Cisplatin (P) versus cyclophosphamide, adriamycin and cisplatin (CAP) for stage III-IV epithelial ovarian carcinoma: a prospective randomized trial.

In 1982 a randomized trial was started to compare a cisplatin-containing polychemotherapy (CAP: cyclophosphamide - CPA 750 mg/m2, adriamycin - ADM 50 mg/m2, cisplatin - P 50 mg/m2 on day 1 every 21 days) with full-dose cisplatin as single agent (P 60 mg/m2/day on days 1 and 2 every 28 days) in 44 patients undergoing exploratory laparotomy or debulking surgery for stage III-IV epithelial ovarian carcinoma with residual disease greater than 5 cm. The response was evaluated at second-look surgery with random biopsies and peritoneal washing. On the basis of the final results the authors underline some data which, although merely indicative (because of the small number of patients) appear to be worth considering since they are in accordance with the latest reports: a) similar response rate (CR + PR = 47%) to first-line treatment in the two groups; b) the CAP treatment may achieve a longer median duration of CRs than the P treatment (20 versus 11 months); c) overall survival seems similar in the two groups of patients (19 versus 18 months), whereas the survival of CRs seems longer in the CAP treated patients (greater than 32 versus 25 months). The authors also discuss some observations on a possible salvage therapy.

Immunophenotypic analysis of the transformation zone of human cervix.

The immunocompetent cell population of the cervical transformation zone of 18 uteri removed for noncervical disease, has been investigated with monoclonal antibodies. The panel included Leu 2a, 3a, 4, 14, and IL II receptor for lymphocytes and T cell subsets, Leu 7 for NK cells, Leu M5, Leu 10, HLA-DR, DRC 1 for dendritic cells, and Leu 6 for Langerhans' cells (LC). In ectocervical epithelium HLA-DR, Leu 6 and Leu 10 antibodies identified subpopulations of dendritic cells which differed in number and in topographic distribution. Furthermore, a strong HLA-DR epithelial positivity was constantly observed in endocervical columnar cells as well as in keratinocytes of squamous metaplasia. Leu 2a+ cells (T suppressor/cytotoxic) prevailed in the stromal and epithelial compartments of ecto/endocervix; in 6 cases, however, Leu 3a+ cells (T helper/inducer) represented the main T cell subset in the ectocervical stroma. B lymphocytes were occasionally noticed in the subepithelial stroma while NK and DRC-1 cells were never observed. Finally, only few lymphocytes displayed a positivity for IL II receptor. This study suggests that several phenotypes of intraepithelial dendritic cells are present in the transformation zone and that endocervical columnar cells and keratinocytes of squamous metaplasia express HLA-DR products; the latter finding may be related to the presence of intraepithelial and stromal T lymphocytes.

[Contraceptive practice and prevention as alternative to legitimization of indiscriminate abortion]. / La pratica contraccettiva e la profilassi come alternativa alla legittimazione dell'aborto indiscriminato

PIP: The problem of legalizing abortion in Italy and possible alternative measures that would limit the need to resort to abortion are discussed. Measures to reduce fetal abnormalities caused by diseases in pregnant women, a more supportive attitude on the part of families, society, and the state toward unmarried mothers, and especially proper education and the use of appropriate contraceptive methods, including free distribution of contraceptives if necessary, are regarded as the best means to reduce the incidence of abortion and to limit it to relatively exceptional, medically justified, cases. The ignorance of many physicians on the subject of contraceptives, which leads to unjustified fears, erroneous prescriptions, and subsequent failures or complications, is also emphasized. Available contraceptive methods, their efficacy, possible side effects, and contraindications, are reviewed and discussed, and amendments to the legislation in force are suggested for the purpose of limiting the number of unwanted pregnancies that prompt requests for abortion.^ieng