The radioenhancement effects of 5-thio-D-glucose and insulin in vivo on a hypoxic P388 murine leukemia.

A radioresistant in vivo tumor consisting of a partially hypoxic P388 murine leukemia growing intraperitoneally (IP) in B6D2F1 female mice was used to test the radioenhancement potential of 5-Thio-D-Glucose (5TDG) and insulin. Pretreated animals were exposed to increasing doses of whole body radiation (5, 10, 20 Gy) and harvested tumor cells were re-injected into new hosts. In this experiment little benefit was demonstrated with 5TDG or the combination of 5TDG and insulin + radiation. The median survival of animals receiving cells pre-treated with insulin and radiation was improved, but, in general, did not reach statistical significance by the log rank method.

A pilot study with ethyl bis (2,2-dimethyl-1-aziridinyl) phosphinate (AB-163) and radiation therapy.

Ethyl bis (2,2 dimethyl-1-aziridinyl) phosphinate (AB-163), a TEPA analogue, was used with radiation therapy in treating 18 patients with advanced malignancies. There were 12 patients with esophageal carcinoma; 3 with adenocarcinomas of the gastrointestinal tract; one, squamous carcinoma of the cervix; and one, adenocarcinoma of the ovary. One hundred mg/M2 AB-163 was given by rapid i.v. drip one half-hour before conventional radiation therapy. The majority of patients received 10 combined treatments. Three of those with squamous cell carcinomas (two in the esophagus and one in the cervix) remained disease-free for more than 2 years. One with liver metastasis and unresectable carcinoma of the stomach survived for 9 months. The drug causes side effects mainly involving the central nervous system and gastrointestinal tract. Drug-related myelosuppression has not been observed. The mode of action is speculated to be a result of active intermediate hydrolysis products which appear capable of phosphorylating X ray induced DNA strand damage. However, much additional investigation is required, both in vitro and clinically, before its efficacy and safety can be demonstrated.

Radiation therapy for esophageal cancer: the Medical College of Virginia experience.

In a retrospective review of 70 patients with carcinoma of the esophagus treated by external beam irradiation therapy from 1968 to 1977 at the Medical College of Virginia, we correlated survival with race, age, sex, histology, and site of tumor. Results of treatment were also analyzed in relation to the length of the esophagus treated, the total area of the treatment field, and the total tumor dose. From this analysis it appears that radiotherapy has a place in the palliative treatment of esophageal cancer and that palliation is independent of the total volume and dose. There is indication that with higher dosage the survival rate is slightly higher.

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.

Role of radiation therapy in rectal cancer.

The advantages and disadvantages of radiation therapy as an adjuvant to surgical resection in potentially curable rectal cancers is summarized by the authors, who are participating in clinical trials to evaluate results.

The importance of histologic grade in stage II endometrial carcinoma.

Twenty-six patients with stage II endometrial carcinoma were reviewed. Survival time was found to be influenced most by histology. Fifteen of 19 patients with a favorable histologic grade survived. The combination of stage II disease and unfavorable histologic condition proved to be ominous, as there were no disease-free survivors in this group. Adequate combinations of pelvic irradiation and operation, as well as radiation therapy alone, provided satisfactory local control. Preoperative external irradiation and intracavitary insertion, followed by total abdominal hysterectomy and bilateral salpingo-oophorectomy, are the preferred treatment sequence.

Adenocarcinoma of the cervix: histopathologic and clinical features.

Primary adenocarcinoma of the cervix and endocervix is an unusual lesion. It is cytologically evasive, diagnostically challenging, histologically variable, and therapeutically perplexing. During the period 1954 through 1971, 53 cases were diagnosed at the Medical College of Virginia, representing 3% of all invasive cervical carcinomas. Clinical material, therapy, and five-year survival statistics have been complied for each histologic type of adenocarcinoma. The average age of the patients was 53.8 years, and the most frequent complaint was abnormal uterine bleeding. Histologically, the majority had adenocarcinomas of the endocervical type. Others, in order of descending frequency, had endometrioid, clear cell, colloid, and adenoid cystic carcinomas. Patients treated for endometrioid carcinomas had the best five-year survival rates. Standardization of the diagnostic process and the use of modern radiation therapy have significantly improved survival. All patients having radiation plus operation or operation alone lived five years or more.

Uterine sarcoma.

Thirty-four cases of uterine sarcoma were studied with regard to their pathologic characteristics and response to treatment. Pathologic features did not always correlate with subsequent course. Combined therapy seems to enhance two-year survival in endometrial stromal sarcoma (ESS), although some patients may have low-grade tumors and hence represent a more favorable group. Adjuvant irradiation may improve local control rates in some mixed mesodermal sarcomas (MMS), but does not add appreciably to survival. It is of doubtful benefit in the leiomyosarcoma (LMS) group. When irradiation is employed, preoperative therapy is preferred except in the highly malignant mixed mesodermal sarcomas where prompt surgery seems indicated first. Supplemental brachytherapy may also be employed.