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Neutron-capture therapy in a case of cerebellar sarcoma treated initially with X-radiation

A clinical and histological study

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  • 4 Citations

Summary

This paper deals with a girl who at birth had a large retroauricular mass diagnosed clinically as hemangioma. It responded well to X-ray therapy. When she was 11 years old, a sarcoma was removed from the cerebellum. No evidence could be found that the sarcoma had originated from the retroauricular tumor. After the use of nitrogen mustard locally and after three courses of X-ray therapy to the tumor over a period of 9 1/2 months — a total radiation dose of approximately 7,953 r — the patient was growing moribund. During 4 neutron-capture treatments, which were directed chiefly toward the suboccipital region, striking improvement occurred — to such an extent that the patient was able for a time to sit up in a wheelchair and converse. As a result of the therapy, all tumor which had spread suboccipitally and into the neck vanished, as did also virtually all tumor in the dorsal third of the cerebellum, i.e., in the region receiving the largest concentration of thermal neutrons. In the middle third of the cerebellum large and small tumor aggregates, some of them calcified, were necrotic and were walled off by hyperplastic connective tissue. In the ventral third of the cerebellum, in a region presumably out of the range of an effective concentration of thermal neutrons, the tumor grew unimpeded.

Evidence indicated that the sarcoma in our case originated in the vascular sheath, chiefly about vessels in the granular layer of the cerebellum.

Life was prolonged approximately 8 months by the neutron-capture therapy.

Résumé

Ce cas est celui d'une enfant qui présentait à la naissance une large masse rétroauriculaire que le diagnostique clinique identifiait comme étant un hémangiome. La radio thérapie eut de très bons résultats. A onze ans on pratiqua l'ablation d'un sarcome cérébelleux qui ne semblait pas avoir été causé par la tumeur rétroauriculaire. Après traitement à moutarde nitrogénée et après trois appliquations de rayon X s'échelonnants pendant neuf mois et demi-soit une dose de radiation d'environ 7,953 r — son état s'aggrava. Pendant quatre traitements de «neutron capture», dirigés principalement sur la région sous-occipitale, on remarqua une amélioration spectaculaire, la malade pouvant s'asseoir et étant même capable de converser pendant quelque temps. Après ce traitement, la tumeur qui s'étendait dans la région sous-occipitale et dans la cou disparut, ainsi que presque toute la tumeur qui se trouvait dans le tiers dorsal du cervelet particulièrement dans la région la plus proche de l'aire sous-occipitale. Dans le tiers moyen cérébelleux on trouva également des agrégats de tumeurs plus ou moins grands, dont quelques-uns calcifiés, qui étaient isolés par un tissu conjonctif hyperplasique. Dans le tiers ventral du cervelet la tumeur ne cessa de croître dans la région non-irradiée par les neutrons. La tumeur était un sarcome d'origine périvasculaire située principalement dans la couche réticulaire cérébelleuse. La vie de la malade fut prolongée d'environ huit mois par le traitement de «neutron capture».

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With 20 Figures in the Text

Read at the 36th Annual Meeting of the American Association of Neuropathologists, Boston, June 12, 1960.

Research supported by the United States Atomic Energy Commission.

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Farr, L.E., Haymaker, W., Calvo, W. et al. Neutron-capture therapy in a case of cerebellar sarcoma treated initially with X-radiation. Acta Neuropathol 1, 34–55 (1961). https://doi.org/10.1007/BF00690477

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Keywords

  • Sarcoma
  • Hemangioma
  • Thermal Neutron
  • Granular Layer
  • Neutron Capture