Intra-arterial infusion chemotherapy in the treatment of locally advanced breast cancer.

The efficacy of intra-arterial infusion chemotherapy (IACT) as the first step in a combined modality therapy in the treatment of locally advanced breast cancer was evaluated in a prospective clinical study consisting of 18 patients, 15 with stage IIIB, and three with stage IV breast cancer. A combined chemotherapy using adriamycin, mitomycin C and 5-Fluorouracil were administered at 3-week intervals until sufficient regression was achieved. Objective response rate was 66.6%. Among the 14 patients who received IACT for induction, plus surgery, simultaneous adjuvant chemotherapy and radiotherapy, 7 were disease-free at a mean of 19.5 (range 4-42) months. Six patients developed various relapses at a mean of 20.6 (range 12-28) months. IACT was found to be quite effective in local control. The early systemic relapse continues to be a serious problem that needs further intervention.

Post-thyroidectomy hypocalcemia: the role of calcitonin, parathormone and serum albumin.

To investigate the pathogenesis of post-thyroidectomy hypocalcemia calcium, phosphate, calcitonin, parathormone, albumin, triiodothyronine and thyroxine levels were monitored during operation and postoperatively in 25 female patients undergoing bilateral subtotal thyroidectomy for non-toxic nodular goiter. A highly significant fall in uncorrected serum calcium and albumin levels started with the completion of lobectomies and a significant correlation between the course of serum calcium and albumin levels were seen, an early peak in calcitonin corresponded well with the a drop in corrected calcium and inorganic phosphate levels. An overt parathyroid response to hypocalcemia was not observed. We conclude, on the basis of the postoperative hypoalbuminemia, that a calcitonin leak triggered the early onset of hypocalcemia while an insufficient parathyroid response contributed to the post-thyroidectomy hypocalcemia.

A prospective evaluation of the treatment of primary or metastatic liver carcinoma with hepatic arterial infusion chemotherapy.

The efficacy of hepatic arterial infusion chemotherapy (HAICT) in the treatment of primary or metastatic liver carcinoma was evaluated in 37 patients. The infusions were administered through a catheter that was placed in the hepatic artery, either surgically or by percutaneous puncture of the femoral artery. A complete response was observed in four patients. A partial response was observed in six patients and a minor response in another six. In nine patients the disease had stabilized, while a progression of the disease had developed in 12 patients. After a mean of 4.7 cycles per patient, the response rate (complete, partial and minor responses) was 43.2% and median survival 12.0 months. Seventeen Grade III toxicities were observed in a total of 174 cycles, but none of them were fatal. HAICT has demonstrated a successful palliation with minimal toxicity in patients with unresectable liver carcinoma.

Post-thyroidectomy hypocalcemia: does arterial ligation play a significant role?

To assess the possible role of truncal ligation of inferior thyroid arteries on post-thyroidectomy hypocalcemia, a prospective study was carried out on 80 patients. Bilateral subtotal thyroidectomy was performed for non-toxic nodular goiter in two groups. Inferior thyroid arteries were ligated bilaterally in 50 patients but not ligated in 30 patients. In both groups mean serum calcium levels on the first and second postoperative days were found to be significantly lower than preoperative levels. However these falls were similar in both groups. We conclude that bilateral truncal ligation of inferior thyroid arteries is not a factor that may cause hypocalcemia due to vascular insufficiency of parathyroid glands.