Assay of anti-cancer drugs in tissue culture: relationship of relapse free interval (RFI) and in vitro chemosensitivity in patients with malignant cerebral glioma.

One hundred and seventeen patients with cerebral glioma (Kernohan grades III and IV) were treated with adjuvant chemotherapy using procarbazine (PCB), CCNU and vincristine (VCR) following whole head irradiation. Cell cultures were prepared from 40 patients in this series and their sensitivity to each cytotoxic drug was assessed in a mictotitration assay with 35 S-methionine incorporation as the end point. Twenty-two of forty (55%) patients responded to PCB and/or CCNU in vitro, and sensitivity to these drugs was linked with increased RFI, whilst sensitivity to VCR was not. The RFI of patients who had responded to PCB or CCNU in vitro was significantly longer than the RFI of patients whose tumours failed to respond in vitro or patients who had not been tested. There was no difference in sex ratio, extent of operation, radiation dose and degree of steroid cover between responders, non-responders and untested groups. Grade III tumours tended to be more sensitive in vitro than grade IV tumours. The age of patients also influenced in vitro chemosensitivity. Patients with chemosensitive tumours in vitro tended to be younger than patients with insensitive tumours in vitro. Further statistical analysis, taking into account these prognostic factors, indicated an association between chemosensitivity in vitro and RFI.

Experience in the treatment of carcinoma of the cervix using a rotational technique.

The radiation technique described is an unconventional method of treatment for carcinoma cervix patients and is essentially external beam therapy alone, using a (60)Cobalt rotation plan. This is in contrast to the more conventional series of 2 or 3 intracavitary radium insertions, either preceded and/or followed by fixed field external beam therapy. An advantage to the patient from this treatment scheme is the avoidance of the trauma associated with the repeated anaesthetics required for uterine and vaginal radium applications. Dosage levels have also been determined to ensure minimal post-radiation complications, and the 5- and 10-year survival rates for stage II and stage III cases are comparable with the survival results published by other centres. The series was treated during 1957-64 and consisted of all stage II and III cases referred to the Westminster Radiotherapy Department during this period, together with 13 stage I cases which were considered to be poor anaesthetic risks, and 4 stage IV cases. The 5- and 10-year survival rates for 69 stage II cases were 44% and 36% respectively, and for 81 stage III cases were 38% and 23% respectively.

Severe gastrointestinal haemorrhage: haemangiomata demonstrated by selective visceral arteriography.

Selective visceral arteriography was found to be invaluable in the management of two cases of severe gastrointestinal haemorrhage associated with cavernous haemangiomata (a large gastric haemangioma and a small jejunal haemangioma). It is suggested that arteriography may be indicated in cases where a previous laparotomy has not shown the cause of bleeding, when the patient's general condition precludes a prolonged operation, and when superficial haemangiomata are found.