The ultimate goal of radiotherapy is to result in complete local control of tumor while sparing the surrounding normal tissues as much as possible. Since the development of CT in 1970s, patient's anatomical normal tissues and the site and extent of infiltration of tumor were identified almost accurately. In addition, the isodose distribution of delivered radiation to target tumor was shown in each cross-section. In the treatment planning of head and neck cancers, CT-reconstruction provided almost 3-dimensinonal inter-relationship between tumor and normal tissues. The utilization of imaging system of the CT scanner made it possible to illustrate in superposition the patient structure image, the radiation beams, and the isodose distributions. Thus it was possible to deliver radiation enough to control the local disease, and to avoid unnecessary administration of radiation to normal tissue such as spinal cord. CT-reconstructed image in axial, sagittal, and coronal planes suggested 3-dimensional radiotherapy treatment planning be possible and practical instead of conventional 2-dimensional planning at coronal plane.
Head and Neck Neoplasms* ; Head* ; Humans ; Neck ; Radiotherapy* ; Spinal Cord

The differentiation between post-radiotherapy lung fibrosis and tumor recurrence is often a dilemma to physicians. Twenty two patients with lung cancer who had received 45~60 Gy to the chest were chosen to study the possible role of gallium-67 scan. Seventeen squamous cell carcinomas were treated with only radiotherapy, 3 small cell carcinomas with combination chemotherapy, 2 adenocarcinomas with lobectomy. A total of 8 patients with pneumonitis with or without fibrosis and recurrence showed uptake of gallium at the site of inflammation. Of the 12 recurrences and residual diseases after radiotherapy, positive gallium uptake was present in 11 cases (92%). Of the 10 recurrence-free cases, all the 5 patients with pneumonitis revealed gallium accumulation. However, 4 of the 5 patients (805) with recurrence-free fibrosis have not accumulated gallium in the fibrotic areas. Fibrosis in 6 patients were developed after 8 months of completion of radiotherapy. These facts suggest that gallium-67 scan after 1 year post-treatment may aid for the discrimination of fibrosis from tumor recurrence unless pneumonitis is present.
Adenocarcinoma ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Discrimination (Psychology)* ; Drug Therapy, Combination ; Fibrosis* ; Gallium ; Humans ; Inflammation ; Lung Neoplasms* ; Lung* ; Pneumonia ; Radiotherapy ; Recurrence* ; Thorax

Mesna has been used with ifosfamide to prevent urotoxicity in the treatment of testicular cancers. This drug also protected the toxicities of adriamycin without compromising cytostatic activity. With n idea of radioprotective role of sulfhydryl group of radioprotectors and of mesna decreasing the toxic effect of adriamycin which produces free radicals, mesna and radiation were administered to mice to study the protective effect of this drug and to identify the difference in regenerative capacity of the germ cells in the testis between radiation-treated and both mesna- and radiation-treated groups. The shape and numbers of spermatogenic cells in the seminiferous tubules were examined every week after irradiation. In both groups, initial reduction and later recovery in germ seel numbers and shape was observed. The lowest germ cell number was found around three weeks after irradiation. Mean germ cell number of the mesna-treated group was significantly higher than radiation-treated group at all observed periods (p<0.05). More competent regeneration was present in mesna-treated group. These results suggest that mesna protect the testis from radiation injury. Further study will be necessary to identify whether mesna protects other tissues from radiation and it does not hamper tumor control.
Animals ; Doxorubicin ; Free Radicals ; Germ Cells ; Ifosfamide ; Mesna* ; Mice* ; Radiation Injuries ; Regeneration ; Robenidine ; Seminiferous Tubules ; Testicular Neoplasms ; Testis*

This is a retrospective study of 62 patients with unresected squamous cell carcinoma of the esophagus treated by radiotherapy alone (25 patients) or combined chemotherapy and radiotherapy (37 patients). Of these, 14 of 25 patients treated by radiation therapy alone and 25 of 37 patients treated by combined chemotherapy and radiotherapy completed radiotherapy consisting of 55 to 60 Gy in 5 to 6 weeks and were analyzed for local control rate and survival rate. Follow up ranged from 6 days to 58 months. Three (8%) of 39 patients had a complete response, twenty-eight(72%) a partial reponse and eight(20%) minimal or no resonse. Overall median survival was 11 months for all stages. The 1 year and 2 year actuarial survival rates were 48.6% and 13% respectively. Age and stage had prognostic significances (p<0.05, p<0.05 respectively). The 1 year survival rate was 70.1% for stage I, 47.6% for stage II, and 28.4% for stage III. The median survival was 19 months for stage I, 11 months for stage II, 6 months for stage III, and 5.5 months for stage III with distant metastases. The 1 year survival rate of patients 55 years and above was 69.6%, 54 years and below was 0%. There was no significant difference in survival rate between treatment modalities, locations of tumor, and responses of tumor.
Carcinoma, Squamous Cell ; Drug Therapy* ; Esophageal Neoplasms* ; Esophagus ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Radiotherapy* ; Retrospective Studies ; Survival Rate

