irradiated so that the underlying normal tissues will be spared from un- necessary irradiation.

Starting in February 1971, a once weekly dose fractionation scheme was employed for total skin electron beam therapy (TSEB) for mycosis fungoides and lymphoma cutis. The dosimetry, technical details, radiobiologic studies and clinical experience of this technic employing 3.5 MeV electrons from a 6 MeV Linear Accelerator have been reported previously. This technique has been extended to other cutaneous malignancies, including: inflammatory breast carcinoma, Kaposi's sarcoma, soft tissue, sweat-gland and ovarian car- cinoma whenever total or sub-total skin irradiation is indicated. The pur- pose of this report is to describe our experience with 23 primary and re- current breast carcinoma patients. Nineteen had inflammatory breast carcin- oma and the rest had widespread metastatic skin lesions. The majority had extensive bleeding ulcers. Routinely, 400 rads once weekly for 6 consecu- tive weeks was delivered to the entire skin surface of the trunk from the chin down to' the level of the umbilicus or symphysis pubis, as indicated clinically. The upper third of the arms were often included. Bulkier lesions received boost treatments to local fields with deeper penetrating electrons from the Betatron. Complete response was obtained in 22 patients that com- pleted the planned course. No untoward reactions were observed and there was less morbidity when compared to a daily fractionation scheme. Duration of remission, patterns of extension and details of technique will be discussed.

(84) UTERINE MALIGNANCIES: A COMMUNITY HOSPITAL EXPERIENCE

Harold Perry, M.D.*, Hank S. Chang, M.D.*, Joseph H. Wahlers, M.D.*, and Alfred I..Sherman, M.D.**

*Abraham & Anna Srere Radiation Therapy Center, Sinai Hospital of Detroit, Detroit, Michigan

**Department of Obstetrics & Gynecology, Sinai Hospital of Detroit, Detroit, Michigan

The Sinai Hospital of Detroit is a university affiliated institution. A retrospective study was undertaken to determine the results of treatment of uterine malignancies in this hospital and to develop guidelines for pro- spective treatment policies.

Three-hundred to 400 malignancies involving the body of the uterus have been seen in the Sinai Hospital of Detroit for evaluation and treatment from 1953 through 1975. During this time interval, a treatment policy combining radiation therapy and surgery has evolved. Several modes of treatment have been utilized including surgery only, pre and/or postoperative radiation therapy and radiation therapy alone.

The treatment policy is dependent upon the histologic diagnosis of the primary neoplasm, the degree of differentation, depth of penetration into the myometrium or origin in the myometrium, involvement of the cervix, uterine size, total gross extent of tumor and the patient's medical status.

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The inter-relationship between these factors has determined the choice of treatment.

Retrospective FIG0 staging has been utilized. Results as related to histology, depth of myometrial invasion, cervical involvement, extra uterine extension and treatment will be described. Possible causation of local failures or local recurrences will be discussed.

(85) SIGNIFICANCE OF THE LEUKOCYTE ADHERENCE I 7 HIBITION TEST IN PATIENTS WITH BREAST CANCER

Julian W. Proctor, MBBS, Ph.D.*, Milton H. Dalbow, M.S.*, David M.P. Thomson, M.D., Ph.D.**, N. Grosser, M.D.**, and Joseph P. Concannon, M.D.*

*Division of Radiation Oncology, Clinical Radiation Therapy Research Center, Allegheny General Hosptial, 320 East North Aveune, Pittsburgh, PA 15212

**Montreal General Hospital Research Institute, Montreal, Quebec, Canada

The serum of patients with Stage I Breast carcinoma "arms" normal con- trol peripheral blood leukocytes in an immunologically specific manner so that on incubation with the Breast Carcinoma antigen the adherent cell populations are inhibited from adhering to a glass surface. The cell involved in the reaction has the morphological and functional characteristics of a monocyte. The test is proving to be highly accurate in diagnosis and may be of biological significance in relation to the patient's own ability to respond to their cancer.

(86) BIOLOGICAL AND IMMUNOLOGICAL BASIS OF COMBINED MODALITY THERAPY FOR ADVANCED HEAD AND NECK CARCINOMAS

S. Rafla, M.D., Ph.D. and S. Yang, Ph.D.

Radiotherapy Department, Methodist Hospital, 506 Sixth Street, Brooklyn, New York 11215

The treatment of advanced tumors of the head and neck especially in oral cavity and pharynx continues to be followed by failure in the majority of cases despite aggressive local management. A series of 54 cases of such tumors who were treated with a combination of radical radiotherapy followed by full surgical removal were examined to assess biological reasons of failure.