[Treatment of metastatic malignant melanoma (author's transl)]. / Klinische Erfahrungen mit DTIC beim metastasierenden Melanom.

24 patients with metastatic malignant melanoma were treated with DTIC applied alone or in combination with other cytotoxic agents (Oncovin, Bleomycin, Adriblastin). Treatment resulted in objective improvement (3 patients), subjective improvement (2 patients), stable state (5 patients). The other patients showed further progression of their disease.

[Simultaneous radiation- and chemotherapy (methotrexate and bleomycin) of inoperable malignant oro-facial tumors]. / Inoperabilis arctáji malignomák radio-kemoterápiával (i. a. methotrexat és bleomycin) történö egyidejü kezelése.

The overall response rate is 65% with 17% CR (medium 56 months) and 49% PR (medium 5 months). The Kaplan-Meier survival plot shows no difference between the previously treated and untreated groups, whereas the kappa 2-analysis indicates a significant advantage for patient with complete response in the previously untreated group (p less than 0.03). Between the different tumor sites and the presence or absence of lymphnodes, there was no significant difference either in survival or in the distribution of the CR, PR and P. The group with bone destruction has a significant shorter median survival time of 9 months versus 15 months in patients with no bone-involvement (p less than 0.03).

Survey of chemotherapy of metastatic renal cancer.

A critical survey is made of cytotoxic chemotherapy of metastatic renal cancer. On the basis of representative summaries, only a few substances such as vinblastine, CCNU, hydroxyurea, and ifosfamide seem to act with some degree of success, but no specific antirenal cancer agent has as yet become available. This outline should provide a more realistic view of the therapeutic possibilities and of the limits of cytostatic chemotherapy in the metastatic phase of renal cancer. It is postulated that chemotherapy should feature more prominently in future therapeutic strategies. Newer cytostatic substances, i.e., second-generation alkylating agents and anthracyclines as well as platinum analogues, may present an advance with regard to side effects and tolerance but are discouraging with regard to their therapeutic efficiency in metastatic renal cancer.

[Complications of the sternal puncture (author's transl)]. / Komplikationen der Sternalpunktion

The case of a 57 year old female patient suffering from plasmocytoma with a sternal fracture after local puncture characterized by a late healing tendency is reported. According to the literature the complications of this diagnostic method, known up to now, are described with special emphasis to the pathomechanism and the clinical course of the mostly fatal sternal perforation with cardiac tamponade. Puncture of the iliac crest instead of the sternal region is recommended in cases with serious osteoporotic or osteolytic defects of the sternal bone.

[Localized poikiloderma vascularis atrophicans as an early manifestation of Hodgkin's disease of the nodular-sclerosing type]. / Lokalisierte Poikilodermia vascularis atrophicans als Frühmanifestation eines Morbus Hodgkin vom nodulär-sklerosierenden Typ.

A 33-year-old female patient is presented with a nine-year history of poikilodermatous, eventually ulcerative skin lesions on the right neck and shoulder. A work-up revealed Hodgkin's disease of the nodular sclerosing type with specific cutaneous infiltrations. Initial combination polychemotherapy followed by supradiaphramatic irradiation has resulted in complete clinical remission of the disease since 15 months.

Palliative and adjuvant chemotherapy of metastatic renal cancer.

Despite the prevalent scepticism regarding its value, chemotherapy for metastatic renal cell cancer was used in 45 patients, of whom 44 were nephrectomized, aged between 34 and 75 yr with a mean age of 57.3 yr. In 32 patients chemotherapy was used as palliative treatment because of the presence of their often multiple metastases or in 13 patients following surgical removal of metastases and/or histologically high-grade malignancy, as adjuvant treatment. Our treatment schedule consisted on day 1 of vinblastine 5 mg/m2 to a maximum of 10 mg provided intravenously in 1 or 2 to 3 week intervals X 6 and CCNU 130 mg/m2 orally each 6th week. This treatment schedule was supported by an intensive antiemetic regimen. Gastrointestinal side effects were well tolerated while 30% hematological depression necessitated extension of treatment intervals. The mean number of cycles was 2.5-3.7, respectively, with a maximum of 6. Palliative treatment resulted in 19% complete plus partial remission, 62% stabilization, and 19% progression, while adjuvant therapy proved to be superior with 10 of 13 patients in remission at 3-21 months, and 1 of 3 patients with metastatic recurrence in further remission for 20 months; two of three patients died. Palliative chemotherapy with CCNU-vinblastine acted successfully by blocking cancer progression, while adjuvant treatment together with surgical extirpation of metastases may have prolonged tumor-free remission.

[Peliosis hepatis, complicating treatment with anabolic steroids (author's transl)]. / Peliosis hepatis, eine Komplikation der Anabolikatherapie

The clinical and pathological findings of peliosis hepatis are reported, complicating a long-term treatment with an anabolic steroid in a 19 year old male patient suffering from chronic aplastic anemia. Following a 15 months course of oxymetholone (Anapolon) a cholestatic jaundice developed without regression despite discontinuing the drug. 4 months later the patient expired as a consequence of his hematologic disease. At autopsy the liver showed a parenchymal type of peliosis hepatis with multiple blood filled cavities and focal liver cell necroses. The pathogenesis of this rare condition is discussed by means of literature demonstrating the hepatotoxic effect of C17-alkylated androgens.

[Oral 5-fluorouracil therapy in liver metastasis]. / Perorale 5-Fluorouracil-Therapie bei Lebermetastasierung.

The therapeutic results of 5-FU given by oral application (15 mg/kg body weight x 10 days) in 11 patients with hepatic metastases (after colorectal and mammary carcinoma) are reported: objective response in 2 patients and subjective improvement in 4 patients contrasts to 3 patients without response and 2 patients with indefinite response to adjuvant chemotherapy. However, a long lasting complete remission in a female patient with important metastatic hepatic involvement following breast cancer must be emphasized.

[Serum fucosyltransferase activity in malignant diseases]. / Serum-Fucosyltransferaseaktivitäten bei malignen Erkrankungen.

Serum Fucosyltransferase activities were measured in 41 controls and in 55 patients with neoplastic diseases. Incorporation of 14C-fucose into the endogenous acceptor of serum and after addition of desialofetuin as exogenous acceptor, was determined. About 83% of patients suffering from various malignant diseases showed pathological fucosyltransferase activities. In all patients with testicular tumours and no detectable metastases after surgery, normal enzyme levels were obtained. After successful chemotherapy, fucosyltransferase activities returned to normal.