sarcoma, is a neoplastic bone formation which reflects the morphological essence of this tumor. Other signs depend on a tumor site in one or another anatomical part of the tubular bone, on rates and type ot tumor growth. In some cases the combination of these signs ensures reliable diagnosis. However, along side with typical forms of osteogenic sarcoma there are also other ones which do not fit into the classical concept of this tumor type resulting in diagnostic difficulties and errors.

In this study there is presented a comparative analysis of immediate results after radiotherapy and combined treatment (radio- and chemotherapy) in 174 patients with highly differentiated inoperable lung cancer. The data were provided by participants of a joint investigation in some CMEA member countries (Hungary, USSR, Czechoslovakia) during the period of 1976 to 1980. In the randomized study radiotherapy (a total dose of 60 Gy) was applied in 98 patients, radiotherapy with chemotherapy (methotrexate and 5-fluorouracil) was applied in 76 patients. The comparative analysis showed that the employment of complementary chemotherapy tend to improve the immediate therapeutic effects. In the case of highly differentiated planocellular carcinoma a pronounced positive effect was seen in 48.6% of patients as compared to the 31.2% of those treated with radiotherapy alone. Nevertheless, with respect to survival rate prolongation, these differences are not manifested in favor of the combined method of treatment. After a conservative treatment (radiotherapy and radiotherapy in combination with chemotherapy) of patients with differentiated types of inoperable lung cancer there was a one-year survival rate of 55.7%, 17.27% of the patients survived for 2 years, and 8.55% for 3 years. In radiotherapy applied alone as in the combined method as well, a direct dependence of survival rate prolongation on immediate therapeutical effects was detected. For more than 1 year survived 49 patients (73.1%) out of 67 exhibiting pronounced immediate effects, and for 3 years survived 8 patients out of 9.

Comparative analysis of the results of radio- and scintigraphic investigation of 101 patients with thyroid cancer (TC) metastases to the bones has shown the appropriateness of combined diagnosis at all stages of patients' examination. The use of osteoscintigraphy with 99mTc-phosphates with subsequent x-ray investigation and whole-body scintigraphy with 131I contributes to early and more complete diagnosis of TC skeletal metastases. Iodine accumulation in TC bone metastases depends on the morphological structure of a tumor, the presence of functioning thyroid tissue and the level of iodine in the patient's body at the time of examination. In complete ablation of thyroid tissue and a low iodine level, iodine concentrating TC metastases in the skeleton are detected in 65.8% of patients with follicular cancer, in 41.7% of patients with papillary cancer, and in rare cases of medullary and undifferentiated TC. The results of combined radiological (with 131I) and scintigraphic investigation reflect important aspects in anatomy and function of TC bone metastases and can be used for the objective evaluation of the effectiveness of applied therapy.