Adjuvant radioimmunotherapy trial with iodine-131-labeled anti-carcinoembryonic antigen monoclonal antibody F6 F(ab')2 after resection of liver metastases from colorectal cancer.

PURPOSE: To evaluate the feasibility of radioimmunotherapy (RIT) with radiolabeled anti-carcinoembryonic antigen antibodies after complete resection of liver metastases (LM) from colorectal cancer. PATIENTS AND METHODS: Twenty-two patients planned for surgery of one to four LM received a preoperative diagnostic dose of a 131I-F(ab')2-labeled anti-carcinoembryonic antigen monoclonal antibody F6 (8-10 mCi/5 mg). 131I-F(ab')2 uptake was analyzed using direct radioactivity counting, and tumor-to-normal liver ratios were recorded. Ten patients with tumor-to-normal liver ratios of >5 and three others were treated with a therapeutic injection [180-200 mCi 131I/50 mg F(ab')2] 30 to 64 days after surgery. RESULTS: Median 131I-F(ab')2 immunoreactivity in patient serum remained at 91% of initial values for up to 96 hours after injection. The main and dose-limiting-toxicity was hematologic, with 92% and 85% grades 3 to 4 neutropenia and thrombocytopenia, respectively. Complete spontaneous recovery occurred in all patients. No human anti-mouse antibody response was observed after the diagnosis dose; however, 10 of the 13 treated patients developed human anti-mouse antibody approximately 3 months later. Two treated patients presented extrahepatic metastases at the time of RIT (one bone and one abdominal node) and two relapsed within 3 months of RIT (one in the lung and the other in the liver). Two patients are still alive, and one of these is disease-free at 93 months after resection. At a median follow-up of 127 months, the median disease-free survival is 12 months and the median overall survival is 50 months. CONCLUSION: RIT is feasible in an adjuvant setting after complete resection of LM from colorectal cancer and should be considered for future trials, possibly in combination with chemotherapy, because of the generally poor prognosis of these patients.

Indoor radon and lung cancer in France.

BACKGROUND: Several case-control studies have indicated an increased risk of lung cancer linked to indoor radon exposure; others have not supported this hypothesis, partly because of a lack of statistical power. As part of a large European project, a hospital-based case-control study was carried out in 4 areas in France with relatively high radon levels. METHODS: Radon concentrations were measured in dwellings that had been occupied by the study subjects during the 5- to 30-year period before the interview. Measurements of radon concentrations were performed during a 6-month period using 2 Kodalpha LR 115 detectors (Dosirad, France), 1 in the living room and 1 in the bedroom. We examined lung cancer risk in relation to indoor radon exposure after adjustment for age, sex, region, cigarette smoking, and occupational exposure. RESULTS: We included in the analysis 486 cases and 984 controls with radon measures in at least 1 dwelling. When lung cancer risk was examined in relation to the time-weighted average radon concentration during the 5- to 30-year period, the estimated relative risks (with 95% confidence intervals) were: 0.85 (0.59-1.22), 1.19 (0.81-1.77), 1.04 (0.64-1.67), and 1.11 (0.59-2.09) for categories 50-100, 100-200, 200-400, and 400+ becquerels per cubic meter (Bq/m), respectively (reference <50 Bq/m). The estimated relative risk per 100 Bq/m was 1.04 (0.99-1.11) for all subjects and 1.07 (1.00-1.14) for subjects with complete measurements. CONCLUSIONS: Our results support the presence of a small excess lung cancer risk associated with indoor radon exposure after precise adjustment on smoking. They are in agreement with results from some other indoor radon case-control studies and with extrapolations from studies of underground miners.

Epidemiología de la lepra en Guadalupe de 1970 a 1983 / The epidemiology of leprosy in Guadeloupe from 1970 to 1983

Se estudiaron la prevalencia y la evolución de la incidencia anual de lepra en Guadalupe entre 1970 y 1983. El análisis de los datos acopiados en el servicio de control de lepra indicó que en 1981 la prevalencia era de 380 por cada 100 000 habitantes, calculada según el número de enfermos incluidos en el archivo activo del registro departamental durante 12 años en el caso de enfermos paucibacilares y durante toda la vida en el caso de enfermos multibacilares. De 1970 a 1983 la incidencia anual disminuyó de 24,0 a 13,0 por 100 000 habitantes. La disminución fue más importante en las formas de lepra paucibacilar que en las de lepra multibacilar, y mucho más importante en menores que en mayores de 15 años. El análisis de la forma de detección reveló que 80% de los enfermos se encontraron mediante la búsqueda pasiva (enfermos sintomáticos que acudieron a consulta), 10% mediante la búsqueda entre la población escolar y 10% mediante la búsqueda entre los contactos domiciliarios de enfermos conocidos. A partir de 1980 se inoculó a ratones con Mycobacterium leprae provenientes de biopsias de enfermos multibacilares para efectuar cultivos y estudiar la sensibilidad del microorganismo a la dapsona y a la rifampicina. Las 16 cepas de M. leprae provenientes de pacientes que padecían recidivas de lepra multibacilar demonstraron ser resistentes a la dapsona, y 15 de estas pusieron de manifiesto una elevada resistencia. De las 19 cepas de M. leprae provenientes de casos nuevos que nunca habían recebido tratamiento, solo ocho eran sensibles a la dapsona. Todas las cepas de M. leprae, tanto de pacientes con recidivas como de casos nuevos, resultaron ser sensibles a la rifampicina. En términos generales, los diferentes parámetros considerados indican que desde el punto devista epidemiológico la lepra ha tenido una evolución favorable en Guadalupe. Por ende, se deben mantener la infraestructura y la organización actual del control de lepra, aunque la frecuencia de la resistencia a la dapsona impone una utilización estricta de la poliquimioterapia