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D-glucose absorption in vivo in mice decreased as a function of dose and time after irradiation returning to normal within a week after irradiation. The lamina propria is seen full of polymorphonuclear leukocytes, other infiltrative cells, capillary and lymphatic network, which seem closely related to chronic enteritis. Since acute and chronic diarrhea after irradiation can be reduced by cholestyramine or acetylsalicylate, malabsorption of bile salts or prostaglandin E of the luminal content has been regarded as a cause of radiation-induced diarrhea. LD 50 of irradiated mice was increased by SOD. From the clinical data, thin physique, previous operation, and total dose of more than 50 Gy could be predisposing factors of radiation-related enteritis.

A case history of a 39-year-old woman with a follicular, medium-size cell type lymphoma (Nodular poorly differentiated lymphocytic lymphoma) is reported. In spite of receiving no treatment, her lymphoma had changed little for 13 years. This case is regarded as a good example for considering the treatment of low grade malignant lymphomas.

The clinical features of 102 patients with low grade non-Hodgkin's lymphomas treated from 1972 to 1981 among the hospitals belonging to the JLRTG were retrospectively reviewed. According to the Rappaport classification, there were 29 cases of NPDL, 26 of NM and 47 of DWDL. The survival rate and relapse-free survival rate for all patients at 10 years were 49% and 41%, respectively. No obvious difference in survival rate was seen by histologic type, but patients with DWDL had a better relapse-free survival rate than those with NM (P less than 0.01). This study also suggested that patients with stages I and II low grade lymphomas might be treated by irradiation alone, if they are staged properly.

The patients of malignant glioma mostly consisting of anaplastic astrocytoma (AA) and glioblastoma (GM) were surveyed at the Committee for Compiling the Manual of Radiotherapy in the Treatment of Brain Tumors, organized by Japanese Association for Radiotherapy Research. Total 286 patients were treated at ten institutes during the period from January 1985 through December 1987. Numbers of cases with AA and GM were 130 and 156, respectively. Concerning the treatment volume, the medium field (50-100 cm2) was applied to 127 patients (37.4%) and the whole brain to 25 one (7.4%). The total dose was given by the range from 56 Gy to 65 Gy in 158 patients (47.6%). One-year survival ratio of AA and GM were 60-75% and 40-65%, respectively. For obtaining the improvement of local control rate, it is considered that the beam focusing onto the target lesion and the sufficient removal of the tumor are necessary and essential.

The dose modifying effects of the age, anatomic location of the normal tissue, positioning of animal during irradiation, preliminary treatment, number of fractions and time interval between doses on response of the normal tissues to radiation were studied, using various kinds of response of mouse hind legs such as early skin reaction, epilation, skin contraction, ulcer formation, leg contraction and growth retardation of femur. The dose modifying factors varied with the kinds and the levels of injuries, meaning that it is very important to define what the critical normal tissue is and its end point first of all, when we discuss the dose modifying factors with respect to the therapeutic gain factors.

Incidence of telangiectasia and ulcer among 118 postoperated breast cancer patients, who were tangentially irradiated at Department of Radiology, Kyushu University from 1961 to 1980, followed more than 5 years were evaluated. Telangiectasia occurred in 5% at 20-35 Gy, in 50% at 50-55 Gy. Ulcer occurred in 5% at 50-55 Gy, in 50% at 70-75 Gy. Skin tolerance dose in Rubin's Table (1972) is correct.

Thyroid function after radiation therapy to the neck was studied in 120 patients, 110 of whom were suffered from malignant lymphomas. No patients had clinical symptoms from thyroid dysfunction, but 9 patients were given thyroid hormone after examination of thyroid function test. TSH elevation rate for 95 patients irradiated to the hole neck by dosage was 0%, 24%, 47% and 47%, for less than 30 Gy, 30-39 Gy, 40-49 Gy and 50 Gy or more, respectively. The effects of lymphangiography and systemic combination chemotherapy on the thyroid function were also discussed.

Cooperative study from six institutes was made for the late radiation damage of oral mucosa and mandibular bone. Analysis was made for the selected patients with oropharyngeal cancer for external beam alone and with tongue cancer for interstitial implant. All of them were followed at least two years without recurrence having no secondary treatment after initial radiotherapy. As for external beam alone, frequency of the mucosal ulcer was not increased with high dose level, but tolerance dose for the oral mucosa was limited from associated mandibular damage. Late damages were not likely after brachytherapy alone.

In a review of 193 patients with carcinoma of the tongue who underwent interstitial radiotherapy in our hospital from November 1978 to 1986, 5 year actuarial local control rate were 97%, 87%, 58% and 77% for T1, T2, T3 and T4 respectively. Mucosal ulcers with tissue defects and bone exposure of the mandible occurred in 5 years after the treatments, 6%, 22%, 44%, and 100% for T1, T2, T3 and T4, respectively. Therapeutic ratio was 1 in patients with T1 who underwent interstitial radiotherapy (70 Gy/7 days) alone while it was less than 1 in those with T2 or more. Therapeutic gain factor was less than 1 in patients with combined external radiotherapy.

