Better survival after combined modality care for adults with Wilms' tumor: a report from the National Wilms' Tumor Study

Article Abstract:

Wilms' tumor is one of the most common childhood tumors. It is rare in adults, however, and its actual prevalence is difficult to determine since it is often categorized with other tumors of the kidney and diagnoses are not always well documented. Wilms' tumor is a tumor of embryonic tissue, but unlike teratomas, which involve all three embryonic layers, Wilms' tumor involves only mesoderm. The prognosis for Wilms' tumor has been poor, but new treatments are improving the outlook. Twenty-seven cases of Wilms' tumor in adults were reviewed to determine if the therapeutic improvements that have been developed for children are benefitting adult patients as well. The case review showed that the adult patients, who were seen between 1979 and 1987, had a 3-year survival rate of 67 percent; this is markedly better than the 24 percent survival reported in the past. It was possible to arrive at several specific recommendations based on this case review. Radiation therapy is not necessary for patients with Stage I disease and favorable histological appearance. Following surgical removal of the tumor, six months of chemotherapy with actinomycin D and vincristine is most appropriate for these patients. However, for patients with more advanced tumors, a longer and more aggressive chemotherapeutic protocol including doxorubicin is necessary. Furthermore, 2,000 cGy irradiation should be applied to the tumor bed (a Gy, or Gary, is 1 joule of energy absorbed per kilogram of tissue), and between 1,200 and 1,500 cGy to the lungs, and 2,000 cGy to the liver if there is indication that these organs are involved. In addition, 3,000 cGy should be applied wherever appropriate if metastases are present. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Prognosis, Demographic aspects, Nephroblastoma, Tumors, Embryonal, Embryonal tumors

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Combined modality therapy for locally advanced non-small cell lung carcinoma

Article Abstract:

Approximately one third of non-small cell lung cancer patients are diagnosed with locally advanced disease. Only a small subset of such patients have cancers that are treatable with surgery. The majority are treated with radiation alone, with a poor chance for long-term survival. To improve the prospects for such patients, a new protocol was designed to combine radiotherapy with chemotherapy using cisplatin, 5-fluorouracil, and etoposide. Previous research has shown that cisplatin sensitizes cells to the effects of radiation, and also exerts a synergistic cell-killing effect with 5-fluorouracil. Concurrent chemotherapy and radiation therapy was given to 64 patients with Stage III non-small cell lung cancer; 60 of the patients were fully evaluable for purposes of the study. In 28 patients, the cancer was operable, and in 23 patients, surgical resection of the cancer was actually performed. An overall three-year disease-free survival rate of 23 percent was observed. Among the 23 patients whose cancer was surgically resected, the three-year disease-free survival rate was 45 percent. A histological evaluation of the response to combined radiotherapy and chemotherapy was made in the 23 patients who underwent surgical removal of their tumor. The histological response rate was 39 percent, which compares favorably with the 27 to 35 percent cited in other published reports. The results suggest that the combined modality treatment is feasible. However, local recurrence of tumor was comparable to that achieved using radiotherapy alone, which suggests that higher doses of chemotherapy may be appropriate. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Radiotherapy, Chemotherapy, Lung cancer, Non-small cell, Non-small cell lung cancer

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SCID mice with HIV encephalitis develop behavioral abnormalities

Article Abstract:

Mice with combined immunodeficiencies develop a condition similar to HIV dementia when they are injected cerebrally with HIV-infected human monocytes. In order to develop a model for study, the mice were reinjected every four weeks for three months. The similarities include brain tumors, forgetful behavior, diminished cognitive function and other symptoms. This suggests that further research might be useful in developing and determining medications and management procedures.

Research, Complications and side effects, HIV infection, HIV infections, Dementia, Encephalitis

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