From July 1984 to September 1988, 27 patients with limited stage small cell lung cancer were treated with combined modality(combination chemotherapy Plus radiotherapy) at the Department of Therapeutic Radiology in Kyungpook National University Hospital. Of the 27 patients, 19(70%) achieved a complete response, 6(22%) a partial response, and 2(8%) no response. Female, performance status HO, serum enolase level below 30ng/ml, radiation dose over 4500 cGy, and 4 or more cycles of chemotherapy had a favorable effect on the rates of complete response, although there were no statistical differences according to the variables. Median survival time was 10 Months and overall 1- and 2-year survival rates were 40.7% and 12.2%, respectively. Complete response(p<0.05), performance status HO(p<0.05), 4 or more cycles of chemotherapy(p<0.05), and radiation dose over 4500 cGy had a significantly favorable effect on 2-year survival rate. Prophylactic cranial irradiation or sex had no effect on survival. The results of this study suggest that radiation treatment should be combined with combination chemotherapy in the therapeutic strategy of SCLC of limited stage.
Carcinoma, Small Cell ; Combined Modality Therapy ; Cranial Irradiation ; Drug Therapy ; Drug Therapy, Combination ; Female ; Gyeongsangbuk-do ; Humans ; Lung Neoplasms ; Phosphopyruvate Hydratase ; Radiation Oncology ; Small Cell Lung Carcinoma* ; Survival Rate

From April 1985 to September 1989, 26 patients with stage IandII non-Hodgkin's lymphoma of unfavorable histology localized in head and neck region were treated with combined modality (combination chemotherapy plus radiotherapy) at the Department of Therapeutic Radiology in Kyungpook National University Hospital. Of the 26 patients, 23 showed complete response and 3 partial response. Between these two groups there were no statistical differences according to the variables. Three-year survival and disease-free survival rate were 62.4% and 65.2%, respectively. Unilateral involvement of neck node (p<0.05), radiation dose over 5000 cgy (p<0.01,) and 6 or more cycles chemotherapy (p=0.06) had a favorable effect on 3-year survival rate. There were 8 recurrences including 3 partial responders, 1 local failure, 1 distant failure, 1 contiguous failure, and 2 simultaneous local and distant failure. It could be suggested that combined modality treatment might be necessary for the treatment of stage IandII Non-Hodgkin's lymphoma of unfavorable histology.
Disease-Free Survival ; Drug Therapy ; Gyeongsangbuk-do ; Head* ; Humans ; Lymphoma, Non-Hodgkin* ; Neck* ; Radiation Oncology ; Recurrence ; Survival Rate

From Feb. 1985 to Feb. 1988, 76 patients with squamous cell carcinoma of the lung treated at the Department of Therapeutic Radiology in Kyungpook National University Hospital were available for the analysis of this study. All patients received radiation of 4000c0y-6600c0y with curative aim. The overall rate of complete response was 25.0% and partial response was 52.6%. The complete and partial regression of tumor was 14.3% in patients treated with dose below 5000 cGy and 84.1% in the group treated with dose above 5000 cGy (p<0.01). The complete response was seen only in the group of patients received radiation at least 6000 cGy. The patterns of failure were as follows. The rate of initial intrathoracic recurrence was 52.6% in patients with complete response. The overall rate of failure was 67.8%. Distant metastasis was found in 47.4% of patients. Bone, contralateral lung, and brain were common metastatic sites in decreasing order. All of the distant metastases and 80% of local recurrences were found within the first year after treatment.
Brain ; Carcinoma, Squamous Cell* ; Gyeongsangbuk-do ; Humans ; Lung Neoplasms ; Lung* ; Neoplasm Metastasis ; Radiation Oncology ; Radiotherapy* ; Recurrence

