(71) SOFT TISSUE EFFECTS FOLLOWING IRRADIATION OF PRIMARY BRAIN AND PITUITARY TUMORS Robert J. Baglan, M.D. and James E. Marks, M.D. Division of Radiation Oncology Washington University School of Medicine St. Louis, MO 63108 From 1974-1978 we irradiated 241 patients with primary brain and pituitary tumors. These cases were analyzed for acute and late effects of radiation on the scalp, ears and eyes. Late radiation effects will be determined as a function of 1) dose-fraction size, 2) size of radiation portals, 3) dose distribution, and 4) beam energy and modality, i.e., photons vs. electrons. Preliminary analysis of 104 patients shows: complete epilation in 52 (50%), partial epilation in 28 (27%), folliculitis in 2 (2%), suturosis in 2, bone exposure in 2, loss of skull flap in 2, scalp swelling in 2, acute temporo- mandibular (TM) joint tenderness in 1, chronic TM joint fibrosis in 1, external ear swelling in 4 (4%), ear chondritis in 1 , external otitis in 2, and otitis media in 2. In 36 patients in whom dose optimization was used, there were 16 complications (ratio 16/36 = 0.44), whiie in 68 patients with equal parallel lications (rat io = 0.07). For dose fractions = 0.19; while for fractions of 180 rads/day opposed loading there were 5 camp of 200 rads/day the ratio is 9/47 it is 12/57 = 0.21. (72) THE TREATMENT OF CRANIOPHARYNGIOMAS IN CHILDHOOD S.C. Delheimer I,2 , J.E. Bruckman3, A.B. Hayles4, R.H. Miller2 , R.V. Randal15, and D.M. Ilstrup6 IMayo Graduate School of Medicine (University of Minnesota) 2Department of Neruologic Surgery 4 3Division of Therapeutic Radiology Department of Pediatrics, Pediatric Endocrinology 6 5Division of Endocrinology Department of Medical Statistics and Epidemiology Mayo Clinic, Mayo Foundation, Rochester, MN. 55901 From 1950 to the end of 1975, 58 pediatric patients with craniopharyngioma were seen and treated at the Mayo Clinic. The patients were equally divided between males and females and the median age was 12 years. Forty-one (70%) of the patients are alive, 29 have no significant problems. The medial follow-up was 150 months, and ranged from 40-348 months. Three patients died from other causes and 14 (24%) died from the disease or from treatment- related problems. The median time to death was 30 months (range O-232 months). The pre-treatment endocrine and ophthalmologic status was compared to the post-treatment results in an attempt to define the effect of therapy on these parameters. Radiographic and pathologic characteristics and type of operation were also analyzed. Thirty-eight patients had operation as the initial management, 12 ASTR 21st Annual Meeting 107

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Page 1: Myelography in treatment planning for medulloblastoma

(71) SOFT TISSUE EFFECTS FOLLOWING IRRADIATION OF

PRIMARY BRAIN AND PITUITARY TUMORS

Robert J. Baglan, M.D. and James E. Marks, M.D.

Division of Radiation Oncology Washington University School of Medicine

St. Louis, MO 63108

From 1974-1978 we irradiated 241 patients with primary brain and pituitary tumors. These cases were analyzed for acute and late effects of radiation on the scalp, ears and eyes. Late radiation effects will be determined as a function of 1) dose-fraction size, 2) size of radiation portals, 3) dose distribution, and 4) beam energy and modality, i.e., photons vs. electrons. Preliminary analysis of 104 patients shows: complete epilation in 52 (50%), partial epilation in 28 (27%), folliculitis in 2 (2%), suturosis in 2, bone exposure in 2, loss of skull flap in 2, scalp swelling in 2, acute temporo- mandibular (TM) joint tenderness in 1, chronic TM joint fibrosis in 1, external ear swelling in 4 (4%), ear chondritis in 1 , external otitis in 2, and otitis media in 2. In 36 patients in whom dose optimization was used, there were 16 complications (ratio 16/36 = 0.44), whiie in 68 patients with equal parallel

lications (rat io = 0.07). For dose fractions = 0.19; while for fractions of 180 rads/day

opposed loading there were 5 camp of 200 rads/day the ratio is 9/47 it is 12/57 = 0.21.

(72) THE TREATMENT OF CRANIOPHARYNGIOMAS IN CHILDHOOD

S.C. Delheimer I,2 , J.E. Bruckman3, A.B. Hayles4,

R.H. Miller2 , R.V. Randal15, and D.M. Ilstrup6

IMayo Graduate School of Medicine (University of Minnesota) 2Department of Neruologic Surgery

4 3Division of Therapeutic Radiology Department of Pediatrics, Pediatric Endocrinology

6 5Division of Endocrinology Department of Medical Statistics and Epidemiology

Mayo Clinic, Mayo Foundation, Rochester, MN. 55901

From 1950 to the end of 1975, 58 pediatric patients with craniopharyngioma were seen and treated at the Mayo Clinic. The patients were equally divided between males and females and the median age was 12 years. Forty-one (70%) of the patients are alive, 29 have no significant problems. The medial follow-up was 150 months, and ranged from 40-348 months. Three patients died from other causes and 14 (24%) died from the disease or from treatment- related problems. The median time to death was 30 months (range O-232 months).

The pre-treatment endocrine and ophthalmologic status was compared to the post-treatment results in an attempt to define the effect of therapy on these parameters. Radiographic and pathologic characteristics and type of operation were also analyzed.

Thirty-eight patients had operation as the initial management, 12

ASTR 21st Annual Meeting 107