Nihon Gan Chiryo Gakkai shi最新文献

The treatment with hyperthermia in combination with radiation and intravesical pirarubicin (THP-ADM) was preliminary investigated in 5 patients with urinary bladder carcinoma in situ. Following intravesical administration of 30 mg THP-ADM, external irradiation of 3.0 Gy was delivered to the urinary bladder. Immediately then, hyperthermia using Thermotron RF-8 was performed for 50 min (intravesical temperature: 42-43 degrees C for 35 min). After five courses of the treatment, complete response has been maintained for 6, 8, and 9 months in 3 patients. However, in a patient with complete response, urinary cytology became positive in the 6th month after the treatment. In the remaining patient treatment was interrupted after only 3 courses due to urinary irritation, urinary cytology didn't become negative. The side effects of the combined treatment were limited to the transient symptoms of bladder irritation in all patients and thermal burn in 2 patients. These preliminary results suggest that this combined treatment may represent an effective conservative therapy for patients with urinary bladder carcinoma in situ.

Using high voltage pulse (initial electric field strength 3kV/cm, duration 4 msec, applied energy 14.9 joule) as a local load, and concentration dependent anticancer drugs such as peplomycin (PEP) 20 mg/kg, cyclophosphamide (CPA) 100 mg/kg, mitomycin C (MMC) 3 mg/kg and cisplatin (CDDP) 5 mg/kg administrated intraperitoneally, the effects on the suppression of primary lesions and on formation of pulmonary metastasis in the spontaneous pulmonary metastatic system of Lewis lung carcinoma were investigated. Though only CPA among single administrated anticancer drugs showed a suppressive effect against tumor growth, remarkable reduction in the size of primary lesions was obtained with a combination of high voltage pulse and an anticancer drug, regardless of various kinds of drug. A maximal ratio of size before and after treatment was 0.05 in PEP, 0.2 in CPA, 0.38 in MMC and 0.14 in CDDP. A combination of PEP or CPA with high voltage pulse had a particularly good effect, reducing the volume of the primary tumor after treatment less than levels before treatment throughout 2 weeks. The use of high voltage pulse alone did not affect any growth kinetics of the primary lesion. The number of pulmonary metastatic nodules was significantly reduced only by CPA among various kinds of single administrated drugs, whereas it was reduced by all treatments with a combination of high voltage pulse and each anticancer drug. The use of high voltage pulse alone did not result in any increase of the number of pulmonary metastatic nodules.(ABSTRACT TRUNCATED AT 250 WORDS)

The tumor can be more selectively heated by applying of high frequency inductive heating after administration of ferromagnetic particles into a tumor. In order to devise a technique used for the selective hyperthermia of a tumor with high frequency inductive heating, we continued fundamental studies using liposomal ferromagnetic particles (HP-LM), which were prepared as follows: triiron tetoraoxide (Fe3O4) particles were coated with liposomal membrane contained hematoporphyrin with neoplastic affinity. In Vivo Studies of Rabbits: We used high frequency inductive heater (NIHON KOSHUHA CO. LTD. YKN-10), frequency: 400 kHz, out put: 10 kW, coil diameter: 90 mm. VX-2 tumor cells at 1.5 X 10(7) were implanted to the lower thigh of rabbit. When the implanted tumor grew up 3 cm in diameter, A-D group were heated and studied. Group A: In a dose of 200 mg/kg of HP-LM was administered into the femoral artery, Group B: In a dose of 100 mg/kg of Fe3O4 was administered into the femoral artery, Group C: Ligation of femoral artery, Group D: Nonadministrated, and then was immediately heated. Group A: In a dose of 200 mg/kg of HP-LM, with heating for 10 minutes, temperature was elevated 14. 8 degrees C at center of tumor. Group B: In a dose of 100 mg/kg of Fe3O4, with heating for 10 minutes, temperature was elevated 10.6 degrees C at center of tumor. Group C: In a ligation of femoral artery, with heating for 10 minutes, temperature was elevated 6.5 degrees C at center of tumor.(ABSTRACT TRUNCATED AT 250 WORDS)

