No abstract

From 1960 through 1973, 415 patients with carcinoma of the esophagus were treated with radiation therapy. Three hundred and thirty-two patients had planned preoperative irradiation to a dose of 4500 rads in 18 fractions, and 101 of these had subsequent resections with either colon or stomach replacement. The operative mortality in this group was 18% and the 2- and 5-year survivals were 22.8 and 13.6%, respectively. The dose of 4500 rads in 18 fractions produced tumor sterilization in 3% and reduction to in situ carcinoma in 10% of these 101 patients. The survival was considerably improved in this small group of patients. Those patients not amenable to exploration had a 3% 5-year and a 5.6% 2-year survival was 12.1%. The overall survival was 9% at 2 years and 6% at 5 years. The results in this series are compared with the most recent reports in the literature.

Three adolescent patients with similar destructive lesions involving the pelvis were found to have unresectable aneurysmal bone cysts. All 3 patients appear to have permanent control and good function from 2 to 7 years after megavoltage irradiation with 4,000 rads. No complications or late sequelae have occurred, and follow-up radiographs demonstrate reconstitution and calcification of the affected bone. A slightly lower dose may be just as effective in controlling such lesions.

Malignant thymoma is a relatively rare condition and a review of the literature reveals approximately 100 reported cases. Only a small percentage of these have been treated with megavoltage radiation therapy; therefore, it is difficult to find the necessary information to establish a proper time‐dose relationship for treatment. This report deals with the radiation therapy and survival data concerning nine patients treated for malignant thymoma during a ten year period at the Medical University of South Carolina. Megavoltage irradiation in the dose range of 3500–4800 rads was employed in all patients. All gross tumor was completely resected in only three patients, two had a biopsy only, and the remaining four had subtotal resections. Local tumor control has been 100% with the average follow‐up being 5.5 years and a minimum of 30 months. Three patients are dead; one from intercurrent disease, one from myasthenia gravis, and one from radiation injury to the spinal cord. One patient is alive with metastatic disease controlled by chemotherapy. The technique of radiation therapy is outlined, as well as suggested treatment policy.