No abstract

The incidence of cancer of the larynx A detailed review of 3445 cases of cancer of the larynx, over a period of 25 years with a follow‐up of 98.8%, reveals an increasing incidence of glottic cancer in men but a much greater increase of supraglottic, glottic and subglottic cancer in women.

Four children with medulloblastoma had massive supratentorial recurrences in the region of the cribriform plate after adequate craniospinal irradiation. The pathogenesis of these recurrences is probably related to underdosage to this region by shielding of the eyes. This hypothesis was corroborated by autopsy findings in two other patients in whom subfrontal implants were histologically different from recurrences elsewhere. Two possible solutions to avoid this problem in the future are suggested.

Forty-four antecedent, synchronous, and metachronous multiple primary cancers were identified among 41 patients who constituted 4.0% of 1028 patients initially treated for Hodgkin's disease during the years 1950-1954, 1960-1964, and 1968-1972. At 5 years post-therapy the cumulative probabilities of developing a multiple primary cancer for patients treated in 1950-1954, 1960-1964, and 1968-1972, were 1.14%, 1.48%, and 4.43%, respectively. At 10 years the cumulative probability of a multiple primary cancer was 2.54% for the 1950-1954 treatment group and 6.52% for the 1960-1964 treatment group. Among those patients 16-39 years of age, initially treated during the period 1960-1964, who had survived 6-10 years after receiving radiation plus single agent chemotherapy, we observed a significant 18-fold increase in the number of multiple primary cancers. A significant occurrence of two multiple primary cancers in a relatively small group of patients treated with chemotherapy only during the period 1968-1972 was also noted. Continued surveillance of patients extensively treated with combination chemotherapy and radiotherapy will enable assessment of the oncogenic potential of these modern therapeutic approaches to the management of Hodgkin's disease.

In a recent survey of the recurrence pattern in 40 medulloblastoma patients treated at Memorial Hospital between 1970 and 1979, 15% of all recurrences were in the region of the cribriform plate, which is an area that is undertreated with commonly employed radiation therapy techniques. The authors, therefore, modified their technique to increase the dose in this area. They report on the initial results in 15 subsequent patients treated with this modification. Ten of the 15 patients had localized tumors (Groups I and II) and 8 of these patients are alive disease‐free compared with 7 of 17 Group I and II patients treated between 1970 and 1979. Three of five patients with disseminated tumors (Groups III and IV) are alive disease‐free compared with none in the previous series. Although the period of follow‐up is relatively short (median, 32 months), the overall survival of patients with medulloblastoma seems to be improved with additional radiation to the region of the cribriform plate. No side effects attributable to this modification were observed. In the opinion of the authors, this modification should be used routinely in patients with medulloblastoma.