Basic and clinical studies for the targeting therapy by using the morphometrical analysis in malignant brain tumors.

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Improved modern neuroimaging techniques and rigid immobilization systems alow confirmation of the target position relative to the proton beam at each treatment, treatment planning based on beam trajectory, dose at each anatomical point, bolus based on accurate assessment of density along each pixel, etc. Proton therapy in our institute showed that the patient could tolerate radiation doses 15-20% higher than those of conventional radiation therapy used. However, it was suggested that the doses needed 140-160 TDF and the tumor volume was less than 10 ml to cure the patients with malignant brain tumor. Therefore, proton beam will be a main instrument of the morphometric targeting therapy for the brain tumors. Neuroimaging is very helpful in estimating clinically the overall extent of the tumor and the peripheral margin. Gd-DTPA MRI can be used effectively in the diagnosis of tumor viability and malignancy after treatment. Furthermore, ^<201>Tl-SPECT appears to be effective for determination of the malignant viability of tumors. In the effectiveness of superselective 1 A chemotherapy of malignant tumors, the antitumor drug was transported into the tumor at an average rate of 6.3% of the total dose injected intra arterially. In calculating the ratio of the delivered ACNU dose to the tumor volume, ACNU of the average 320 mug/ml might be needed as the effective treatment. From DNA content analysis, it is suggested that the malignant brain tumors have different bilogical heterogeneity and its analysis requires further study for the morphometric targeting therapy.