Yasunobu Maehara

Clinical study of the radioprotective effects of amifostine (YM-08310, WR-2721) on chronic radiation injury☆

We have previously reported that Amifostine, a radioprotective agent, was effective in treating acute radiation mucositis in the head and neck region. We found that when a considerable amount of Amifostine accumulates in the salivary glands, it may be useful in preventing chronic disturbances of salivary secretion. We have observed an increase in the uptake of Ga-67-citrate to the salivary glands when they were irradiated. In this paper, the radioprotective effects of Amifostine, in treating chronic radiation injury of the salivary glands, were studied, using the cessation of an increase in uptake of Ga-67-citrate after radiotherapy as the criterion. The subjects were 105 patients, (280 salivary glands in Ga-scintigrams) with malignancy of the head and neck region treated by irradiation from 1978 to 1984. Ga-negative glands were recognized in 97%, that is, 36 out of 37 glands, before irradiation, and the figure decreased to 19%, seven out of 37, within 1 to 2 weeks (10Gy less than or equal to) after the start of radiotherapy. In patients who were irradiated with more than 30 Gy and in whom scintigraphy was performed at 6 months or more after radiotherapy, Ga-negative glands were recognized in 18 out of 41 glands, 44%, with Amifostine, compared with 13%, four out of 32 glands, without Amifostine. A difference was recognized between these two groups in the negative change in Ga-67 uptake after radiotherapy (p less than 0.05). These facts suggest that Amifostine may have a radioprotective effect on chronic radiation injury.

Non-Marfan idiopathic medionecrosis (cystic medial necrosis) presenting with multiple visceral artery aneurysms and diffuse connective tissue fragility : Two brothers

Two brothers with multiple visceral artery aneurysms or dilatations and diffuse connective tissue fragility who did not have clinical features of Marfan syndrome are reported. One presented with retroperitoneal hemorrhage during angiography, and idiopathic medionecrosis was proved by resection of the aneurysms. These cases belong to the heterogeneous group of Marfan syndrome. The angiographical features (multiple dilation of visceral arteries) suggests fragility of connective tissue and is predictive of hazards during and after a catheterization and operation.

A Case of Posttherapeutic Sclerotic Change of Bone Metastasis from Renal Cell Carcinoma which Proved Histopathologically to Be Complete Response

A 60-year-old man with renal cell carcinoma and metastases to the right 7th rib and L2 vertebra (T2N0M1, OSS) was treated with interferon-alpha and the uracil and tegafur combination following nephrectomy. One and a half years later on bone scintigraphy, the abnormal accumulation had disappeared at the L2 vertebra and weakened in its intensity at the right 7th rib. Plain X-ray revealed that the metastatic lesion at the right 7th rib had decreased in size and had been replaced by calcification. The right 7th rib was removed surgically and step-sectioned pathological specimens revealed necrosis with no viable cancer cells.

Radiotherapy for patients with primary cancer of the lung. Application of radiotherapy to adenocarcinoma.

過去25年間に主として放射線治療が施行された肺腺癌137例を対象とし, 病態, 組織亜型による予後, 長期生存例, 死因などを検討した.I・II期の5年相対生存率は, それぞれ19%, 20%であった.I・II期症例の組織亜型別の予後は, 分化型が低分化型より良好であった.5年生存例は5例で, 全例分化型であった.死因分析では, I・II期で遠隔転移死, 他病死がそれぞれ33%にみられた.以上から, 早期の分化型腺癌は, 根治的放射線治療の対象となりうる.

A Study on Histological Subclassification of Small Cell Carcinoma of the Lung

昭和34年4月から, 昭和51年12月までに, 当科を受診した原発性肺癌患者479例のうち, 小細胞癌は56例で, これらを燕麦細胞型と中間細胞型とに細分類し比較検討した.胸部X線像では, 燕麦細胞型がより浸潤性性格を有するのに比し, 中間細胞型では圧排性性格を有し, 腫瘤を作る傾向がみられた.病期では, 燕麦細胞型にIV期症例が多くみられた.予後では, 燕麦細胞型にて, 放射線・化学療法併用例に生存月数の延長がみられた.