ABSTRACT
31 patients with intermediate and high-grade non-Hodgkin lymphomas were treated by a six-drug alternating regime comprising four cycles of 200 mg/m2 i.v. methotrexate on days 8, 15, 28 and 35, 50 mg/m2 i.v. Adriamycin on day 1, 40 mg/m2 oral prednisolone on days 1-7 and 21-27, 120 mg/m2 i.v. etoposide on days 21-23, 600 mg/m2 i.v. cyclophosphamide on day 21 and 1.4 mg/m2 i.v. vincristine on day 1 (MAPECO). In all, 3 patients had stage I disease, 12 stage II, 6 stage III and 10 stage IV. Of 28 evaluable patients, 19 were complete responders (68%) and 9 were partial responders (32%); at 2 years, the actuarial relapse-free survival of the 19 patients achieving complete remission is 80%, and 5 patients remain in complete remission at 3 years. This is a preliminary report of an effective intensive regime with acceptable toxicity.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Lymphoma, Non-Hodgkin/drug therapy , Actuarial Analysis , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Cyclophosphamide/administration & dosage , Cyclophosphamide/adverse effects , Doxorubicin/administration & dosage , Doxorubicin/adverse effects , Drug Evaluation , Etoposide/administration & dosage , Etoposide/adverse effects , Humans , Lymphoma, Non-Hodgkin/mortality , Methotrexate/administration & dosage , Methotrexate/adverse effects , Middle Aged , Prednisolone/administration & dosage , Prednisolone/adverse effects , Time Factors , Vincristine/administration & dosage , Vincristine/adverse effectsABSTRACT
Fifty-four patients with musculo-aponeurotic fibromatosis treated with surgery, surgery and planned post-operative radiotherapy, or radiotherapy alone between 1936 and 1982 have been retrospectively reviewed. Twenty-seven patients had a previous excision before definitive treatment. All patients in whom surgery was known to be incomplete and who had no further treatment relapsed. Nine patients had a complete surgical excision alone and 1 relapsed. Twenty-nine patients were treated with surgery and post-operative radiotherapy and 7 relapsed. Relapse was associated with small field size, orthovoltage irradiation, and doses less than 50 Gy. Radiotherapy was effective in preventing relapse in 6 of 8 cases incompletely excised and in all of these cases the total dose was more than 50 Gy. In 13 assessable patients with clinically evident disease, 14 fields were treated with radiotherapy. Complete response was achieved in 9 fields (although one subsequently relapsed and 2 had a marginal relapse), partial response in 4, and disease stasis in one. Complete resolution took up to 21 months and total doses ranged from 35.2 Gy to 64 Gy. Radiotherapy is indicated in cases of incomplete excision and inoperable disease. Doses should be radical and fields should be sufficiently generous to encompass the anatomical limits of the infiltrated tissues.
Subject(s)
Fibroma/therapy , Adolescent , Adult , Aged , Aged, 80 and over , Child , Combined Modality Therapy , Female , Fibroma/radiotherapy , Fibroma/surgery , Humans , Male , Middle AgedABSTRACT
The Westminster Hospital treatment policy for operable breast cancer is presented in this paper and particular attention is paid to its technical aspects. The techniques of tumour lumpectomy, radical external beam irradiation and local boosting therapy with iridium implantation are described in detail. Our initial results with this approach are encouraging and will shortly be reported. In view of this and the obvious advantages of breast conservation we hope that techniques similar to this will be adopted by others working in this field.
Subject(s)
Breast Neoplasms/radiotherapy , Brachytherapy/instrumentation , Breast Neoplasms/surgery , Combined Modality Therapy , Evaluation Studies as Topic , Female , Humans , Mastectomy , Prognosis , Radiotherapy/instrumentation , Radiotherapy DosageABSTRACT
Survival and local control data are presented for a series of 109 cases of soft tissue sarcoma treated 1958--73. A five-year minimum follow-up period is available. The two-year and five-year survival rates for the complete series are respectively 80 and 68%. In a comparison of survival results for different histological subgroups we found a 94% two-year survival for liposarcomas compared with 80% for fibrosarcomas and 74% for synovial sarcomas; and five-year survivals of 73, 68 and 51% respectively. Sixty-two per cent of the series achieved local control of the disease after initial treatment, and this figure increased to 83% after further treatment. Eighty-six per cent of tumours of the extremities (66/77) were controlled locally without amputation. Of those in the complete series whose disease recurred, either locally or distantly, 50% experienced this recurrence within one year of initial treatment. In only 7% did the recurrence occur more than five years after initial treatment. These results are encouraging and we conclude that they justify an initial treatment policy of conservative surgery combined with radical radiotherapy.
