Neoadjuvant chemotherapy in marginally resectable stage III M0 non-small cell lung cancer: long-term follow-up in 41 patients

Forty-one patients with marginally resectable stage III M0 non-small cell lung cancer (NSCLC) were entered into a study evaluating neoadjuvant cyclophosphamide, adriamycin, and cisplatin chemotherapy (CAP) followed by radiotherapy and subsequent resection. Postoperative radiotherapy and additional CAP were also administered. The objective disease regression rate prior to surgery was 72% (2 complete, 12 partial, and 7 minimal responses). Thoracotomy was carried out in 37 patients (90%), with resection of all gross disease in 36 patients (97%). Relapse occurred in 22 (61%) of the resected patients, involving chest only (four patients), chest and extra thoracic (nine patients), and extra thoracic only (nine patients). Subsequent CNS relapse developed in 9 (25%) of 36 postop patients in association with other sites of relapse (five patients) or as a solitary location (four patients). Only one of seven patients receiving prophylactic cranial irradiation (PCI) developed CNS relapse compared with 7 (26%) of 27 patients not receiving PCI. The median long-term follow-up for 14 living patients is 53+ months, with a rang of 38+ to 71+ months. Median survival for all patients is 32 months, with 1-year survival being 75%. The survival curve shows a plateau of 31% from 3 to 5+ years. Using a log rank test, no prognostic subgroups could be identified that significantly affected response rate, disease-free survival, or overall survival. While neoadjuvant CAP followed by radiotherapy appears to improve survival, more effective chemotherapy along with randomized studies are needed to determine the role of initial chemotherapy in marginally resectable NSCLC.     

辐射后骨髓造血基质细胞对粒系造血祖细胞生长的影响

本文观察了骨髓造血基质细胞贴壁层及细胞悬液对 GM-CFU-C 生长的影响及照射后的变化。实验结果表明,骨髓基质细胞贴壁层及细胞悬液均有增高 GM-CFU-C 产率的作用。这种刺激性影响与基质细胞贴壁层的细胞密度和细胞悬液的浓度没有依赖关系。1～5Gyγ线照射的骨髓基质细胞贴壁层和细胞悬液支持 GM-CFU-C 集落生成的作用明显削弱。文中讨论了造血基质细胞的辐射损伤在放射病骨髓综合征发病机理中的意义。     

Treatment of Cushing's Disease in Childhood and Adolescence by Stereotactic Pituitary Irradiation

ABSTRACT. Eight children with Cushing's disease aged 6-18 years were treated with external radiation to the pituitary gland using ⁶⁰Co gamma radiation given with stereotactic technique. The dose given varied between 50 and 70 Gy. The observation time was 2.6 to 6.75 years. Seven children had a clinical remission with normal urinary Cortisol excretion. One child had insufficent effect of two irradiations and underwent bilateral adrenalectomy. In the patients in remission the growth velocity increased during the first year after treatment but growth retardation occurred again during the second year. Insufficient growth hormone secretion was demonstrated in all subjects. Two patients were given thyroxine substitution and three showed evidence for secondary hypogonadism. In conclusion, stereotactic pituitary irradiation was effective in normalizing the excessive glucocorticoid production in children with Cushing's disease. However, with the doses used, it was not possible to maintain a normal anterior pituitary function.     

低剂量辐射对大鼠营养代谢的影响

雄性Ｗｉｓｔａｒ大鼠３０只，随机分为两组：实验组￣（１８７）Ｃｓ２３．５ｍＧｙ照射，每周一次，实验期３个月，总照射剂量２８０ｍＧｙ；对照组正常饲养。观察低剂量辐射对大鼠营养代谢的影响，结果表明：与对照组相比血清维生素Ａ、Ｅ水平无明显变化；血清总蛋白含量有所下降，氨基酸升高；血清常量元素升高，微量元素下降，但均无统计学显著性；尿维生素Ｂ＿１、Ｂ＿２排出量明显高于对照组水平，血清铁明显下降，具有统计学意义。     

Wilms' Tumor Complicated by Veno-Occlusive Disease of the Liver (VOD): Current Concepts and a Case Report

A 2-year-old boy, undergoing treatment for Wilms' tumor, developed in some respects unusual manifestations of veno-occlusive disease of the liver. Reporting the case, we also review the current clinical and radiological concepts of this neglected complication of cancer therapy. Misinterpretation of symptoms and signs is probably rather common and may prove fatal. Recognition of the disorder calls for immediate discontinuation of chemotherapy and irradiation. Supportive intensive care is frequently necessary. Following recovery, cautiously tailored tumor therapy may be reinstated.     

