Improved therapeutic index by leucovorin of edatrexate, cyclophosphamide, and cisplatin regimen for non-small-cell lung cancer.
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Biomedical subjects
Publications and source records attributed to H I Libshitz.
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Six opossums were evaluated as a possible animal model of radiation esophagitis. In a single exposure to the esophagus, four animals received 60Co radiation of various doses; two served as controls. Pre- and postirradiation evaluations using fiberoptic endoscopy, mucosal biopsy, barium esophagography, and manometry were performed. Esophagitis developed at one week in irradiated animals. Opossums receiving 17.5, 20, and 22.5 Gy (1,750; 2,000; and 2,250 rad) became anorexic one week postirradiation, and abnormal motility subsequently developed. The controls and the animal receiving 15 Gy (1,500 rad) remained normal. Histological changes in the irradiated opossum esophagus resembled those found in humans.
The skeletal effects of megavoltage irradiation (60Co) in 25 long term survivors of Wilms' tumor are described. In general, the changes seen with megavoltage irradiation are as frequent but not as severe as those previously reported after orthovoltage irradiation. Vertebral body changes generally occur within 5 years after irradiation. Scoliosis and/or kyphosis do not usually develop until after five years postirradiation. Kyphotic curves tend to progress after the adolescent growth spurt while scoliotic curves do not. Other bony and nonosseous changes are detailed.
In 103 patients with a diagnosis of carcinoma of the esophagus, admission chest films were reviewed for abnormal findings attributable to the carcinoma. The presence or absence of these findings was analyzed and correlated with tumor resectability, complications, overall survival, and survival as related to tumor location. Unexpectedly, the group of patients who had normal films had a lower resectability rate (30% vs. 41%). There was no significant difference in survival rates of patients with or without chest film abnormalities (12.4 vs. 11.7 months).
Single and double contrast barium esophagram examinations were performed on 42 opossums. Each animal was anesthetized with pentabarbital sodium, a catheter was placed in the esophagus, and barium or barium and air were injected into the esophagus. Two radiographs per second for 7 seconds were taken. The radiographs were reproducible and of high quality.
Ultrasonographic findings in 13 right adrenal gland neoplasms were reviewed. Primary malignancy was the etiology in four patients and metastatic malignancy in nine. Anterior displacement and/or indentation of the posterior aspect of the inferior vena cava was present in nine patients. This sign, although nonspecific, helpful in the localization and diagnosis of right adrenal lesions.
Mediastinal germ cell tumors are a rare primary malignancy. An overview of the presenting clinical symptoms, radiographic appearance, patterns of extention and metastasis, and autopsy findings are presented. The difficulty in totally excluding an occult gonadal primary lesion in noted. The theories of the genesis of these tumors are briefly reviewed.
Review of the number of lung cancers subsequently developing in patients with chronic leukemia or lymphoma revealed a statistically significant (p less than .001) increase in the incidence of lung cancer in these patients. Of 684 patients with chronic leukemia seen between 1961 and 1972 (followed through 1976), 19 developed lung cancer versus 3 expected cases. Of 2708 patients with lymphoma seen in the same period, 23 developed lung cancer versus 7 expected cases. These data indicate that lung cancer be given serious consideration when a new pulmonary lesion is noted in these patients, and biopsy may be warranted.
Two patients who received radiation therapy to the thorax and who developed recurrent spontaneous pneumothoraces are presented. Patients with recurrent pneumothoraces secondary to radiation have not been described previously. Pleural changes secondary to radiation may contribute significantly to the complicated clinical course of these patients.
Skin thickening of the breasts of 22 women undergoing excision biopsy of a breast cancer and subsequent radiation therapy to 5,000 rad is considered. The skin thickness of the treated breast returned to normal in 17 of 22 patients studied. Of the 17, nearly 60% returned to normal in 2 years, over 80% in 3 years, and the rest by 4 years. The period of follow-up was less than 4 years in the five patients with residual skin thickening. The alterations in skin thickness are consistent with the histopathologic changes seen in radiation dermatitis.
Lymphangiographic appearance following radiotherapy is described in 21 patients with pre- and posttherapy lymphangiograms. Following radiotherapy to normal lymphatics, decrease in nodal size and lymph vessel caliber is noted uniformly after 12 months. Before 12 months the development of these changes is variable and may not be seen, especially during the first several months. Following irradiation of abnormal lymph nodes, dilatation of the lymph vessels distal to the abnormal nodes may occur. These lymphangiographic findings can be related to histologic changes seen in lymph nodes after radiation therapy.
Two ankylosing spondylitis patients with upper lobe fibrocystic disease are reported. The occurrence of pulmonary parenchymal disease as part of the primary pathologic process in ankylosing spondylitis is now accepted as an integral part of the disease. The frequency of superinfection of cavitary lung disease with Aspergillus is noted. Another unusual superinfection, Mycobacterium scrofulaceum, is reported.
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Breast cancer screening detected 139 biopsy-proved malignancies in 16,000 slef-selected women (8.7/1,000). In these, xeroradiography detected 78% (109), clinical examination 55% (76), and thermography 39% (54). In all 16,000 women, the thermogram was interpreted as positive in 17.9% (2,864). The greatest effectiveness of mammography vs. clinical examination was seen in detection of early breast cancers (small lesions with negative axillary lymph nodes). In this group, thermography was less effective than it was in patients with larger lesions and lymph node metastases.
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Findings by xeromammography and clinical examination were compared in 16,000 self-selected women aged 45-64 who participated in a voluntary breast cancer screening program. A total of 138 malignancies were detected: 108 (78%) by mammography and 78 (57%) by clinical examination. Mammography was more effective for large breasts, fatty breasts, and in older women. Conversely, clinical examination was more effective for small breasts, dense breasts, and retroareolar lesions. Clinical detection decreased strikingly for lesions with negative lymph nodes, in situ and microinvasive lesions, deeply situated lesions, and lesions where microcalcifications were the sole mammographic finding.
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Mammograms of 81 patients who received radiation therapy to the breast were analyzed for patterns of pre- and postirradiation calcifications. Malignant calcifications may remain stable, diminish, or completely disappear following irradiation. The persistence of calcifications need not indicate residual cancer. Calcifications can develop following irradiation which are similar to either intraductal or secretory calcifications. Unusual calcifications may develop at the site of an irradiated cancer. It is important to recognize that benign calcifications can develop so that they will not be confused with recurrent malignancy.