A retrospective analysis was performed on 23 patients with pineal region tumors treated with radiation from 1979 through 1985 at the Department of Therapeutic Radiology, Seoul National University Hospital, Histologic confirmation was done in only one case by surgical removal, and in the remaining 22 patients, the diagnosis was based on clinical and radiological findings. The radiation volume was the primary tumor site in 1 case, whole brain in 14 cases, and the whole craniospinal axis in 8 cases. The overall 5 year survival was 71.5%. The 5 year survival was 69. 3% for whole brain treated group and 73.3% for craniospinal axis treated group. The survival for the two groups did not differ significantly. In two cases sites of recurrence were detected. One in supratentorial area, and the other in the lung. The results from this retrospective analysis and the review of other reports indicate that routine use of prophlatic spinal irradiation is not warranted in pineal region tumor, and the craniospinal irradiation is recommended in cases with high risk for subarachnoid seeding such as positive CSF cytology, surgical removal or biopsy.
Axis, Cervical Vertebra ; Biopsy ; Brain ; Craniospinal Irradiation ; Diagnosis ; Humans ; Lung ; Pinealoma* ; Radiation Oncology ; Radiotherapy* ; Recurrence ; Retrospective Studies ; Seoul

A retrospective study was performed on 15 patients with suprasellar germ cell tumors treated by megavoltage external beam irradiation between Feb. 1979 and Dec. 1985. Follow-up period of survivors was 30 to 91 moths. Histologic diagnosis was obtained before radiation therapy in 10 patients (9 germinomas and 1 mixed). Five patients were treated without histologic verification. In 9 patients with biopsy-proven germinomas radiation therapy was delivered to the craniospinal axis in 6, to the whole brain in 3. In 5 patients with mixed germ cell tumor or elevated tumor marker, irradiation was delievered to the craniospinal axis in 2, to the whole brain in 2, and to the primary site only in 1. Total doses ranged from 5,000 to 5,500 cgy to the promary site, 3,000 to 4,400 cgy to the whole brain, and 1,300 to 3,000 cgy to the spine. In these 14, local tumor was controlled and primary or spinal failure was not observed. One patient without elevated tumor marker was treated to the whole brain, The tumor was not controlled and he had spinal recurrence. It is proven that radiation therapy is an effective treatment for suprasellar gern cell tumors. The neuroendocrinologic presentation, tumor marker status, early response to radiation measured on CT seem to be useful means for selecting patients for radiation therapy when tissue diagnosis is not available.
Axis, Cervical Vertebra ; Brain ; Diagnosis ; Follow-Up Studies ; Germinoma ; Humans ; Moths ; Neoplasms, Germ Cell and Embryonal ; Recurrence ; Retrospective Studies ; Spine ; Survivors

A retrospective analysis was performed on 49 patients with astrocytoma of glioblastoma multiforme of brain who received postoperative radiotherapy in the period between February 1979 and December 1985. Fourteen patients had grade I astrocytoma, 11 patients grade II, 14 patients grade III, and 10 patients glioblastoma multiforme. Three year actuarial surival rates were 85.7%, 44.6% and 23.1% for grade I,II, and III astrocytomas, respectively. One and 2 year actuarial survival rates for patients with glioblastoma multiforme were 54.5% and 27.3%, respectively. Histologic grade, age, extent of operation and tumor location were revealed to be prognosticators.
Astrocytoma* ; Brain* ; Glioblastoma* ; Humans ; Radiotherapy* ; Retrospective Studies ; Survival Rate

The usefulness of hypertemie for cancer therapy have well been established. The purpose of the present investigation was to ascess the effect of step-up (42 degrees C -> 44 degrees C sequence ) and step-down (44 degrees C -> 42 degrees C sequence) heating on the skin of the hind foot of the mouse. Hyperthermic treatments were given by immersion the hind foot of the mouse in circulating water baths. Skin response was studied by the leg reaction, which was scored according to a numerical scoring system proposed by Urano et al (1980). The results were as follws 1.The sking damage of 44 degrees C control group was more severe than 42degree C control group (p<0.0.5), except for 15min. heating group. 2. The skin damage of step-down group was more severe than step-up group (p<0.0.5). 3. The skin damage of 44 degrees C control group was more severe than step-up group when there is no difference in 44 degrees C heatingtime of step-up group from 44degree C control group (p<0.0.5). 4. In step-down group, the skin damage was more severe than 44degree C control group after preheating 45 min at 44 degrees C (p<0.0.5). Therefore, the above findings suggest the normal tissue damaged by step-up heating was correlated with heating time of post step-up. The dropping of heating temperature in late phase had more severe damage of the skin than that in early phase during hyperthermia, and so contineous control of satisfactory temperature should be considered as the one of the most important factor for prognosis, complications of clinical hyperthermia
Animals ; Baths ; Fever* ; Foot ; Heating ; Hot Temperature ; Immersion ; Leg ; Mice* ; Prognosis ; Skin* ; Water

