These results support that gabapentin decreases hot flashes, to a moderate degree, in men with androgen ablation-related vasomotor dysfunction.

Chronic damage following external irradiation of the normal pituitary and thyroid glands, delivered incidentally during radiotherapy of neoplasms of the head and neck may be more common than has been appreciated in the past. A case of a child who developed pituitary dwarfism 5 1/2 years after radiation therapy has been delivered for an embryonal rhabdomyosarcoma of the naso-pharynx is described. A review of similar cases from the literature is presented. Likewise, external irradiation of the normal thyroid gland produces a spectrum of radiation-induced syndromes. Clinical damage to the pituitary and thyroid glands is usually manifested months to years after treatment and is preceded by a long subclinical phase. A careful exclusion of these glands from radiation treatment fields is recommended whenever possible. An early detection of endocrine function abnormalities in patients receiving radiation to these glands is desirable, since appropriate treatment may prevent the deleterious effects of external irradiation of the pituitary and thyroid glands.

A series of patients with clinically localized Ewing's sarcoma has received systemic chemotherapy as an adjuvant to irradiation of the primary tumor site. Five of the patients developing metastases after minimal chemotherapy were observed to have dissemination to the usual sites, i.e., lung and skeletal system. Two of 3 patients developing metastatic disease after more aggressive adjuvant chemotherapy presented with central nervous system involvement in the absence of clinically progressive disease in other sites. Such cases have not been previously reported in the medical literature. It is postulated that this pattern of metastasis is the consequence of chemotherapy effectively suppressing systemic metastases while leaving the central nervous system pharmacologically unprotected because of the “blood‐brain barrier.” The modification of our therapeutic approach on the basis of this experience has been to include prophylactic treatment of the central nervous system with intrathecal chemotherapy and whole brain irradiation.

Curative radiotherapy was attempted in treating 256 patients with unresected or partially excised gliomas of the brain and spinal cord. Survival decreased with increasing age, reflecting the different incidences of tumor types in various age groups. Actuarial 5-year survival ranged from 85% for cerebellar astrocytomas, to 47% for medulloblastomas, to 41% for cerebral hemispheric astrocytomas, and 0% for glioblastoma multiforme. Further improvements in survival utilizing radiotherapy are unlikely until new adjuncts are developed, for higher radiation doses may lead to a disproportionate increase in radiation corn plications.