Third whole-brain radiation therapy for multiple brain metastases. Should it be considered in selected patients?

Whole brain reirradiation for the treatment of multiple brain metastases has shown promising results. However, concerns remain over the possible neurotoxic effects of the cumulative dose as well as the questionable radiosensitivity of recurrent metastases. A second reirradiation of the whole brain is ordinarily performed in our department for palliative purposes in patients presenting with multiple metastatic brain progression. For this study, an investigational third whole brain reirradiation has been administered to highly selected patients to obtain disease control and delay progression. Clinical outcomes and neurological toxicity were also evaluated.

Survival of Japanese beetle, Popillia japonica Newman, larvae in field plots when infected with a microsporidian pathogen, Ovavesicula popilliae.

Japanese beetle, Popillia japonica Newman, is an important invasive pest that causes significant damage to golf courses, blueberries, raspberries, hops and many other crops and ornamentals in the eastern United States. This study was conducted to determine the survival of Ovavesicula popilliae-infected larvae compared with uninfected larvae from October to May. Larvae were collected from two sites, one where O. popilliae was active and one where it had not yet been detected. Larvae were placed into plastic sleeve-pots containing 15 cm-diameter cores of turfgrass with roots and soil intact. Larvae collected from both locations were put into sleeve-pots at both locations to account for soil and site factors. Results of this experiment in both years confirm that Japanese beetle larvae infected with O. popilliae do not survive well from October to May. We estimate that at an epizootic location where the pathogen has been active for several years, at least 76.5% of the Japanese beetle larvae infected in October do not survive until May. When the observed amount of population reduction (27-29%) due to natural pathogen infection of larvae in our field plots is combined with a 50% reduction in eggs produced by infected females as previously reported, annual population declines due to O. popilliae would average 40% (assuming a typical adult female infection rate of 25%). This rate of population reduction is consistent with previous reports of Japanese beetle population decline over a period of several years at O. popilliae epizootic sites.

Radiation therapy in urinary cancer: state of the art and perspective.

Invasive urinary tumours are relatively rare, and their treatment may cause important changes in urinary, sexual and social functions. A systematic review of external radiation therapy studies in urinary cancers was performed. This synthesis of the literature is based on data from meta-analyses, randomised and prospective trials and retrospective studies. There are few controlled clinical trials using adjuvant or radical radiotherapy with or without chemotherapy in cancer of the kidney, ureter and urethra. There are several reports on multimodality treatment in invasive bladder cancer: intravesical surgery and neoadjuvant chemotherapy to radiotherapy or concomitant radiochemotherapy with organ preservation. The conclusions reached for renal cancer are controversial, and data on cancers of the urethra and ureter are few and inconclusive. Sufficient data now exist in the literature to demonstrate that conservative management with organ preservation is a valuable alternative to radical cystectomy, the traditional gold standard, in invasive bladder cancer.