Radiation treatment of retinoblastoma: experience in the past two decades.

This series of 193 patients represents the results in management of retinoblastoma. In cases treated 15 years ago when definitive radiotherapy and fat soluble chemotherapy were not utilized, the results of the treatment were very disappointing. The outcome was more promising after October 1985. Even if all the patients were in the advanced stages, we had a promising outcome, so effective modality of treatment is the most important prognostic factor. The other factors that influence the prognosis include the time for initial treatment, the time for starting the postoperative radiation and the efficiency of the radiation treatment. The follow-up period of 2 years after treatment is adequate to predict the outcome.

The experience in using whole pelvic irradiation in management of massive bleeding from carcinoma of the uterine cervix.

At the Radiation Therapy Section, Ramathibodi Hospital, from June 1, 1981 to May 31, 1991, there were 35 out of 1,683 new cases of carcinoma of the uterine cervix which presented with massive bleeding per vagina. All were treated via cobalt-60 teletherapy covering the whole pelvic region by 12 x 12 cm2 or 16 x 16 cm2 field sizes. Eighteen cases received a radiation dose of 300 cGy/fraction while 16 cases received 400 cGy and one case received 600 cGy. All had bleeding controlled within 2-6 fractions, twenty-two cases (62.9%) within 3 fractions and 34 cases (97.1%) within 5 fractions. There was no severe acute complication in all patients. In 10 patients who were followed up to the range of 3-70 months, median 16.5 showed no severe late complications.

Results of treatment in stage IIB squamous cell carcinoma of the uterine cervix: comparison between two and one intracavitary insertion.

To compare the results of treatment in stage IIB squamous cell carcinoma of the uterine cervix of two treatment regimens, two radium insertions vs one insertion, a prospective randomized study was carried out at Ramathibodi Hospital from 1 January 1983 to 31 December 1986, and the results were evaluated at the end of March 1991. The patients in treatment I (90 cases) received 40-41.4 Gy whole pelvic external irradiation and two intracavitary radium insertions, while patients in treatment II (53 cases) received 50.0-50.4 Gy and one intracavitary insertion. Both groups received the same total dose at point A, about 85-90 Gy. At 4 and 5 years, by the Kaplan-Meier survival curve, the disease-free survivals were 76 and 76% vs 79 and 79%, respectively, in treatment I and treatment II, which showed no significant difference by the log-rank test. Both groups had comparable serious complication rates, 0% vs 1.9%, respectively. However, grade I complications in treatment II, 35.8%, were higher than those in treatment I, 17.8% (P less than 0.01). Therefore, we concluded that treatment II provided the same disease-free survival and a very low rate of serious complications. To replace treatment I, the dose at the rectum and urinary bladder should be maintained with caution.