[Radiotherapy of carcinoma of the esophagus. Histopathological studies of preoperatively irradiated and autopsy cases].
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Biomedical subjects
Publications and source records attributed to T Kusuhara.
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The radiographic findings from 226 patients with acute gastric anisakiasis are reviewed. Suggestive but indeterminate findings such as coarse and broad gastric folds caused by mucosal edema were demonstrated in 224 patients (98%). In 179 patients (88%) mucosal edema was so extensive that it occupied more than half of the entire gastric wall. The most diagnostic radiographic finding, present in 139 patients, was the appearance of a threadlike filling defect about 3 cm in length, showing an anisakis larva itself. Careful demonstration of these radiographic findings is useful for the diagnosis of acute gastric anisakiasis.
Correlation between dose and tumor response by cell types was determined in 50 patients with lung cancer in order to predict the possibility of further tumor regression. The TDF (time-dose-fractionation) concept was used as dose factor. The radiation source was a cobalt-60 gamma-ray or linear accelerator 10 MV X-ray. As a routine regime a fraction dose of 2 Gy five times per week was given to 39 of the 50 patients, but a dose of 2 Gy three times per week or of 1.5 Gy five times per week was given to seven and four patients, respectively. Radiation response was the best in small cell carcinoma and better in adenocarcinoma than in squamous cell carcinoma, showing a tumor regression rate of 50% or more in 90%, 80% and 58% of the patients, respectively. The correlation between tumor regression rate and TDF values was good in squamous cell carcinoma (r = 0.73) and small cell carcinoma (r = -0.72), but poor in adenocarcinoma (r = -0.10). These results suggest that in squamous cell carcinoma improvement of tumor regression can be expected by increasing TDF values, and in adenocarcinoma and small cell carcinoma the optimal TDF values are about 100 and 60 to 80, respectively.
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A 51-year-old male with undifferentiated adenocarcinoma of the lung associated with sarcoidosis is reported. Scalenus node biopsy and open thoracotomy revealed sarcoid granuloma. High levels of serum angiotensin-converting enzyme and ocular findings also suggested sarcoidosis. No malignant cells were recognized by repeat lymph node biopsy. However, post-mortem examination showed bronchial carcinoma; no sarcoid granuloma was found. The diagnostically difficult points of our case are discussed.
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Serum ferritin levels were studied in 264 patients who were consisted of 153 patients with various malignant neoplasms and 111 patients with various benign diseases. Positive rate of serum ferritin in all patients with malignant neoplasms was 35%. Hepatomas and pulmonary cancer showed relatively high positive rate, respectively 65% and 42%. In patients with benign diseases, hepatic diseases showed the high positive rate (52%) and the other benign diseases was low positive rate (11%). The relationship between serum ferritin and alpha-feto-protein in patients with hepatomas and other liver diseases was low. And the relationship between serum ferritin and CEA (carcinoembryonic antigen) in patients with malignant neoplasms of gastrointestinal tract was also low. It seemed that the measurement of serum ferritin levels will be of low value in the differentiation of the patients with malignant neoplasms.
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We report our experience with radiation therapy in 2 patients with anaplastic esophageal cancer with extensive distant metastases. Radiotherapy was given to the primary esophageal lesions and in both patients the tumors completely disappeared after irradiation with 2000 to 3000 rads. However, the metastatic lesions of the bone and liver did not respond despite the administration of BLM + PT -207 + BEMP in one case and METVFC + FT -207 in the other. Both patients died 4 and 5 months, respectively, after beginning the treatment. Effective chemotherapy of metastases needs to be developed because the primary lesions of anaplastic esophageal cancer are highly sensitive to radiation therapy.
Two patients with inflammatory breast cancer treated with a combination of radical mastectomy, irradiation, and immunochemotherapy are reported. After radical mastectomy, both patients were given a dose of 4000 rad and 5000 rad to the chest wall and parasternal lymph nodes, and 5000 rad to the axillary and supraclavicular lymph nodes. However, both patients died of recurrence within the irradiated field of the chest wall and metastatic spread to the neighbouring skin. A discussion on the dose and field in radiation therapy for inflammatory breast cancer is presented.
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