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After removing resectable lesions at operation, residual cancer nests were sterilized by irradiation before surgical closure. The great advantage of intraoperative radiotherapy lies in the treatment of lesions such as gastric cancers located near radiosensitive organs, and radioresistant tumors, such as soft-tissue sarcoma. Since the lesion is exposed directly to irradiation, a cancerocidal dose can be delivered without affecting normal structures. Clinical results have shown that cure can be expected following excision of the primary mass.

We have identified potassium 2-nitroimidazole-1-acetohydroxamate (KIH-802) as a hypoxic cell radiosensitizer potentially superior to Miso. The water-soluble acetohydroxamates of 2-nitroimidazole (KIH-802; free acid 801) and 4-nitroimidazole (KIH-852) were designed, synthesized, and evaluated by in vitro and in vivo screening against EMT6 cells. Enhancement ratios of KIH-802 and 801 were 1.92 and 1.68, respectively, compared with 1.58 for MISO all at 1 mM. These acetohydroxamates are also expected to be more effective in vitro than SR-2508 based on our previous experiments. In vivo ERs of KIH-802, 801, and 852 were 1.75, 1.50, and 1.35, respectively, compared with 1.57 for MISO all at the same dose of 200 mg/kg. The data clearly show that the addition of an acetohydroxamic acid moiety to the 2-nitroimidazole skeleton can enhance radiosensitizing ability.

The case histories of 58 patients irradiated for pineal tumors were reviewed to assess indications and radiotherapy techniques. The survival rates were 61% at five years and 58% at 10 years in all cases. The five-year survival rate was 85% for 21 patients with germinoma, 69% of 26 with tumors not histologically confirmed, and zero for patients with glioma and teratoma. Doses ranging from 1,500 to 1,699 rets with or without decompression definitely improve the prognosis in pineal tumors. Field size and changes in CT scans during radiotherapy are also discussed.

A CT method for evaluating cavernous sinus invasion by pituitary adenomas or parasellar tumors is described. This technique is easily performed without special software. A persistent, isolated visualization of the internal carotid artery seems to indicate invasion of the cavernous sinus.

We devised a new kind of culture tube with which a cell suspension could be warmed through both the inside and outside walls. Use of this tube makes it possible to measure the effects of short-term hyperthermia more accurately than with the conventional tubes, which is heated through the outside wall only. Temperature curves rose significantly faster in the double-walled tube than in the conventional one. The accelerated heating efficiency of the new tube was also seen by the enhanced inhibition of [3H]thymidine incorporation into the DNA of Ehrlich ascites tumour cells grown in these tubes at the same final temperature as in a conventional tube.

The effect of hyperthermia on the activity and the messenger RNA levels of ornithine decarboxylase (ODC), which has a rapid rate of turnover in cultured cells, was studied in Ehrlich ascites tumor cells. When the cells were incubated at 42 degrees C, elevation of ODC activity by a change of the medium was prevented. Total RNA was isolated from cells treated at 37 degrees C or 42 degrees C, and the relative abundance of the ODC mRNA was measured by Northern blot analysis. These levels in heat-treated cells were comparable to those in control cells. Inhibition by hyperthermia was reversible. The recovery was suppressed by cycloheximide but not by actinomycin D. In hyperthermic-treated cells, the biological half-life of ODC was 14 min, which was the same time as for cells cultured at 37 degrees C. These results suggest that hyperthermic treatment of Ehrlich ascites tumor cells suppressed ODC induction during translation, not during transcription or after translation.

It has been confirmed gradually that transcatheter arterial embolization is the most effective, conservative therapy for the treatment of unresectable hepatic cell carcinoma (hepatoma). Embolization or one shot therapy was carried out in a clinical trial involving 41 patients with unresectable hepatoma visiting our department. Embolization group (emboli G): 19 cases. 1 to 6 embolizations in each case. One shot group (one shot G): 22 cases. Medications: Mitomycin C 10-40 mg and others. Disappearance rate of icterus after treatment was 50% (emboli G) and 25% (one shot G). Decrease in size of hepatomegaly or tumor was seen in 84% (emboli G) and 32% (one shot G) which was statistically significant (less than 1%). Serum AFP titer after embolization decreased in all cases but in only 5 of 12 cases (ca 41%) after one shot (less than 1%). Effective cases measured by Karnofsky's method were 18 out of 19 cases (95%) in emboli G, but in one shot G only 10 out of 22 cases (ca 45%)(less than 0.1%). Survival rate after each therapy was 67% (emboli G) and 38% (one shot G) after 6 months, and 59% (emboli G) and 19% (one shot G) at 1 year respectively. One study showed that transcatheter arterial embolization therapy was much more effective than one shot therapy.