A retrospective analysis of 22 patients with central nervous system (CNS) non-Hodgkin's lymphomas seen from 1978 to 1989 at Hamamatsu University Hospital was carried out. These were corresponding to 16% (22/137) of non-Hodgkin's lymphomas treated by irradiation during the same period. Six patients had primary intracranial involvement, six had secondary one, five had leptomeningeal involvement and five had spinal cord compression. Median survival of these groups 29 months, 7 months, 6 months and 4 months, respectively. On the case primary intracranial involvement, neurological signs and symptoms and performance status (PS) were improved in most patients. Whole brain irradiation with a dose of 45 Gy to 50 Gy followed by systemic chemotherapy was considered as effective treatment modalities. On the other hands, for the secondary intracranial lymphomas, clinical symptoms and PS were excellently improved by radiation therapy, however these were not reflected to survival. The conditions having primary site on gastrointestinal tract and relapse as systemic dissemination were considerable risk factors for the control of CNS involvement. For these patients, prophylactic chemotherapy should be necessary. Improvement of PS on patients with leptomeningeal lymphomas was obtained in only 3 of 5 cases. These were treated by irradiation on whole spine or neuroaxis and intrathecal MTX injection. We observed 2 cases dying from cerebrovascular accident and one case from leukoencephalopathy. This showed that such combination therapy should be carefully attempted. Five patients having spinal cord compression suffered from paraplegia and none of them had been improved on their symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)

To investigate the immunological effect of Sizofilan (SPG) combined with radiotherapy, we evaluated the immunological parameters in 22 patients with uterine cervical cancers. Twelve cases were treated with SPG combined with radiotherapy (SPG group), and the other ten cases, with radiotherapy only (control group). As a result, 1) During radiotherapy, the numbers of lymphocyte and CD2 positive cell decreased in SPG and control groups. After radiotherapy, however, its numbers in SPG group became significantly higher than in control group (p less than 0.05). The number of CD3 positive cell also presented a tendency to increase after radiotherapy in SPG group. As for CD20 positive cell, its numbers were kept unchanged after radiotherapy in both two groups, and no significant difference was observed between them. 2) NK cell activity decreased during radiotherapy in both two groups. After radiotherapy, its activity in SPG group recovered to its pre-value and became significantly higher than that in control group (p less than 0.05). 3) SPG did not any prominent effect on CD4/CD8 ratio. 4) The adverse effect of SPG to liver or kidney function were not observed in our patients. The SCC level in SPG group decreased rapidly by radiotherapy as well as that in control group, and no significant difference was observed in SCC levels between them. So it was suggested that SPG did not suppress the cytocidal effect of radiation to cancer cells. Based on these findings, it was concluded that SPG prompted the recovery of not only lymphocyte, especially T cell, but also NK cell activity. These immunological findings presented a usefulness of clinical application of SPG to radiotherapy in patients with uterine cervical cancers.

To investigate whether each of cisplatin (CDDP) and carboplatin (CBDCA) was AUC (Area Under the Curve)-dependent or time-dependent drug, Human Tumor Clonogenic Assays (HTCA) were performed in various exposure times of CDDP or CBDCA using PC-9 cells. From the result of this study, it was shown that CDDP and CBDCA were AUC dependent drugs. Furthermore, to evaluate the combination effect of CDDP and CBDCA, we carried out HTCA using PC-9 and PC-14 (human lung adenocarcinoma cell lines) cells, and evaluated the combination effect by the median effect analysis of Chou, T.C. and Talalay, P. The combination effects were above the additive effects at the AUC ratios of free Pt in the exposure medium of 3.2, 6.5, 13.1 (CBDCA/CDDP). Especially in the combination of 3 hours exposure of CBDCA followed by 1 hour exposure of CDDP, the Combination Index by median effect analysis was from 0.74 to 0.86 at the AUC ratio of 13.1. But the combination effect was antagonistic at that of 19.5. CDDP and CBDCA, which are AUC dependent drugs, have shown different side effects in previous clinical practice. And the combination effect of both drugs is more than additive effect at the AUC ratios of free Pt of 3.2, 6.5, 13.1 (CBDCA/CDDP). It is considered that the combination chemotherapy of CDDP and CBDCA for patients of lung adenocarcinoma may be useful.

