U. Rao

Treatment of adult neuroblastoma

Twelve patients, all over 17 years of age, with adult neuroblastomas, an entity recently described, were seen at Roswell Park Memorial Institute for the period from 1950 to 1977. Four of these patients who were treated by multimodality therapy constitute the bulk of this report. One patient had a complete response and showed no evidence of desease 23 months after treatment with surgery and combination chemotherapy (CYVADIC); she also had maturation of established metastases. Another patient remained stable for 22 months after treatment with combination chemotherapy. These results indicate that chemotherapy may be effective treating adult neuroblastoma patients as complete remissions are achieved and survival times prolonged.

Chemotherapy followed by lung resection in inoperable non-small cell lung carcinomas due to locally far-advanced disease†

From 1977, 29 patients with inoperable non‐small cell lung carcinoma due to locally far‐advanced disease underwent lung resection after receiving two to eight courses of chemotherapy. After the surgery was performed, three additional courses of chemotherapy were given. The overall median survival from onset of the chemotherapy was 30.5 months; postoperatively, it was 24.5 months (five patients survived > 5 years). Postoperative mortality was 10.3%. The overall survival results compare favorably with those obtained with radiation therapy.

High-dose methotrexate as secondary chemotherapy in metastatic soft-tissue sarcomas

High‐dose methotrexate in a dose of 2–4 g/m2 every four weeks was given as secondary chemotherapy to 22 patients with metastatic soft‐tissue sarcoma; toxic reactions included 1 death and 2 instances of moderate hematopoietic toxicity. The remaining patients tolerated this treatment without difficulty. Of 18 patients with measurable evaluable disease, 17 demonstrated progression. One patient with metastatic angiosarcoma had a complete response lasting for 15 months. Three patients were given adjuvant high‐dose methotrexate following wedge resections of pulmonary metastases. One patient demonstrated recurrence after four months, another after 13 months, and the third after 15 months. One additional patient underwent resection of pulmonary metastases following two months of stabilization with high‐dose methotrexate and has continued free of disease with high‐dose methotrexate as adjuvant for eight months. Five patients are alive and have been disease‐free for an average period of 14 months. Four of these underwent operative treatment combined with chemotherapy. The effectiveness of high‐dose methotrexate appears limited in soft‐tissue sarcomas when it is given as secondary chemotherapy.

Adjuvant specific immunotherapy of resectable squamous cell lung carcinoma. Analysis at the eighth year.

SummaryFrom June 1976 to June 1981, 86 patients with resectable (Stage I and II) squamous cell lung carcinoma were entered into a randomized controlled study with three arms:I.Control Group — no treatment postoperatively.II.Specific Immunotherapy Group — three monthly doses of 500 μg of tumor associated antigen (TAA) emulsified with complete Freunds adjuvant (CFA).III.Nonspecific Immunotherapy Group — three monthly doses of CFA emulsified in saline. All the patients in the study received skin tests with PPD (5TU) and 100 μg of the same TAA used for the immunotherapy at 1, 4, 6, 9, and 12 months postoperatively.Patients in both immunotherapy groups showed a tendency for a better disease-free interval and overall survival compared to those of the control, but these interval and beneficial therapeutic effects were statistically significant only in the Group III patients who had no hilar lymph node metastasis (T1N0 and T2N0).Although Group III was originally designated as a nonspecific immunotherapy group, retrospectively, it should be called a lowdose specific immunotherapy group because these patients actually received a total of 500 μg of TAA (as skin tests) and three doses of CFA at separate sites.