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An update of mortality due to brain neoplasms and other causes among employees of a petrochemical facility.

In an update of an earlier investigation of brain tumors, mortality patterns were examined for 7849 male employees who worked at a petrochemical plant from 1941 through 1983. The update added 6 years of observation (1978 to 1983). During this period, the brain tumor (BT) mortality risk declined relative to the US population, but continued to be higher than expected in hourly workers (5 observed/3.4 expected). Similar to the earlier studies, BT occurrence was not explained by patterns of production work assignments. Mortality rates for hourly and salaried workers from all causes combined, total cancer and respiratory cancer were lower than US population rates. Lower rates for these causes were also seen for white and nonwhite production and maintenance workers. Liver cancer rates were greater than expected in white production workers (3 observed/1.6 expected) and included two men assigned more than 40 years ago to vinyl chloride-related departments. Mortality rates due to malignant melanoma were elevated in white maintenance workers (5 observed/2.0 expected) and may be explained by heavy sun exposure in outdoor work.

Brain Neoplasms↗

Treatment of low malignancy brain neoplasms by means of stereotactic interstitial radiotherapy.

The authors report their results of 37 patients with low malignancy brain tumors seated in deep or highly functional areas not amenable to traditional surgery, nor to conventional radiochemotherapy. In the past 5 years these patients were treated by means of stereotactic interstitial radiotherapy. The isotope employed in all cases was 125I. Stereotactic radioisotope implants were always preceded by multiple stereotactic biopsies affording precise histological diagnoses. A 6-month to 5-year follow-up shows a survival rate of 72.6% (29 patients), and of these patients, 80.9% (26 out of 29) had complete social reentry.

Brachytherapy↗

Growth hormone therapy and tumor recurrence. Findings in children with brain neoplasms and hypopituitarism.

We report the outcome of growth hormone (GH) therapy in 34 children (17 boys and 17 girls) with brain tumors in whom hypopituitarism developed. The types of tumors included the following: craniopharyngiomas (18); germinomas (four); astrocytomas (three); chromophobe adenomas (three); medulloblastomas (two); glioma (one); dermoid (one); retinoblastoma (one); and metastatic rhabdomyosarcoma from the pelvis (one). Ninety-four percent of the patients were GH deficient post-tumor therapy, which consisted of surgery with and without radiotherapy. Twenty-four of 34 patients received GH. Eight of 24 patients receiving GH had recurrence of tumor; 16 were tumor free eight to 72 months after initial therapy. Eleven patients had 12 recurrences. Patients with tumor recurrence had a considerably lower growth rate during the first year of GH therapy than those without recurrence (mean, 3.5 +/- 1.3 cm/yr v 6.2 +/- 2.5 cm/yr). Three of 11 patients with recurrence had not received GH therapy; however, one was receiving testosterone intramuscularly monthly at the time of a second recurrence. Thus, 24 of 34 patients with brain tumors and hypopituitarism received GH therapy. Eight (33%) of 24 had tumor recurrence, compared with three (30%) of ten who did not receive GH. The data suggest that GH therapy is probably not associated with increased rate of tumor recurrence.

Adolescent↗