Intracellular ions which have a major role in cellular function have been reported to affect repair of radiation damage. Recently it has been reported that ouabain sensitizes A549 tumor cells hut not CCL-120 normal cells to radiation. Ouabain inhibits the Na+-K+-pump rapidly thus it increases intracellular Na concentration. Vanadate which is distributed extensively in almost all living organisms in known to be a Na+-K+-ATPase inhibitors. This study was performed to see any change in radiosensitivity of tumor cell by vanadate and any role of Na+-K+-ATPase in radiosensitization. Experiments have been carried out by pretreatment with vanadate in human cell line(A549, JMG) and mouse cell line(L1210, spleen). For the cell survival MTT assay was performed for A549 and JMG cell and trypan blue dye exclusion test for L120, and spleen cells. Measurements of Na+-K+-ATPase activity in control, vanadate treated cell, radiation treated cell (9 Gy for A549 and JMG, 2 Gy for L1201, spleen), and combined 10-6 M vanadate and radiation treated cells were done. The results were summarized as follows. 1. L1210 cell was most radiosensitive, and spleen cell and JMG cell were intermediate, and A549 cell was least radiosensitive. 2. Minimum or cytotoxicity was seen with vanadate below concentration of 10-6 M. 3. In A549 cells there was a little change in radiosensitivity with treatment of vanadate. However radiation sensitization was shown in low dose level of radiation i. E. 2-Gy. In JMG cells no change in radiosensitivity was noted. Both L1210 and spleen cell had radiosensitization but change was greater in tumor cell. 4. Na+-K+-ATPase activity was inhibited significantly in tumor cell by treatment of vanadate. 5. Radiation itself inhibited Na+-K+-ATPase activity of tumor cell with high Na+- K+-ATPase concention. Increase in radiosensitivity by vanadate was closely associated with original Na+-K+-ATPase contents. From the above results vanadate had little cytotoxicity and it sensitized tumor cells to radiation. Inhibitory effect of vanadate on Na+-K+-ATPase activity might be one of the contributing factors for radiosensitization to tumor cells which has greater enzyme activity than that of normal cell. It was suggested vanadate could be used as a potential radiosensitizer for tumor cells.
Animals ; Cell Survival ; Humans ; Ions ; Mice ; Ouabain ; Radiation Tolerance* ; Spleen ; Trypan Blue ; Vanadates*

No abstract available.
Sarcoma, Ewing*

From July 1979 through March 1985, 112 patients with carcinoma of the uterine cervix were treated by whole pelvis irradiation and intracavitary radiation with Cs-37. The treatment consisted of 3600rad-200rad to the whole pelvis by parallel opposing portals, 5 days per week, 180-00rad per day. Parametrial boost with 400-00rad was given in 60 patients. 2 intracavitary Cs-37 radiation using TAO applicator were done with 7-0 days interval. Total treatment times were 40-5 days with average 52 days. Total dose of radiation to point A varied from 6820 to 10500rad with average 8388rad and to point B from 4850 to 6899rad with average 5898rad. All patients had follow up from 6 months to 75 months and median follow up of 31 months. 9(8%) had stage Ib, 14(12.5%) had stage IIa, 50(44.6%) had stage llb, 33(29.5%) had stage III, 6(5.4%) had stage IV. 110 patients had squamous cell carcinoma and 2 patients had adenocarcinoma. 5 year actuarial survival rates were 61.8% for the entire group, 84.6% for stage Ib, 77.8% for stage IIa, 56.7% for stage IIb, 60% for stage III, 33.3% for stage IV. RT dose to medial parametrium (point A) below 8000rad resulted in 7/18(38.9%) failure (=death) in contrast to 25/94 (26.5%) failure with dose over 800rad. RT dose to lateral parametrium (point B) below 6000rad yielded 20/63 (34.9%) failure compared to 10/49 (20.4%) failure with dose over 6000rad. Poor survival group of age were between 40-9 years with failure of 14/41 (34.1%). There was no increased failure rate below age of 40 with failure of 2/11 (13.9%). The results suggest that survival is as good as other published data, and that higher doses over 8000rad to point A and 6000rad to point B should be delivered.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cervix Uteri* ; Female ; Follow-Up Studies ; Humans ; Pelvis ; Survival Rate ; Troleandomycin

