ABSTRACT
The records of 98 children with suprasellar tumors treated between 1950 and 1975, at Columbia-Presbyterian Medical Center, were reviewed. Most of the children with germ cell tumors or posterior chiasmal gliomas irradiated with 5000 rad in six weeks using extended field, children with craniopharyngiomas treated with total resection when the tumor was limited to the suprasellar area, and children with craniopharyngiomas treated with combined surgery and postoperative irradiation when the lesions could not be resected totally, have generally survived long with reasonably good quality of life. More passive dependent immature responses were noted in most children with anterior chiasmal gliomas due to persistent residual mass after irradiation, although they have survived long. An attention to details of the clinical picture, the age at presentation, the finding of diabetes insipidus, and the presence of calcification and intrasellar extension of the tumor, should help with the selection of the appropriate treatment technique and, thus, influence the probability of tumor control as well as of complications.
Subject(s)
Craniopharyngioma/pathology , Pituitary Neoplasms/pathology , Adolescent , Child , Child, Preschool , Craniopharyngioma/radiotherapy , Craniopharyngioma/surgery , Female , Glioma/pathology , Humans , Infant , Male , Neoplasm Recurrence, Local , Optic Chiasm , Pituitary Neoplasms/radiotherapy , Pituitary Neoplasms/surgery , Prognosis , Quality of Life , Radiotherapy Dosage , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
Between 1950 and 1976, 24 patients with cerebellar hemangioblastomas received postoperative radiation therapy. In retrospect, the low-dose radiotherapy that was practiced in the 1950s and early 1960s has been associated with inferior survival rates. Since 1963 and with increased awareness of the effects of radiotherapy, patients receiving high-dose irradiation postoperatively have generally survived longer. Postoperative radiotherapy is used whenever the neoplasm has not been totally excised. This more likely to occur with solid hemangioblastoma and neoplasms arising in the brain stem. In addition, radiotherapy should be used when the tumor recurs after total excision. The recommended dose is in the range of 4500--5000 rads in 4 1/2--5 weeks.
Subject(s)
Cerebellar Neoplasms/radiotherapy , Hemangiosarcoma/radiotherapy , Adolescent , Adult , Aged , Cerebellar Neoplasms/surgery , Female , Hemangiosarcoma/surgery , Humans , Male , Middle Aged , Prognosis , Radiotherapy Dosage , Retrospective StudiesSubject(s)
Carcinoma in Situ/radiotherapy , Carcinoma, Squamous Cell/radiotherapy , Laryngeal Neoplasms/radiotherapy , Carcinoma, Squamous Cell/surgery , Female , Humans , Laryngeal Edema/etiology , Laryngeal Neoplasms/surgery , Male , Neoplasm Recurrence, Local/surgery , Radiation Injuries , Radiotherapy Dosage , Radiotherapy, High-Energy , Remission, Spontaneous , Time Factors , Vocal CordsABSTRACT
Hyperthermia combined with 60Co gamma irradiation was studied using V79 hamster cells cultured in vitro. Modest hyperthermia (41 degrees C for 6 hrs.) enhanced the cell killing produced by acute exposure to radiation. The same treatment enhanced the effect of low dose-rate irradiation (200 rads/hr.) even more. The sequence in which modest hyperthermia was combined with low dose-rate irradiation was important. Maximal enhancement was observed when hyperthermia was followed by irradiations. The probable explanation is that, by damaging the repair system, prior heat renders the cells unable to repair sublethal damage during subsequent low dose-rate irradiation.
Subject(s)
Cell Survival/radiation effects , Hot Temperature , Radiation Tolerance , Animals , Cells, Cultured , Cobalt Radioisotopes , Cricetinae , Dose-Response Relationship, Radiation , In Vitro Techniques , Radioisotope Teletherapy/instrumentationABSTRACT
Sixty-one patients with midline pineal tumors and 16 patients with suprasellar germinomas were treated with surgical decompression and relatively high-dose radiotherapy of the primary site. Results were excellent, and there were no long-term complications. Ten per cent of midline pineal tumors and 37% of suprasellar germinomas metastasized to the cerebral or spinal subarachnoid space within 6 months to 5 years. Irradiation of the entire neural axis is recommended for locally extensive tumors, simultaneous pineal and hypothalamic lesions, and all biopsy-proved germinomas. The five-year survival rate was 79% for midline pineal tumors and 77% for suprasellar germinomas.
Subject(s)
Brain Neoplasms/radiotherapy , Pinealoma/radiotherapy , Adolescent , Adult , Brain Neoplasms/diagnosis , Child , Child, Preschool , Female , Humans , Infant , Male , Neoplasm Metastasis , Neoplasm Recurrence, Local , Pinealoma/diagnosis , Teratoma/radiotherapyABSTRACT
Exposure of hamster cells to 42.5 degrees C for long periods leads to the development of thermal tolerance; the slope of the survival curve become shallower after about 3.5 to 4 hours. If two 4-hour exposures at 42.5 degrees C are separated by various periods of time, thermal tolerance is eliminated by 20 hours. Prolonged exposure at 42.5 degrees C offers considerable protection from subsequent treatments to acute hyperthermia at 45 degrees C indicate or in conditioned medium or balanced salt solution failed to reveal any evidence of repair of potentially lethal damage.
