Fernando G. Bloedorn

Bronchogenic Carcinoma: Further Experience with Preoperative Irradiation

he overall five-year survival of patients with bronchogenic carcinoma is generally reported to be somewhere between 5% T and 10% [31. In an effort to raise this survival rate, the Divisions of Thoracic Surgery and Radiotherapy at the University of Maryland embarked some eight years ago on a program of combined preoperative radiotherapy and surgery for cancer of the lung [2]. In order to be eligible for the study, a patient had to have a lesion: (1) confined to one hemithorax with or without chest wall invasion; (2) with or without metastasis to mediastinal, scalene, or supraclavicular nodes; (3) without associated pleural effusion. From the start of the study until December, 1961, 192 patients met these criteria and constitute the basis for this report. All patients have had at least three years to be at risk. The radiotherapy plan has been published elsewhere [l], but con-

Radiotherapy in Carcinoma of the Bladder: Possible Complications and Their Prevention

The treatment of carcinoma of the bladder by irradiation is a difficult problem and should be undertaken only by a team of specialists with particular interest and proper training. It is impossible to continue with the classic approach of surgeon vs. radiotherapist, each trying to solve all the problems by himself. Much is to be gained by mutual collaboration and an approach to the problem on an integral basis, with consideration of all important factors of histology, natural behavior of the disease, common extension of the tumor, general condition of the patient, and urinary function. The results obtained thus far in the therapy of carcinoma of the bladder have been poor, regardless of the procedure employed. It is our impression that considerable improvement would be effected if the policy of treatment were based on all the factors enumerated above, as is done in carcinoma in such locations as the head and neck and uterine cervix. The use of supervoltage radiotherapy (1 to 24 Mev or cesium or cobalt tel...

Operation, external irradiation, radioactive isotopes, and chemotherapy in treatment of metastatic ovarian malignancies

Abstract Of 169 patients with malignant ovarian tumors, 6 died of postoperative complications, 14 had disease limited to one ovary and were treated by operation only, 10 had disease extending outside the peritoneal cavity and received palliative therapy. The remaining were divided into two groups according to the extension of the disease: 70 patients had malignant growth extending to the pelvis only and 69 had cancer extending to the upper abdomen. Three modes of therapy were used in subsequent periods: (1) operation and external irradiation; (2) operation and irradiation plus radioactive colloidal gold; (3) operation, irradiation, and chemotherapy. Complications of treatment and survival were analyzed in relation to extension and histologic type of the tumor and type of therapy used.

Time-Dose-Volume Relationship in Hodgkin's Disease

The time-dose relationship in the treatment of Hodgkins disease has been previously examined by Scott and Brizel (1), Friedman and Pearlman (2), and Paterson (3). Figure 1 shows how these authors differ in their findings for the time-dose relationship for local control of the disease. The data of Paterson are taken from his book and probably represent an exclusion line, although details are not given. By exclusion line, we refer to one above all failures to control local disease. In control of disease only the local response is considered, that is, whether or not there was recurrence in a treated area, regardless of whether or not there was extension of disease to adjacent or remote areas. Friedmans line was drawn in a similar manner, and again details were not given in his paper, which was primarily concerned with the time-dose relationship in the treatment of mycosis fungoides. Scotts line is based upon data of successful local treatment of Hodgkins disease, and the line was calculated by the method...

Combined Radical Radiotherapy and Surgery in the Treatment of Bronchogenic Carcinoma

The purpose of this work is to evaluate the feasibility of combining preoperative radical irradiation and radical surgical extirpation in the management of bronchogenic carcinoma. This investigation is being carried out as a joint project of the Divisions of Radiotherapy and Thoracic Surgery at the University of Maryland Hospital. All patients admitted to the hospital with a diagnosis of lung cancer and with disease limited to one lung and the mediastinum are included, as well as cases which at previous thoracotomy were considered inoperable due to local extension of the tumor. Cases in which surgery was contraindicated by associated medical conditions have been excluded. Technic of Treatment In all cases a positive histologic diagnosis is obtained before initiation of therapy. If necessary, an exploratory thoracotomy is performed to obtain biopsies of the primary tumor and mediastinal nodes. Irradiation, in the form of cobalt-60 teletherapy, is then started. The minimum volume irradiated includes the pri...