Chemical Modifiers of Cancer Treatment

in Chemical Modifiers of Cancer Treatment (1995, August 22)

Combined radiotherapy and radioimmotherapy of human colon carcinoma grafted in nude mice.

in Cancer Research (1995), 55

The effect of combined radioimmunotherapy (RIT) and fractionated external beam radiotherapy (RT) was assessed in two human colon cancer xenografts, Col 12 and LS174T in nude mice. These tumors were ... [more ▼]

The effect of combined radioimmunotherapy (RIT) and fractionated external beam radiotherapy (RT) was assessed in two human colon cancer xenografts, Col 12 and LS174T in nude mice. These tumors were selected for being resistant to RIT alone, as is usually the case in the clinical situation. Tumor-bearing mice were treated with a combination of five X-ray fractions over 5 days followed by RIT with two doses of 1.5 mCi 131I-labeled anticarcinoembryonic antigen monoclonal antibody F(ab')2. In Col 12 and LS174T, RIT alone achieved a regrowth delay similar to that of fractionated RT with total doses of 28 and 26 Gy, respectively. In both tumor types, an additive therapeutic effect, measured as increased regrowth delay or local control, was observed when combining RT of different dose levels with RIT. Normal tissue responses were assessed by monitoring acute peak skin reactions and blood cell count. Bone marrow depression for the combination treatment was similar to that of RIT alone; relative to skin, at equitoxic levels, no mice bearing Col 12 tumors were locally controlled with a 32 Gy RT dose alone, while this RT combined with RIT gave a local control of 100%. These studies show a therapeutic benefit when external beam RT is combined with RIT. [less ▲]

The rationale to switch from postoperative hyperfractionated accelerated radiotherapy to preoperative hyperfractionated accelerated radiotherapy in rectal cancer

in International Journal of Radiation, Oncology, Biology, Physics (1995), 32(1), 181-188

To demonstrate the feasibility of preoperative Hyperfractionated Accelerated Radio Therapy (preop-HART) ini rectal cancer and to explain the rationales to switch from postoperative HART to preoperative ... [more ▼]

To demonstrate the feasibility of preoperative Hyperfractionated Accelerated Radio Therapy (preop-HART) ini rectal cancer and to explain the rationales to switch from postoperative HART to preoperative HART. View the MathML source: Fifty-two consecutive patients were introduced in successive Phase I trials since 1989. In trial 89-01, postoperative HART (48 Gy in 3 weeks) was applied in 20 patients. In nine patients with locally advanced rectal cancer, considered unresectable by the surgeon, 32 Gy in 2 weeks was applied prior to surgery (trial 89-02). Sicne 1991, 41.6 Gy in 2.5 weeks has been applied preoperative to 23 patients with T3—T4 any N recatl cancer immediately followed by surgery (trial 91-01). All patients were irradiated at the department of radiation-oncology with a four-field box technique (1.6 Gy twice a day and with at least a 6-h interval between fractions). The minimal accelerating potential was 6 MV. Acute toxicity was scored according to the World Health Organization (WHO for skin and small bowel) and the Radiation Therapy Oncology Group criteria (RTOG for bladder). This was done weekly during treatment and every 3 months thereafter. Small bowel volume was estimated by a modified “Gallagher's” method. View the MathML source: Acute toxicity was acceptable both in postoperative setup. The mean acute toxicity was significantly lower in trial 91-01 compared to 89-01. This difference was due to the smaller amount of small bowel in irradiation field and lower total dose in trial 91-01. Moreover, there was a significantly reduced delay between surgery and radiotherapy favoring trial 91-01 (median delay 4 days compared to 46 days in trial 89-01). Nearly all patients in trial 89-02 and 91-01 underwent surgery (31 out of 32; 97%). Resection margins were negative in 29 out of 32. Hospitalization duration in trial 91-01 was not significantly different from trial 89-01 (19 vs. 21 days, respectively). View the MathML source: Hyperfractionated accelerated radiotherapy immediately followed by surgery is feasible as far as acute toxicity is concerned. Preoperative HART is favored by a significantly lower acute toxicity related, in part, to a smaller amount of irradiated small bowel, and a shorter duration of the delay between radiotherapy and surgery. Moreover, the hospital stay after preoperative HART is not significantly increased [less ▲]

The rationale to switch from postoperative accelerated radiotherapy to preoperative hyperfractionated accelerated radiotherapy in rectal cancer.

in International Journal of Radiation, Oncology, Biology, Physics (1995), 32(1), 181-188

Purpose: To demonstrate the feasibility of preoperative Hyperfractionated Accelerated RadioTherapy (preop-HART) in rectal cancer and to explain the rationales to switch from postoperative HART to ... [more ▼]

