Three-dimensional conformal radiation therapy and periodic irradiation with the deep insipration breath-hold technique for hepatocellular carcinoma.

Nine cases of primary hepatocellular carcinoma were treated with 3D-conformal radiation therapy using computerized planning system. This technique permits the precise delivery of a high dose of radiation to the target while sparing most of the normal liver tissue. In order to decrease the effect of organ movement related to respiration, periodical irradiation was combined with the deep inspiration breath-hold technique. The radiation dose was equivalent to conventional radiation with a total dose of 50-70 Gy with 2 Gy, 5 times a week. Irradiation was given in 1-10 fractions which encompassed the target with 90 per cent isodose line. The patients tolerated the treatment procedure well without any complications inherent to the technique. The tumors were decreased in size, the pain symptom and abdominal discomfort were relieved for 3-20 months. This technique is an effective and safe treatment for palliation in hepatocellular carcinoma especially in locally advanced stages with large or multiple lesions. However, long term follow-up should be done to evaluate the late radiation effect and clinical outcome.

Serum tissue polypeptide specific antigen (TPS) in locoregional failure and distant metastasis of cervical carcinoma.

Tissue polypeptide specific antigen (TPS) was measured by the ELISA Technique in the sera of 51 patients with locoregional failure and metastasis of squamous cell carcinoma of the cervix in order to evaluate the serum level of TPS in known cases of metastasis and recurrence. There were 32 cases of local residual or recurrent disease and 19 cases of distant metastasis, including lymph nodes (paraaortic and supraclavicular lymph node) and visceral metastasis. The range of TPS levels in the locoregional failure group were 38.2 355.2 micro/l with a mean of 312.5 and 35.7 - 4822 micro/l with a mean of 833.36 micro/l in the metastatic group. With the cut-off value of 90 micro/l, the rates of TPS elevation were 27 in 32 cases (84.37%) of the loco-regional failure group and 16 in 19 cases (84.21%) of the metastatic group. Among the metastatic group, the mean of TPS level in visceral metastasis was much higher than the group of lymph node metastasis (1518.4 micro/l vs 215.1 micro/l). TPS level might be used as the follow-up guide for prediction of locoregional failure and metastasis in squamous cell carcinoma of the cervix after the completion of the treatment. In patients with a significantly high level of serum TPS, the distant metastases or local recurrence should be searched for. However, a prospective study of TPS levels in cervical cancer patients after completion of treatment should be done in order to evaluate the sensitivity and specificity of this tumor marker.