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3638 Background: The rate of local recurrence(LR) for rectal cancer ranges from 10 to 40%. Most patients are referred for radiotherapy. Radiotherapy is generally considered palliative treatment. Th...

4124 Background: We reported that the 4-fraction/1-week carbon ion radiotherapy, that had been conducted from April 2001 to February 2003 within a phase II clinical study, appeared to be safe and t...

4090 Background: Both radicality and minimal invasiveness are essential for the treatment of hepatocellular carcinoma (HCC), because in 85% of all patients the condition is associated with liver cirrhosis. Carbon ion radiotherapy is expected to potentially have both the natures because of its excellent dose distribution and its high cytocidal effect resulting from biologically unique characteristics. Methods: Forty-four patients with histologically documented HCC were treated with 4-fraction carbon ion radiotherapy of 52.8 GyE total dose from April 2001 to February 2003. In this report, thirty-six patients with 36 lesions, whose follow-up periods were longer than one year, were the subjects. Fifteen had recurrent tumors (locally: 9, regionally: 6). Six were at Stage I of the disease, 20 at Stage II and 10 at Stage IIIA according to the UICC criteria (Sixth Edition). Child-Pugh grade was A in 28 and B in 8 patients. Mean maximum tumor size was 4.0 (1.2–7.5) cm in diameter. Anti-tumor effect was evaluated b...

3098 Background: The development of the novel carbon ion radiotherapy (CIRT) in the treatment of refractory cancers has resulted in the need for a way to accurately evaluate patients' prognosis. Am...

Background/Aims The liver has a tremendous ability to hypertrophy in compensation for acute parenchymal loss by surgical hepatectomy and possibly by radiotherapy. This ability, however, is impaired in the cirrhotic liver and therefore major hepatectomy is even precluded from a treatment of choice for hepatoma. Radiotherapy can be an alternative treatment of hepatoma and the ability to hypertrophy will be a major determinant of radiation tolerance. The aim of this study is to determine the ability of the cirrhotic liver to hypertrophy following radiotherapy. Materials and Methods Thirty-two series of CT scans of hepatoma patients with cirrhotic livers were used. These tumors were treated by proton beam radiotherapy of doses ranged from 72 to 84 Gy +/_ chemoembolization therapy. The tumors were selectively irradiated leaving most part of the non-tumorous liver intact. A minimum follow-up period was 12 months after initiation of radiotherapy. The total liver volume and the treated liver volume (recognized as an area of altered density after radiotherapy) were measured to examine a change of liver volume. Results The total liver volume decreased mostly over half a year after radiotherapy and then tended to increase moderately. The treated liver volume continued to decrease even 12 months after radiotherapy. This change of both liver volume was smaller in more severely cirrhotic livers, Conclusions The cirrhotic liver certainly hypertrophys in response to radiotherapy, although it occurs rather moderately and slowly.

This article describes a method which uses CT scans and immobilizing shells in radiation treatment planning (CT-assisted planning) for paranasal sinus carcinomas and the value of this method on the treatment outcome. Results of the treatment for 82 patients who had CT-assisted planning were compared with that of 88 patients who had no such treatment planning. It has been concluded that the combined use of CT and the shell in treatment planning permitted a 3-dimensional localization of both the tumor and critical normal structures with great accuracy, leading to an improved long-term survival and a reduced complication rate. The multivariate regression analysis for predicting significant prognostic factors also confirmed the valuable role of CT in terms of survival and primary tumor control. The actuarial 5-year survival rate was 51% in all patients, whereas, by using CT-assisted planning, it was improved to 61%. The improved survival was observed among the patients with tumors of the suprastructures where tumors were located adjacent to the critical organs (brain and eye). Major complications attributable to radiation have included instances of brain and ocular damage. CT-assisted planning, however, has been proven effective in avoiding brain necrosis and preserving eye sight.

Clinical trials of pion radiotherapy are being conducted at the Clinton P. Anderson Meson Physics Facility (LAMPF) in Los Alamos. For pion treatment planning, computerized tomography (CT) is used for three-dimensional localization of tumor and critical normal structures and for corrections for tissue inhomogeneities. Techniques that make anatomical information on CT scans directly transferable to therapy planning are described, as well as a technique for taking simulation and verification portal films using orthodiagraphic projection. Several requirements for direct use of CT scans in pion treatment planning are discussed. Finally, the effects of patient positioning on organ and tumor mobility and tissue inhomogeneity as shown by CT images are demonstrated.

Treatment results were investigated in 113 previously untreated patients with clinical Stage I and II (Ann Arbor) non-Hodgkin's lymphoma of the head and neck. Fifty-six Waldeyer's ring, 34 other extranodal sites, and 23 cervical nodal lesions were included. The overall relapse-free survival at 5 years was 41%. Age and Ann Arbor stage influenced relapse-free survival. The results suggested that the tumor cell burden is a fundamental prognostic factor for patients with Waldeyer's ring disease and for patients with only cervical nodal disease. Abdominal relapse was most frequent, followed by generalized relapse. From 1981, patients were randomized in a clinical trial to receive either chemotherapy (cyclophosphamide, vincristine, and prednisone [CVP], five courses) or whole-abdominal irradiation (25 Gy/20 Fr) as an adjuvant therapy. Patients could not tolerate the whole-abdominal irradiation well. A significant improvement in survival has been obtained by adjuvant chemotherapy.

A total of 77 patients with nasopharyngeal carcinoma were retrospectively reviewed for the effectiveness of combining chemotherapy (CT) with radical radiotherapy (RT). From 1972 to 1976, 26 patients were treated with a relatively short course of radical RT alone: 52-55 Gy/16 Fx/4 wk (study 1). From 1977 to 1982, 29 patients were also treated with radical RT alone, but with a more prolonged fractionation schedule: 65-70 Gy/26-28 Fx/6.5-7 wk (study 2). In 1983, the policy was to combine CT and RT. From 1983 to 1987, 22 patients received four to six courses of CMU regimen (consisting of cyclophosphamide, methotrexate, and UFT, a 5-fluorouracil analog) after completion of radical RT (study 3). The three studies were comparable with regard to patient characteristics: histologic type, stage, sex, and age distribution. There were no significant differences in survival and relapse figures between study 1 and study 2, but study 3 compared favorably with study 1 and study 2 in actuarial survival, relapse-free survival, relapse rate, and median relapse time. A mild nausea and transient granulocytopenia during CT was the only side effect encountered. In conclusion, the use of CT in combination with RT appeared to increase significantly the chance of long-term survival and probable cure.

OBJECTIVE. To achieve dynamic contrast-enhanced hepatic volumetric cine imaging, we developed a prototype 256-MDCT scanner. This study examined the feasibility of the technique for human hepatic imaging in three hepatocellular carcinoma patients.CONCLUSION. Volumetric cine imaging successfully visualized dynamic contrast enhancement of the hepatocellular carcinoma. It is helpful to evaluate the phase of contrast enhancement or for functional studies of the head, renal artery, coronary artery, and liver.

The National Institute of Radiological Sciences in Chiba, Japan (NIRS) has the highest number of patients with lung cancer treated with carbon ion beams in the world. This report describes the techniques and clinical trials that have been undertaken at NIRS and preliminary results of a current study on single-fraction irradiation. The data are compared to recent results for the treatment of peripheral stage I lung cancer from the literature.