Antonio Rodriguez-Antunez

Fast neutron irradiation of metastatic cervical adenopathy: The results of a randomized RTOG study☆

Between 1977 and 1982, 199 evaluable patients with measurable cervical adenopathy were entered on a prospective, randomized RTOG study evaluating the use of fast neutrons in treatment of advanced, inoperable squamous cell carcinomas of the head and neck region. One hundred-eleven patients were randomized to receive mixed beam radiation therapy, and 88 were randomized to the photon control treatment. The complete response rates were 86% for mixed beam vs 75% for photons for Stage N1 nodes, 62% for mixed beam vs 48% for photons for Stage N2 nodes, and 63% for mixed beam vs 53% for photons for N3 nodes. The percents of patients remaining free of their adenopathy for two years were 78% for mixed beam vs 55% for photons for Stage N1 nodes, 39% for both mixed beam and photons for N2 nodes and 24% for mixed beam vs 13% for photons for N3 nodes. The median disease-free status was 20.3 months for mixed beam treated patients and 6.4 months for photon-treated patients. Patients who had clearance of cervical adenopathy survived significantly longer than those who did not.

The use of computed tomography for radiation therapy treatment planning.

In this treatment planning method, information from total body scans is fed into a radiation therapy treatment computer, the Artronix PC-12 system with 16K core. By providing an accurate profile of the patients anatomy, total body computed tomography may contribute greatly to the solution of complex treatment problems involving the head and neck, thorax and abdomen.

Recent Advances in Nuclear Medicine

This volume is the fifth in a series that began in 1948. The subjects covered in it are limited to instrumentation in positron emission tomography, and heavy-ion radiotherapy. The volume is intended as both a historical document and a presentation of the current status of instrumentation in radiopharmaceuticals and positron emission tomography and of the use of neutrons and heavy ions for radiography and tumor therapy. It is designed for investigators in nuclear medicine, medical physics, and radiotherapy. (JMT)

Preoperative Irradiation of Carcinoma of the Rectum

The authors present the five-year results of their program of aggressive preoperative irradiation in cancer of the rectum. Survival rates were above expectations in patients with Duke Stage A (tumor confined to the colon wall) and Stage B disease (tumor invading the pericolon fat). Patients with Stage C disease (tumor in the lymph nodes) did not benefit from preoperative irradiation, most likely due to the high incidence of distant metastases in such cases. No serious complications were observed.

Treatment of Carcinoma of the Esophagus and Gastric Cardia with Concentrated Preoperative Irradiation Followed by Early Operation: A Progress Report

Abstract Our experience in treating carcinoma of the esophagus and cardia of the stomach with a concentrated, abbreviated course of irradiation followed by early operation is reported. The treatment protocol consists of three consecutive 800 R cobalt 60 teletherapy treatments on successive days followed by esophagogastric resection in ten to fourteen days. This treatment was used routinely in 70 consecutive patients seen between 1964 and 1971. Seven patients are living; 5 have survived more than two years postoperatively. These 5 patients all had unusually favorable tumors with no involved lymph nodes found in the resected specimen. Since the only good results occurred in unusually favorable cases, it is difficult to substantiate significant benefit from the addition of this form of radiation therapy to surgical treatment. The routine use of preoperative irradiation has been discontinued.

Photoscanning in Diagnosis of Carcinoma of the Pancreas

Excerpt The use of75Se-tagged methionine for photoscanning the pancreas has offered promise of improved and earlier diagnosis of pancreatic cancer. The diagnostic problem in patients with early car...

Fast neutron beam radiation therapy in the United States

Following a 30-year hiatus after Dr. Stones work in the 1930s and 1940s, clinical trials with fast neutrons were restarted in the United States in 1972. Approximately 2500 patients have been treated with neutrons since that time. Three hundred and seven patients with squamous cell carcinomas of the head and neck were entered on an RTOG-coordinated randomized study comparing standard photon irradiation with mixed beam radiation therapy. No significant differences were noted in the local control, survival or complication rates. One hundred and sixty patients were entered on a randomized glioblastoma study. Although there were no significant differences in median survival, autopsy results showed greater tumor effect on the neutron-treated tumors. Twenty-six patients were treated for transitional cell carcinomas of the bladder with either preoperative mixed beam irradiation or mixed beam irradiation alone. Both the local control rates and survival rates compare favorably with photon radiation therapy. The future of fast neutron beam radiation therapy in the United States is discussed.

High-Dose Preoperative Irradiation of Esophageal Cancer

It is today fully accepted by radiotherapists that, when irradiation and surgery are to be combined, the irradiation should be given first in the majority of cases. The radiobiologic bases for preoperative irradiation were summarized by Bloedorn (1), and radiologic publications contain convincing experimental and clinical evidence in this respect. There is still disagreement among clinicians, however, on the optimum interval between irradiation and operation. If advantage is to be taken of the radiation effect upon the size of the tumor so as to render it resectable, then logically surgery should be delayed until the radiation changes in tumor size are maximum. It is worth emphasizing here that an excessive length of time could increase the difficulty of resection and interfere with healing. If reduction of tumor size is not pertinent and the sole interest in irradiation is to diminish the transplantability of the disseminated tumor cells at the time of operation, then the interval between irradiation and...

New Dimensions in Computed Tomography

Total body CT scanning may be utilized as a means of treatment planning for radiation therapy. Computer reconstruction of coronal and sagittal views from CT cross-sectional slices was accomplished by taking each of the cross-sectional images and placing them together in the specific order in the sequence in which they were scanned to form a cube. Once the cube is built, retrieving in the sagittal and coronal views is readily achieved.

Assessment of function in the transplanted kidney with 131-I hippuran.

After transplantation of a kidney, several clinical problems or complications may develop. On many occasions, the first step is to determine whether or not the homograft is viable. Complications are acute rejection, ureteral obstruction and leakage of urine into the peritoneal cavity.