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using a rotation technique. The overall treatment time is still only 4.5 months. The first 25 patients with a maximum follow up of 6 months will be presented, compa- ring the radiotherapy technique, response and morbidity with our previous experience using the fractionated course.

Hypofractionated (0nce-A-Week) Radiation Therapy For Treatment of Advanced Lung Cancer . 1 Poulter_, C., Rubi~ l, P., VanHoutte 2, p.,

Salazar 5, O., Lush-, C. i. University of Rochester, Rochester, New York, U.S.A. 2. Institut Jules Bordet, Bruxelles i000, Belgique. 3. University of Maryland Hospi- tal, Baltimore, Maryland, U.S.A.

Between February 1980 and January 1984, 70 patients with advanced lung cancer were registered to receive 5.00 Gy once weekly to a total dose of 50-60,00 Gy (1826-2050 ret). Seventy-three percent completed treat- ment to at least the 50.00 Gy dose and all cases where therapy was incomplete were attributable to disease symptomatology or progression rather than treatment-related causes. Acute toxicity was, in fact, mini- mal and incidence of late effects such as fibrosis was virtually no different than that found with standard fractionation schedules. Preliminary evaluation of re- sponse yielded a response rate comparable to that achieved with conventional frac- tionation regimens. Final analysis evalua- ting response, disease-free and overall survival rates, acute and late toxicities, with stratification by histologic cell type, is in process.

~ice-A-Week Irradiation for Locally Advan- ced Non-Small Cell Lung Cancer. Alberti, W., Stuschke, M., Niederle, N., Doberauer, C., Scherer, E. West German Tumor Center, Essen. F.R.G.

Radio-oncologic innovations aiming at improvement of the local tumor control include unconventional fractionation sche- mes. Twice-a-week irradiation schedule was investigated at our center in the time period between sep. 81 to mai 84. Thirty eight patients (pts) with inoperable non- small cell lung cancer (limited disease) with a median age of 56 years (range 44 to 76) were irradiated according to the fol- lowing schedule: 2 x 4 Gy per week to a total dose of 52 to 60 Gy. 28 pts (74%) achieved objective tumor response (CR: 5 and PR: 23 pts). Another i0 pts showed stable disease (NC, n=8) or progressive disease (PD, N=2). Fifteen pts are survi- ving. The median observation time of the survivors is 13 months and the median survival for all patients is I0 months. Median survival correlates well with treat- ment response (CR: 15 mo, PR: ii mo, NC +

PD 6 mo). Acute side effects including esopha-

gitis, tracheitis and nausea were common but mild. Late complications such as radiation pneu- monitis or pulmonary fibrosis were clinical insignificant and did not require treatment.

We conclude: i. Hypofractionation schedule leads to high remission rates with tolerable side effects. 2. Therapy failures were mainly encountered when patients developed extensive metastatic disease. Therefore a combined moda- lity approach including radio-/chemotherapy seems to be a suitable therapeutic regimen for such patients.

Interstitial Radiation Therapy - An Extension of Surgery for Lung Carcinoma. Isterabadi, S., Horowitz, B., Kvale, P., Lewis, J. Henry Ford Hospital, Detroit, Michigan.

Over a four year period, 38 patients with pulmonary malignancies underwent 39 radioactive iodine seed implantations (RISI). Irriduim af- terloading catheters were also used in 14% of patients. In 59%, RISI was incidental if re- sectable lesions were found at thoracotomy de- spite negative staging. In 41%, RISI was plan- ned in patients with recurrent neoplasms after chemotherapy or external beam radiation. Pri- mary lung carcinomas (79% of cases) included adeno- 46%, squamous 27%, nonsmall cell undif- ferentiated 17%, and small cell 10%; other chest neoplasms (21%) included metastatic syno- vial cell and osteogenic sarcomas, hemangioperi- cytomas, testicular and thyroid carcinomas, mesothelioma, thymoma, and neuroblastoma. An average of 45 seeds was implanted per patient (range 5-103); the mean irriduim dosage was 2500 RADS (range 1000-4500). There were no hos- pital deaths. Complications included postope- rative bleeding - 1 case, prolonged air leak - i, and fever of unknown origin - 3. The ave- rage tumor diameter of 5.2 cm preoperatively decreased to 3.0 cm at a mean follow-up of 12.0 mo. Progressive disease claimed 26% of this series with a mean time to death of 7.8 mo. 22% of patients with extensive mediastinal or hilar lymph node metastasis survived 18 mo or more while 11% survived 24 mo. or more. Al- though most individuals in this series have not reached end of life, RISI seems to offer a useful surgical approach to patients with unresectable pulmonary malignancies at the time of thoracotomy or limited therapeutic al- ternatives with recurrent carcinoma.

Effect of Treatment Planning With Computed To- mography on Prognosis of Patients With Inope- rable Carcinoma of the Lung. COX, J.D., Derus, S., Gillin, M., Byhardt, R.W., Kline, R.W., Lawlor, P., Reavis, R., Hartz, A. Radiation Oncology Department, Medical College of Wisconsin, Milwaukee, WI.

A retrospective study was undertaken to determine the value of thoracic CT in diagno- sis and treatment planning of patients who received radiation therapy for inoperable or