Injuries of the rectal wall were examined up to 327 days in patients with uterus cancers after radiation therapy with 60Co gamma-rays. Various types of morphological changes were observed at the end of the therapy and the changes could be seen even 327 days after therapy with doses of 3,240-6,040 rad. The percentage of goblet cells in the rectal wall fluctuated for about 50 days after therapy and then became stable, but was slightly less than pre-irradiation level. The changes in the percentage seemed to represent radiation damages to the epithelial cells in the wall. The late effects in the blood vessels were probably more important than damages to the epithelial cells in the wall.

The hepatic blood flow (HBF) of patients with liver disease was measured by per-rectal portal scintigraphy with the use of 133Xe. To analyze the time-activity curves of the liver and portal vein, washout curves of the liver were plotted, and from those, the HBF and the ratio of the HBF of the right lobe of the liver to that of the left lobe (R/L ratio) were calculated. The HBF were 143 +/- 17 ml/100 g/min in 5 patients with chronic inactive hepatitis, 119 +/- 20 ml/100 g/min in 4 patients with chronic active hepatitis, and 73.2 +/- 23.4 ml/100 g/min in 7 patients with cirrhosis of the liver. All of four patients whose HBF was under 100 ml/100 g/min and whose R/L ratio was under 1.0 had cirrhosis of the liver. Only one of the 9 patients whose HBF was over 100 ml/100 g/min and whose R/L ratio was over 1.0 had cirrhosis of the liver. The results suggested that per-rectal portal scintigraphy is a useful and noninvasive method to measure the hepatic blood flow.

In a multicentered randomized prospective study, hepatic arterial embolization using gelatin sponge (GS) alone or together with anticancer agents was performed in a total of 112 patients with hepatocellular carcinoma to ascertain the clinical availability of the anticancer agents combined with gelatin sponge. Envelopes, each of which contained a note mentioning one of the following three kinds of regimens, were allocated at random to the participating institutes: 1) GS + mitomycin C (MMC) 10 mg + adriamycin (ADR) 20 mg (group A, n = 45), 2) GS + MMC 10 mg + ADR 20 mg + 200 mg/day of oral 5-fluorouracil (5-FU) (group B, n = 36), and 3) GS + 200 mg/day of 5-FU (group C, n = 31). The envelopes so allocated were opened just prior to embolization, and the treatment was carried out as instructed. Survival rates were estimated according to the method of Kaplan-Meier for comparative analysis. The survival rate was significantly higher in group A than in group C on days 465 (p less than 0.05). It was also significantly higher in group B than in group C on days 279, 558 and 651 (p less than 0.05) as well as on days 372 and 465 (p less than 0.01). These observations suggest that this embolization using anticancer agents such as MMC and ADR, compared with the embolization using gelatin sponge alone, may exert a life-prolonging effect in patients with hepatocellular carcinoma.

33 patients with thyroid mass were studied by intravenous digital subtraction angiography (IV-DSA), thyroid scintigraphy (TS), ultrasonography (US), and computed tomography (CT). The detective rate of lesion by each diagnostic imaging was as follows: IV-DSA 71%, TS 70%, US 94%, and CT 76%. US was the most excellent and most sensitive diagnostic imaging of both benign and malignant lesions. As regards the thyroid cancer by IV-DSA, malignant findings were heterogeneity, an irregular contour, and an unclear contour of tumor stain. Specific diagnostic rate of each imagings was as follows: IV-DSA 88%, TS 100%, US 86%, and CT 75%. US was not so good imaging of a specific diagnosis for the thyroid mass. As regards the thyroid mass, influence of the common carotid artery and the internal jugular vein were investigated by the degree of compression of both vessels on IV-DSA. However IV-DSA could not reveal tumor invasion to these vessels. We learned present the limit of diagnosis of the thyroid mass due to IV-DSA, because IV-DSA was unable to reveal to us exactly information of both a sensitive and a specific diagnosis. We, however, think that IV-DSA is a useful diagnostic imaging as a mapping study which reveals a coronal image of a relationship between the thyroid mass and the common carotid artery and/or the internal jugular vein in surgery.