Adjuvant chemotherapy in surgicallyresect able locally advanced colorectal carcinoma: fluoro-uracilbiomodulationby folinicacid versus interferon

Surgical curative resection of locally advanced colorectal cancer [stage B2 and C] is unfortunately followed by high risk of recurrent malignancies. Ultimate control requires effective adjuvant therapy. The aim of this study was to evaluate efficiency of two regimens of modulation of adjuvant 5 fluorouracil [5 FU] by folinic acid versus interferon after surgical resection of locally advanced colorectal carcinoma. 105 patients with histologically proven colorectal carcinoma [stage B2 and C only] were included in this study. Patients were subjected to surgical treatment with operative resection followed by randomization into 3 groups, each of 35 patients. Group A received 5 FU alone, group B received in addition calcium leucovarin [L V], while group C received interferon in addition to 5 FU. Patients were followed up for a median of three years. All groups were comparable as regard age, sex, histological type, stage and clinical presentation. Three years overall and disease- free survival were relatively higher in patients of group B and C, that received 5 FU modulators. Also recurrence rate was less in group B and C than in group A, but not reaching a significant level. The clinical stage of the disease was the most important prognostic factor followed by the histopathological differentiation of the tumour. Most of patients tolerated chemotherapy with transient mild to moderate degree toxicities. Hematological and gastro intestinal toxicities were comparable in the 3 groups in group C there was mild toxicities related to interferon

Role of dibromdulictol as a radlosensltlzer using two radiotherapy schedules for the management of brain secondaries

The present study analyzed 70 patients with brain secondaries from solid tumours referred to Radiotherapy and Oncology Unit, Faculty of Medicine, University of Alexandria between 1988 and 1990. Whole brain irradiation was the standard method of treatment using Co-60 teletherapy. Four treatment schedules were evaluated including SO GY/2 weeks without and with Dibromdulictol [DBD] [group I and II respectively], 30 GY/3 weeks without and [group III and IV respectively]. Good to fair tolerance was observed in 16/20 [80%], 22/15 [80%] 15/20 [75%] and 13/15 [80%] in the four treatment groups respectively, P>0.05. Performance status was not significantly improved following treatment in radiotherapy + DBD groups compared to radiotherapy alone, P>0.05. Furthermore the addition of DBD to radiotherapy was accompanied, with increased, incidence of toxicities especially haematological one9 yet the latter were tolerable and reversible. Intracranlal relapses were lower. In radiotherapy and DBD than those of radiotherapy alone, P> 0.05. On the other hand, no significant survival difference was observed among different treatment groups

Role of radiation therapy in management of corpus uteri carcinoma 5 and 10 years

130 patients with different stages of endometrial adenocarcinoma were analyzed retrospectively between 1974 and 1984 divided into two groups according to the primary line of treatment whether surgical or radiotherapeutic. Group [A] 54 patients treated by surgery followed by postoperative external irradiation and/or brachytherapy. Group [B] 76 patients primarily treated by radiotherapy due to medical contraindication to surgery, refusal of surgery OF inoperability. Upper vaginal recurrences were significantly reduced by the addition of intracavitary irradiation in both groups. Five year direct survival was 40.0% while at ten years it was 25.3%. Survival was found be influenced by treatment modality, stage, and grade

role of postoperative irradiation in intracranial menlngloma

Ninety five patients with intracranial meningioims were included in this study. Total surgical removal was done in 51 patients and partial removal was done in 44 oases. Postoperative radiotherapy was applied in 63 oases depending on the extent of surgery and/or histologioal findings. Objective complete response was achieved in 67/95 of the cases. The 5 year actuarial survival rate was 93.8% in -cases with limited disease treated by complete removal alone, 89.5% in malignant types treated by complete removal and postoperative radiotherapy and 87.5% in patients whose tumours were incompletely removed and treated by radiotherapy

Hyperfractionation in the radiotherapy of carcinoma of the bilharzial bladder

Hyperfractionation schedule [three fractions per day for five consequent days] was tried in 15 patients with T3-T4 carcinoma of the bilharzial urinary bladder. The results were compared to conventional split course radiotherapy given to another matching group of 15 patients. The study showed the superiority of the hyperfractionation technique in inducing tumor regression and in improving patient's survival. Both groups of patients tolerated the complete radical course of radiotherapy

Soft tissue sarcomas in adults: a clinico-pathologic study of 215 cases

215 cases of soft tissue sarcomas were treated by surgery and irradiation [147 cases] or irradiation alone [68 cases]. These included: fibrosarcoma 86 cases, liposarcoma 44 cases, rhabdomyosarcoma 38 cases and angiosarcoma 17 cases. The other types constituted 14% of this series. The results of the study show that: 1. Simple excision and post-operative radical irradiation is the treatment of choice in early and moderately advanced local tumours. In this group of patients the rate of local tumour control was 70% and the minimum five year survival was 52%. 2. Radical radiotherapy of locally advanced non-resectable tumours is less rewarding: 25% local control and 35% five years survival. 3. The best prognosis in the whole series was seen in patients with fibrosarcomas and liposarcomas. The clinical extent and the site of the tumours were important prognostic factors

study of the changes in blood lipids in malignant disease before and after radiation therapy

Derangement of lipid metabolism was assessed in 40 cancer patients and compared with ten normal controls. The changes in blood lipid [increased levels of fatty acids, triglyceride and total lipids] were related to the extent of the tumour and the degree of tumour response to radiotherapy. The data suggest that the clinical stage can influence the degree of these abnormalities. Normal levels of blood lipids were found in patients with stage I disease and abnormally high levels in those with higher stages in both types of tumours examined. This can be attributed to increased mobilization of fats secondary either to fat-mobilizing hormone or to a neurohumoral response. The presence of intolerance to glucose and resistance to insulin in our patients may be contributing factors. Favourable response to treatment was associated with a significant drop in the blood lipids to normal or near normal levels. Treatment failure however was associated with a persistance of the abnormally high initial levels

study of the changes in carbohydrate metabolism in malignant disease before and after radiation therapy

The measured metabolic parameters in 40 patients with malignant disease, compared to ten normal subjects, showed a decreased tolerance to glucose and increased resistance to insulin. This was associated with hyperlipaemia. A positive correlation was established between the extent of the tumours and the degree of these abnormalities. Favourable clinical response to radiotherapy was accompanied with a significant improvement in glucose utilization and a greater sensitivity to insulin. This coincide with a decrease in the hyper-fatty acidaemia. By contrast, the initial intolerance to carbohydrates did not improve in patients with unfavourable response. These patients showed also diminished sensitivity to insulin and persistant hyperlipaemia