Nodular hepatocellular carcinoma: treatment with subsegmental intraarterial injection of iodine 131-labelled iodized oil

Article Abstract:

Hepatocellular carcinoma is a form of liver cancer; this malignancy is more common in Asian nations than in the United States. The prognosis for this form of liver cancer is quite poor, and the average survival time may be around six months. Although the liver cancers may be quite small at the time of diagnosis, surgery is often impossible; the cancer may be in an inoperable site or may be scattered in several places. Furthermore, patients with hepatocellular carcinoma are also very likely to have liver cirrhosis, which may also make liver surgery impractical. Researchers have observed that oily substances injected into the main liver artery (for purposes of enhancing X-rays) seemed to be preferentially retained by cancerous over normal tissue. This fact may prove useful in designing treatments for hepatocellular carcinoma. Lipiodol is an oily compound used in enhancing X-rays; since lipiodol contains the chemical element iodine, it is a simple matter to replace the normal iodine-127 in its chemical structure with the radioactive isotope iodine-131. If the liver cancers selectively retain the resulting radioactive oil, it was hypothesized, they may contribute to their own destruction by irradiation. This method of selective irradiation was used in the experimental treatment of 24 patients with hepatocellular carcinoma. The adverse effects were mild and well tolerated by the patients; these effects included fever, nausea, and mild abdominal pain. Imaging of radioactive emissions confirmed that the tumors were sequestering the radioactive oil; the smaller tumors, however, were the most affected. Almost 90 percent of the liver cancers smaller than 4.0 centimeters were reduced in size by the treatment. Only one fourth of the tumors larger than 5.1 centimeters showed a decrease in size. The patients avoided the complications of bone marrow suppression and hypothyroidism because the radioactive iodine used in the treatment could not freely travel through the body. Twelve of the 24 patients who participated in this study remain alive more than one year after starting treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Radiotherapy, Iodine, Liver cancer, Radioiodine

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Comprehensive management of locally advanced breast cancer

Article Abstract:

Patients with locally advanced breast cancer have a poor prognosis. Locally advanced breast cancer describes cases without signs of distant metastatic spread, but with cancerous invasion of the underlying muscle and the overlying skin, which may have ulcerations or satellite nodules. Inflammatory breast cancer is considered a distinct form of locally advanced breast cancer. Even with the best therapeutic approaches available, from 50 to 70 percent of women with locally advanced breast cancer die of the disease. One approach that may be used to treat locally advanced breast cancer is neoadjuvant chemotherapy. In contrast to adjuvant chemotherapy, which is chemotherapy given to supplement surgical treatment, neoadjuvant chemotherapy is more aggressive chemotherapy administered prior to surgery. It has the advantage of providing therapy sooner after diagnosis and eliminating any postsurgical growth spurt of the tumor. In addition, the effectiveness of the chemotherapy can be directly evaluated at surgery, which may help in planning future treatment protocols. Disadvantages, however, include a larger tumor burden than for postoperative chemotherapy and inability to precisely stage the tumor. Since it is already clear that postoperative adjuvant chemotherapy provides survival advantage over surgery alone, even for Stage I and Stage II breast cancers, the effectiveness of neoadjuvant chemotherapy cannot be ethically compared to surgery alone. Studies need to be designed to determine if neoadjuvant chemotherapy confers any survival advantage over postoperative chemotherapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Breast cancer, Adjuvant chemotherapy

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