Fifty patients with residual, unresectable or recurrent rectal cancer were treated with external irradiation using a 6-MV linear accelerator at the Division of Therapeutic Radiology, Department of Radiology, Kangnam St. Mart's Hospital, Catholic University Medical College during the period of April 1983 to December 1987. This paper describes the results of a retrospective analysis of the results of external irradiation for the residual, unresectabel and recurrent rectal cancer in 46 patients. Four patients were lost to follow-up. Of the 46 patients, 18(39%) presented with unresectable primary lesions and 28 (61%) with residual or recurrent rectal cancer. In 93%, the pathologic diagnosis was adenocarcinoma. Resonse to irradiation was observed in 22 (73%) out of 30 patients who were treated for pain, 12 (86%) out of 14 patients who were treated for mass, and 17 (77%) out of 22 patients who were treated for bloody discharge. The actuarial postoperative 2-year and 3-year survival rates in recurrent and unresectable patients were 43% and 22%, respectively. However, the post-RT 2-year survival rate was 13% (6/46).
Adenocarcinoma ; Diagnosis ; Humans ; Lost to Follow-Up ; Particle Accelerators ; Radiation Oncology ; Rectal Neoplasms* ; Retrospective Studies ; Survival Rate

From March, 1983 to March, 1987, 16 patients with esophageal steno-obstruction due to nonesophageal tumors were treated in the Division of Therapeutic Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. The patient characteristics, effect of radiotherapy (XRT) on esophageal steno-obstruction and survival were evaluated. The most common primary tumor was lung cancer (14/16) and the middle third of the esophagus was most frequently involved (14/16). Improved clinical response was observed in 80% of the patients who finished the planned courses of XRT. The mean radiation dose evoking the improvement of dysphagia was 2,993 cGy given over a period of 3 to 4 weeks. The Kaplan-Meier estimates of survival at 15 and 30 weeks of follow-up were 60% and 46%, respectively. In the completed group who finished the whole planned courses of XRT, survival rates were 77% and 51%, respectively. Four patients were alive over 90 weeks with normal passage of food.
Deglutition Disorders ; Esophagus ; Follow-Up Studies ; Humans ; Lung Neoplasms ; Radiation Oncology ; Radiotherapy ; Survival Rate

Thirty-five patients with locally advanced gastric carcinoma were treated with combined modalities of external radiation therapy (RT) and 5-FU based chemotherapy at the Division of Radiation Therapy, Department of Radiology, Kangnam St, Mary's Hospital, Catholic University Medical College from May 1983 to May 1987. The purpose of this retrospective study is for the evaluation of the palliative response to RT. There were 25 men and 10 women. The age ranged from 38 to 80 years (median: 56 years). The pathologic classification showed 14 (40%) poorly differentiated, 12(34%) moderately differentiated, 3 (9%) well differentiated adenocarcinomas, 2 mucinous cystadenocarcinomas, 1 signet ring cell and 3 not specified ones. The time intervals from the initial surgicopathologic diagnosis to the starting day of RT was within 1 year for 18 (51%), 1 to 2 years for 8 (23%) and 2 to 3 years for 5 (14%), respectively. The major symptoms to be treated were pain in 30 (86%), mass for 29 (83%), obstruction for 11 (31%) and jaundice for 9 (26%) patients. The response rate (patient number of positive response/total patient number) according to treated radiation doses were observed as follows; 14/16(88%) for 40~50 gy, 8/10 (80%) for over 50 gy, 6/8 (75%) for 30~40 gy and 8/15 (53%) for 20~30 gy in decreasing order. The over all survival was 3.6 months and that of 5FU+RT, FAM+RT and RT alone groups were 4.6 months, 3.7 months and 2.5 months respectively. Complications induced by RT were nausea and vomiting in 16 (46%), diarrhea in 7 (20%), leukopenia in 6 (17%) and anemia and intercurrent pneumonia in each 3 (9%) patients in decreasing order.
Adenocarcinoma ; Anemia ; Classification ; Cystadenocarcinoma, Mucinous ; Diagnosis ; Diarrhea ; Drug Therapy ; Female ; Fluorouracil ; Humans ; Jaundice ; Leukopenia ; Male ; Nausea ; Pneumonia ; Retrospective Studies ; Vomiting

