Interstitial brachytherapy in carcinoma of the penis.

AIM: Keeping in line with the increasing emphasis on organ preservation, we at the Tata Memorial Hospital have evaluated the role of Ir-192 interstitial implant as regards local control, functional and cosmetic outcome in early as well as locally recurrent carcinoma of the distal penis. PATIENTS AND METHODS: From October 1988 to December 1996, 23 patients with histopathologically proven cancer of the penis were treated with radical radiation therapy using Ir-192 temporary interstitial implant. Our patients were in the age group of 20 to 60 years. The primary lesions were T1 in 7, T2 in 7 and recurrent in 9 patients. Only 7 patients had palpable groin nodes at presentation, all of which were pathologically negative. The median dose of implant was 50 Gy (range 40 to 60 Gy), using the LDR afterloading system and the Paris system of implant rules for dosimetry. Follow-up ranged from 4 to 117 months (median 24 months). RESULTS: At last follow-up 18 of the 23 patients remained locally controlled with implant alone. Three patients failed only locally, 2 locoregionally and 1 only at the groin. Of the 5 patients who failed locally, 4 were successfully salvaged with partial penectomy and remained controlled when last seen. Local control with implant alone at 8 years was 70% by life table analysis. The patients had excellent functional and cosmetic outcome. We did not record any case of skin or soft-tissue necrosis. Only 2 patients developed meatal stenosis, both of which were treated endoscopically. CONCLUSION: Our results lead us to interpret that interstitial brachytherapy with Ir-192 offers excellent local control rates with preservation of organ and function. Penectomy can be reserved as a means for effective salvage.

[Interstitial curietherapy in penile carcinoma. Preliminary study]. / Curiethérapie interstitielle dans le carcinome pénien. Etude préliminaire.

Eight patients of histologically proven penis carcinoma treated by Iridium-192 implant are reported. The tumours were T1 in 2 patients, T2 in 5 patients and T3 in 1 patient. Groin status was N0 in 4 patients and N1-2A in 4 patients (fine needle aspiration cytology was negative in the latter 4 patients). Six patients achieved complete local control with excellent cosmetic result with follow-up ranging from 6 to 24 months. One patient who had local failure was salvaged by partial penis amputation, and one patient was lost to follow-up (LTFU). None of the patients developed groin nodes.

Estudio del consumo de once medicamentos priorizados por A.T.M. Nacional y su comportamiento en la Región III, 1986 - I Semestre 1987

Presenta el comportamiento del consumo de once medicamentos priorizados en la Región III, Managua, durante el año 1986 y el primer semestre de 1987, a fin de determinar la incidencia del consumo regional en el consumo nacional, los niveles de satisfacción de la demanda regional, la relación entre lo abastecido por el nivel central y el consumo de la Región. Los criterios para la selección de los productos a investigar fueron la demanda que tenían éstos en los distintos servicios de salud en el sector, su costo representativo dentro del presupuesto destinado para la compra y la eficacia y riesgo que presentaban éstos medicamentos. Se concluye que lo abastecido por el Centro de Abastecimiento Médico (CAN) no estaba de acuerdo a las solicitudes realizadas por la Región III; que la relación existente entre el abastecimiento por la región a las unidades y los mínimos programados de todos los medicamentos estudiados presentaban índices por debajo de un 100 por ciento. Recomiendan determinar por los niveles correspondientes las causas que motivan el no cumplimiento de los abastecimientos del CAM a las solicitudes realizadas por la Región III; estudiar las causas que las solicitudes de la Región III al CAM presentan variaciones en relación a mínimos programados y consumos históricos. Determinar un sistema de información y registros más operativo a todos los niveles que satisfagan las necesidades reales de información para poder proporcionar una mejor oferta en relación a la demanda

Acceleration of neoplasms of reticular tissue with syngeneic thymic graft under renal capsule and gamma radiation.

Weanling ICRC female mice were given syngeneic neonatal thymus graft under renal capsule and two weeks later whole-body gamma-radiation (group ITR). The findings on ITR were compared with three controls--untreated (C), thymus grafted (IT) and irradiated (IR). In ITR group 15/15 developed generalized neoplasms of reticular tissue at 5 to 8 months and single mammary tumor at 7 months. In IR group 12/13, 21/25 in IT and 5/23 in C had neoplastic changes at 7-month onwards. Microscopically these neoplasms had diffuse or focal proliferation of modified reticulum cells, histiocytes, lymphocytes and giant cells. Localized thymic tumors showed either the same picture or prominence of small lymphocytes. Mammary tumors developed in 12/25 IT, and 8/25 in C and nil in IR.

Enhancement of leukemia and mammary tumor development in ICRC mice with subcapsular graft of neonatal thymus.

Weanling ICRC mice were given a syngeneic graft of neonatal thymus. The control (C) and experimental mice (IT) were observed for their natural death. Neoplasms of the reticular tissue developed in 80% (19/23) mice of IT group and 21% (5/23) in control. Mammary tumors developed in 52% (12/23) in IT group and 35% (8/23) in controls. Cell of origin of the leukemia was reticular in 9/23, lymphocytic in 7/23 and mixed lesion in 3/23 in IT group; while in controls it was 2/23 and 3/23, respectively and mixed lesion was absent. All mammary tumors were of adenocarcinoma series.