[Intratumoral injection of macroaggragated albumin and colloidal 32P for the treatment of hepatocellular carcinoma].

OBJECTIVE: To study the tumor deposition and systemic distribution of colloidal (32)P in single colloidal (32)P injection and macroaggragated albumin (MAA) injection followed by colloidal (32)P and to evaluate their clinical effects and side effects for the treatment of hepatocellular carcinoma. METHODS: H(22) hepatocellular cancer cells were inoculated subcutaneously in the right fore leg of Balb/c mice. When the tumors reached to 1.0 cm in diameter about 10 days postinjection, the mice were divided into two groups randomly. In the first group, the tumors were only injected with 1.85 MBq of colloidal (32)P; while in the second group, with 1 +/- 10(5) particles of MAA followed by 1.85 MBq of colloidal (32)P. The radioactivity in the tumor, blood, heart, liver, kidney, spleen, and bone of each animal was determined at 30min, 24 h, 48 h, 8 d, and 16 d postinjection. Histopathology of tumors was observed at 16 d and 1 month postinjection. The ultrasound-guided intratumoral injection of MAA and colloidal (32)P was performed on 30 patients with hepatocellular cancer. The evaluation of efficacy and side effects was made on the basis of clinical manifestations, histopathological changes, variations in tumor size, serum AFP, the functions of heart, liver, kidney, blood routine, and immune functions before and after the treatment. RESULTS: Intratumoral injection of colloidal (32)P resulted in necrosis and fibrosis of the tumor cells. Pretreatment with MAA before administration of colloidal (32)P effectively decreased the diffusion of colloidal (32)P from the tumor to blood, and led to retention of colloidal (32)P in the tumor for a longer time. After treatment, a significant shrinkage of the tumor size was seen in all cases with the average shrinkage rate of 53.25%. Serum AFP values decreased remarkably. Clinical symptoms alleviated. The survival rate of 1, 2, and 3 years was 90%, 76.67%, 43.33%. No side effect was found. CONCLUSIONS: Intratumoral injection of MAA and colloidal (32)P is a simple, safe, and effective alternative for the treatment of hepatocellular cancer.

Radiation and pregnancy.

Irradiation during pregnancy may occur either as the result of radioactive pollution of the environment, or during a medical procedure using x-rays or radionuclides. While the former is usually unforeseeable, the latter is known and accepted by both physician and patient.Recent statistics estimate that about one quarter of pregnant women have had a radiographic experience during the pregnancy, either for obstetrical reasons or in the course of medical and dental examinations. The amount of radiation delivered to the fetus is in the range of one rad or less. Radionuclidic procedures may result in fetal radiocontamination, chiefly after placental transfer and fetal uptake. Radioiodine, radioactive calcium and selenomethionine are dangerous for the fetus, since they cross the placenta freely and are taken up by fetal tissues. The labelled proteins, radiocolloids and some mercury compounds remain in the maternal compartment and therefore can affect the fetus only through their gamma radiation at some distance from the fetus.The teratogenic effect, the leukemogenic threshold and the lowered resistance to neonatal infections have been demonstrated after irradiation with doses far higher than those encountered during diagnostic applications of ionizing radiation. Statistical data suggest an increase of susceptibility to leukemia in infancy after intra-uterine irradiation at a diagnostic level. Cytogenic analysis may.... offer valuable data for the establishment of the extent of radiation damage.