Hyperfractionated split-course whole abdominal radiotherapy for ovarian carcinoma: tolerance and toxicity.

Whole abdominal irradiation after chemotherapy and second look laparotomy for advanced ovarian carcinoma is poorly tolerated because of hematologic toxicity that frequently necessitates interruption or abandonment of treatment. A new treatment strategy using a hyperfractionated split course schedule to deliver a total of 30 Gy in 30 fractions over 6 weeks was designed in an attempt to overcome this problem, while not compromising the tolerance of late reacting normal tissues. Of 23 patients treated between August 1984 and June 1986, only one failed to complete therapy as scheduled.

Safety of adjunctive transvaginal beam therapy in the treatment of squamous cell carcinoma of the uterine cervix.

At The University of Texas M. D. Anderson Hospital and Tumor Institute at Houston between 1970 and 1980, 159 patients with bulky cervical cancers of FIGO Stages IB or II were treated with transvaginal orthovoltage radiotherapy (TVR) as an adjunct to standard external beam megavoltage irradiation and brachytherapy.

The role of radiation therapy in stages A2 and B adenocarcinoma of the prostate.

Between 1965 and 1982 definitive external beam radiation therapy was given to 114 patients with clinically Staged A2 (32 patients) and B (82 patients) adenocarcinoma of the prostate. These patients were not considered to be surgical candidates because of age, comorbidity or disease extent, or because they had refused surgery. Total prostatic doses ranged from 60 to 70 Gy.

Prognostic implications of age in breast cancer patients treated with tumorectomy and irradiation or with mastectomy.

Conservation breast treatment is of particular interest to young women, but whether saving the breast carries a penalty in shorter survival or local-regional recurrent disease has not been well-established. At The University of Texas M.D.

In vivo selection of highly metastatic cells from surgical specimens of different primary human colon carcinomas implanted into nude mice.

The purpose of these studies was to select and isolate cells with increased liver-metastasizing potential from heterogeneous primary human colon carcinomas (HCCs). Cells derived from a primary HCC classified as Dukes' stage B2 were directly established in culture or were injected into the subcutis, cecum, or spleen of nude mice. Progressively growing tumors were excised, dissociated, and established in culture.

Conservation surgery for T2 and T3 carcinomas of the supraglottic larynx.

The treatment of choice for supraglottic carcinomas of intermediate size (stages T2 and T3) remains controversial. Between 1974 and 1983 in our institution, 139 patients with supraglottic carcinoma of intermediate size were judged retrospectively to have been technically amenable to conservation surgery. Primary disease control at three years was achieved in 100% of the patients treated by supraglottic laryngectomy, 91% (34 patients) of those treated by total laryngectomy, and 69% (81 patients) of those treated by radiotherapy.

Multivariate analysis of prognostic factors in regional cutaneous metastases of extremity melanoma.

In 135 patients with regional cutaneous recurrence of extremity melanoma, the prognostic significance of 12 clinical and pathologic variables was analyzed in four alternative Cox stepwise regression models and by single variable analysis. A highly significant fit of the regression (P less than 0.01) identified four factors that particularly influenced survival: the presence of intradermal or mixed (as opposed to purely subcutaneous) metastases (P less than 0.

Increased content of chondroitin sulfate proteoglycan in human colorectal carcinoma metastases compared with the primary tumor as determined by an anti-chondroitin-sulfate monoclonal antibody.

To determine if the amount of chondroitin sulfate proteoglycan (CSPG) in human colorectal tumor tissue correlates with the tumor's aggressiveness we immunochemically determined the CSPG levels in colorectal carcinomas at different stages. A total of 50 specimens--4 polyps, 15 stage B tumors, 9 stage C tumors, 12 stage D tumors, 7 liver metastases, and 3 lymph node metastases--were examined. Tumor tissues were extracted with 4 M guanidine hydrochloride containing protease inhibitors.

Bilateral primary breast cancer in patients treated with adjuvant therapy.