Purpose: To demonstrate the feasibility of preoperative Hyperfractionated Accelerated RadioTherapy (preop-HART) in rectal cancer and to explain the rationales to switch from postoperative HART to preoperative HART. Methods and 1989. In trial Materials: Fifty-two consecutive patients were introduced in successive Phase I trials since 89-01. m&operative HART (48 Gv in 3 weeks) was applied in 20 patients. In nine patients with locally advanced rectal cancer, considered unresectable by the surgeon, 32 Gy in 2 weeks was-applied prior to surgery (trial 89-02). Since 1991, 41.6 Gy in 2.5 weeks has been applied preoperatively to 23 patients with T3-T4 any N rectal cancer immediately followed by surgery (trial 91-01). All patients were irradiated at the department of radiation-oncology with a four-field box technique (1.6 Gy twice a day and with at least a 6-h interval between fractions). The minimal accelerating potential was 6 MV. Acute toxicity was scored according to the World Health Organization (WHO for skin and small bowel) and the Radiation Therapy Oncology Group criteria (RTOG for bladder). This was done weekly during treatment and every 3 months thereafter. Small bowel volume was estimated by a modiiied “Gallagher’s” method. Results: Acute toxicity was acceptable both in postoperative and preoperative setup. The mean acute toxicity ~significantly lower in trial 91-01 compared to 89-01. This difference was due to the smaller amount of small bowel in irradiation field and lower total dose in trial 91-01. Moreover, there was a significantly reduced delay between surgery and radiotherapy favoring trial 91-01 (median delay 4 days compared to 46 days in trial 89-01). Nearly all patients in trial 89-02 and 91-01 underwent surgery (31 out of 32; 97%). Resection margins were negative in 29 out of 32. Hospitalization duration in trial 91-01 was not significantly different from trial 89-01 (19 vs. 21 days, respectively). Conclusions: Hyperfractionated accelerated radiotherapy immediately followed by surgery is feasible as far as acute toxicity is concerned. Preoperative HART is favored by a significantly lower acute toxicity related, in part, to a smaller amount of irradiated small bowel, and a shorter duration of the delay between radiotherapy and surgery. Moreover, the hospital stay after preoperative HART is not significantly increased. [less ▲]

Radiochirurgie et radiothérapie stéréotaxique

in Médecine et Hygiène (1995), 53(2088), 2002--2009

La radiochirurgie, appelée radiothérapie stéréotaxique lorsqu'il s'agit d'un traitement fractionné, s'effectue en Suisse depuis 1993, soit par accélérateur linéaire modifié, soit par Gamma Knife. Par ... [more ▼]

La radiochirurgie, appelée radiothérapie stéréotaxique lorsqu'il s'agit d'un traitement fractionné, s'effectue en Suisse depuis 1993, soit par accélérateur linéaire modifié, soit par Gamma Knife. Par cette technique on arrive à administrer une dose élevée de radiations à des lésions intracrâniennes circonscrites d'une taille de 3 à 4 cm au maximum, tout en ménageant les tissus normaux avoisinants. Lorsque les lésions sont plus grandes, mal délimitées, ou de forme irrégulière, c'est la radiothérapie conventionnelle et conformationnelle qui offre une meilleure répartition des doses. Les principales lésions considérées pour la radiochirurgie sont les malformations artérioveineuses, les métastases cérébrales solitaires, les méningiomes de la base, les schwannomes vestibulaires et certaines récidives focales de gliomes. [less ▲]

Protection of the small bowel with a silicone tissue expander prosthesis and a polyglycolic acid mesh during radiation therapy for cervical carcinoma

in British Journal of Obstetrics & Gynaecology (1994), 101

L'hyperthermie, une modalité oncologique pluridisciplinaire

in Médecine et Hygiène (1994), 52(2037), 1720-1722

L-hyperthermie consiste en l'élévation de la température du corps ou d'une de ses parties, par des moyens externes au-delà de 41°C. La chaleur a une activité cytotoxique propre et provoque une ... [more ▼]

L-hyperthermie consiste en l'élévation de la température du corps ou d'une de ses parties, par des moyens externes au-delà de 41°C. La chaleur a une activité cytotoxique propre et provoque une sensibilisation des cellules aux radiations ionisantes ou à la chimiothérapie. Le gain thérapeutique est environ de 2. Seules les tumeurs superficielles peuvent être traitées adéquatement par les moyens actuels. Les indications sont la palliation de tumeurs superficielles telles que les récidives loco-régionales du cancer du sein, les récidives ganglionnaires de cancers ORL et les cancers de la peau, en particulier les mélanomes [less ▲]

Prognosis of human chorionic gonadotropin-producing seminoma treated by postoperative radiotherapy

in International Journal of Radiation, Oncology, Biology, Physics (1993), 27(1), 17-24

