Proceedings of the 40th Annual ASTRO Meeting

REFRESHER COURSE DESCRIPTIONS

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limited to the recurrent disease setting. These data suggest that brief symptomatic relief results in two- thirds to three-quarters of patients. Subsequent trials in Vancouver and Japan established that in patients with advanced disease, a combination of external beam and endoesophageal brachytherapy was feasible with acceptable morbidity and no mortality. Quality of life analysis suggested improved swallowing ability and reduction in dysphagia in these patients. In a series of almost 300 patients, a small subset were treated with curative intent with planned resection after brachytherapy and external beam radiotherapy, resulting in a median survival of 43 months. Such data led to the incorporation of brachytherapy boost, into RTOG 9207, a Phase 1/11 trial for localized cancer of the esophagus combining external beam radiation and esophageal brachytherapy in combination with chemotherapy. Complete response to therapy was seen at the primary site in 73% of patients, suggesting that endoesophageal boost could be incorporated in the current standard of care which utilizes combination chemoradiotherapy. Two prospective trials from China and India have validated survival benefit with this approach.

503 Post-Operative Radiation Therapy for Advanced Head and Neck Cancers Ding Jen Lee, M.D., Ph.D., Johns Hopkins Hospital, Baltimore, MD

Purpose/Objective: To review the biologic and clinical basis of post-operative radiation therapy for head and neck cancers. Indications, techniques and results are discussed. Regions of interest include oral cavity, oropharynx, larynx, hypopharynx and major salivary glands.

504 Radiation and Hypoxia Induced Changes in Gene Expression: Diagnostic and Therapeutic Uses in Radiotherapy Amato J. Giaccia, Ph.D., Stanford University, Stanford, CA

Purpose/Objective: This course will primarily focus on how our knowledge of radiation and hypoxia inducible genes can be used in diagnostic tests with microchip-based technology, and to predict both tumor and normal tissue response to radiotherapy. A secondary focus of this class will be on the use of radiation and hypoxia inducible transcriptional regulatory elements in gene therapy strategies against cancer that are either presently in clinical trial or will shortly be in clinical trial. In addition, we

will also discuss the long-term goal of how the transcriptional response of both tumor and normal cells to radiotherapy or hypoxia is being used to identify inducible genes whose expression is essential for cell and tissue survival to each stress. We will especially try to ensure that all audience members, regardless of their backgrounds are able to follow the essential points of the course. Such a course on inducible-gene expression will be useful in providing state-of-the-art information on new therapeutic strategies that my impact clinical practices in the not so distant future.

505 Carcinoma of the Esophagus Bruce D. Minsky, M.D., Memorial Sloan Kettering Cancer Center, New York, NY

Goal: To examine the role of a variety of therapeutic approaches to esophageal cancer including pre- operative combined modality therapy, surgery, and non-operative combined modality therapy. The results of recently completed and the rationale of the design of new Intergroup trials will be discussed.

506 Retinoblastoma: Genetics, Diagnosis, Treatment and Sequelae Edward C. Halperin, M.D., Duke University Medical Center, Durham, NC

This refresher course will survey the genetic basis of retinoblastoma, techniques of diagnosis, forms of therapy, proposals for protocols emphasizing chemotherapy plus focal therapy and the long-term consequences of cure of this fascinating childhood malignancy.