Between 1974 and 1986, 1036 patients with operable breast cancer were treated with doxorubicin-containing combination chemotherapy regimens. Of these, 44 patients had bilateral breast cancer prior to initiation of adjuvant therapy (prechemotherapy) and 17 patients developed primary breast cancer on the contralateral side during or after completion of adjuvant therapy (postchemotherapy). The objectives of the study were twofold: to determine the incidence of bilateral primary breast cancer and to determine the effect of second primary breast cancer on prognosis of patients treated for disease in the contralateral breast.

Acute and late toxicity associated with sequential bleomycin-containing chemotherapy regimens and radiation therapy in the treatment of carcinoma of the nasopharynx.

Between 1975 and 1984, 33 patients with squamous cell carcinoma of the nasopharynx received adjuvant chemotherapy before and/or after definitive radiotherapy at UT M. D. Anderson Hospital.

Growth potential of human colorectal carcinomas in nude mice: association with the preoperative serum concentration of carcinoembryonic antigen in patients.

A preoperative serum carcinoembryonic antigen (CEA) concentration greater than 5 ng/ml portends a poor prognosis for patients with colorectal carcinoma. The purpose of this study was to determine if the tumorigenicity of colorectal carcinomas in nude mice was associated with the preoperative serum CEA concentration. Neoplasms from 53 patients were either implanted as fragments or dissociated with collagenase and DNase, and 3 x 10(6) viable cells were injected into the flanks of BALB/c nude mice.

Identification of cell surface cathepsin B-like activity on murine melanomas and fibrosarcomas: modulation by butanol extraction.

Cathepsin B (CB) is a lysosomal cysteine protease that may play a role in the activation of extracellular degradative enzymes involved in the destruction of the subendothelial matrix and extravasation of metastatic tumor cells. In this study we have investigated the cell surface expression of a CB-like enzyme on the surface of tumor cell variants expressing both high and low metastatic potentials. Cell surface CB-like activity was demonstrated by incubation of intact viable cells and isolated plasma membranes with the selective chromogenic substrate N-carbobenzoxyvalyllysyllysylarginyl-4-methoxy-beta-naphthylamide.

Estimation of human reproductive risk from animal studies: determination of interspecies extrapolation factors for steroid hormone effects on the male.

The problem of extrapolating effects of reproductive toxins on experimental animals to predict the doses that would produce infertility in human males is discussed using published data on effects of testosterone and estradiol on sperm production in the rat, rabbit, rhesus monkey, ram, stallion, and humans. This analysis indicates that calculation of the dose of testosterone that reduces human sperm counts by a given percentage is best done using the dose administered to laboratory animals expressed on the basis of body weight, as opposed to some other parameter such as body surface area. A survey of the available data in the literature indicates the incompleteness of the data set and the specific information needed to improve the basis for extrapolation.

Lethal efficacy of doxorubicin on human medullary thyroid carcinoma cells in vitro.

Cytotoxicity of doxorubicin was evaluated on a cultured human thyroid carcinoma (MTC) cell line, TT, by the colony-formation technique. The concentration-dependent survival curve showed a biphasic exponential pattern. Doxorubicin in concentrations of 5 X 10(-9) to 3 X 10 (-5) M produced a 15% to 71% cell kill after 1 hr of treatment.

Surgical margins in squamous cell carcinomas.

Positive or negative surgical margins of excision cannot predict the clinical course of patients with squamous cell carcinomas of the head and neck. Local recurrences are increased in frequency and number when invasive or in situ carcinoma or severe dysplasia is present at the margins. Histologic grade of the carcinoma has no influence.

Cellular pharmacology of liposomal cis-bis-neodecanoato-trans-R,R-1,2-diaminocyclohexaneplatinum (II) in mouse resident peritoneal macrophages, Kupffer cells, and hepatocytes.

