Difficulties using the Franco-Italian Glossary in assessing toxicity of cervical cancer treatment

Shakespeare TP, Ferrier AJ, Holecek MJ, Jagavkar RS, Stevens MJ. Difficulties using the Franco-Italian Glossary in assessing toxicity of cervical cancer treatment. Int J Gynecol Cancer 1998; 8: 51–55
We assessed the toxicities of patients treated for cervical cancer using the revised Franco-Italian Glossary (FIG). A total of 69 separate complications were appraised in 47 patients; however, only 43.5% of these side-effects could be accurately graded. In all, 56.5% of toxicities could not be scored for a variety of reasons: (1) the FIG does not account for all possible complications of cervical cancer treatment; (2) some important toxicities are regarded as too minor to be graded; (3) subjective assessment of some side-effects did not allow consensus to be reached when assigning a grade; (4) we could not accurately score toxicities using the FIG in a retrospective manner. Previous studies utilizing the FIG retrospectively have noted few problems with its use, with no indication of the number of toxicities unable to be graded. In view of the inability to grade the majority of complications in the present study in an accurate manner, we conclude that the revised FIG requires detailed data that are best collected prospectively and that several minor modifications of the glossary should be considered. Results of studies using the glossary retrospectively should be viewed with caution.     

食管癌加速超分割放疗的临床研究

目的：评价加速超分割放射治疗食管癌的疗效。方法：食管鳞癌９８例随机分为常规组和加速超分割组。常规组：１８０～２００ｃＧｙ／次，５次／周，总量６０００～７０００ｃＧｙ／６～７周；加速超分割组：１５０ｃＧｙ／次，２次／日，间隔６小时，总量５４００ｃＧｙ／３５周。两组病人均采用６０Ｃｏ远距离外照射。结果：常规组１，３，５年生存率分别为４６％（２３／５０）、２０％（１０／５０）、１２％（６／５０）；加速超分割组１，３，５年生存率分别为７０８％（３４／４８）、３９６％（１９／４８）、２９２％（１４／４８），加速超分割组明显优于常规组（Ｐ＜００５），而两组放疗反应和并发症无明显差异。结论：加速超分割放疗能明显提高食管癌病人的生存率，但不增加放疗反应及并发症。     

Copper radionuclides and radiopharmaceuticals in nuclear medicine

The chemistry, radiochemistry, radiobiology, and radiopharmacology of radiopharmaceuticals containing copper radionuclides are reviewed. Copper radionuclides offer application in positron emission tomography, targeted radiotherapy, and single photon imaging. The chemistry of copper is relatively simple and well-suited to radiopharmaceutical application. Current radiopharmaceuticals include biomolecules labelled via bifunctional chelators primarily based on cyclic polyaminocarboxylates and polyamines, and pyruvaldehyde-bis(N⁴-methylthiosemicarbazone) (PTSM) and its analogues. The chemistry of copper, of which only a fraction has yet been exploited, is likely to be applied more fully in the future.     

恶性梗阻性黄疸的外科姑息治疗

不能切除肿瘤的恶性梗阻性黄疸的外科姑息治疗方法繁多，本文介绍自1989年以来，采取开腹经不同途径的带支撑导管胆肠内引流的方法治疗30例，减黄确切，尚对7例高位胆管癌在解除胆道梗阻的基础上行术后(192)Ir和(60)Co联合放疗，提高了病人生存质量及延长了生命。     

三维适形放射治疗门静脉癌栓23例

目的探讨三维适形放射治疗门脉癌栓的近期疗效.资料与方法 23例均为肝癌介入治疗后出现门静脉癌栓,其中原发性肝癌8例,转移性肝癌15例,所有病人均在介入治疗2～4次后出现门静脉癌栓.采用三维适形照射的方法,每例均设定4～6个非共面野,单次照射剂量3～7Gy,6～15次,每日或隔日照射,总剂量42～48 Gy.结果总有效率3个月为82.6%,6个月为95.7%,Kaplan-Meier分析法,1、2、3年生存率分别为82.6%、43.5%和26.1%,中位生存期14个月.Cox回归分析提示Child-Pugh肝功能分级和单次照射剂量与预后有关.结论三维适形放射治疗肝癌介入后门静脉癌栓是一种方法简单、病人易于接受、近期疗效显著的可行性方法,值得临床推广.     

Response of Orbital and Central Nervous System Metastases of Retinoblastoma Following Treatment with Cyclophosphamide/Doxorubicin

A 3.5-year-old boy with orbital and central nervous system extension of unilateral retinoblastoma received chemotherapy consisting of intravenous cyclophosphamide and doxorubicin and intrathecal methotrexate. Complete shrinkage of orbital tumor, phthisis bulbi,'and disappearance of intracranial metastases occurred following chemotherapy. Response of the intra-cranial tumors reflected the combined effects of cyclophosphamide and doxorubicin; the contribution of each agent could not be assessed. Cerebrospinal fluid tumor cells persisted prior to delivery of craniospinal irradiation, and were detected again 6 weeks after completion of irradiation.     

肺癌放疗或化疗后的病理形态及PCNA,p53表达的观察

应用抗增殖细胞核抗原和抑癌基因ｐ５３蛋白的单克隆抗体对３７例放疗或化疗后的肺癌进行了检测，并与未经术前治疗的肺癌组织进行对照，部分组织进行了超微结构观察。结果发现：（１）放疗或化疗对肺癌组织细胞浆及胞核有不同程度的破坏。（２）放、化疗后组织（除分化型腺癌外）ＰＣＮＡ指数下降明显（Ｐ＜０．０１或Ｐ＜０．０５）。（３）放疗后肺癌组织ｐ５３表达率减低，但化疗后变化不明显。     

视网膜母细胞瘤术后随访

复查69例视网膜母细胞瘤,56眼进入青光眼期。病理检查:未分化型占80%,对肿瘤细胞已浸润至视网膜、玻璃体及视神经断端者,术后深部X线或钴~(60)照射,很有价值,可提高存活率。本病易误诊为眼内炎、青光眼等。     

Epidural compression from metastatic tumor with resultant paralysis

To determine the value of the usually given urgent palliative radiotherapy in paraplegic patients with epidural compression from metastatic tumor, 20 consecutive cases treated between 1981 and 1986 were retrospectively analyzed. Bronchogenic and prostatic carcinoma were the more common extraspinal sources of metastasis. Epidural metastasis involved the thoracic spine in most cases. The onset of neurological symptomatology was frequently within two weeks prior to hospitalization. The majority of the subjects received at least 3000 cGy given in 10 to 15 fractions. Symptomatic (pain relief) response rate was 78 (7/9) percent. The observed period of survival averaged 2.5 months after treatment. This study reaffirmed the little chance for recovery of lost limb(s) motor function. None of the patients (most of whom were paraplegic from two to 90 days pre-irradiation) became ambulatory including the two in whom irradiation was administered within 24 hours from the onset of paraplegia.