Survival of carcinoma of the prostate patients less than 55 years old compared to older patient groups.

Both incidence and death rate from cancer of prostate are rising. Prostate cancer is the most common malignancy in man and second most common cause of death in men. Lung cancer is the leading cause of death in men. Carcinoma of prostate is generally a disease of older men. Carcinoma of prostate can also occur in the middle-aged men. This study was performed to find whether the middle-aged men survived longer than older men when both groups of patients were compared according to equivalent stage of the disease. In this series, survival is slightly better in younger age groups when patients of all stages are pooled together. Due to small number of patients in younger age groups, survival difference cannot be calculated for each stage of the disease.

Report of a prospective trial--split course versus conventional radiotherapy in the treatment of non small cell lung cancer.

A prospective randomized trial was started in January 1982, to compare morbidity and survival of two different radiation regimens for the treatment of non-small cell lung cancer (NSCLC). The trial was closed in December 1988. One group of patients was treated by conventional daily radiation therapy, and the other group by split course therapy. To maintain uniformity, a single physician staged and treated all patients and noted morbidity during treatment. Two hundred seventy-three consecutive lung cancer patients were treated. Only patients who completed the full radiation therapy course were included in this study. One hundred fourteen patients were treated with split course therapy, and 159 patients were treated by conventional daily radiation therapy. A few patients did not return for the second course of treatment, which accounts for the different number of patients in the two arms of the study. There was no statistically significant difference in survival between the two arms. Median survival for the split course and the continuous fraction therapy regimens was 11.6 months and 10.9 months, respectively. Split course radiation was associated with less morbidity.

Management of brain metastases: past, present, and future.

Brain metastasis is an important cause of morbidity and mortality in cancer patients. Because most of these patients die of systemic disease, the primary therapeutic goal is to improve the quality of life. Conventional therapy for brain metastases is usually whole-brain irradiation. Chemotherapy often results in regression of brain metastases in chemosensitive tumors. We review our institutional experience in the treatment of brain metastasis with both radiation and chemotherapy. In the future, improvement in the management of brain metastases will depend on improved chemotherapy, radiosensitizers, and radiotherapy techniques such as stereotactic radiosurgery.

Management of malignant thymoma.

Six cases of malignant thymoma were treated by various methods, i.e., surgery, radiotherapy and chemotherapy. The combination of surgery and radiotherapy seems to be the most effective method of treatment. Histology does not seem to influence survival.

Comparison of survival of black and white patients in each stage of Hodgkin's disease during 1970-1980.

A survival and mortality study of all the patients referred to the radiotherapy department between 1970 and 1980 with a diagnosis of Hodgkin's disease was performed. Generally, black patients with cancer have a poorer survival rate compared with that of white patients with cancer, as reported by the U.S. Department of Health and Human Services. In this series, no difference in survival and mortality was found between patients of the two races when they were compared in each stage of Hodgkin's disease.

Combined therapy as an alternative to exenteration for locally advanced vulvovaginal cancer. II. Results, complications, and dosimetric and surgical considerations.

We have introduced a therapeutic alternative to exenteration for locally advanced vulvovaginal cancer using surgery for the vulvar (external genital) phase of this disease presentation, combined with radiotherapy for the internal genital phase (with adequate overlap of fields to protect surgical margins). The rationale is that this approach treats the cancer and its dual regional spread patterns, while at the same time preserving the bladder and/or rectum, and should be associated with less morbidity and mortality than exenterative surgery. This report updates our experience with a total of 48 treated cases (37 primary cases and 11 cases of recurrent disease). Of the 37 primary cases, 20 were FIGO stage III, 4 were FIGO stage IV, and 3 other cases represented "field" cancers involving vulva and/or cervix and/or vagina. Utilizing a Life Table analysis, the 5-year survival for the primary cases was 75.6%. Published FIGO survival for stage III is 32% and for stage IV 10.5%. Life Table analysis projects a 62.6% survival for recurrent cases and an overall 72% 5-year survival for all 48 cases treated. With 48 patients treated, 48 bladders and 48 rectums were at risk for surgical removal had exenteration been employed. One patient had a total pelvic exenteration for local failure, and one had a posterior exenteration for local failure. One bladder and one rectum were lost to permanent diversion because of radiation injury. Thus, 5 of these major viscera were lost of the 96 total, and 91 (94.8%) were retained. Radiation therapy and surgical details have been reviewed relevant to local control and local failure and complications. The continuing evolution of treatment modifications of all modalities will be discussed. The apparent advantages of this combined therapeutic approach over exenterative surgery include high probability of bladder and/or rectal preservation, low primary mortality, low treatment morbidity, and very good results in cancer control.

Carcinoma of the piriform sinus.

Carcinoma of the piriform sinus is one of the most aggressive tumors of the head and neck region. Almost 80% to 90% of the patients will be first seen in the advanced stages. No method of treatment is satisfactory. We present results of various methods of treatment, of which the combination of surgery and radiotherapy may be the best.

Malignant fibrous histiocytoma arising from chronic ulcer.

A patient had malignant fibrous histiocytoma that developed in a chronic ulcer. Squamous cell carcinoma can develop on long-standing ulcers, but malignant fibrous histiocytoma developing in an ulcer is extremely rare.

Oxygen at 2 atmospheres absolute pressure does not increase the radiation sensitivity of normal brain in rats.

Cranial radiation was administered to CD Fisher rats at 1.0, 1.5 and 2.0 atmospheres absolute oxygen pressure. Life span following radiation was recorded. Surviving animals were killed at 28 weeks and the brains were examined independently by two neuropathologists. Survival time was significantly less in animals receiving higher doses of radiation but showed no relationship to the oxygen pressure in the environment of the animal at the time radiation was administered. Microscopic examination of the brain did not reveal any differences in animals radiated in a normobaric or hyperbaric oxygen environment. It is concluded that hyperbaric oxygen does not sensitize the normal brain to the effects of ionizing radiation.

Thymus irradiation for myasthenia gravis.

Twenty-eight patients with progressive myasthenia gravis without thymoma received treatment of 3000 rads (30 Gy) to the anterior mediastinum, and a followup was conducted for five to 18 years. Twenty-four patients had generalized myasthenia, and four had ocular myasthenia gravis. Twenty patients with generalized myasthenia survived the several month post-treatment period and improved, but four died during that period. The improvement lasted a median of 1.5 years, and older patients had longer remissions than younger patients. The four patients who had ocular myasthenia did not change after treatment. Mediastinal irradiation produces a temporary remission in generalized myasthenia.