[Balloon occluded arterial infusion of CDDP combined with angiotension II in advanced bladder carcinoma].
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Biomedical subjects
Publications and source records attributed to S Onohara.
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A patient with brain metastases from prostatic cancer received chemotherapy using CDDP alone. A dose of 80 mg of CDDP was administered twice intravenously, followed by intra-arterial injections of 70 mg and 50 mg for the primary lesion over the course of three months. The main brain tumor showed a 70% decrease in size when estimated by CT, along with improvement of clinical symptoms related to the brain metastases. Intravenous injection of CDDP may thus have potential therapeutic value against metastatic brain tumors.
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ACTH-stimulation adrenal imaging (ACTH-I) was performed in 14 patients after baseline imaging (B-I) was performed. In six patients with no adrenal diseases in whom the findings of B-I were equivocal, morphologic normality of the adrenals was confirmed by ACTH-I because of increased adrenal uptake of radioiodocholesterol. In three patients with cortisol-producing tumors, visualization of contralateral glands by ACTH-I provided indirect evidence for autonomous cortisol secretion of the tumors. In three patients with pheochromocytoma or cyst, ACTH-I increased adjacent cortical radioactivity to more clearly delineate the lesions. In two patients with primary adrenocortical insufficiency, exogenous ACTH had no effect on adrenal uptake of the tracer. Correlation was observed between response of the adrenal net counts and urinary excretion of 17-OHCS and 17-KS. ACTH-I is useful when B-I does not provide sufficient diagnostic information or further information is needed due to low or absent radioiodocholesterol uptake by the adrenal gland(s).
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Cis-diamminedichloroplatinum II (CDDP; 52-169 mg/m2) mixed with angiotensin II (1.5-10 micrograms/min) was infused into the hepatic artery in 33 patients with hepatocellular carcinoma. Simultaneously, sodium thiosulfate (10-50 g) was administered intravenously in order to reduce the systemic toxicity of CDDP. Over 50 per cent reduction in tumor size was obtained in 18 patients (55%). Complete response was achieved in 4 patients (12%). Serum alpha-fetoprotein (AFP) levels decreased by more than 75 per cent in 10 of 18 patients in whom the previous AFP level was more than 200 ng/ml. The one year survival rate was estimated at 61 per cent by the Kaplan-Meier method. Alimentary symptoms (nausea, vomiting) were mild or non-existent in nearly 90 per cent of treatments. Peptic ulcer and abdominal pain were manifested in small numbers. Severe changes in the laboratory data were not observed. High dosage arterial infusion of CDDP and angiotensin II and intravenous injection of sodium thiosulfate was well tolerated and gave effective therapy in hepatocellular carcinoma.
An adrenal pheochromocytoma was visualized with thallium-201 chloride. Tl-201 concentration was observed in the cellular and vascular portion of the tumor immediately after its intravenous injection and decreased with time. Tl-201 may be a useful imaging agent for localizing pheochromocytomas.