The analysis of peri-tumor necrosis following the subcutaneous implantation of autologous tumor cells transfected with an episome transcribing an antisense insulin-like growth factor 1 RNA in a glioblastoma multiforme subject.

A subject inflicted with glioblastoma multiforme who received partial tumor resection and radiotherapy was recruited for an ex vivo gene therapy protocol using irradiated autologous tumor cells that had been engineered to suppress the expression of insulin-like growth factor I as the tumor vaccine. After subcutaneous injection for 8 weeks, the subject developed peri-tumor necrosis with mass effect. The authors wondered whether this event could have resulted from the tumor vaccine. The tissue section bordering the necrotic tumor tissue to the viable normal tissue was examined for nature of any infiltrated cells and their activities. Lymphocytes, macrophages, and a small number of neutrophils diffused into the necrotic tumor tissue were found. The infiltrated lymphocytes consisted of both CD4+ and CD8+ T cells. The functional activity of these lymphocytes was demonstrated by the active production of interferon y and tumor necrosis factor alpha based on the respective immunofluorescent staining localized to these cells. This finding is compatible with the proposed mechanism underlying the tumor vaccination. However, the contribution of radiation treatment to this event cannot be clearly ruled out.

The efficacy of chemically-stabilized chlorite-matrix (TCDO) in the management of late postradiation cystitis.

Carcinoma of the uterine cervix is the most common cancer of women in Thailand. The most frequent complication after pelvic radiation for uterine cancer is radiation cystitis. The management of severe late postradiation cystis is far from satisfactory. The objective of this study was to evaluate the efficacy of chemically-stabilized chlorite-matrix (TCDO) in patients with severe radiation cystitis. This study was conducted at the Department of Obstetrics and Gynecology, Ramathibodi Hospital and the Department of Radiology, Siriraj Hospital between September 1997 and September 1998. Twenty patients with grade 3 radiation cystitis after radiotherapy were enrolled into this study. TCDO was administered at a dose of 0.5 ml/kg body weight per day on 5 consecutive days as intravenous infusion over 4 hours. The response rate after the first cycle was 80 per cent with 30 per cent of the patients showing complete response. The follow-up time (13 patients) ranging from 1-9 months revealed no recurrent bleeding. There were no side effects from TCDO therapy. The result suggests good efficacy of TCDO in the treatment of postradiation cystitis.

Neoadjuvant carboplatin & 5 fluorouracil combination chemotherapy and radiotherapy in the treatment of locally advanced head and neck cancer: primary report.

We studied the effect of neoadjuvant carboplatin/5-FU combination chemotherapy and radiotherapy in the treatment of 53 patients with locally advanced head and neck cancer in Siriraj Hospital. Carboplatin 350-450 mg/m2 I.V. on day 1, and 5-FU 1,000 mg/m2/d on days 1-4, were administered either on an in- or out-patient basis. We obtained a response rate of 85 per cent, with 13 per cent complete response after 2-3 cycles of neoadjuvant chemotherapy. After the completion of subsequent radiotherapy, the response rate increased to 94 per cent, with 40 per cent CR. After the additional 2-3 cycles of postradiation chemotherapy, the final overall response rate was 96 per cent, with 77 per cent CR. Only 4 per cent of patients had grade 3 GI toxicity and 25 per cent of patients had grade 2, 3 myelosuppression. All patients tolerated the treatment very well. Long-term study for the duration time of response and survival are being collected.