Romuald Krajewski

Maria Sklodowska Curie Memorial Cancer Centre, Gleiwitz, Silesian Voivodeship, Poland

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Publications (17)11.47 Total impact

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    ABSTRACT: Objective: The study focuses on the comparison of tissue reaction to titanium and bioresorbable implants with and without postoperative irradiation on an animal model. Materials and methods: Thirty-nine LEW/W rats were randomly assigned to experimental or control groups. One titanium and one bioresorbable screw (poly-L-lactide [PLLA] and L- and D-lactide poly-L/D-lactide [PDLLA]) were implanted into the left scapulas of 24 rats. Half of them received 30 Gy to the operation site and the other half received 42 Gy. In the control groups, 3 rats received 30 Gy, and 6 rats received 42 Gy to the scapula area without operation; and 6 rats had implants inserted as in the experimental group, but received no postoperative irradiation. The scapulas were removed 14 or 30 days after irradiation and a histologic analysis was performed. Results: The host tissue reaction to titanium and PLLA-PDLLA screws without postoperative irradiation was of similar intensity. In irradiated animals, the inflammatory tissue reaction was more evident around the titanium screws than around the bioresorbable screws, irrespective of the radiation dose and of the time that elapsed from the irradiation. The reaction was more evident on the 14th day than on the 30th day after the last radiation dose (70 and 86 days after surgery, respectively). The intensity of the inflammatory tissue reaction, irrespective of the implant type, was more intense in the group irradiated with 42 Gy. Conclusions: PLLA-PDLLA implants appear to cause less tissue reaction after irradiation and could be safer reconstructive devices than titanium implants for patients undergoing surgery and adjuvant radiotherapy for cancer.
    09/2015; 120(4):443-52. DOI:10.1016/j.oooo.2015.06.036
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    ABSTRACT: The investigation was performed in order to evaluate the use of Gafchromic EBT films for measurements of dose distributions created during radiotherapy in tissues surrounding titanium or resorbable implants used for joining and consolidating facial bones. Inhomogeneous dose distributions at implant-tissue interfaces can be the reason of normal tissue complications observed in radiotherapy patients after surgery with implants. The dose measured at a depth of 2.5 cm on contact surfaces, proximal and distal to the beam source, between the titanium implant and the phantom material was 109% and 92% respectively of the reference dose measured in a homogeneous phantom. For the resorbable implants the doses measured on the proximal and the distal contact surfaces were 102% and 101% respectively of the reference dose. The resorbable implants affect the homogeneity of dose distribution at a significantly lesser degree than the titanium implants. Gafchromic EBT films allowed for precise dose distribution measurements at the contact surfaces between tissue equivalent materials and implants.We measured doses at contact surfaces between titanium implants and RW3 phantom.We measured doses at contact surfaces between resorbable implants and RW3 phantom.We compared doses measured on contact surfaces and doses in homogeneous phantom.Doses at contact surfaces between RW3 phantom and titanium were distorted about 8-9%.Doses at RW3 phantom and resorbable implant contact surfaces were distorted about 2%.
    Radiation Physics and Chemistry 10/2014; 104. DOI:10.1016/j.radphyschem.2014.03.008 · 1.38 Impact Factor
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    Andrzej Kawecki · Romuald Krajewski
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    ABSTRACT: Principles of follow-up management in patients treated for head and neck tumors are not very strictly defined, and practice varies between countries, centers, and specialists. Details of follow-up procedures, including timing of outpatient visits and diagnostic imaging, are specific for tumor types and localizations but also depend on treatment modalities used, availability of diagnostic procedures, and socioeconomic factors. The authors describe general principles of follow-up in head and neck cancer patients. Clinical observation and laboratory and imaging studies in patients who had received radical treatment should focus on early identification of recurrent or second primary tumors to allow for a salvage radical therapy. In patients who initially had received a palliative care, the follow-up should focus on proper management of symptoms.
    memo - Magazine of European Medical Oncology 05/2014; 7(2):87-91. DOI:10.1007/s12254-014-0143-y