We examine the influence of CDDP and BLM on the cell cycle in the patients with uterine cervical cancer. Specimens were obtained from 8 cases of local recurrent uterine cervical cancer which were treated with CDDP and BLM bolus infusions into bilateral internal iliac arteries. Except for two patients who showed no response according to the criteria of the National Cancer Institute (NCI), the other patients exhibited partial response (PR). The concentrations of BLM and CDDP were 0.83 +/- 0.05 microgram/g and 2.9 +/- 0.54 microgram/g in the tumor tissues 24 hours after treatment. The peak values of the drug concentrations in serum, which were observed at 30 min for both drugs, were 0.92 +/- 0.12 microgram/ml BLM and 1.02 +/- 0.65 microgram/ml CDDP and the concentrations of the drugs decreased rapidly in the serum. The higher levels of CDDP and BLM were retained in the tumor tissue 24 hours after treatment, than in serum. Changes in DNA content determined by flow cytometry, revealed that proliferation indices (PI) increased after treatment only in PR cases. The mean increase in the ratio was 0.10 +/- 0.015. The BrdU staining showed that cells in S phase increased in tumor tissues. Labeling indices increased from 0.10 +/- 0.04 to 0.18 +/- 0.05. These results suggested that cell synchronization was induced by CDDP and BLM in vivo. PI seemed a useful parameter for measuring drug sensitivity.

To obtain a precise preoperative diagnosis of benign and malignant ovarian tumors, multivariate analysis was performed using a combination of tumor markers, diagnostic imagings, clinical findings and epidemiological data. Twenty-eight factors were selected for a discriminant analysis, which included 10 factors for tumor markers, 8 for diagnostic imagings, 4 for clinical features and 6 for epidemiological data. On 235 patients (malignant: 100, benign: 135), the usefulness of the discriminant analysis was evaluated retrospectively. As a results, an accuracy of preoperative discrimination was 82% for a discriminant analysis of tumor markers alone, 91% for diagnostic imagings, 84% clinical findings and 65% for epidemiological data. Twenty-one factors were selected by chi-square test or T-test. When 21 factors were used, the sensitivity and the specificity for the diagnosis of malignant ovarian tumor were 98% and 88% respectively. The results indicate that the discriminant analysis is valuable for preoperative discrimination of patient with ovarian tumors.

An evaluation of excisional biopsy for tongue carcinoma (T1, T2) as a surgical treatment was performed. Forty-seven patients who received excisional biopsy among 394 patients with tongue carcinoma (T1, T2) treated in National Cancer Center Hospital during 24 years were examined. These patients were divided into following three groups: group a) patients treated with excisional biopsy only, group b) those treated with excisional biopsy and cryosurgery, group c) those treated with excisional biopsy and radiotherapy. We examined local control rate of these groups, degree of differentiation in histopathological examination, and median cancer free surgical margin. From these we obtained following results: 1) There was no significance in local control rate among these three groups (group a 77%, group b 84%, group c 45%) 2) There were no local recurrences in the patients with cancer free margin of 5 mm or more except when the histopathology showed perineural invasion, lymphatic vessel invasion, and/or deep invasion to the muscle. 3) Even if we had cancer positive surgical margin with excisional biopsy, we could obtain high local control rate (75%) with additional cryosurgery. We conclude that excisional biopsy for tongue carcinoma (T1, T2) is a good method for primary therapy.

MRI findings of pelvic radiation changes in 42 patients were correlated with the tumor and critical tissue dose, time post treatment, and clinical symptoms. The severity of tissue changes was graded. The ability of MRI to differentiate post radiation tissue changes from residual or recurrent tumor was also correlated. Radiation tissue toxicity increased significantly when the dose exceeded 4,500 cGy, with the incidence of marked rectal changes rising from 8% to 44% with a dose greater than 4,500 cGy. All grades of tissue change were seen in the rectum of time from start of therapy. All patients who exhibited clinical grade 2 or 3 rectal changes showed moderate or severe changes on MRI. Grade 1 MRI changes indicative of mucosal edema were present in 33% of patients with no clinical symptoms. In conclusion, the gradation and sequence of MRI changes following radiation therapy to the pelvis have been documented and correlated with clinical findings. With its potential for distinguishing radiation change from recurrent tumor. MRI should prove to be of value in the assessment of the post-radiation pelvis.