[Acinic cell tumor of the epipharynx--a patient treated with surgery and high-dose intracavitary radiation therapy]

A case of acinic cell tumor of the epipharynx is reported. The patient was a 41-year-old man. The tumor was surgically removed by the transpalatal approach. Light microscopically, the lesion was composed of serous acinic cells with eosinophilic granules, clear cells with water-clear cytoplasm and their intermediate type, vacuolated cells. The serous acinic cells were PAS (periodic acid-Schiff)- and DPAS (PAS with diastase predigestion)-positive. The clear and vacuolated cells were PAS- and DPAS-negative. The patient underwent early postoperative radiation therapy; high-dose intracavitary radiation therapy using remote-controlled afterloading equipment was given subsequent to the external radiation therapy. The patient has been free of recurrence and abnormal findings for one year after treatment.

Whole brain irradiation for metastases from lung carcinoma. A clinical investigation

Sixty-nine consecutive patients with brain metastases from lung carcinoma were randomly allocated to one of two radiation therapy schedules: 30 Gy/10 fractions/2 weeks or 50 Gy/20 fractions/4 weeks. The improvement rate for neurologic function was similar in the two groups. The median survival times for patients receiving the short course and the long course were 4 months and 3 months, respectively. The half-year survival rate was 42 per cent after the short course and 14 per cent after the long course (p less than 0.05). Performance status and lactate dehydrogenase were other factors which significantly influenced the half-year survival rate.

Rectal complication after remote afterloading intracavitary therapy for carcinoma of the uterine cervix

From August 1978 through December 1980, 119 patients of previously untreated carcinoma of the uterine cervix were treated using RALS, remote afterloading high dose rate intracavitary therapy at our department. The data from 92 out of 119 patients were available for analysis of rectal complication. The incidence of major rectal complications was only 2% (2/92). Uni- and multivariate analyses were used based on the external criterion variable of rectal complication which included even minor injuries. By using these methods, it was clearly indicated that these factors such as TDF of rectum, Z-coordinate of weighted geometric center (WGC-Z), the dose of whole pelvic irradiation, history of chemotherapy and Treponema pallidum hemoagglutination test (TPHA) were important for occurrence of rectal complication. According to discriminant score, 71 out of 92 cases (77%) could be correctly discriminated.

[Radiation therapy for primary non-Hodgkin's lymphoma of the head and neck]

Thirty-seven previously untreated cases of primary non-Hodgkin's lymphoma in the head and neck were treated at our department from September 1977 through January 1983. The survival rate at three years by stage was 84% in stage I, 44% in stage II and 0% in stage III and IV. Stage, T- and B-cell markers, initial primary site, the level of lymph node involvement (UICC, 1978) and number were important prognostic factors. Chemotherapy in the pre- or post-radiation period was essential, especially in stage II. It was proved that adequacy of radiation portals with special reference to anatomical considerations was necessary.

[Investigation of rectal and bladder complications after RALS therapy for carcinoma of the uterine cervix]

From August 1978 through December, 1980, 119 patients with previously untreated carcinoma of the uterine cervix were treated using RALS, (remote-controlled) high dose rate intracavitary radiotherapy. The data from 92 out of the 119 cases were available for multivariate analysis for rectovesical complications. By using this method, it was clearly indicated that factors such as TDF of the rectum, weighted geometric center (WGC)-Z, the dose of whole pelvic irradiation, chemotherapy and TPHA were important in the occurrence of rectal complications. However, there was no definite physical or physiological factor to predict the occurrence of bladder complications.

[Evaluation of the accuracy in radiotherapy for carcinomas of the hypopharynx and larynx]

Immobility and reproducibility were investigated to evaluate the accuracy in radiotherapy for carcinomas of the hypopharynx and larynx. Based on our comparative study using a semi-conductor detector, a light-cast shell is sufficient to maintain immobility during radiotherapy. In most cases, the range of reproducibility was within 5 mm throughout the course of radiotherapy.

[Prophylactic central nervous system irradiation for childhood acute lymphoblastic leukemia]

Documentation on 324 children with leukemia who underwent cranial irradiation between 1972 and 1981 was collected from 15 participating hospitals in the Kansai Cancer therapy Group. Among 182 children with acute lymphoblastic leukemia, records on 90 children treated with prophylactic cranial irradiation (2,400 rads) plus intrathecal methotrexate in 12 hospitals were available for analysis. There was no significant difference in survival between the two prognostic groups based on age and initial WBC count at diagnosis, i.e., overall, relapse-free and CNS relapse-free 5-year survivals in the good and intermediate prognostic groups were 57% vs. 51%, 55%, vs. 49%, and 83% vs. 95%, respectively.

[Central nervous system irradiation for children with leukemia]

Between 1972 and 1981, 247 patients with acute lymphoblastic leukemia were treated with prophylactic CNS irradiation. Cranial irradiation (2400 rad) plus intrathecal methotrexate was the prophylactic CNS therapy of choice. At 5 years, the overall, relapse-free and CNS relapse-free survival rates were 51%, 47% and 79%, respectively. Our findings suggest that more attention should be paid to the inferior border of the radiation field, since the anterior and middle cranial fossae were sometimes not included and the second spine was almost always excluded.

[Evaluation of radiation therapy of brain metastases from lung carcinoma using multivariate analysis]

A randomized clinical trial of whole brain irradiation for brain metastases arising from lung cancer is in progress to improve survival and the quality of life. Between September 1980 and July 1982, 40 patients were treated using 4 MV X-ray. Concerning the radiation dose, laboratory tests and the physical condition of the patients, we analyzed 22 data items by means of quantification II, one of the methods of multivariate analysis. We found that neurologic function, performance status and LDH are important factors in assessing the 120-day survival.

Revaluation of treatment result of carcinoma of the hypopharynx using quantification II of multivariate analysis

In a material of 336 patients with squamous cell carcinoma of the hypopharynx treated from 1956 to 1980, overall 5 year survival rate of carcinoma of the hypopharynx was 25%. According to the stage classification, 5 year survival rates were 74,41,28 and 7% in I,II,III and IV, respectively. As to the treatment modality, 5 year survival rates were 31,24,41,31 and 0% by surgery, radical radiotherapy, preoperative radiotherapy, radical radiotherapy with salvage surgery for recurrence and palliative treatment, respectively. Based on the application of quantification II, we may reasonably conclude that 3 year survivors are mainly discriminated by stage of the disease and treatment modality.

Dynamic computed tomography of hepatocellular carcinoma

Nineteen patients with clinically proven hepatocellular carcinoma were studied by dynamic computed tomographic (CT) scanning. Ten consecutive 3 sec scans were performed within 30 sec, providing uninterrupted data collection. Dynamic CT scanning was useful in recognizing tumor vascularity, multiple small tumors, isodense tumors on conventional CT scans, the capsule of an encapsulated hepatocellular carcinoma, arteriovenous shunts, and vascular pools. Time-density curves were useful in evaluating the hemodynamics of the tumors; these could be classified into three types according to differences in their enhancement patterns.