Jones Eo

Contrast‐enhancing computed tomography ring in glioblastoma multiforme after intraoperative endocurietherapy

The significance of the contrast‐enhancing ring seen on serial follow‐up postirradiation computed tomograms (CT) of the brain was evaluated in a group of 41 patients with glioblastoma multiforme (GM) who were treated in a phase I/II study by means of intraoperative remote afterloading endocurietherapy (ECT) with a high activity cobalt 60 probe (20.00 Gy) in one high‐dose rate fraction), and conventional fractionated external‐beam (EXRT) radiotherapy (60.00 Gy in 30 fractions in 7.5 weeks). All received minimum total tumor doses of 80.00 Gy. After completion of treatment, all patients were followed with serial CT scans of the brain. Two to 6 months after treatment, 27 of 41 patients developed the similar thin‐walled, regular, contrast‐enhancing CT rings with low‐density attenuation inside and outside the ring. Postmortem study in two of these patients revealed that the thin‐walled, regular, contrast‐enhancing ring represented a continuous capsule of dilated cerebral vessels with inner low‐density attenuation corresponding to necrosis, and outer low‐density attenuation corresponding to edema. The CT appearance of the thin‐walled, regular, contrast‐enhancing ring produced after high‐dose rate intraoperative ECT and EXRT is distinctly different from the CT ring characteristic of untreated or recurrent GM. After high‐dose rate intracranial ECT and EXRT, the appearance of a post‐ECT contrast‐enhancing CT ring should not be automatically interpreted as recurrent disease as previously reported after conventional fractionated EXRT.

Transperineal 125iodine endocurietherapy of prostate cancer.

We present the improved implant technique, intraoperative and postoperative complications, local control, and survival of 67 patients with cancer of the prostate treated by means of percutaneous transperineal template permanent 125iodine interstitial endocurietherapy (ECT). This ECT technique is a simple, easily learned, accurate and rapid procedure that can be performed without subjecting the patient to celiotomy. The use of vicryl carriers for permanent 125iodine implantation of the prostate with the percutaneous transperineal template technique prevents seed loss and permits implantation of patients after transurethral resection of the prostate (TURP).

Dual-field rotational (DFR) technique for total-skin electron-beam therapy (TSEBT).

Comparison of dosimetry measured in a noncylindrical Rando-Alderson phantom by two-field, four-field, and six-field total-skin electron-beam therapy (TSEBT) techniques with our dual-field rotational (DFR) technique reveals a superior dosimetry for the latter. Our technique of dual-field rotational DFR-TSEBT is described in detail, and its advantages and indications for the primary management of cutaneous T-cell lymphoma (CTCL) and Kaposis sarcoma (KS) are discussed.