Exposure of UVB-sensitive mice to immunosuppressive doses of UVB in vivo fails to affect the accessory function or the phenotype of draining lymph node dendritic cells

Abstract Following the application of sensitizing chemicals to the skin, hapten-bearing Langerhans cells (LC) and possibly other cutaneous dendritie-cells (DC) migrate to the draining lymph nodes (DLN) of mice and induce the proliferation of antigen specific effector T cells. This migration of DC to the DLN is required for the induction of primary immune responses. In certain strains of mice, irradiation with ultraviolet-B light (UVB) before sensitization results in the suppression of contact hypersensitivity responses. in vitro investigations have suggested that one influence of UVB is to modify the ability of Langerhans cells (LC) to present antigen. In the present investigation, putative UVB-induced alterations in lymph node DC in vivo were examined. Lymph node DC were analysed following exposure of C3H/HeN mice to an immunosuppressive dose of UVB (1440 J/m²) 48 and 24 h prior to skin painting with the sensitizers fluorescein isothiocyanate or oxazolone. In functional studies. DC prepared from the DLN of contact sensitized mice were examined for their ability to induce hapten-specific secondary T-lymphocyte proliferative responses or mixed lymphocyte reactions in vitro. It neither case was the activity of DC influenced by local exposure to an immunosuppressive dose of UVB. The migration of LC from the epidermis to the draining lymph node in response to contact sensitization is associated with increased expression of several membrane determinants necessary for effective antigen presentation, including intercellular adhesion molecule-1 (ICAM-I: CD54), B7-2 (CD86) and la antigen. The expression of these molecules was identical on DC isolated from the DLN of UVB-irradiated and from control, unirradiated mice. Thus, the immunosuppressive effect of UVB on Ihe cutaneous immune system may not necessarily reflect changes in the antigen-presenting DC that accumulate in the DLN following skin sensitization.     

Hypoplasty of the breast due to x-ray irradiation

We treated five women with hypoplasty of the breast induced by radiation. Only one of these women underwent mammaplasty with the use of a latissimus dorsi muscle flap and prosthesis. Hypoplasty of the breast is considered a result of imprudent utilization of x-ray irradiation of young patients with benign skin diseases. To prevent underdevelopment and hypoplasty, attention must be directed to the risk involved in radiation therapy for benign diseases.     

小鼠放射损伤和放烧复合伤的肠上皮畸形细胞

140只小鼠,分为单放(~(60)Co 12Gy)、放烧(12Gy+15％体表皮肤Ⅲ度烧伤)和正常对照组。观察小肠上皮畸形细胞的形成及转归。认为小肠隐窝受射线损伤较重的幼稚细胞增殖周期受到严重阻滞,G_1期到G_2期均延长逐渐形成畸形细胞。有的畸形细胞不分裂直到脱落;有的发生流产性增殖;有的则发生病理性核分裂,从而形成形态多样化细胞。难以证实畸形细胞能起到修复肠上皮的作用,但它可能具有一定的吸收、分泌功能,并起到一定的屏障作用。     

头部X线照射对去胸腺雄性大鼠神经内分必功能的影响

初生48h内去胸腺的成年雄性大鼠下丘脑-垂-体-性腺及皮质系统功能发生改变。经10GyX线头部照射后2天,除了下丘脑M-Enk含量增加外,血清LH和FSH、血尿睾丸酮和皮质酮、垂体和睾丸cAMP以及下丘脑β-EP和L-Enk含量都有不同程度降低,与正常雄性大鼠头部照射后的变化不一致。这些结果提示,由于去胸腺大鼠影响了神经内分泌功能,不可能产生正常大鼠头部照射后所见到的那些变化。     

微波内照射犬肝的生物学效应—肝、脾、淋巴结、骨髓及血清酶的变化

本文报道采用单极同轴天线插入犬肝行微波内照射实验研研。输入功率为60w,作用时间为单根天线插两次,每次照射3分钟;术后2小时、7天、14天和28天,将犬分别处死,取肝,脾和肠系膜、肝门及胸骨后淋巴结活检并作骨髓涂片,与未作微波照射犬取同种组织对照。肠系膜淋巴结的滤泡数,其皮质与髓质的比值;和脾脏滤泡数等术前及术后比铰,相差非常显著。提示微波内照射后机体的体液免疫有增加现象。 肝组织形态变化分三个区:坏死区、纤维肉芽组织区和活肝区。发现坏死区内有较多高热气囊肿形成。降低输入功率后,可避免较大的气囊肿形成。