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    ABSTRACT: Mesenchymal chondrosarcoma (MChS) is a rare, high-grade malignant tumor which occurs both in the bone and soft tissue. The extraskeletal location comprises one third of all MChS and in review of the up-to-date literature, about 30 cases of the orbital involvement were found. The authors present clinical, radiological and pathological findings of two cases of MChS of the orbit occurring in young adult females: primary extraskeletal MChS of the orbit and skeletal MChS of the ethmomaxillary complex with secondary orbit involvement. The histopathological examination revealed a characteristic biphasic pattern composed of small round to spindle-shaped cells, mimicking Ewing sarcoma family of tumors, with areas of a haemangiopericytoma-like pattern and admixed cartilage foci. One of the patients had local recurrence 3 years after initial surgical removal. Subsequently, she underwent enucleation followed by chemotherapy. The other patient had a biopsy and debulking resection of the tumor and started chemotherapy. Ten months follow-up of this patient show no evidence of metastasis.
    Polish journal of pathology: official journal of the Polish Society of Pathologists 01/2012; 63(1):80-4. · 1.13 Impact Factor
  • European Journal of Anaesthesiology 01/2008; 25. DOI:10.1097/00003643-200801001-00104 · 2.94 Impact Factor
  • Skull Base Surgery 01/2007; 17. DOI:10.1055/s-2007-1091185 · 0.60 Impact Factor
  • Skull Base Surgery 01/2007; 17. DOI:10.1055/s-2007-1090876 · 0.60 Impact Factor
  • Skull Base Surgery 01/2007; 17. DOI:10.1055/s-2007-984257 · 0.60 Impact Factor
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    Romuald Krajewski · Andrzej Kawecki · Andrzej Kukwa
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    ABSTRACT: AimTumours situated in the region of the base of the skull are at the limits of possibility for radical resection and in patients with malignant tumours it is necessary to use combined methods of treatment. The purpose of this paper is to evaluate the early results of combined treatment tumours of the base of the skull.Materials/MethodsBetween 1994 and 2004 68 patients with malignant tumours of the base of the skull and 10 with benign tumours were treated by an interdisciplinary group. Treatment included surgery, radiotherapy, and chemotherapy.ResultsAfter a period of post operative observation (median length 19 months), 32 patients with malignant tumours were without recurrence of disease, 8 lived with the tumour, 21 died as a result of disease progression and 4 died of other causes. Information was unavailable for 3 patients. Among 10 patients with benign tumours, 5 lived without symptoms of disease and 5 with the tumour.ConclusionsBecause of the limited possibilities regarding radical removal of malignant tumours in the region of the base of the skull, combined treatment using radiotherapy, surgery and, in some cases, chemo therapy is standard. Use of aggressive treatments gave local control in about half the patients though further observation is necessary in order to assess later oncological results.
    Reports of Practical Oncology and Radiotherapy 12/2005; 10(2-10):28-31. DOI:10.1016/S1507-1367(05)71115-9
  • M. Symonides · P. Sowinski · R. Krajewski
    European Journal of Anaesthesiology 05/2005; 22(Supplement 34). DOI:10.1097/00003643-200505001-00502 · 2.94 Impact Factor
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    Reports of Practical Oncology and Radiotherapy 12/2003; 8. DOI:10.1016/S1507-1367(03)70637-3
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    R. Krajewski · A. Kawecki · A. Kukwa
    Reports of Practical Oncology and Radiotherapy 12/2003; 8. DOI:10.1016/S1507-1367(03)70638-5
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    Reports of Practical Oncology and Radiotherapy 12/2003; 8. DOI:10.1016/S1507-1367(03)70669-5
  • W Bochenek · G Hatlinski · A Kukwa · R Krajewski
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    ABSTRACT: A case of a 44 year-old woman farmer with a total deafness and lack of vestibular function on the left side operated upon the cerebello-pontine cystic neuroma 2.5 x 2.0 x 1.5 cm large via the retromastoidal craniectomy is presented. Despite of the negative audiological tests' results the cochlear nerve flatten on the tumor was cautiously separated. Some time after surgery, she observed "a partial recovery of hearing" in the operated ear confirmed by the tonal (mean 0.5-2 kHz 36 dBHL) vocal SRT 70 dB), BERA and EOAEs tests. The paralysis of the left vestibular function did not recover. In consecutive audiogram a notch at 6 kHz 15 dB deep appeared in the operated ear and one can presume an increased vulnerability of this ear to the noise of the agricultural machines used by then by the patient.
    Revue de laryngologie - otologie - rhinologie 02/2002; 123(3):199-201.
