Jerome M. Vaeth

Effects of Radiation Therapy in Survivors of Wilms's Tumor

Of 30 children treated for Wilmss tumor at the University of California Hospitals, San Francisco, between 1926 and 1956, 16 survived five years. The survival of these 16 patients and the related data were previously reported (7, 8, 10). Thirteen of these 16 survivors had received irradiation either as a postoperative measure, or both preoperatively and postoperatively. As would be expected when large doses of ionizing radiation have been delivered to young children, bodily changes were observed in later years. The factors responsible for these changes are the subject of this report. Method and Material In 1960 an attempt was made to locate the 13 irradiated five-year survivors for follow-up examination. One of the 13, we learned, had died of pulmonary tuberculosis eleven years after treatment. On necropsy, no evidence of Wilmss tumor had been present. The 12 remaining survivors answered by telephone or letter and, within the next eighteen months, 9 of them appeared for examination. Each examination incl...

Postirradiation induration as a prognosticator. A retrospective analysis of squamous-cell carcinomas of the oral cavity and oropharynx.

Abstract The authors analyzed retrospectively 49 cases of squamous-cell carcinoma of the oral cavity and oropharynx followed for a minimum of two years after irradiation. There was no correlation between predictability of tumor control by irradiation at the primary site and the presence or absence of residual local induration. The immediate postirradiation clinical assessment of tumor regression in this anatomic site should therefore not be used in making therapeutic decisions or in predicting curability.

Radiotherapeutic management of locally advanced carcinoma of the breast.

Carcinoma of the breast is responsive to irradiation, and we have validated this conclusion by our experience. Considering the advanced stage of the disease presented in this series of 27 cases, we may also conclude that radiation therapy offers a highly successful chance of local as well as regional nodal disease control for long periods of time in the large majority of these unfortunate women. The treatment, when carefully planned and executed, is well tolerated; indeed, it permits post‐irradiation conservative or even radical surgery should the lesion become operable.

Tissue-Culture Studies of Human Oral Carcinoma 1. Proliferative Capacities of Non-malignant and Malignant Oral Explants:

During recent years tissue-culture systems have been used widely as models for a variety of biologic investigations. Derived data have increased understanding and opened approaches to further study of cancer as well as to many other enigmatic disease processes. More specifically, in the area of cancer management most investigations have dealt with the effects of physical and chemical agents on cell growth and metabolism; very little data has been accumulated in relation to diagnosis or prognosis. There is disagreement among investigators as to whether the findings from experiments on standard cell lines are directly applicable to other neoplasms in their natural tumor bed. If investigations utilizing tissue-culture systems could be related to individual-patient problems, the resulting data could be useful in the clinical management of cancer. A project evolved in which oral tissues obtained from individual patients were to be cultured and investigated. Ultimately it was hoped that such studies might lead to conclusions that would in themselves offer guidance in the diagnosis, treatment, and prognosis of individual oral cancers. Initial experiments were designed pertaining to growth and morphology of oral explants and established cell lines in tissue culture. This phase of the report is intended to describe and discuss some of the problems encountered in explanting and cultivating oral cells.

Phantom Dosimetry Study of Shaped Cobalt-60 Fields in the Treatment of Hodgkin's Disease

In recent years there has been a decided trend among radiation therapists to treat localized Hodgkins disease in an increasingly more radical manner. This has included not only higher doses, but also the use of larger treatment portals. A technic of treating the upper torso has evolved in which all the lymph node-bearing areas of the cervicothoracic region are treated in continuity by a single portal. This is accomplished by interposing appropriately shaped lead blocks in the treatment beam to shield such vital structures as lung and cervical spinal cord. The technic has been referred to as the “cervicothoracic bath” or more commonly as the “mantle.” Although this treatment method is very much in vogue at the present time, there has been little published work pertinent to the dosimetry of such shaped fields. The study reported here was performed to satisfy some misgivings in the calculation of doses with the mantletype field. Materials and Methods The Alderson phantom man used in this study is representa...

The Perineal Field in the External Irradiation of Cancer of the Prostate: A Modified Regato Technique

(1) 50 consecutive patients with cancer of the prostate, stages A2 through C2 received external irradiation. The whole pelvis was treated using 4-MV photons, and a prostate boost was given through the perineum using a cesium-137 teletherapy unit. (2) The treatment technique was easily duplicated daily and was well tolerated. There were no grade 2, 3 or 4 complications. (3) Local control was excellent: 96% of all cases. (4) Disease-free survival was high. (5) Potency was maintained in the majority of this elderly population. Considering that American males have an increasing longevity and thus a greater likelihood of developing cancer of the prostate, external-beam radiation therapy should be utilized in the future even more so than today. We must continue to refine radiation therapy techniques in order to further increase disease-free survival and reduce radiation morbidity.

ADENOCARCINOMA OF THE NASOPHARYNX.

In most series of malignant tumors of the nasopharynx that have been reported (1, 3–8, 11–14, 16, 17), adenocarcinomas represent less than 5 per cent of the total number of cases. Despite the recognized high incidence of neoplasms of the nasopharynx among the Chinese and Indonesians (2, 8, 18) adenocarcinoma is almost unknown in these groups. The biologic behavior of adenocarcinoma in its response to irradiation varies from the more common histologic types of nasopharyngeal cancer. The disease frequently persists at the primary site, and the patients die of extension into the skull and brain. Radiation therapists must be aware of these differences and, hence, of the radiotherapeutic approach to the disease. From the evidence in the literature, adenocarcinoma of the nasopharynx is seldom cured (1, 3–8, 11–14, 16, 17). Cures have nevertheless been reported when the radiation dose is carried to a high level within the nasopharynx (10, 14, 15). A twelve-year survival after surgical removal has also been recor...