To answer the question whether last clonogenic cell should be eradicated for the tumor to be controlled, radiation tumor control study was performed using microscopic tumors of variable sizes ranging from 101 to 105 tumor cells. TCD50's estimated from experimental data were 14.8, 27.1, 42.4, 49.9 and 65.5 gy for 10(1), 10(2), 10(3), 10(4) and 10(5) tumor cells, respectively. Theoretical calculations, assuming that all the clonogenic cells should be inactivated, were 15.65, 28.50, 40.97, 53.41 and 65.85 gy. From this well matched data, it can be concluded that all the clonogenic cells should be eradicated for tumor control, at least in this tumor model.
Animals ; Fibrosarcoma* ; Mice*

No abstract available.
Esophageal Neoplasms* ; Esophagus* ; Radiotherapy*

The normal intracranial structures are relatively resistant to therapeutic radiation, but may react adversely in a variety of ways and the damage to nerve tissue may be slow in making its appearance and once damage has occurred the patient recovers slowly and incompletely. Therefore, it is important to consider the possibility of either recurrent tumor or late adverse effect in any patient who has had radiotherapy. The determination of morphological/pathological correlation is very important to the therapeutic radiologist who uses CT scans to define a treatment volume, as well as to the clinician who wishes to explain the patient's clinical state in terms of regress, rogression, persistence, or recurrence of tumor or radiation-nduced edema or necrosis. The authors are obtained as following results; 1. The field size (whole CNS, large, intermediate, small field) was variable according to the location and extension of tumor and histopathologic diagnosis, and the total tumor dose was 4,000 to 6,000 rads except one of recurred case of 9,100 rads. The duration of follow up CT scan was from 3 months to 5 year 10 months. 2. The histopathologic diagnosis of 9 cases were glioblastoma multiforme (3 cases), pineal tumor (3), oligodendroglioma (1), cystic astrocytoma (1), pituitary adenoma (1) and their adverse effects after radiation therapy were brain atrophy (4 cases), radiation necrosis (2), tumor recurrence with or without calcification (2), radiation-nduced infarction (1). 3. The recurrent sysptoms after radiation therapy of brain tumor were not always the results of regrowth of neoplasm, but may represent late change of irradiated brain. 4. It must be need that we always consider the accurate treatment planning and proper treatment method to reduce undesirable late adverse effects in treatment of brain tumors.
Astrocytoma ; Atrophy ; Brain Neoplasms* ; Brain* ; Central Nervous System* ; Diagnosis ; Edema ; Follow-Up Studies ; Glioblastoma ; Humans ; Infarction ; Necrosis ; Nerve Tissue ; Oligodendroglioma ; Pinealoma ; Pituitary Neoplasms ; Radiotherapy ; Recurrence ; Tomography, X-Ray Computed

The authors have intended to measure intrinsic dose distribution by Farmer dosimeter in irregularly shaped fields such as L.M. and T shape models in order to determine dose in homogeneity in those models. We made 2 off-xis points in each model and measured the depth dose at 1.5, 5 and 9cm below surface. The results showed 1~3% dose discrepancy between 2 points. We also measured the depth dose by geometric approximation and computer calculation in those models, and came to the conclusion that computer calculation using Clarkson's principle is simpler and the measurements are closer to the ideal data obtained by the experiment in three models of irregularly shaped fields than those of geometric approximation method.

The peripheral dose, defined as the dose outside therapeutic photom fields, Which is responsible for the functional damage of the critical organs, fetus, and radiation-nduced carcinogenesis, has been investigated for 60 Co gamma ray and 10 MV X ray. It was measured by silicon diode controlled by semiautomated water phantom without any shielding or with lead plate of HVL thickness put horizontally or vertically to shield stray radiations. Authors could obtain following results. 1. The peripheral dose was larger than 0.7% of central axis maximum dose even at 20cm distance from field margin. That is clinically significant, so it should be reduced. 2. Even for square fields of 10MV X ray, radial peripheral dose distribution did not coincide with transverse distribution, because of the position of collimator jaws. 3. Between surface and dm the peripheral dose distributions show a pattern of the dose distribution of electron beams and the maximum dose was approximately proportional to the length of a side of square filed. 4. The peripheral doses depended on radiation quality, field size, distance from field margin and depth in water. Distance from field margin was the most important factor. 5. Except for near surface, the peripheral dose from phantom was approximately equal to that from therapy unit. 6. To reduce the surface dose outside fields, therapist should shield stray radiations from therapy unit by lead plate of at least one HVL for 10 MV X-ay and by bolus equivalent to tissue of 0.5cm thickness for 60 Co. 7. To reduce the dose at depth deeper than dm, it is desirable to shield stray radiations from therapy unit by lead.
Axis, Cervical Vertebra ; Carcinogenesis ; Fetus ; Gamma Rays* ; Jaw ; Silicon ; Water

No abstrac available