Evaluation and treatment of patients receiving radiation for cancer of the rectum or sigmoid colon in the United States: results of the 1988-1989 Patterns of Care Study process survey.

Purpose: For the first time, a Patterns of Care Study (PCS) was conducted in 1989 to determine the national practice standards of radiation oncologists in evaluating and treating adenocarcinoma of the rectum and sigmoid colon.

Materials And Methods: A national survey of 73 institutions using two-stage cluster sampling was conducted, and specific information on 408 patients from 69 facilities with adenocarcinoma of the rectum and sigmoid colon who received radiation as part of definitive or adjuvant management was collected.

Results: Using the modified Astler-Coller (MAC) pathologic staging system, the stage distribution was as follows: A, 0.

A therapeutic approach to primary adenocarcinoma of the cervix.

Retrospective study of 97 patients with primary adenocarcinoma of the uterine cervix was undertaken to evaluate the efficacy of two treatment methods, radiation alone and radiation plus surgery. Of 31 Stage I patients, 16 were treated with radiation alone and 15 with combined radiation plus surgery. There was no difference in 5-year disease-free survival of Stage I patients treated by either method.

A therapeutic approach to early vocal cord carcinoma.

One hundred and twenty patients with early glottic carcinoma received radiation therapy at the University of Maryland Hospital from 1959 to 1977. The radiation dose ranged from 55 Gy in 4 weeks for small T1a lesions to 65 Gy in 61/2 weeks for T2 lesions. The local control rates by irradiation alone for stages T1a, T1b, and T2 were 92, 91 and 88 per cent, respectively, while 5-year determinate disease-free survival rates were 96 per cent for stage I disease and 88 per cent for stage II disease.

Radiation management of carcinoma of the tonsillar region.

This is a retrospective analysis of 185 patients with squamous cell carcinoma of the tonsillar region treated at the Department of Radiation Oncology, University of Maryland Hospital from 1956 to 1977. All patients were treated by one of the following: (1) external beam therapy alone; or (2) combined external beam and interstitial brachytherapy. Five-year disease-free survivals, for early Stages (I and II), are 100% and 73%, comparable to the other series published in the literature.

Confirmation of a speculation concerning average tissue-air ratio determinations for rotational Co-60 radiation therapy treatment planning.

The question of the number of radii which are necessary to accurately determine the average tissue-air ratio (TAR) to be used in 60Co rotational radiation therapy treatment planning was studied using actual patient contours. It was found that 12 radii adequately determine the average TAR for clinical purposes.

Prospects of computed tomography in radiation therapy.

Computerized tomography has become an essential element in the staging of tumors and in the localization of the tumor and neighboring normal tissues for treatment planning. It offers the potential for more accurate delivery of higher doses with improved therapeutic ratio, for the identification of and correction for tissue inhomogeneities, and for three-dimensional treatment planning. For treatment planning purposes only minor changes are required in the current generation of scanners.

Carcinoma of the breast.

In the present stage of our knowledge, it is evident that radiation therapy as a primry form of potentially curable treatment is a valid alternative to radical surgical extirpation. It offers women with early carcinoma of the breast the opportunity to avoid a serious cosmetic, functional and psychologic problem with no increased risk in terms of survival or local control of the neoplasm. The physician faced with such a patient need no longer believe that the woman who refuses mastectomy is automatically electing some inferior course.

Radiation treatment of primary carcinoma of the female urethra.

Because of the rarity of the primary carcinoma of the female urethra, there has been limited experience of individual institutions in management of this disease. Treatment by radiation alone required radium implant skill in early cases and individualized consideration for integrating external and internal irradiation in more advanced cases. From 1961 to 1975 a total of 16 women with histologically verified primary urethral carcinoma were given radiation treatment at the University of Maryland Hospital.

Radiation management of primary carcinoma of the vagina.

This 15-year retrospective study includes 71 patients with diagnosis of primary carcinoma of the vagina treated at the University of Maryland Hospital, Radiation Therapy section from 1957 to 1970. The lesions were staged according to the system advocated by International Federation of Gynecology and Obstetrics (FIGO) with a minor modification (Perez et al.11).

Pre-cystectomy radiation for carcinoma of the bladder: 17-year experience.

Our experience with pre-cystectomy radiation for carcinoma of the bladder from July 1959 through June 1976 is presented. Pre-cystectomy radiation would appear to be beneficial in the management of patients with invasive bladder cancer. There is an impressive improvement in survival rates in those patients demonstrating reduction in staging after radiation.

Treatment of primary adenocarcinoma of the cervix.

Between 1956 and 1971, a total of 74 cases of adenocarcinoma of the cervix was treatedin the Division of Radiation Therapy of the University of Maryland Hospital. Radical radiation therapy was followed by routine surgery early in the study;after 1967, surgery was used only for radiation failure. The likelihood of local control and 5-year survival was not improved by the routine addition of surgery to radical radiation, although the incidence of serious complications was markedly elevated.