It was already reported in else where that a standard linear accelerator, with only slight modification can function in a manner similar to Leksell's Gamma unit device in the treatment of inoperable deep seated intracranial lesions. Using collimated narrow beams, a localization system and special computer programs for precise patient positioning and a high concentration of irradiation dose within the lesions, eleven patients with AVMs and brain tumor have now been treated since 1988. The 6 MeV linear accelerator and Hitchcock stereotactic frame was used of the all procedures. In 10 of the 11 patients, no side effects occurred. The first 7 patients, who could be observed 3 months or longer have been studied radiologically and clinically. In 6 patients marked decrease in contrast enhancement and sometimes dramatic clinical improvement was achieved. In one case a marked increase of the surrounding brain edema occurred 7days after radiosurgery, who was operated on. The radiantion dose was based on the volume, location and radiosensitivity of the lesion which ranged 15-40 Gy.
Brain Edema ; Brain Neoplasms ; Humans ; Particle Accelerators* ; Patient Positioning ; Radiation Tolerance ; Radiosurgery*

PURPOSE: Intraluminal High dose rate brachytherapy is an accepted treatment for the tumors of GI tract. However, there is only some limited clinical data for intraluminal high dose rate brachytherapy for the tumors of GI tract. MATERIALS AND METHODS: Between February 1991 and July 1993, 18 patients who have the tumors of GI tract (esophageal cancer-8 cases, rectal cancer-10 cases) were treated with gigh dose rae iridium-192 afterloading system )Microselectron-HDR, Nucletron CO, Netherland) at the department of therapeutic radiology, St. Mary's hospital, Catholic university medical college. Age rage was 47-87 years with a mean age 71 years. All patients were treated with intraluminal high dose rate brachytherapy within two weeks after conventional external radiation therapy and received 3-5 Gy/fraction 3-4 times per week to a total dose 12-20 Gy (mean 17 Gy). Standard fractionation and conventional dose were delivered for external radiation therapy. Total dose of external radiation therapy ranged 41.4-59.4 Gy (mean 49.6 Gy). Median follow up was 19 months. RESULTS: The analysis was based on 18 patients. The complete response and partial response in esophageal cancer was similar (38%). Two year rates for survival and median survival were 13% and 10 months, respectively. Among 10 patients of rectal cancers, partial response was obtained in 6 patients (60%). There was no complete response in the patients with rectal cancer, but good palliative results were achieved in all patients. CONCLUSION: Although the number of patients was not large and the follow up period was relatively short, these findings suggested that intraluminal high dose rate brachytherapy could be useful in the treatment of the patients with advanced tumors of GI tract.
Brachytherapy* ; Esophageal Neoplasms ; Follow-Up Studies ; Gastrointestinal Tract* ; Humans ; Radiation Oncology ; Rage ; Rectal Neoplasms

Eight patients with intracranial tumors or arteriovenous malformation (AVM)s which were less than 3 cm in diameter were treated by a technique of stereotactic radiotherapy during the 4 months period from July 1988 through October 1988 at the Division of Radiation Therapy, Kang-Nam St. Mary's Hospital, Catholic University Medical College. The patients were diagnosed as AVMs in 3 cases, acoustic neurinoma, craniopharyngioma (recurrent), hemangioblastoma, pineocytoma, and pituitary microadenoma in each case. There are several important factors in this procedure, such as localization system, portal, field size, radiation dose, and perioperative supportive care. It is suggested that stereotactic radiotherapy may be performed safely with a radiation dose of 12-30 gy. So this noninvasive procedure can be used to treat unresectable intracranial tumors or AVMs. Of these, clinical symptoms had been regressed in AVMs in 2 cases at 3 months and 2 months after Stereotactic radiotherapy, one of whom was confirmed slightly regressed on the follow-up angiogram. And also craniopharyngioma and pineocytoma was minimally regressed on 3 month follow-up CT.
Arteriovenous Malformations ; Craniopharyngioma ; Follow-Up Studies ; Hemangioblastoma ; Humans ; Neuroma, Acoustic ; Particle Accelerators* ; Pinealoma ; Portal System ; Radiotherapy*