[Surgical and technical aspects of regional chemotherapy by means of an arterial catheter port]. / Chirurgické a technické aspekty regionální chemoterapie prostrednictvím arteriálního portkatétru.

Metastases of colorectal carcinoma seem the most common liver tumors in our patients. Up to date clinical studies reveal in these the best results with intraarterial chemotherapy employing continuous or intermittent infusions of fluoropyrimidins. These require permanent vascular access. Techniques of implantation in normal an abnormal vascular anatomy, methodology of catheter patency maintenance, port maintenance and salvage of malfunction catheter feature as a group of new, technical and surgical problems. Together with the simultaneously solved problems as effective anticancer agents option and way of their administration they jointly condition a favourable effect of regional chemotherapy. The technical and surgical aspects result in further indication criteria for intraarterial chemotherapy, which is then conducted in a close cooperation of a surgeon and clinical oncologist.

[Intra-arterial chemotherapy in inoperable and recurrent rectal tumors]. / Intraarteriální chemoterapie inoperabilních a recidivujících nádoru rekta.

Intraarterial chemotherapy was used to affect inoperable or relapsing tumors of the rectum or rectosigmoid. Seldinger's approach was used to catheterize both internal iliac arteries and recently also the inferior mesenteric artery in the second stage. Of the cytostatics mitomycin C 2 x 10 mg/2 h and fluorouracil 2 x 500 mg/24 h were administered over four days. No skin damage was observed in the region supplied by the branches of the catheterized arteries as simultaneously hydrocortisone was administered intraarterially in doses of 2 x 50 mg/24 h in the first two days and 2 x 25 mg/24 h in the remaining two days. No adverse effects of the treatment were recorded. Of the nine patients over 50% regression was achieved in 3 cases established by CT, stabilization of the process in 2 cases, and in 4 cases objectivization failed. Remission of symptoms and improvement of performance was observed in 8 patients, in 1 patient the method failed to be effective. Intraarterial chemotherapy of the pelvic region is considered suitable also for preoperative cytoreduction.

Renal excretion of neopterine and biopterine in patients with malignant melanoma and Hodgkin's disease.

In two groups of patients with checked diagnoses of the malignant melanoma and Hodgkin's disease we followed changes of the renal excretion of two major pterines, neopterine and biopterine. In patients with the malignant melanoma, we found a remarkable increase of the excretion of neopterine, which depends on the extent of the involvement and, by contrast to this, in patients with Hodgkin's disease we found a remarkable decrease of the excretion of biopterine, also dependent on the extent of the involvement. In both types of the tumor disease the ratio neopterine: biopterine is remarkably increased as compared to controls.

An experimental model for predicting the synergism of hyperthermia with cytostatics.

A simple prediction test for a combination of hyperthermia and chemotherapy checked on three experimental tumors and cells of the normal murine thymus is described. The testing procedure is based on checking the incorporation of labeled 125I 5-iodo-2-deoxyuridine into the DNA of tested cells affected solely by the enhanced temperature or by the cytostatic itself, or by a combination of both agents. The statistical analysis of repeated results demonstrated the reproducibility of the test. Testing of the potentiation effect of different non-cytostatic substances with enhanced temperatures also gave results corresponding to findings of other authors, performed in vivo or by the use of other techniques. Thus, this simple method is recommended for a screening, before considering the individual use of the combination of hyperthermia and chemotherapy in patients.

Adjuvant and curative chemotherapy of the gastric cancer.

The authors report on the results of combined chemotherapy using cyclical alternations with several non-crossed resistant combinations in patients with gastric carcinoma in the adjuvant and palliative indication. The report includes also a small group of 6 patients with locally inoperable carcinoma, treated by radio-chemotherapy, followed by subsequent second-look resection and postoperative chemotherapy. Prolongation of survival in these patients indicates that possible benefit of the treatment regimens administered may be expected. Prospective randomized study is recommended to check the obtained results.

Retention of labelled 5-iodo-2-deoxyuridine after intratumorous injection as a possible indicator of the cellular kinetics.

On the basis of an experimental model of the Lewis lung carcinoma a possibility was checked of obtaining basic kinetic data about the individual proliferation of tumour cells by a method of measuring the incorporation of labelles 125I 5-iodo-2-deoxyuridine intratumorously with a subsequent measurement of the retained activity in the tumour. These activity, which resides in the tumour for a time longer than 24 hours depends on the fraction of cells, that in the synthetic part of the cell cycle at the time of the injection.

Survival of patients with advanced ovarian carcinoma treated with Penberol.

The authors report their results of treatment in patients with ovarian carcinoma (stages III and IV, FIGO classification) with the cytostatic Penberol (cis-beta-4-pentoxybenzoyl-beta-bromoacrylic acid), synthesized at the Research Institute for Pharmacy and Biochemistry in Prague. The present communication links on the paper published in 1980. Out of 20 patients treated with Penberol, 11 have responded by a complete remission persisting for 8-55 months; in five of them the remission has not finished as yet. Both in the experiment and in the clinic the behavior of Penberol differs from that of classical cytostatics, and the observations evaluated so far attest to antitumor activity based on inhibition of the cell energetic metabolism.

Urinary excretion of pterins in tumor-bearing patients.

In a group of 14 individuals without tumor disease and 125 patients with verified malignant tumors we checked the applicability of determination of the pterins concentration in urine by the procedure described by RAO et al. [3]. In total of 242 examinations were performed. The results were compared with the thin-layer chromatography and on the basis of these comparisons the method was modified. Correlation of the clinical conclusion and the values of tests was obtained in 76% of cases. In patients with undoubtedly persisting tumors the correlation was found in 73%, in a group of patients with the leukemia and lymphomas in 97%, with mammary carcinoma in 81%. Evaluation made in these patients prior to the chemotherapy initiation correlated in 100%. This simple test offers a possibility of the use in differential diagnosis of malignant process or in the course of the screening.

Preliminary results with the new cytostatic Penberol in ovarian carcinoma.

The authors present results of a preliminary study on the efficiency of the preparation Penberol [VUFB Prague (cis-beta-4-pentoxy-benzoyl-beta-bromoacrylic acid) CHECO protocol number 4] in the ovarian carcinoma of the stage III and IV (FIGO) in which the drug was used after the failure of the first choice chemotherapy. Out of ten patients, complete regression of the lesions was achieved in 7 patients, only in two cases the regression was lower than 50% and in one case a progression was encountered during the therapy. The median of the duration of non-completed remission is 15+ months. As to the side effects, in half cases the dose of the preparation was reduced by 1/3 because of diarrhea induced by irritating action of the drug on the intestinal wall. No other side effects of the therapy were observed.