Stephen M. Stowe

Limitations of adjunctive surgery in carcinoma of the cervix

Abstract This study analyzed 41 patients with bulky/barrel-shaped Stage IIB cervical carcinoma. Twenty patients were treated with radical radiation alone. Twenty one patients had post-radiation surgery; ten underwent total abdominal hysterectomy and lymphadenectomy and eleven underwent extrafascial hysterectomy. Histologic review of the submitted specimens showed complete tumor sterilization in all but two. One of these had a microscopic focus of residual tumor with changes suggesting radiation damage; the other had wide-spread disease. All but one of the submitted nodal specimens were negative. Among patients receiving radiation and surgery, there was a 15% incidence of fistulization. In addition these patients had an unusually high incidence (60%) of prolonged (more than 18 months) unilateral and bilateral obstructive uropathy. Patients managed by radiation alone showed a 5% incidence of fistulization and 30% incidence of obstructive uropathy. This high incidence of ureteral obstruction following radiation alone without concurrent disease has not been reported previously. This study questions the routine use of abdominal hysterectomy with or without lymphadenectomy following radical radiation therapy in the treatment of Stage IIB disease and outlines the criteria for the combination of the modalities.

Monocytosis: a new observation during radiotherapy.

Abstract Absolute cell counts were performed on patients prior to, during, and after irradiation. A total of 29 patients were evaluated prior to any irradiation; approximately equal numbers had malignant disease of the pelvis and thorax. In addition 44 patients were studied randomly during irradiation only. Absolute cell counts on a 10,000 cell sample demonstrated the usual neutropenia, lymphopenia and eosinophilia. A marked consistant monocytosis also was noted. Parallel 100-cell counts done manually were statistically inconclusive. This has not been reported previously.

Combined radiotherapy and Corynebacterium parvum treatment of rat tumors with different immunogenicity.

Abstract This report presents evidence that combined radiotherapy and Corynebacterium parvum treatment gives better results than radiotherapy alone in rats bearing a chemically induced highly immunogenic transplanted fibrosarcoma termed BP 179; however, similar behavior is not observed with either of two weakly immunogenic mummary carcinomas, 13762 or ME/H. Relative immunogenicity is determined by the ability of immunized rats to reject tumor cell challenge. Both 13762 and ME/H carcinomata grow progressively and metastasize early to the retroperitoneal cavity and lungs if they are left untreated. Local radiotherapy of the primary tumor has no influence on growth of metastases whether it is combined with C. parvum or not. Results of cell-mediated cytotoxicity studies with lymphocytes from BP 179 and ME/H tumor bearing rats treated with radiation or radiation plus C. parvum support the in vivo findings of combined radiotherapy. These data suggest that unlike strongly immunogenic tumors, weakly immunogenic tumors will not respond better to C. parvum combined with radiation therapy.

Hyperthermia: Healing and Hazard in Tumor Bearing Rats

We have treated a metatasizing tumor in the rat with hyperthermia, as welI as the contralateral normal Iimb by immersion in a 43 C bath. Whole body (rectal) temperatures were allowed to reach 40.5 - 41.0 C for one hour, and possible harmful effects on the host immune system investigated. Treatment which caused regression of the primary tumor also significantly reduced extent of retroperitoneal metastases. Lymphocytotoxicity against tumor target celIs in vitro assayed one and two days after hyperthermia revealed no reduction in celI mediated immunity.