PURPOSE: To evaluate effect of postoperative radiotherapy on survival and local control for patients with non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Ninety two NSCLC patients with N1or N2 involvement who were treated with postoperative radiotherapy following surgery with curative intent from May 1987 to October 1999 were retrospectively analyzed. Age of the patients was ranged from 32 to 78 years. According to TNM Stage, 35 patients had Stage II and 57 had Stage III disease. There were 49 patients with N1 involvement and 43 patients with N2 involvement. Fifty six patients were noted to have T1~2 tumors and 36 patients to have T3~4 tumors. Delivered total dose was ranged from 40 to 60 Gy. Majority of patients received 50 Gy or 50.4 Gy. Follow-up period was ranged from 9 month to 7 years with median follow-up of 26 months. RESULTS: Overall survival rates at 3 and 5 years for entire group of patients were 46% and 38%, respectively. Corresponding disease free survival rates were 44% and 36%. There was significant difference in survival between patients with Stage II and Stage III disease (50% vs 28% at 5-year). Five year survival rates for N1 and N2 patients were 52% and 20%, respectively (p<0.05). These were 40% and 34% for patients with T1~2 tumors and T3~4 tumors. There were documented local relapses in 13% of the patients. For patients with N1 and N2 Stage, local relapse rates were 8% and 18%, respectively. CONCLUSION: Our study confirms that postoperative radiotherapy for patients with non-small cell lung cancer improves local control. However, influence of postoperative radiotherapy on long-term survival is less clear. More effective systemic treatment to prevent distant metastasis should be investigated in future study to improve long-term survival.
Carcinoma, Non-Small-Cell Lung* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Radiotherapy* ; Recurrence ; Retrospective Studies ; Survival Rate

PURPOSE: This study was performed to evaluate the effectiveness and tolerance of craniospinal irradiation for patients with medulloblastoma and to define the optimal radiotherapeutic regimen. MATERIALS AND METHODS: We retrospectively analyzed the records of 43 patients with medulloblastoma who were treated with external beam craniospinal radiotherapy at our institution between May, 1984 and April, 1998. Median follow up period was 47 months with range of 18 to 86 months. Twenty seven patients were male and sixteen patients were female, a male to female ratio of 1.7 : 1. Surgery consisted of biopsy alone in 5 patients, subtotal excision in 24 patients, and gross total excision in 14 patients. All of the patients were treated with craniospinal irradiation. All of the patients except four received at least 5,000 cGy to the posterior fossa and forty patients received more than 3,000 cGy to the spinal cord. RESULTS: The overall survival rates at 5 and 7 years for entire group of patients were 67% and 56%, respectively. Corresponding disease free survival rates were 60% and 51%, respectively. The rates of disease control in the posterior fossa were 77% and 67% at 5 and 7 years. Gross total excision and subtotal excision resulted in 5 year overall survival rates of 76% and 66%, respectively. In contrast, those patients who had biopsy alone had a 5 year survival rate of only 40%. Posterior fossa was a component of failure in 11 of the 18 recurrences. Seven recurrences were isolated to the posterior fossa. Four patients had neuraxis recurrences, three had distant metastasis alone and four had multiple sites of failure, all involving the primary site. CONCLUSION: Craniospinal irradiation for patients with medulloblastoma is an effective adjuvant treatment without significant treatment related toxicities. There is room for improvement in terms of posterior fossa control, especially in biopsy alone patients. The advances in radiotherapy including hyperfractionation, stereotactic radiosurgery and 3D conformal radiotherapy would be evolved to improve the tumor control rate at primary site.
Biopsy ; Craniospinal Irradiation ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Male ; Medulloblastoma* ; Neoplasm Metastasis ; Radiosurgery ; Radiotherapy* ; Radiotherapy, Conformal ; Recurrence ; Retrospective Studies ; Spinal Cord ; Survival Rate

PURPOSE: To evaluate the effectiveness and tolerance of postoperative external beam radiotherapy for patients with low grade glioma of the brain and define the optimal radiotherapeutic regimen. MATERIALS AND METHODS: Between June, 1985 and May, 1998, 72 patients with low grade gliomas were treated with postoperative radiotherapy immediately following surgery. Median age was 37 years with range of 11 to 76 years. Forty one patients were male and 31 patients were female with male to female ratio of 1.3:1. Of those patients, 15 underwent biopsy alone and remaining 57 did subtotal resection. The distribution of the patients according to histologic type was as follows: astrocytomas-42 patients (58%), mixed oligodendrogliomas-19 patients (27%), oligodendrogliomas-11 patients (15%). Two patients were treated with whole brain irradiation followed by cone down boost and remaining 70 patients were treated with localized field with appropriate margin. All of the patients were treated with conventional once a day fractionation. Most of patients received total tumor dose of 5000~5500 cGy. RESULTS: The overall 5 and 7 year survival rates for entire group of 72 patients were 61% and 50%. Corresponding disease free survival rates for entire patients were 53% and 45%, respectively. The 5 and 7 year overall survival rates for astrocytomas, mixed oligodendrogliomas, and oligodendrogliomas were 48% and 45%, 76% and 56%, and 80% and 52%, respectively. Patients who underwent subtotal resection showed better survival rates than those who did biopsy alone. The overall 5 year survival rates for subtotal resection patients and biopsy alone patients were 67% and 43%, respectively. Forty six patients who were 40 years or younger survived better than 26 patients who were 41 years or older (overall survival rate at 5 years, 69% vs 45%). Although one patient was not able to complete the treatment because of neurological deterioration, there was no significant treatment related acute toxicities. CONCLUSION: Postoperative radiotherapy was safe and effective treatment for patients with low grade gliomas. However, we probably need prospective randomized trial to define optimal treatment timing and schedule for low grade gliomas and select patient group for different treatment philosophies.
Appointments and Schedules ; Astrocytoma ; Biopsy ; Brain* ; Disease-Free Survival ; Female ; Glioma* ; Humans ; Male ; Oligodendroglioma ; Philosophy ; Radiotherapy* ; Survival Rate

