Calibration of the Nuclear Associates 07-621 precision photometer.

The spectral response of the Nuclear Associates 07-621 photometer has been measured over an extended range (400-990 nm). The measurements reveal that the photometer shows large deviations from the standard CIE photopic response. In particular it has considerable excess response in the red (650-780 nm) and in the near infra red (780-990 nm). Although the instrument is claimed to have a photometric accuracy of +/- 7% this is only realised when measuring sources, such as tungsten lamps, which are rich in the red and near infra red regions of the spectrum. When used with sources, such as fluorescent lamps, which contain little radiation in the range 650-1200 nm it underestimates the light output by approximately 20%. As a consequence this photometer can only be used in radiology QA for such tasks as measuring view box luminance if the appropriate correction factor is used. This factor should be determined at the outset by comparing the Nuclear Associates 07-621 with a high quality photometer using the same type of light that is emitted by the boxes.

Radical radiotherapy for carcinoma of the vulva.

A study was made of 58 patients with carcinoma of the vulva treated by radical radiotherapy between 1965 and 1982. The choice of treatment technique was influenced by site and extent of disease as well as the general condition of the patient. The crude 5-year survival was 26% (15/58). Local control was achieved in 40% of cases and was associated with tumour size of 4 cm or less. Radionecrosis occurred in nine cases but none of these required surgical intervention. Surgery remains the treatment of choice for carcinoma of the vulva. This report emphasizes that radical radiotherapy has a curative potential in those cases considered unsuitable for surgery and that the necrosis type and rate are within the limits of acceptable morbidity.

Retrospective study of radiotherapy in early carcinoma of the prostate.

During the years 1978 to 1983 there was a 10-fold increase in the number of patients with T1-T4 NX M0 carcinoma of the prostate referred to the Christie Hospital for radical radiotherapy. A retrospective survey of 170 patients treated during this period showed an overall age-corrected 5-year survival rate of 49%. The survival of patients in whom referral for radiotherapy had been delayed was 37% compared with 56% for those given immediate treatment. Patients with poorly differentiated tumours had a significantly reduced survival compared with those with well differentiated tumours. The overall complication rate from radiotherapy was 4% and this low rate is attributed to the small volume used uniformly for treatment.

Adenoid cystic carcinoma of the salivary glands.

Eighty-two patients with adenoid cystic carcinoma treated by a radical course of radiotherapy are reviewed. In 44 cases the tumour arose in the major salivary glands and, of these, 77% had an incomplete surgical excision and 23% had only a tumour biopsy before radiotherapy. Thirty-eight tumours arose in the minor salivary glands and, of these, 18% had an incomplete surgical excision and 82% a biopsy only before treatment. Primary tumour control was achieved in 67% of patients at 5 years. The local control was significantly better in patients who had an incomplete surgical excision: 86% compared with 37% at 5 years. The local control of tumours arising in the major salivary glands is significantly better than that of tumours arising in the minor glands, but this difference is explained by more patients with major gland tumours having had incomplete surgery. For patients treated after only a biopsy, local tumour control was achieved in 37%, demonstrating the radioresponsiveness of this type of carcinoma. No difference in survival was demonstrated in patients with major or minor gland tumours. Despite local tumour control, 43% of patients with major gland tumours died from metastatic disease. The commonest cause of death of patients with minor gland tumours was local failure.

A randomised clinical trial to contrast radiotherapy with radiotherapy and methotrexate given synchronously in head and neck cancer.

Three hundred and thirteen patients with squamous cell cancer of the head and neck were entered in a randomised clinical trial to determine whether the addition of methotrexate during the course of irradiation improved the rate of primary control and subsequent survival. The overall primary control (P = 0.016) and survival (P = 0.075) for the patients receiving methotrexate was better than the patients treated by radiotherapy alone. The improvement in primary control (P = 0.0019) and survival (P = 0.0089) in patients with oropharyngeal cancers who had methotrexate in addition to radiotherapy is statistically significant. The treatment was well tolerated and there has been no increase of late morbidity.

Megavoltage electron beam therapy in the treatment of basal and squamous cell carcinomata of the pinna.

Kilovoltage X-ray therapy has considerable limitations when trying to obtain good functional results in patients with skin carcinomas arising on the pinna. Megavoltage electron beams with their better quality of radiation and homogeneous dose distribution have been recognised to have theoretical advantages. Forty-three patients with basal and squamous cell carcinomata arising on the pinna were treated radically using a 10 MeV electron beam. The technique and dosage are described and discussed. Primary cancer control with retention of the pinna was achieved in 34 patients. Salvage pinnectomy was performed in four patients for recurrence and one patient for radiation necrosis. Two patients with large primary tumours failed to resolve and died of their disease. The advantages for the patient of the policy of primary radical electron mean therapy are discussed.

Treatment of advanced head and neck cancer using synchronous therapy with methotrexate and irradiation.

A pilot study of synchronous methotrexate and radiation therapy was carried out in 50 patients with advanced carcinoma of the head and neck, of whom 48 were assessable for response. Complete resolution of disease, maintained for 2 years, was achieved in 21 patients (45%), and in 19 out of 36 patients (53%) with carcinoma of the oropharynx and hypopharynx. The treatment was well tolerated, with acceptable morbidity.

Treatment of advanced head and neck carcinoma with synchronous irradiation and methotrexate.

Thirty-four patients with advanced head and neck cancer were treated by synchronous radiotherapy and methotrexate (MTX) (100 mg/m2). Complete resolution of disease was obtained in 18 patients, the median remission of patients being 17 months. In general, treatment was well tolerated, although mucosal reaction was prolonged in 50% of patients. Drug-induced hematological toxicity was observed in six patients (18%) and one patient died. As a result of these findings, a random clinical trial to compare X-ray therapy with X-ray therapy and MTX in advanced head and neck cancer has been commenced.

A fast system for reporting the Farnsworth-Munsell 100-hue colour vision test.

We have developed a system for rapidly reporting the Farnsworth-Munsell (FM) 100-hue test using a personal computer and a bar code scanner. The computer generated report duplicates the conventional manual report of the FM 100-hue test so is very familiar to ophthalmologists and optometrists. The new system has proved to be of great assistance both in saving time and in eliminating arithmetic errors in the scoring calculations. The scanner technique produces two reports, one for each eye, within 4 min of the patient completing the test. This compares with the 60 min required by the conventional manual reporting system. In addition, it also gives a statistical analysis of the results in accordance with Verriest norms. The program is very versatile and user friendly, achieving a standard not present in the other FM 100-hue computerised systems currently available. As a consequence it makes this valuable diagnostic test much more accessible to patients and clinicians.