Malignant melanoma. Results of palliative radiotherapy

IntroductionRadiotherapy of malignant melanoma is often performed in palliative therapy of recurrences, metastases “in transit”, bones and brain metastases, to prevent bleeding and to control the pain. Because of existence of large “shoulder” in the radiation cell survival curve, high fraction doses are used.Material and Methods27 patients with local lymph nodes metastases or local recurrences of malignant melanoma were palliatively irradiated. This group included patients after surgical treatment and disqualified for second operation. They were irradiated with 9 MV photons or Co 60 gamma rays, fraction dose was of 6 Gy (2 fractions weekly), total dose was of 36 Gy (18 patients) or 48 Gy (9 patients).ResultsTotal remission was achieved in 14 cases, partial remission in 8 cases, no remission we observed in 5 cases. 5-year survival rate was 40,7% (11 patients). In the group of patients irradiated with total dose of 36 Gy 5-year survival rate was 44,4% (8 of 18), in other group irradiated with total dose of 48 Gy 5-year survival rate was 33,3% (3 of 9).ConclusionPart of patients with malignant melanoma cured with palliative radiotherapy can survive over 5 year

Posture and low back pain during pregnancy — 3D study

Objectives: Back pain is a common complaint of pregnant women. The posture, curvatures of the spine and the center of gravity changes are considered as the mechanisms leading to pain. The study aimed to assess spinal curvatures and static postural characteristics with three-dimensional surface topography and search for relationships with the occurrence of back pain complaints among pregnant women. Material and methods: The study was conducted from December 2012 to February 2014. Patients referred from University Clinic of Gynecology and Obstetrics were examined outpatient at the Posture Study Unit of Department of Orthopaedics and Traumatology. Sixty-five women at 4–39 weeks of pregnancy were assessed and surveyed with Oswestry Disability Index; posture was evaluated using surface topography. Results: The study confirmed that difficulties in sitting and standing are significant in the third trimester of the pregnancy. The overall tendency for significant lumbar curvature changes in pregnant women was not confirmed. Major changes in sagittal trunk inclination in relation to the plumb line were not observed in the study group. Conclusions: The issue regarding how the pregnancy causes changes in spinal curvature and posture remains open for further studies. Presented method of 3D surface topography can reveal postural changes, but that requires several exams of each subject and strict follow-up of the series of cases