PURPOSE: To evaluate the effectiveness and tolerance of patients ofexternal beam radiotherapy ofr carcinoma of the extrahepatic biliary system (EHBS) including gall bladder (GB) and extrahepatic bile ducts (EHBD) and to define the role of radiotherapy for these tumors. METHODS AND MATERIALS: We retrospectively analyzed the records of 43 patients with carcinoma of the EHBS treated with external beam radiotherapy at our institution between April, 1986 and July, 1994. Twenty three patients had GB cancers and remaining 20 patients did EHBD cancers. Of those 23 GB cancers, 2 had Stage II, 12 did Stage III and 9 did Stage IV disease, respectively. Male to female ratio was 11 to 12. Fifteen patients underwent radical surgery with curative intent and 8 patients did biopsy and bypass surgery alone. Postoperatively 16 patients were irradiated with 4500 cGy or higher doses and 4 patients with 3180 to 4140 cGy. Follow up periods ranged from 8 to 34 months. RESULTS: overall median survival time of patients with GB cancer was 11 months. Median survival time for patients with Stage III and IV disease were 14 months and 5 months, respectively. Corresponding two year survival rates were 36%(4/11) and 13%(1/8), respectively. Those who underwent surgery with curative intent showed significantly better survival at 12 months than those who underwent bypass surgery alone(67% vs 13%). None of the patients died of treatment related complications. Median survival time for entire group of 20 EHBD patients was 10 months. Median survivals of 10 Stage III and 7 Stage IV disease were 10 and 8 months, respectively. Two patients who underwent Whipple's procedure had 11 and 14 month survival and those treated with resection and drainage showed median survival of 10 month. CONCLUSION: Postoperative external beam radiotherapy for carcinoma of the extrahepatic billary system is well tolerated and might improve survival of patients. especially those with respectable lesions with microscopic or gross residual disease after surgery.
Bile Duct Neoplasms ; Bile Ducts, Extrahepatic* ; Biopsy ; Drainage ; Female ; Follow-Up Studies ; Gallbladder Neoplasms ; Humans ; Male ; Radiotherapy* ; Retrospective Studies ; Survival Rate ; Urinary Bladder

Computation of three dimensional dose distribution using CT image and RT plan was applied to a case of pituitary adenoma. Algorithm was based on two dimensional Tissue Maximum Ratio model extended to the third dimension. The resulting isodose curve of transeverse, coronal and sagittal section was demonstrated. This RT plan allows computation of dose distribution in any arbitarily defined plane in addition to conventional cross sectional view.
Pituitary Neoplasms*

The beam characteristics and dosimetric measurements of the 10 MV X-ray beam from a Mevatron KD linear accelerator are examined. The Percent Depth Dose (PDD) table and the Tissue Maximum Ratio (TMR) table are taken from measurement as a function of the field size and the depth. The calculated TMR table from PDD table is compared with those from measurement. Other beam characteristics such as output factor, beam profile (including flatness, symmetry and penumbra), wedge, and the variation of Dmax are presented.
Particle Accelerators*

Some modern accerelators provide a dual energy for photon beam treatment. The main advantages of dual energy in the treatment of rectosigmoid or rectal cancer are as follows. Dose in the critical organ such as small intestine, bladder and genital organ are reduced. Presacral and perineal area is fully covered. Dose distribution analysis such as calculation of dose in a target volume, isocenter, Dmax and dose spectrum in any region of interest are possible. Examples of plan are given and results are discussed.
Genitalia ; Intestine, Small ; Rectal Neoplasms ; Urinary Bladder