Treatment of Pulmonary Metastatic Wilms' Tumor

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  • ウイルムス腫瘍肺転移巣の治療について : 放射線治療及び治療後肺機能検査
  • ウイルムス シュヨウ ハイ テンイソウ ノ チリョウ ニ ツイテ ホウシャセン

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Seventy cases of Wilms' tumor, operated at the Pediatric Surgical and Second Surgical Departments of Chiba University, received postoperative radiotherapy to the tumor bed at the National Institute of Radiological Sciences during a period from 1970 to 1979. Five cases developed pulmonary metastasis later, which was controlled by radio-chemotherapy. These patients are presented and discussed for methods of treatment and postirradiation pulmonary functions. Whole lung irradiation for diffuse and small field irradiation for solitary metastasis are our protocol of radiotherapy. The former is with a dose limited under 1,500 rad, and the dose for the latter is deceided by a dose-response curve due to the change of tumor size. When the dose-response curve showed and exponentially pattern, small field irradiation was continued. Quantitative study measuring regional ventilation of the postirradiated lung using 133Xe was carried out in three cases. There was no difference between irradiated field and non-irradited portion in washout curve, but there was a little difference in each in mean transit time. In other words, the mean transit time was longer in irradiated field than non-irradiated portion.

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