Tapan A. Hazra

Management of small cell carcinoma of the lung. Therapy, staging, and biochemical markers

A chemotherapeutic regimen consisting of BCNU, cyclophosphamide, vincristine, and procarbazine was evaluated in 43 patients with small cell carcinoma of the lung. The majority of patients received radiation therapy to the primary tumor, but chemotherapy alone was utilized in a group of patients with widely disseminated disease. In addition to thorough staging with radioisotope scans and bone marrow biopsies, a study of calcitonin and histaminase as biochemical markers was performed. The BCVP chemotherapy resulted in a complete and partial response rate of 53% when given alone or in conjunction with radiotherapy. The survival data are preliminary, but the complete responders do have a statistically significant better survival (mean of +295 days) than the partial responders and nonresponders. Hypercalcitonemia was not detected in our patients, but elevated histaminase activity was found in eight of 24 patients with small cell carcinoma and in only one of 19 patients with squamous and large cell carcinoma.

The occurrence of metastasis outside the abdomen and retroperitoneal space in invasive carcinoma of the cervix

Abstract In this study, 1142 cases of carcinoma of the cervix were reviewed for distant metastasis, especially to bone; 498 in situ lesions were not included. Of the 644 remaining cases of invasive carcinoma, there were 29 cases of remote metastases; 15 were to the lung, and 12 were to bone, an incidence of 1.8%. No bony metastasis was found at initial staging and diagnosis. The earliest discovery of bone metastasis was 8 months after diagnosis, with most occurring between 1 and 3 years. Routine bone survey is not recommended as part of staging examination. Recommendations are made to discover distant metastatic lesions in invasive cervical carcinoma.

Survival in carcinoma of the lung after a split course of radiotherapy

Abstract Seventy-five consecutive patients with untreated, unresectable, localized bronchogenic carcinoma were treated by a split course external beam radiotherapy. The survival rates of 96 and 43 per cent at one and two years compares very favourably with those reported in the literature. The tumour dose of 4,500 rads in 15 fractions and in an overall time of five weeks was very well tolerated.

Telecobalt therapy for prostatic cancer: rationale, results, and future considerations

External supervoltage radiation is now an accepted form of treatment for adenocarcinoma of the prostate but the tumor response cannot be predicted. We hope in the future that accurate clinical staging coupled with a biological staging of the tumor cells with catalase activity will enable us to predict this response. Ionizing radiations act by producing active radicals, hence the rationale of studying the tissue catalase activity in conjunction with the histological grading may provide a more accurate index of patients who would gain the most benefit from radiotherapy. (auth)

Retroperitoneal liposarcoma in a child

Retroperitoneal liposarcoma is a rare tumor in children and has been reported previously on only three occasions. This is the fourth such case, presenting with a large mass on the left side which displaced the sigmoid and ureters to the right. The patient was treated with surgery, radiotherapy, and chemotherapy. She is alive and well more than four years after therapy was instituted. A review of the pertinent literature cites the need for radio- and chemotherapy especially when surgical removal is incomplete.

Altered Growth and Development of Lower Teeth in Children Receiving Mantle Therapy

The improvement in survival and local control rates in children with neoplasms in the head and neck region can be expected to demonstrate increased iatrogenic adverse effects of treatment. The authors report on mandibular growth and developmental abnormalities in 3 children with Hodgkin disease treated by external beam megavoltage therapy. Radiations to the mandible during mantle field therapy were measured and found to be significant. Possible methods of dose reduction are discussed.

Wilm's tumour.

Abstract The role of cyclic chemotherapy in patients with localized Wilms tumour is raised. Analysis of results of 37 patients with Wilms tumour, treated and followed up at the Johns Hopkins Hospital, is presented. “Prophylatic” irradiation of both lungs was carried out in five patients, along with one course of Actinomycin-D, and all of these patients are doing well with minimal follow-up period of six years.

Delayed Hypersensitivity to DNCB and Survival Following Radiation Therapy in Patients with Solid Malignant Tumors

Delayed hypersensitivity to dinitrochlorobenzene (DNCB) was tested prior to radiation therapy in 206 patients with solid tumors. The patients were separated into a DNCB-positive group who showed a significant response to DNCB and a DNCB-negative group who did not. After one year, it was found that patients with a positive DNCB reaction had a statistically better chance of survival than those with a negative DNCB reaction. Although this is not proof that DNCB testing can indicate those patients who should be excluded from radical therapy, it can help identify those who may respond favorably to extended efforts at palliation or cure despite clinically advanced disease.

Treatment of P388 Leukemia in Vivo With Perfluoroctylbromide and Radiation: A Preliminary Study

Perfluorinated hydrocarbon compounds (PFHC) possess unique physical properties suggesting possible usefulness in man. Their low surface tension allows free flow into tiny folds and crevices, facilitating dispersion along peritoneal surfaces affected by a tumor. These substances are also oxygen solvents. BDF1 female mice injected intraperitoneally (IP) with 10(6) P388 mouse leukemia cells were studied following treatment with preoxygenated compound 1913 and increasing doses of radiation. Preliminary results suggest increased life span compared to radiation treatment alone. Radioenhancement at high sublethal doses of whole-body radiation cannot be excluded.

Collimator Misalignment in High Energy Therapy Machines

Measurements of the intensity distribution of a 60-Co beam revealed a significant field distortion caused by minor misalignment of the collimator assembly which was not detected by routine methods. Accurate monitoring of radiation intensity distribution and periodic visual inspection of collimators are suggested for early detection of this problem.