The in vitro and in vivo interaction of liposomal cis-bis-neodecanoato-trans-R,R-1,2-diaminocyclohexaneplatinum++ + (II) (L-NDDP) with mouse resident peritoneal macrophages (RPM), Kupffer cells (KC), and hepatocytes was studied. The peak in vitro uptake of L-NDDP by RPM was 12.5 ng elemental platinum/100 micrograms cell protein and constituted 0.

Randomized trial of beta-lactam regimens in febrile neutropenic cancer patients.

A three-arm prospective randomized trial was designed to compare the efficacies of piperacillin plus vancomycin, ceftazidime plus vancomycin, or all three drugs as initial therapy for fever in neutropenic cancer patients. The objectives were to determine whether a broad-spectrum penicillin was as effective as a broad-spectrum cephalosporin and whether two beta-lactam antibiotics were more effective than one. Four hundred and seventy of the 519 febrile episodes entered in the study could be evaluated for response.

Physical therapy techniques in the treatment of the head and neck patient.

Limited jaw openings, which may develop following surgery and radiation therapy is a significant clinical problem. Some patients develop restricted oral opening because of extensive fibrosis and scarring of the affected tissues. The aid of the physical therapist is invaluable in the treatment of these patients.

Pitfalls and practice of Luria-Delbrück fluctuation analysis: a review.

Luria-Delbrück fluctuation analysis provides a method to estimate mutation rates in cell populations. Originally designed for bacterial populations, the method now is widely applied in somatic cell genetics and in cancer biology. However, there are fundamental genetic differences between bacteria and somatic cells, and this together with the inherent mathematical complexity of fluctuation analysis can lead to many pitfalls in its application.

Potassium inhibition of transforming protein P85gag-mos and reversal of the transformed phenotype in 6m2 cells.

K+ at high concentrations (52-72 mM hypertonic KCl) has been reported to induce reverse transformation in the 6m2 cell, which is a clone of normal rat kidney cells (NRK) infected with a temperature-sensitive transformation virus. When exposed to high K+, 6m2 cells grown at the permissive temperature (33 degrees C) exhibit normal morphology and reduced soft agar growth, characteristics of cells grown at nonpermissive temperature (39 degrees C). In the current study, flattening of cells and rearrangement of surface microvilli were demonstrated by scanning electron microscopy to occur within 6 hr of exposure to high K+, similar to the effect of temperature shift to 39 degrees C.

Analysis of metal-induced mutations altering the expression or structure of a retroviral gene in a mammalian cell line.

Carcinogenic metal compounds, with the exception of chromium(VI), have been found to be poorly mutagenic in both prokaryotic and mammalian cell mutagenesis assays, yet they are clearly clastogenic (Hansen and Stern, 1984). Thus, the role of metals as initiators in carcinogenesis has been difficult to delineate. In an effort to develop a model system capable of assaying DNA damage caused by carcinogenic metals, we have investigated the role of NiCl2, CdCl2, Na2CrO4, and NMU in a murine sarcoma virus-infected mammalian cell line in which expression of the retroviral v-mos gene is growth-temperature regulated.

Regulated expression of tumor-specific and MHC class I antigens in an ultraviolet radiation-induced murine skin cancer.

Previous studies have shown that the ultraviolet (UV) radiation-induced tumor UV-1591 expresses a novel class I antigen that functions as a tumor-specific transplantation antigen (TSTA). The purpose of this study was to determine whether expression of novel class I TSTA and expression of endogenous class I antigens in UV-1591 are regulated independently or coordinately. Expression of both TSTA and H-2Kk antigens increased simultaneously after treatment of UV-1591 cells with either 5-azadeoxycytidine (5-azaC) or interferon-gamma (IFN-gamma).

Islet cell tumors metastatic to the liver: effective palliation by sequential hepatic artery embolization.

The value of sequential percutaneous hepatic artery embolization with polyvinyl alcohol particles was examined in 22 patients with islet cell carcinoma metastatic to the liver. Nine patients had gastrinoma, 2 had glucagonoma, and 11 had no discernible hormonal secretions or syndromes. Ninety-seven embolizations were done with a median number of 4 (range, 1 to 12) per patient.