From 1984 to 1988, fourt two patients with nasopharyngeal cancer were treated at the Department of Radiation Oncology in Kyungpook National University Hospital. Thirteen patients refused treatment and the median survival time was 7.8 months. Twenty nine patients received a full course of radiation at least 70 gy to the primary site and 60 gy to the nodal sites. These patients were all belonged to stage III or IV. The local control rate was 75% in squamous cell carcinomas, and all the patients with lymphoepithelioma showed a complete response. Overall locoregional failure was 27.6%. Distant metastasis was the predominant pattern of failures; 4/6 in lymphoepithelioma, 4/10 in squamous cell carcinoma. The Three-year-survival rate for squamous cell carcinoma was 40.5%, and for lymphoepithelioma 25.9%, respectively. This may be due to the more frequent distant metastases in lymphoepithelioma and ineffective chemotherapy. No survival correlation was found with the level of neck node involvement. Though adjuvant chemotherapy was found to be of no benefit in overall survival, more prudent and aggressive chemotherapy would be necessary.
Carcinoma, Squamous Cell ; Chemotherapy, Adjuvant ; Drug Therapy ; Gyeongsangbuk-do ; Humans ; Nasopharyngeal Neoplasms* ; Neck ; Neoplasm Metastasis ; Radiation Oncology ; Radiotherapy

Fourty nine patients with squamous cell carcinoma of oral tongue were reviewed retrospectively for the evaluation of clinical manifestation and for the comparison between therapeutic modalites. The gross shape of the tumor was infiltrative in 22, ulcerative in 12, and ulceroinfiltrative type in 10 patients. Direct extension of the tumor was most commonly to the floor of the mouth. The incidence of nodal metastasis generally increased with tumor stage. 55% of the patients showed neck nodal metastasis at the time of diagnosis. Ipsilateral subdigastric node were most commonly involved, followed by submandibular nodes. The 5-year survival rate of patients treated with surgery and radiotherapy was 58.7% in contrast to 21.6% in radiation alone group. Overall 5-year survival rate was 31%. In radiation alone group, half of the patients in stage I, II were locally controlled. But the local control in stage III, IV was much inferior to early lesions. Especially, of 4 patients combined with implantation tecnhnique, 3 were completely controlled. 5-year survival rate of these implanted patients was 50%, 49.4% of patients treated over 7,000 cGy survived 5 years. This was significant in contrast to 6.4% of the group treated below 7,000 cGy. The most common sites of failures were primary sites. In early lesions primary radiotherapy with implantation would be an appropriate treatment in cancer of oral tongue, operation reserved for radiation failure. Operation and adjuvant radiotherapy is recommended in cases of advanced disease.
Carcinoma, Squamous Cell* ; Diagnosis ; Humans ; Incidence ; Mouth ; Neck ; Neoplasm Metastasis ; Radiotherapy ; Radiotherapy, Adjuvant ; Retrospective Studies ; Survival Rate ; Tongue* ; Ulcer

In order to determine the value of induction chemotherapy (CT) for inoperable head and neck cancer, the authors conducted a retrospective study. Fifty-five patients were treated with CT and radiotherapy(RT)(CT + RT group). This group was compared with a group of 54 patients treated RT alone (RT alone group). The CT regimen used were CF (cis-platine + 5-FU), CVB(cyclophos-phamide + vincristine + bleomycin), CAP (cyclophosphamide + adriamycin + prednisolone) or PVBM(cis-platine + vincristine + bleomycin + methotrexate). Toxicity from induction chemotherapy was minimal, and toxicity was limited primarily to nausea and vomiting, mucositis and myelosuppression. The complete response (CR) rate to CT was 14.5% and the partial response (PR) rate was 47.3% for an overall major response rate of 61.8%. The major response rate at the completion of loco-regional therapy was 87.3% (48/55) with 32 CR (58.2%) and 16 PR (29.1%) for CT-RT group and 81.5% (44/55) with 27 CR(50.0%) and 17 PR (31.5%) for RT alone group (p=0.57). Median follow-up of CT-RT group was 17 months and 11 months for RT alone group. Median survival was 36 months for CT-RT group and 24 monts for RT alone group (p=0.3). The overall survival rate at 2 years, 3years and 5 years, respectively was 60.9%, 48.6% and 42.5% for CT-RT guoup, and 54.9%, 49.9% for RT alone group (p=0.33). Comparision between patients in both groups, stratified by overall stage, T and N stage, site, and pathology, all failed to show any significant difference in survival rates. We conclude that this retrospective study failed to demonstrate an advantage for induction chemotherapy in inoperable head and neck cancer.
Bleomycin ; Doxorubicin ; Follow-Up Studies ; Head and Neck Neoplasms* ; Head* ; Humans ; Induction Chemotherapy ; Mucositis ; Nausea ; Pathology ; Radiotherapy* ; Retrospective Studies ; Survival Rate ; Vincristine ; Vomiting