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    ABSTRACT: The giant pituitary adenoma surgery remains a real challenge to any neurosurgeon. Despite an extensive development of transsphenoidal techniques, open craniotomy procedures still are required in 5-10% of all cases with pituitary adenoma. The skull base surgery techniques not only allow to minimize the surgery-related trauma of the brain, but also improve the access to the operating field. In the years 1998-2001 the authors operated on the total of 395 pituitary adenoma patients, mostly using the transsphenoidal approach (320 cases), with skull base surgery techniques applied in 75 cases (i.e. in 19% of all patients)--in 67 patients the transbasal-subfrontal approach was applied, and in 2 cases--lateral rhinotomy. There were two indications to the transbasal-subfrontal approach: a large size of the tumor causing visual disturbances, and extension of the adenoma to adherent anatomical spaces. In this group of patients the total removal of the tumour was achieved in 88% of cases. In the remaining patients remnants of the tumor were left in the cavernous sinuses. The skull base surgery techniques are most useful in the treatment of selected patients with pituitary adenoma.
    Neurologia i neurochirurgia polska 01/2002; 36(6):1121-30; discussion 1131-3. · 0.64 Impact Factor
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    Romuald Krajewski · Andrzej Kukwa
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    ABSTRACT: Surgical exposure of internal acoustic meatus via typical suboccipital retrosigmoid craniotomy is limited by inner ear structures that should remain intact if hearing preservation is attempted. Feasibility of supracerebellar-infratentorial approach to the meatus with more medial angle of exposure and with preservation of inner ear structures was studied on fresh cadavers and on computed tomography pictures of temporal bones. Anatomical relationships of internal acoustic meatus and adjacent structures show marked individual variability. When typical retrosigmoid craniotomy is used to expose meatal fundus, significant medial retraction of cerebellar hemisphere is required in 47% of the patients to avoid opening endolymphatic spaces. Internal acoustic foramen and meatus can be exposed via craniotomy situated under transverse sinus, with 10-15 mm downward retraction of cerebellum. Medial extent of craniotomy can be planned on preoperative imaging studies. Infratentorial supracerebellar exposure of internal acoustic meatus allows for more medial angle of surgical approach than standard retrosigmold craniotomy. It can be used when preoperative imaging studies show that anatomical relationships between internal acoustic meatus and inner ear structures would require excessive cerebellar retraction to visualize a whole tumor inside meatus.
    Skull Base 02/1999; 9(2):81-5. DOI:10.1055/s-2008-1058153
  • A Kukwa · R Krajewski · M Pietniczka · P Wójtowicz
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    ABSTRACT: Surgery for extensive skull base lesions inevitably creates multiple tissue defects that require reconstruction. In this paper reconstruction methods applied in 41 skull base surgery procedures are presented. Anterior cranial fossa was involved in 13 operations (4 malignant and 9 non-malignant tumours), middle and posterior cranial fossa in 28 (9 malignant and 19 non-malignant). As a rule all the defects were reconstructed in one stage, immediately after tumour removal. Titanium mesh was the only alloplastic material used to cover bone defects in 7 patients. Otherwise only autografts were used. Postoperatively in all the patients in whom excision and repair of dura was necessary, continuous lumbar drainage of cerebrospinal fluid was maintained for 4-6 days. In anterior cranial fossa area large pediculated, vascularized periosteal flap allowed for reliable separation of upper airways from intracranial cavity. Titanium mesh was used to cover orbital wall defects. In the area of middle cranial fossa and temporal bone the most important aspects of reconstruction were watertight closure of the dura, separation of the surgical cavity from nasopharynx with rotated temporalis muscle, and facial nerve reconstruction (the nerve was reconstructed in 7 cases). Additionally in 1 patient hypoglossal nerve was sutured end-to-end. In 2 patients the invaded segment of internal carotid artery was excised and replaced with prosthesis. In 13 patients the surgical procedure was performed in an area that was previously operated upon and/or irradiated. Delayed healing was seen in 6 cases, but none required additional procedures and the wounds were completely healed with local treatment. Reconstruction methods presented in this paper are relatively simple and do not necessitate modern materials. Even in extensive procedures proper wound healing and satisfactory cosmetic result were obtained.
    Neurologia i neurochirurgia polska 07/1998; 32(4):853-62. · 0.64 Impact Factor

Publication Stats

12 Citations
11.47 Total Impact Points


  • 2014
    • Maria Sklodowska Curie Memorial Cancer Centre
      Gleiwitz, Silesian Voivodeship, Poland
  • 2005
    • Greater Poland Cancer Centre
      Posen, Greater Poland Voivodeship, Poland
  • 2003
    • Centrum Onkologii-Instytutu
      Warszawa, Masovian Voivodeship, Poland