Abstract
An intraoperative irradiation with an electron dose of 1,000-1,500rads carried out in three cases of abdominal tumor. In this radiotherapy technique, radiation damage to the normal structures is minimized, since the normal organs adjacent to the tumor can be shifted from the field so that the lesion may be exposed directly to high dose radiation. Thus, a sufficient dose can be delivered to the lesions without affecting the small intestine or other organs. Indication of intraoperative irradiation for children with abdominal tumor is summarized as follows : a) the primary tumor must be extirpated surgically, b) the residual tumor should be microscopic or small and unresectable because of its location adjacent to the important organs. Case 1 : Five year old boy with bilateral Wilms'tumor, who received left nephrectomy fifteen months ago, underwent right nephrectomy under hemodialysis. The tumor was 17.2×10×7.5cm in size located right retroperitoneal area with invasion to liver and lymph node metastases along the abdominal aorta. The primary tumor was removed but elimination of the metastatic lesions was incomplete. A single dose of 1,000rads was delivered to the infiltrated retroperitoneal tissue including the contact metastases to the liver through 8cm diameter field and the lymph node metastases through 10×8cm field. Case 2: The patient was one year and eleven month old girl with right Wilm's tumor. The primary tumor was 11 X 9. 0×6.5 cm in size and was removed by right nephrectomy. A single dose of 1,500rads was given to the tumor bed through 8cm diameter field. Case 3: The patient was nine month old boy with neuroblastoma, which could not be determined the primary lesion, The mass of paraaortic lymph node was removed and found multiple mesenteric lymph node metastases.Infiltrated paraaortic lesion and mesenteric lymph node metastases were irradiated with 1,500rads through 6cm diameter and 6×8cm field. Indication, irradiation technique, and dose of intraoperative irradiation for the abdominal tumor in children were discussed.
