No abstract available

[en] A pilot study of synchronous methotrexate and radiation therapy was carried out in 50 patients with advanced carcinoma of the head and neck, of whom 48 were assessable for response. Complete resolution of disease, maintained for 2 years, was achieved in 21 patients (45%), and in 19 out of 36 patients (53%) with carcinoma of the oropharynx and hypopharynx. The treatment was well tolerated, with acceptable morbidity. (author)

[en] Sarcomas rarely follow irradiation of benign lesions of bone as the dangers of this form of therapy is well recognised. Forty-three patients with soft tissue neoplasms - mainly carcinoma - were irradiated and developed sarcomas in the radiation field. Twenty-four of these patients were seen at this centre in the last decade, a considerable increase compared to earlier years. Radiation osteitis may indicate the nature of the tumour but was only present in 50%. A purely lytic or purely sclerotic pattern was commoner than a mixed lytic and sclerotic appearance. CT scan, bone scan and angiography were helpful in delineating disease but did not assist in diagnosing the type of tumour. A tumour arising within the irradiated field is an indication for biopsy. Prognosis of radiation-induced sarcoma (RIS) remains poor, only five of the 43 patients survived 5 years. (author)

[en] Nine patients with advanced head and neck cancer were treated by irradiation consisting of three fractions a day of 180 rad administered with intervals of 4 h. The total dose was 4860-5400 rad in an overall time of 11-12 days. The acute mucosal reactions produced by this multifractionated schedule were similar to those observed with conventional fractionation. The acute skin reactions were minimal. The period of acute reactions were shorter than is generally observed with conventional fractionation. In six patients with a follow-up time of six months or longer no late reactions were detected with the exception of one patient requiring permanent tracheostomy because of laryngeal oedema. In the whole group of patients loco-regional control of the disease was achieved. Six patients had maintained the full response for six months or longer. The results so far obtained with this multiple fractions a day schedule are encouraging. More patients have to be entered in this study in order to draw definitive conclusions. (author)

[en] Fifty-four female patients under 45 years of age were followed-up for assessment of ovarian function after treatment for Hodgkin's disease. Forty-six patients had oophoropexy performed, but it was found that in only 28 (60.8%) were the ovaries sufficiently displaced from their normal positions that, had an inverted 'Y' field of irradiation been applied, the ovaries would have been spared. In the 12 patients who were treated by irradiation alone (including an inverted 'Y' field), only one patient maintained normal ovarian function. Therefore, it is suggested that as oophoropexy and the shielding performed at inverted 'Y' irradiation has proved of limited value in preserving ovarian function further measures should be taken. (author)

[en] A clinical study of computed tomography (CT) was undertaken in 35 patients with tumours involving the larynx. Twenty-seven had primary laryngeal neoplasms, five had tumours arising in adjacent structures but invading the larynx and three who had undergone total laryngectomy were investigated for possible recurrence. The findings were compared with conventional radiological methods and clinical assessment. Confirmation was obtained from laryngectomy specimens in four patients and at autopsy in one. CT provided additional pre-operative information on 14 occasions. This included better delineation of submucosal tumour extent, invasion of the pre-epiglottic space and cartilage displacement or invasion. (author)

[en] A procedure for estimating the rectal dose-rate in patients treated by a Selectron remote-afterloading machine is described. This entails dose-rate measurements using low-activity test sources whilst the patient is still in theatre. The standard applicators were modified to enable the rectal dose to be reduced. (author)

[en] One hundred and ten patients with hypospadias underwent excretory urography and micturating cysto-urethrography before surgical correction. Urographic studies revealed abnormalities in 50 patients (45%), mainly anomalies of ascent and rotation of the kidneys. None of these patients required corrective surgery. Voiding cysto-urethrography disclosed disease of the urinary tract in 65 of 110 patients (59%). Meatal stenosis was found in 38 patients and a rudimentary vagina or a prostatic utricle was revealed in 11 others. Vesico-ureteral reflux was present in 14 patients, seven of whom had meatal stenosis as well. Cystitis was found in eight and a stricture of the membraneous urethra in one patient. The voiding cysto-urethrogram is able to demonstrate functionally significant meatal stenosis, genital abnormalities and vesico-ureteral reflux. It can also serve as a useful baseline for comparison with postoperative studies. It is therefore considered that it should be included in the preoperative work-up of every patient with hypospadias. Excretory urography, however, is perhaps indicated only in those with urinary tract infection, or in patients otherwise symptomatic. (author)

[en] The uptake and subcellular distribution of sodium iothalamate-¹²⁵I (Conray-¹²⁵I) and meglumine ioglycamate-¹²⁵I (Biligram-¹²⁵I) have been studied in human brain tumours following intravenous injection of the agents. In seven patients given Conray-¹²⁵I the mean tumour uptake of the compound was 2.8 +- 1.1 (SD)% administered dose per kilogram of fresh tissue, and the plasma to tumour concentration ratio was 2.0 +- 0.6 (SD). Subcellular fractionation studies showed that 82 +- 6 (SD)% of the total tissue Conray-¹²⁵I was contained in the cytosol. Similar studies in three patients given Biligram-¹²⁵I gave a mean tumour uptake of 3.3 +- 0.6% dose per kilogram with a plasma to tumour concentration ratio of 6.7 +- 3.8. On subcellular fractionation 81 +- 4% of the total tumour Biligram-¹²⁵I was found in the cytosol. The distribution of the two agents in the plasma and tumour cytosol was studied by gel permeation chromatography on Sephadex-G25. No protein binding of Conray-¹²⁵I was observed in either plasma or cytosol, but whereas Biligram-¹²⁵I was always protein-bound in the plasma, that contained in the tumour cytosol was not protein-bound. It is concluded that neither Conray nor Biligram are taken up by the cells of brain tumours to any significant extent and that the increased X-ray attenuation observed in areas of tumour following administration of these agents probably reflects increases in the vascularity and interstitial fluid mass in the region of the lession as compared to that in normal tissue. (author)

[en] An argument is advanced for the use of partial rotational techniques for the treatment of carcinoma of the bladder. One hundred and seventy cases are analysed; the majority were T3 solid transitional cell lesions with an overall (corrected) survival rate of 24.7%. Salvage cystectomy produced a four-year survival rate of 40% when performed within six months of the radiotherapy. (author)