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Background and purpose The aim of this study was to define the effects of voluntary anal contraction on prostate motion in an experimental setting. Materials and methods Thirty-eight patients (median age, 76years) with prostate cancer underwent thin-slice computed tomography (CT) in the vicinity of the prostate before and after active anal contraction. Three-dimensional displacement of the pelvis and prostate was measured. Results Mean (±standard deviation, SD) overall displacement of the prostate due to anal contraction was 0.3±1.4mm to the right, 9.3±7.8mm to the anterior, and 5±4mm to the cranial direction. Mean displacement of the pelvis was 0.5±1.8mm to the right, 4.1±7.1mm to the anterior, and 1±3mm to the cranial direction. Mean displacement of the prostate relative to the pelvis was 0.1±1.1mm to the left, 5.2±3.3mm to the anterior, and 4±4mm to the cranial direction. Conclusions Voluntary anal contraction within an experimental setting induces large prostate and bone motion, mainly in the anterior and cranial directions. The frequency and magnitude of actual anal contractions during radiotherapy for prostate cancer need to be determined.

To evaluate the use, structural principles, operation, and acquired reproducibility of a respiratory monitoring device to be used for voluntary patient breath holding.Evaluation was performed of a respiratory monitoring device that enables determination of the respiratory level in a patient by measuring the movement of two contacts on the abdomen and chest wall. Neither metallic nor electronic materials are used in the mechanics for this device. The initial study group comprised 21 consecutive patients (15 men, six women; mean age, 75 years; range, 56-92 years) with lung or abdominal tumors who underwent examination with the device and computed tomography (CT) for three-dimensional reproducibility of lung base position during voluntary breath holding with or without use of the device.One patient with mild dementia was excluded; in most of the remaining 20 patients, high reproducibility of the breath-holding position was achieved in a short time with the device. In these 20 patients who were able to adapt to use of the device, three-dimensional mean maximum differences in lung base position during three random voluntary breath holds were 2.0 mm along the cranial-caudal axis, 1.5 mm along the anterior-posterior axis, and 1.2 mm along the right-left axis. The differences in all axes were significantly smaller with use of the respiratory monitoring device than without the device.The device demonstrates satisfactory reproducibility of voluntary patient breath holding easily and inexpensively and may offer a convenient device for easy use during irradiation with voluntary breath-holding conditions that require a small internal margin.

Patients with locally advanced breast cancer were treated with intravenously administration of weekly docetaxel (20 mg/m2) and concurrent radiation therapy (66-70 Gy). A complete response was achieved in both cases and toxicities were tolerable. The protocol was effective as a radical or palliative treatment for locally advanced breast cancer.

We report a case of aorto-bronchial fistula (ABF) caused by a self expanding metallic stent (EMS) 51 days after insertion into the left main bronchus. The patient presented with left main bronchial stenosis caused by post-operative local recurrence of esophageal cancer. Post-operative radio therapy totaling 40 Gy and post-recurrence radiotherapy totaling 34 Gy were administered, with daily fractions of 2 Gy. Stenosis of the left main bronchus improved slightly, and was followed with insertion of EMS to prevent restenosis. The patient experienced massive hemoptysis for 3 days before sudden death. Autopsy revealed the EMS edge perforating the descending aortic lumen. Tumor infiltration and bacterial infection were observed on the wall of the left bronchus, and atherosclerosis was present on the aortic wall around the fistula. It should be noted that the left main bronchus was at considerable risk of ABF after insertion of EMS for malignant stenosis, and prophylactic sent insertion into the left bronchus without imperative need must be avoided.

Sarcomatoid carcinomas of the larynx account for less than 1% of all malignant laryngeal tumors and there is currently no consensus regarding the clinical course or appropriate management of this disease. A case of sarcomatoid carcinoma of the larynx displaying rapid systemic progression after radiotherapy and a brief review of the literature are presented.

7220 Background: The early stage lung cancer patients are increasingly detected due to the popularization of CT examination. The purpose of this study is to evaluate results in 3 years of our novel...