277

with CR might explain this finding,

Hyperfractionation in the Radiation Therapy of Unresectable Non-0at Cell Carcinoma of the Lung: Preliminary Report of a RTOG Pilot Study. Seydel, H.G., Diener-West, M., Urtasun, R. et al. Henry Ford Hospital, Department of Therapeutic Radiology, Detroit, MI 48202, U.S.A. Int. J. Radiat. Oncol. Biol. Phys. ii: 1841-1847, 1985.

Patients with localized unresectable non-oat cell carcinoma of the lung were treated by supervoltage radiation therapy to the primary tumor, mediastinum and supra- clavicular lymph nodes with 50.4 Gy, 42 fractions of 1.2 Gy, twice daily, 4 to 6 hours apart, 5 times a week. Small field treatment to the known involved areas of primary and lymph nodes was given from 9.6 to 24 Gy, also with 1.2 Gy, twice daily. One hundred twenty-five patients were ente- red, three of whom were cancelled and two were ineligible. Of the remaining 120 eli- gible patients, i0 patients received a dose of 50.4 Gy, 20 received 60.0 Gy, 79 received 69.6 Gy and ii patients received 74.4 Gy. Of these, nine patients were unable to comple- te hyperfractionated radiation therapy for various reasons. Treatment was discontinued or stopped in 14 patients because of early death or deterioration of the patient's con- dition. Four additional patients were found to have unacceptable doses to tumor or nor- mal tissues, for a total of 27 patients with protocol violations. Complete regression occurred in 19% of TI-T3, N0-N2 patients with 9% among T3.3b, T4 or N3 patients Partial regression was 29 and 41%, respec- tively. There were six cases of severe and two of life-threatening toxicity, but there were no fatalities attributable to the treatment. Toxicity consisted mainly of pneumonitis and pulmonary fibrosis as well as esophagitis. Median survival of the entire group was 77.2 months, which is consistent with previous experience with the treatment of localized inoperable non-oat cell carci- noma of the lung by radiation therapy. Further study of this method of treatment is warran- ted.

Treatment Results after Radiotherapy with Unconventional Fractionation in the Inope- rable, Non-Small-Cell Bronchial Carcinoma. Alberti, W., Niederle, N., Stuschke, M., Konietzko, N. Strahlenklinik, Klinikum der GHS, D-4300 Essen i, Germany. Prax. Klin. Penumol. 39: 832, 1985.

Forty non-small-cell lung cancer patients (limited disease: 37, extensive disease: 3) with a median age of 58 (range 44 to 76) were irradiated between Sept. 1981 to Dec. 1983 according to the following schedule:

2 x 4 Gy per week to a total dose of 52 to

60 Gy. Cytostatic chemotherapy with vinde- sine/cisplatinum preceded irradiation in 16 patients. In 75% (n = 30) complete or parti- al remission was achieved. Eighteen patients are surviving. The median observation time of the survivors is 8 months and the median survival for all patients is ii months. Acute side effects were common but mild. Late com- plications were c%inically insignificant and did not require treatment.

NewMethod in Radiotherapy of Bronchial Carcinoma: Endobronchial Small-Field Radio- therapy Using the Iridi~,-192 High Dose Afterloading Technique in Combination with the Neodymi~YAG-Laser. Macha, H.N., Mai, J., Stadler, M. et al. Lungenabteilung der Stadtischen Krankenhaus- er Havelhohe, i000 Berlin 22, Germany Dtsch. Med. Wochenschr. iii: 687-691, 1986.

106 patients with inoperable malignant tumours constricting the central bronchial tree underwent endobronchial small-field radiotherapy with iridium-192 at high dose between June 1983 and September 1985. Treat- ment was performed using the computed-guided after-loading technique and a flexible bron~ choscope under local anaesthesia. In complete occlusion of a bronchus by the tumour, a neodymium YAG-laser was applied (57 patients) to allow insertion of the after-loading probe. Endoscope showed tumour regression in 75% of the patients, accompanied by clinical improvement. Pulmonary function tests, ar- terial blood gas analyses and pulmonary perfusion scans yielded a highly signifi- cant improvement of data after treatment. The procedure also proved effective upon exhaustion of external radiation. Apart from its positive palliation, endobronchial small- field radiotherapy using high doses of iri- dium-192 also has a curative effect, thus opening up a new approach to the therapy of advanced bronchial carcinoma.

The Response of A t e l e c t a s i s from Lung Cancer to Radiat ion Therapy. Majid, O.A., Lee, S., Khushalani, S., Seydel, H.G. Department of Therapeutic Radiology, Henry Ford Hospital, Detroit, MI 48202, U.S.A. Int. J. Radiat. Oncol. Biol. Phys. 12: 231- 232, 1986.

Between January 1981 and June 1983, 33 newly diagnosed patients with lung cancer presented with radiological findings of atelectasis. These patients were treated by primary radiation therapy, with doses ranging from 1200 to 6000 cGy. The response of atelectasis to radiation therapy was established on the basis of follow-up chest roentgenograms. Of the 28 patients with non- small cell caricnoma of lung, there were 17 (61%) who had improvement of the atelecta- sis. Among these, 13 patients were treated

with doses ranging from 5000 to 6000 cGy in