Radiotherapy of unicentric mediastinal Castleman's disease.

Castleman's disease is a slowly progressive and rare lymphoproliferative disorder. Here, we report a 55-year-old woman with superior mediastinal Castleman's disease being misdiagnosed for a long term. We found a 4.3 cm mass localized in the superior mediastinum accompanied with severe clinical symptoms. The patient underwent an exploratory laparotomy, but the mass failed to be totally excised. Pathologic examination revealed a mediastinal mass of Castleman's disease. After radiotherapy of 30 Gy by 15 fractions, the patient no longer presented previous symptoms. At 3 months after radiotherapy of 60 Gy by 30 fractions, Computed tomography of the chest showed significantly smaller mass, indicating partial remission. Upon a 10-month follow-up, the patient was alive and free of symptoms.

[Stereotactic radiotherapy for multiple brain metastases].

BACKGROUND & OBJECTIVE: Stereotactic radiotherapy (SRT) has obvious advantages in treating intracranial tumors, but there are few reports about application of SRT to multiple intracranial tumors. This paper summarized the therapy outcome of patients with multiple brain metastases, and evaluated the efficacy and application of SRT. METHODS: Clinical data of 136 patients with multiple brain metastases received radiotherapy from Jun. 1996 to Dec. 2002 were reviewed. Of the 136 patients, 52(38.2%) received conventional radiotherapy alone (CR group), 84(61.8%) received SRT or SRT plus whole brain radiotherapy (SRT group). RESULTS: Clinical effective rate, and elimination rate of brain metastases (diameter of > 20 mm) were significantly higher in SRT group than in CR group (96.4% vs. 86.5%, P=0.02; 70.4% vs. 36.0%, P=0.007). Persistent brain edema rate was 8.3% in SRT group, and 9.6% in CR group (P=0.767). Intracranial tumor recurrence rate was 25.0% in SRT group, and 19.4% in CR group (P=0.653). Median survival time was significantly longer in SRT group than in CR group (10.5 months vs. 6.5 months, P=0.014); 1-year survival rate was significantly higher in SRT group than in CR group (40.5% vs. 21.2%, P=0.023). CONCLUSION: Reasonable application of SRT could improve life quality and treatment outcome of patients with multiple brain metastases, reduce intracranial tumor recurrence and radiation damage, and prolong patients'survival time.

[Clinical observation of hypoxic radiotherapy for nasopharyngeal carcinoma].

BACKGROUND & OBJECTIVE: The clinical application of hypoxic radiotherapy (RT) was developed at a high speed in China in recent years. The protective effect of hypoxic RT on normal tissues has been proved. However, there was not an affirmative answer whether hypoxic RT had any protective effect on tumor. This study was designed to analyze this question by comparing clinical results of hypoxic RT with regular RT in nasopharyngeal carcinoma (NPC) patients. METHODS: A series of 117 patients with NPC who underwent hypoxic RT or regular RT between March 1992 and June 2000 in PLA 309 Hospital was enrolled. The cancers were staged as I, II, III, and IV in 11, 30, 57, and 19 cases, respectively. Of these, 69 received hypoxic RT, and 48 received regular RT. There was no significant difference in age, sex, TNM staging, pathological type, adjuvant therapy between two groups (P>0.05). All patients underwent 6MV X-ray and 8-12 MeV electronic beam. The nasopharyngeal areas received dose of 72 Gy (range, 68 to 82 Gy), and neck positive lymph node regions received dose of 64 Gy (range, 60 to 70 Gy). RESULTS: The incidence rates of 2-3 degree early irradiation toxicity of oropharynx mucous membrane, salivary gland, and II- III degree late dry mouth were 23.2%, 26.1%, 37.7% in hypoxic RT group and 77.1%, 62.5%, 91.7% in regular RT group, respectively(P 0.05). The 1-, 3-, 5-, 7-year survival rates were 97.1%, 83.7%, 74.4%, 54.5% in hypoxic RT group and 97.9%, 86.8%, 70.2%, 54.7% in regular RT group, respectively (P>0.05). CONCLUSION: Hypoxia could alleviate irradiation toxicity and reduce complication rate of NPC patients. There is no significant difference between hypoxic RT and regular RT in tumor recurrence and metastasis and the survival rate of NPC. Further study is needed.