To clarify the controversy about the management and prognosis of human chorionic gonadotropin-producing seminoma, the records of 132 patients with abnormal human chorionic gonadotropin values treated with ... [more ▼]

To clarify the controversy about the management and prognosis of human chorionic gonadotropin-producing seminoma, the records of 132 patients with abnormal human chorionic gonadotropin values treated with radiotherapy were analyzed. METHODS AND MATERIALS: The records of 1169 patients with pure seminoma treated in 10 institutions were screened for serum or urinary human chorionic gonadotropin. One hundred and thirty two patients with elevated human chorionic gonadotropin were found: 96 Stage I, 20 IIA, 7 IIB, 8 III and 1 IV. Median age was 34 y., mean follow-up was 5.0 years [range 1-12 y]. All received infradiaphragmatic radiotherapy (median dose 30 Gy), 25 (2 Stage I, 11 IIA, 5 IIB and 7 III) supradiaphragmatic radiotherapy (median dose: 28.5 Gy) and 10 had also initial chemotherapy (3 Stage IIB 6 III and 1 IV). Patients were allocated to three groups according to human chorionic gonadotropin values: (a) moderate elevation: up to 10 times (104 pts), (b) high elevation: 10 to 100 times (20 pts), (c) very high elevation: over 100 times the upper limit of normal value (8 pts). RESULTS: The proportion of Stage I, II and III was 76%, 19%, 5% in the ME group versus 50%, 35%, 15% in the high elevation group (p < 0.05). In the very high elevation group there were 7 Stage I and 1 Stage IV. Of 132 patients, six died (three dead of disease, two suicides, one acquired immunodeficiency syndrome). The 5 years overall survival probability was 94%. There were seven recurrences (initial stage: 1 Stage I, 2 IIB, 3 III and 1 IV). Of these, there were one in-field recurrence, 3 out of field and 3 in both sites. In 5 of 7, the human chorionic gonadotrophin level was again elevated at recurrence. The 5 years recurrence-free-survival probability was 94% (98% for Stage I, 100% for Stage IIA and 65% for Stage IIB and III [p < 0.001 between I and IIB + III, p < 0.05 between IIA and IIB + III]). Four of the 7 recurrences were salvaged by chimiotherapy +/- radiotherapy. In the high elevation and very high elevation groups, the 5 years recurrence-free-survival was 88%, vs. 96% for the moderate elevation group (p = 0.10). CONCLUSION: Based on this series of patients, human chorionic gonadotropin production is not an unfavorable prognostic factor in pure seminoma. Even in the subgroups with high or very high human chorionic gonadotropin levels (who had a higher proportion of advanced stages), the prognosis remained excellent. In Stage I and IIA seminoma with abnormal human chorionic gonadotropin levels, recurrence rate after post-operative radiotherapy alone is extremely low. [less ▲]

Third-body irradiation as an effective palliative treatment for painful multiple bone metastases resistant to chemo- or hormonal treatment

in Radiotherapy & Oncology (1993), 28(1), 76-78

Fifty-three patients had 54 third-body areas irradiated for breast and prostate bone metastases using the third-body irradiation technique during a period of 6 years. These patients were previously ... [more ▼]

Fifty-three patients had 54 third-body areas irradiated for breast and prostate bone metastases using the third-body irradiation technique during a period of 6 years. These patients were previously treated with chemotherapy, hormonal therapy and limited field irradiation. Seventy percent responded completely and 24% partially. This modality is safe and effective for pain relief. [less ▲]

La place de la radiothérapie dans le traitement des sarcomes des tissus mous

in Bulletin du Cancer. Radiothérapie : Journal de la Société Française du Cancer : Organe de la Société Française de Radiothérapie Oncologique (1993), 80(1), 13-26

La radiothérapie des sarcomes des tissus mous est revue à travers la littérature. Comme la chirurgie, le traitement actinique fait partie du traitement standard. Comparée à la radiothérapie postopératoire ... [more ▼]

La radiothérapie des sarcomes des tissus mous est revue à travers la littérature. Comme la chirurgie, le traitement actinique fait partie du traitement standard. Comparée à la radiothérapie postopératoire, l'approche préopératoire et/ou interstitielle offre l'avantage potentiel de nécessiter de façon plus systématique une approche multidisciplinaire ab initio. Par ailleurs, la radiothérapie préopératoire implique une irradiation des tissus sains moins importante et donc une réduction probable de la toxicité. Le contrôle local et la survie sont comparables pour les deux modalités radiothérapeutiques. Toutefois, la comparaison entre différentes séries reste ardue vu l'hétérogénéité des populations étudiées. Une solution serait d'effectuer une étude randomisée [less ▲]