Ifosfamide in advanced carcinoma of the esophagus: a phase II trial with severe toxicity

Seventeen patients with advanced epidermoid carcinoma of the esophagus were treated with ifosfamide (IFOS) 1.5 mg/m2/day intravenously on days 1-5 every 28 days. Mesna was given concurrently at 20% of the IFOS dose prior to and 4 and 8 h after IFOS for uroprotection. Toxicity in this trial was severe since life-threatening leukopenia occurred in one patient, Grade 3 nausea and vomiting (necessitating termination of treatment) in two patients, and Grade 3 neurotoxicity (cerebellar dysfunction) in two patients. Two patients developed severe infections (Grade 3). Only four patients experienced no toxicity. One patient had a partial response with a response duration of 8 weeks. The median survival of all patients is 10 weeks. It is concluded that IFOS as given in this trial has limited activity in esophagus carcinoma with severe toxicity.     

Improved remission rates and remission duration in young women with metastatic breast cancer following combined oophorectomy and chemotherapy: a study of Cancer and Leukemia Groupe B.

One hundred fifty-seven premenopausal women with metastatic breast cancer were prospectively randomized to treatment consisting of oophorectomy + vincristine, prednisone, cyclophosphamide, methotrexate, 5-fluorouracil (VPCMF) (Reg. I) or oophorectomy + cyclophosphamide (Reg. II) or oophorectomy followed by an observation period (Phase 1), followed by VPCMF (Phase 2) (Reg. III). Complete plus partial response rates were 72% on Reg. I, 65% on Reg. II, 18% on Reg. III, Phase 1 and 50% on Reg. III, Phase 2. Median duration of response for Reg. I was 17 months, for Reg. II 16 months, and for Phase 1 and Phase 2 of Reg. III, respectively, 5 months and 8 months. The response rate for patients treated with oophorectomy plus chemotherapy is significantly higher than the response rate achieved with oophorectomy alone as first treatment following the appearance of metastases in premenopausal women.     

Blood flow imaging with MR: spin-phase phenomena

Blood flow phenomena occurring when flow is within the magnetic resonance (MR) imaging plane were analyzed. In this situation, the signal intensity of vascular lumina is predominantly determined by spin-phase change phenomena, and section transition effects of moving spins can be neglected. In this paper, we develop the concepts of in-plane flow, with emphasis on the notion that the spatial variations in velocity and acceleration of blood, which mainly occur along vessel walls, are important determinants of intravascular signal loss in MR images. Flow patterns in the large mediastinal arteries were qualitatively and quantitatively analyzed in six healthy subjects and 14 patients with hemodynamic abnormalities using multiple electrocardiograph-gated image acquisition; ungated studies of 30 patients were analyzed for venous flow effects. Intraluminal signal was strongly dependent on the phase of the cardiac cycle and the echo number. Signal loss was found to occur along vessel walls, in vascular bends, and at bifurcations.