Examination by questionnaire of 102 institutions utilizing radiation therapy throughout the country revealed 97 cases of radiation necrosis of the brain, 41 cases of which have received only one course of radiation therapy with either high energy x-rays or 60Co gamma-rays and that have been histologically confirmed for necrosis. The dose fractionation relationship causing necrosis presumed by Strandquvist's diagram proved to be located along the line with the slope of 0.44 from the interception of 9.9 Gy with a single irradiation. Our own experience of brain tumor and cancer of the paranasal sinus told 2 with developed necrosis (incidence, 0.6%) of 325 cases on radiation therapy at a dose of 50-60 Gy and 5 (incidence, 2.0%) of 253 cases on radiation therapy at a dose of more than 60 Gy.

The incidence of rectal bleeding (Grade II or III) after radiotherapy for carcinoma of uterine cervix were studied. All cases were treated by external irradiation (ERT) and intracavitary irradiation (ICR). The dosage of rectal bleeding at 5% level were as followed; 40 Gy by ERT and 27 Gy at point A by ICR in National Sapporo Hospital, 36-40 Gy by ERT and 24 Gy at point A by ICR in Aichi Cancer Center, 40 Gy by ERT and 27 Gy at point A by ICR in Kyushu Cancer Center.

Histological findings of malignant tumors were reviewed in relation to the prognosis following surgery, radiotherapy and/or chemotherapy. To say the histological grading of malignancy by differentiation (maturation), estimation of it seemed to be subjective and it did not always correlate with the disease free survival rate. Histological findings which indicated a high degree of tumor-host interaction were a good predictor of the prognosis as well as the cell type, and the disease free survival rate of the cases with these findings was relatively higher following not only surgery, radiotherapy but also chemotherapy.

The role of lymphography for patients with malignant lymphomas involving Waldeyer's ring was retrospectively reviewed. The materials were 97 patients who were treated at Kyushu University Hospital from January, 1966 to December 1982. Lymphography was performed in 72 patients. Abnormal retroperitoneal nodes were detected only in 13 of them (18%). Six of the 7 patients (86%) with gastrointestinal involvement as well as Waldeyer's ring had positive lymphography, whereas only 6 of the 51 patients (12%) without gastrointestinal involvement had such findings. Although there was a significant difference in survival by cervical and inguinal lymph node status, no such discrepancy was seen between 41 stage II patients staged after lymphography and 16 stage II patients staged clinically. All these results suggest that lymphography is not always essential for patients with malignant lymphomas involving Waldeyer's ring.

Incidence rate of pulmonary fibrosis with elevation of diaphragma was calculated for 118 postoperated breast cancer patients who were tangentially irradiated at the Department of Radiology Kyushu University from 1961 to 1980 and followed more than 5 years. 5%, 50% occurred at 40-45 Gy, 60-65 Gy, Rubin's Table (1972) is possible correct.

During an 11 year period, from 1976 to 1986, 33 (10.1%) out of 328 patients with oral cancer treated at our clinic had either a scarred pulmonary tuberculosis (TB) or active TB. Four of these 33 patients developed active TB. In two of these cases TB occurred before the therapy of oral cancer commenced and in the other two, after the operation for oral cancer. In one of the 4 cases, a recrudescence of the TB was suspected. Five cases that were suspected of having TB on analysis of their chest X-rays were administered prophylactic anti-tuberculous chemotherapy, after which no recrudescence or onset of TB.

Results of treatment of 25 Hodgkin's disease patients at Kyushu University Hospital from 1981 to 1985 were reviewed. Total nodal irradiation or MOPP chemotherapy was used mainly. The actuarial 5-year survival rate, 87.2%, was significantly better than the 41.0% of 61 patients treated between 1966 and 1980 (P less than 0.01). However, 12 of the 24 patients in remission eventually relapsed. To further improve the survival rates of patients with Hodgkin's disease, technical improvements in total nodal irradiation and altering Adriamycin-containing chemotherapy protocol from MOPP chemotherapy are advisable.

One hundred and one patients of less than seventy years old with T1, T2 and N0 carcinoma of the tongue were graded according to the Jacobson-Yamamoto's grading (1-4 D). All patients were also classified into two groups such as less than fifty years old group and fifty to seventy years old group. Patients with grade 3, 4 C and 4 D carcinoma had more metastases to the cervical lymph nodes than grade 1, 2. Patients with T2N0 carcinoma showed approximately same five year cervical lymph node metastases free survival rate. However, the five year survival rate of less than fifty years old group was significantly lower than that of fifty to seventy years old group. In T2N0, grade 3-4 D carcinoma cases, more dead cases were found in less than fifty years old group than in fifty to seventy years old group.

Incidence of rib fracture was analyzed for 118 postoperated breast cancer patients who were tangentially irradiated at the Department of Radiology, Kyushu University, from 1961 to 1976 and followed more than 5 years. Rib fracture was observed in 5% and 50% of cases treated with total radiation doses of 32.5 Gy and 52.5 Gy respectively.