Neurotoxicity of intraventricularly administered alpha-interferon for leptomeningeal disease

Article Abstract:

One of the newer approaches to the treatment of cancer is the attempt to use biological response modifiers to marshall the patient's own immune responses against the tumor. Biological response modifiers include a host of different natural substances, including alpha-interferon. Alpha-interferon has been used with some success in the treatment of many cancers. Like all agents used in the treatment of cancer, alpha-interferon can exert toxic effects which limit the dose that can be administered. In the case of alpha-interferon, a major dose-limiting factor is toxicity to the nervous system. Previously reported nervous system toxicities included such symptoms as confusion, impaired memory, and loss of coordination. However, in a recent series of patients with metastatic cancer (cancer which has spread from the original site to other parts of the body), the neurological symptoms were significantly more severe in eight of the nine patients. All nine patients had cancer, such as lung cancer or breast cancer, which had spread to the meningeal sheath covering the brain. The patients were treated with large doses of alpha-interferon directly into the cerebrospinal fluid, so that the interferon would reach its target easily. Seven patients developed a progressive vegetative state; several were unresponsive in all ways except for opening the eyes in response to pain. Fortunately, the condition proved to be reversible, although it took an average of three weeks after the cessation of treatment for the patients to be able to respond to verbal commands. The precise cause of neurological toxicity in patients treated with alpha-interferon is not known. While the direct injection of alpha-interferon into the cerebrospinal fluid results in a dose 3,000 times greater than injection into the blood, previous studies using similar injections have not reported such drastic adverse effects. The patients in the present study had, however, received radiotherapy for their cancer prior to the administration of alpha-interferon. Although it cannot be concluded with certainty, the disturbing possibility is that the effects of radiation and the effects of alpha-interferon may combine in some way to produce an especially serious adverse effect on the nervous system. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Neurotoxic agents, Interferon alpha

---

Circumscribed scleroderma induced by postlumpectomy radiation therapy

Article Abstract:

Scleroderma is a disease in which the skin seems tough and leathery. It may involve internal organs as well. When the condition is limited only to a circumscribed area of the skin, it is often called morphea. The cause of scleroderma is not known. However, in a recent case, circumscribed scleroderma seems to have been the result of radiation therapy. The patient was a 57-year-old woman who had been treated for breast cancer. The early stage cancer was surgically removed without removal of the breast and underlying tissues (lumpectomy). In such cases, the remaining tissues are irradiated to reduce the likelihood that any cells which may have escaped from the primary cancer might survive to cause a future relapse. In the present case, the treated breast became hard, reddened, and painful about six weeks after radiation treatment. These symptoms were first considered to be an indication of infection, but antibiotic treatment did not improve the condition. Ten months later the skin in the affected area was hard and had a peau d'orange (orange peel) appearance. A biopsy was taken and confirmed scleroderma as the diagnosis and ruled out competing diagnostic possibilities. There has been some suggestion in the past that scleroderma may be more common among breast cancer patients. However, most of the patients reported in these studies have had systemic scleroderma. In the present case, two facts strongly suggest that the radiation itself was responsible for causing the condition: the scleroderma was limited to the skin that was subjected to radiation; and the lesion appeared within weeks after radiation treatment. Since other conditions, including a form of cancer called scirrhous carcinoma, have symptoms that resemble scleroderma, it is important that the diagnosis of radiation-induced scleroderma be made carefully. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Scleroderma (Disease)

---

Thermography in the follow-up of breast cancer patients after breast-conserving treatment by tumorectomy and radiation therapy

Article Abstract:

Screening programs for breast cancer and greater breast cancer awareness have resulted in a larger number of breast cancers being diagnosed at an early stage, when breast-conserving therapy is practical. Although patients who have had a breast tumor removed are at high risk of recurrence, diagnosing the recurrence is more difficult than observing the original tumor, since the scar tissue from the surgery creates irregularities which are difficult to distinguish from tumor tissue, and which may mask the early stages of tumor recurrence. There has been some suggestion in the medical literature that thermography, the graphic measurement of body temperature, is useful in screening for recurrences of breast cancer. Indeed, some have suggested the procedure is superior to mammography. However, few quantitative data are available on this subject. To determine if thermography is effective, a total of 2,432 measurements were analyzed from 292 patients without evidence of recurrence, and 146 measurements were analyzed from 17 patients with recurrent tumor. No significant temperature differences were observed between the two groups. The results suggest that thermography is of no value in screening breast cancer patients for tumor recurrence. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Surgery, Medical thermography

Similar abstracts:

• Abstracts: Immunogenicity of tetravalent rhesus rotavirus vaccine administered with buffer and oral polio vaccine. Patient appointment failures in pediatric resident continuity clinics
• Abstracts: The importance of empathy as an interviewing skill in medicine. Requiem for an unknown leper
• Abstracts: Adverse psychologic consequences of positive cytologic cervical screening. Cytologic screening after hysterectomy for benign disease

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.