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A retrospective study was made on 57 cases with mostly advanced hypopharyngeal tumors. The patients were irradiated between 1960 and the end of 1983 at the Radiologic Hospital of the University of Münster. 39 patients were submitted for radiotherapy as primary treatment, nine patients were irradiated postoperatively, and nine further patients received adjuvant cytostatic chemotherapy. The overall five-year survival rate was 16%. 19% out of all patients developed recurrences within one year following the treatment.

Report of an eight-year-old boy presenting with untreatable focal epilepsy and slowly progressing hemiparesis combined with personality changes. Continuous diagnostic efforts eventually resulted in the diagnosis of a primary intracranial rhabdomyosarcoma several months later. The delay in making the correct diagnosis was due to the fact that the malignant process originated as a diffuse involvement of the leptomeninx, and only in later stages a tumor mass developed. Nosology and histogenesis of primary intracranial rhabdomyosarcomas are discussed.

A retrospective study compiles the therapy results of 164 evaluable patients with lingual tumors who had been irradiated primarily or as part of a combined surgical-radio-oncologic treatment scheme at the Radiologic Hospital of the University of Münster. The five-year survival rate of all patients in all stages is 22%, and there were no statistically significant differences in the prognosis of carcinomas of the body of the tongue (22%) and carcinomas of the base of the tongue (25%). Our own experiences as well as the communications in literature show that the dose necessary, depending on the stage, is 55 to 60 Gy for small tumors (stages I and II), given within six weeks into the region of the primary tumor. In case of extended tumors (stages III and IV), 60 to 70 Gy have to be administered in seven to eight weeks. The split-course irradiation applied in our own cases produced a small rate of side effects without any demonstrable bad influence on the prognosis. For the irradiation of regional lymph nodes which has to be performed after neck dissection, too, 45 to 50 Gy should be given within four to five weeks. This dose should be increased by about 10 to 15 Gy in case of manifestations in extended regions. The excellent efficiency of intraoral electron irradiation is pointed out.

The authors describe chordomas, i.e. relatively rare dysontogenetic tumors, their different localisations and the possibilities of radiologic diagnosis. Particular attention is paid to the therapy methods, namely operation, radiotherapy, and their combination, and to the problem of the high rates of local recurrences (36% on an average). The therapeutic problems of seven own cases are discussed and compared to those mentioned in literature. Surgery which should be performed as radically as possible and subsequent high dose radiotherapy (6000 rad) are stated to be at present the most promising therapy combination.

The x-ray morphology of posttraumatic intrapulmonary haematomas and pneumatoceles is described on the basis of 12 cases in a total of 211 patients with blunt thoracic traumas. The article also reports on the course of these haematomas and pneumatoceles. The problem of the development of a barotrauma through PEEP ventilation is discussed, taking the clinical courses into consideration. A characteristic feature of all the discussed cases was the tendency to spontaneous regression as well as continuous decrease in size roentgenologically; this enabled safe differential diagnosis against other cystic pulmonary changes.

The authors present 230 patients submitted to postoperative intralymphatic radiotherapy (ELRT) with radioactive Lipiodol UF because of a malignant melanoma of the inferior extremity. The incidence and volume of a possible invasion of the contrast medium into the lung and the resulting radiation exposure is indicated. Even if very low quantities of the contrast medium (3.5 ml and 7.0 ml, respectively) are used, only 22% of the cases show no pulmonary activity at all. Those patients who underwent bipedal ELRT showed more frequently higher radiation exposure. A correlation between lymph node weight and radiation exposure of the lung could not be demonstrated.

A retrospective analysis was made about the results achieved in 64 patients after combined surgical and radiotherapeutic treatment. The tumor areas were irradiated by fast electrons or cobalt 60 with 50 to 55 Gy, the lymph nodes received doses of 45 to 55 Gy. Local tumor control was achieved in 27 out of 28 patients irradiated immediately after surgery (96%). In case of demonstrated lymph node invasion, local control was achieved in 14 out of 19 cases (74%). The median survival was 9.6 years for patients in stage T1/2, N0, M0 and 2.5 years for patients in stage T1-4, N+, M0. The first two years following to therapy were decisive for the prognosis. Among those of our patients who developed recurrences during this period, not one could be cured in the long run. Two years after the end of therapy, the survival probability of patients without lymph node metastases becomes comparable to the survival curve of normal male population of the same age. In the treatment of penile carcinoma, a gradual proceeding depending on the stage is recommended for the combination of surgery and radiotherapy. In case of lymph node metastases, the application of adjuvant chemotherapy should be taken into consideration.

The palliative effect of treatment stands in the first place in radiation therapy of the esophageal carcinoma. Clinical and roentgenolocical features before and after radiation therapy are reported for 172 patients having been treated under high-voltage conditions between 1962 and 1977. The response of the tumor to irradiation is largely dependent on the tumor shape as visible in the radiograph. In case of tumors growing in polypous shape, often a regression of the tumor is observed even after low doses. An effect beginning later but frequently lasting for a longer time is found with tumors of circular stenosing and diffusely infiltrating growth. All in all a temporary dilatation of the tumor stenosis was achieved in 52% of the patients. Serious side effects of the radiation treatment rarely were observed.

Characteristic CT findings of intramedullary, intradural and epidural as well as of vertebragenic and paraspinal tumours are described, basing on literature and on the authors patient material. The value of CT is discussed and compared with that of other imaging modalities. Attention is also drawn to the value of i.v. application of contrast medium and of primary or secondary CT myelography.

At the department of Maxillofacial Surgery of the University of Münster, squamous cell carcinomas of the lip, oral cavity, and oropharynx are treated according to the principle of surgical resection of the tumour and, if indicated, radical neck dissection. In cases of lymph node infiltration, additional radiotherapy is given. The data of 352 patients, treated within 15 years, were evaluated with regard to 5-year minimal survival rate and to the incidence of recurrences in correlation to the tumour stages and form of treatment.