Malcolm Y. Colby

TREATMENT OF MALIGNANT NEOPLASMS OF THE GASTROINTESTINAL TRACT WITH A COMBINATION OF 5-FLUOROURACIL AND RADIATION: A RANDOMIZED DOUBLE-BLIND STUDY.

Combined chemotherapy and irradiation in the management of malignant disease is a subject of wide and current interest. It has been hoped that the combining of these therapeutic modalities would produce results superior to those achieved with either alone. Hodnett recently reviewed the literature in this field (4). Some authors believe that their results demonstrate marked synergism or additive effects of the combined therapy, while others have withheld judgment, pending the results of controlled studies. The University of Wisconsin group published several reports of controlled studies. They used 5-fluorouracil (5-FU) and irradiation to treat mammary carcinoma of mice (6) and the same combination for bronchogenic carcinoma in man (1, 3). In the animal studies, the combination of 5-fluorouracil, actinomycin P2, or cyclophosphamide (Cytoxan) with fractional x-ray therapy resulted in increased inhibition of tumor growth as well as in prolonged survival when compared to either mode of therapy alone. From thei...

Radiation Therapy of Brain-Stem Tumors

TUMORS OF the brain stem reportedly (1, 5) are seen most frequently in young children. In untreated cases, the disease usually progresses rapidly from the first symptom to death, although in some instances the natural history may be more indolent. These tumors are quite rare, always unresectable, and usually not amenable to biopsy. Such factors tend to limit the radiotherapists experience and to make the results of his treatment difficult to evaluate. With the above facts in mind, it was thought worthwhile to review the Mayo Clinic experience with radiation treatment for this condition. Materials And Methods Evaluation was made in a retrospective fashion of patients whose diagnosis was established on a clinical basis only, on the basis of a diagnostic radiographic procedure (fractional pneumoencephalogram, angiogram, or Pantopaque rhombencephalogram), or on the basis of surgical observation of the tumor with or without biopsy confirmation. Radiation therapy was given for 677 of 1,772 patients having clin...

Cystectomy after radiotherapeutic ablation of invasive transitional cell cancer.

Of 282 patients with invasive bladder carcinoma treated by a combined protocol of preoperative irradiation and total or partial cystectomy 84 had no residual carcinoma in the surgical specimens. Of these 84 patients who have been at risk for 12 to 149 months 59 (70 per cent) are alive.

Invasive bladder carcinoma managed by irradiation and surgery

Four hundred forty-four patients with invasive vesical carcinoma were entered in a nonrandomized treatment program of preoperative irradiation and surgical extirpation of the primary lesion. Fifteen of the patients did not undergo surgery, and an additional 13 were found at operation to have an inoperable lesion. Thus, 416 patients, at risk for more than two years, were available for statistical study. Pathologic findings constitute the basis for the calculation of crude survival rates. Five-year survival for 107 patients without residual carcinoma was 66 per cent, approximating the 71 per cent for the 160 patients with low-stage carcinoma. By contrast, 149 patients with high-stage carcinoma had a five-year survival of 31 per cent. The need for a yet undefined adjuvant modality is evident.

EVALUATION OF RESULTS OF RADIATION TREATMENT OF PITUITARY CHROMOPHOBE ADENOMAS PRODUCING VISUAL IMPAIRMENT.

In the early years of the twentieth century, treatment of pituitary tumors was placed on a sound basis by the pioneer work of Beclere (1) and other workers in the field of radiotherapy, and by Cushing (2) and others in surgery. Since those early days there has been (to quote Dyke and Davidoff (3)) …“some tendency on the part of radiotherapeutists and neurological surgeons to show preference for their own type of therapy.” In the nearly half century since this pioneer work, the “tendency” still seems to exist, probably because even to this date no sound objective method of evaluating treatment has found general acceptance and usage. Emphasizing this point are two editorial comments from the most recent Yearbook of Radiology (4): (a). “The chronicity and variability in progression of chromophobe adenomas make evaluation of any treatment difficult…” (b) “One of the difficulties in evaluating the results of treatment of pituitary adenomas is the inability to find something to measure….” Also, as Paterson (5) ...

Radiation therapy and 100 per cent oxygen breathing in the treatment of adenocarcinomas of the large bowel. A controlled study.

The oxygen effect is a well established radiobiologic principle. The exploitation of this effect in clinical radiation therapy has not been particularly rewarding. The work of Cater and Silver (1) and Rubin (2) has indicated, however, that breathing 100 per cent oxygen at atmospheric pressure during conventionally fractionated radiation therapy is worthy of investigation. In 1964, our group undertook a study of patients with adenocarcinoma of the large bowel in whom the lesion was unresectable at the time of operation, or biopsy verified a recurrent tumor. There was no clinical or laboratory evidence of distant metastasis. All known tumor could be encompassed within radiation-therapy portals of 20 × 20 cm or less. All patients were treated with supravoltage radiation therapy at the rate of 1,000 to 1,200 rads in five to six fractions per week to a total midplane dose of 3,750 to 4,500 rads. Composition of the treatment groups was determined by random selection. Onehalf the patients breathed 100 per cent o...