Kenneth E. Ellingwood

The effects of irradiation on the eye and optic nerve

Abstract Late effects of irradiation of the eye and optic nerve in 74 patients are reviewed. Time-dose analyses are performed for lacrimal apparatus, retinal, and optic nerve injuries. Management of radiation complications is discussed. Recommendations are made regarding radiation treatment techniques and methods of reducing the risk of late injury.

Cancer of the nasal cavity and ethmoid/sphenoid sinuses

During the period from October 1964 to September 1975, 32 patients were treated at the University of Florida for a variety of malignant tumors of the nasal cavity and ethmoid/sphenoid sinuses. All were treated with radical irradiation, 6091 to 7972 rad, in 6 to 9 weeks, cobalt‐60. Pretreatment work‐up revealed evidence of orbital invasion in 7 patients and involvement of the cranial contents, base of skull, or nasopharynx in an additional 15 patients. Local control was achieved in 95% of nasal cavity cases and 71% of ethmoid/sphenoid sinus cases at 2 years or more. The 5‐year actuarial survival rate was 59%, and 5‐year survival without evidence of disease was 50% (13/26). Patterns of extension in advanced lesions are clues to potential undetected extension in early cases which must be included in the treatment volume. Eye complications were minimal when it was possible to avoid treatment of the entire eye, but developed in all cases requiring treatment of the entire orbit. Acute and chronic complications involving the eye, ear, central nervous system, sinuses, and nose were reviewed and correlated with initial tumor extent, dose, and radiation treatment technique.

Postdiversion precystectomy irradiation for cancer of the bladder.

This is the first report of a 4‐year prospective trial of integrated irradiation and cystectomy in the management of advanced bladder carcinoma. Patients are treated sequentially with staging laparotomy and urinary diversion, highdose preoperative irradiation (5,000 rad/30 treatments/42 days), and total cystectomy. Twenty‐eight consecutive patients have been entered into the study; all had Grade III or IV tumor or clinical evidence of invasion (Jewett Stage B1‐D1). Local control has been achieved in 21 of 22 patients, and the 4‐year actuarial survival is 54%. The initial staging procedure not only defines inoperable patients, but also allows completion of urinary diversion prior to small bowel irradiation with fewer anastomotic problems. Acute and chronic complications have been minimal, and there have been no treatment‐related deaths. Cancer 43:1032‐1036, 1979.