Primary mediastinal nonseminomatous germ cell tumors: a modern single institution experience

Article Abstract:

Primary mediastinal germ cell tumors are thought to arise from the errant migration of germ cells during embryonic development. Such tumors are rare, and the prognosis is significantly poorer than with testicular germ cell tumors. Nonetheless, the prognosis has improved dramatically since the introduction of cisplatin as a chemotherapeutic agent. Out of 31 patients with mediastinal nonseminomatous germ cell tumors that were believed to be the largest ever reported, 18 achieved disease-free status, and 15 of these remain alive and disease-free. Eleven of the 18 received only chemotherapy, and seven had adjunctive surgery after chemotherapy. The 13 patients who failed initial chemotherapy and 24 patients who were referred after failing initial chemotherapy elsewhere, were given savage chemotherapy. Four of these patients remain alive. The data suggest that a cure rate of 50 percent may be expected with chemotherapy and adjunctive surgery in these cases, which is significantly worse than the 90 percent that may be expected with testicular cancer. Part of the disparity may be due to patients with mediastinal nonseminomatous germ cell tumors being usually diagnosed at a more advanced stage. In addition, patients with these tumors have a propensity for the development of other non-germ cell neoplasms as well. In this study, 3 of 31 patients developed hematologic cancers, which are not believed to have resulted from treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Germ cell tumors, Germinoma, Tumors

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Thoracic radiotherapy does not prolong survival in patients with locally advanced, unresectable non-small cell lung cancer

Article Abstract:

Lung cancer is an often fatal, malignant disease that is associated with smoking. Lung cancers are classified by the type of malignant cell present, and the non-small cell type is the leading cause of cancer-related deaths in the United States. The condition has a high mortality because most patients are not good candidates for surgery, either because the tumor is too far advanced or the patient could not withstand the surgery. For the 30 percent of patients with advanced, inoperable non-small cell lung cancer, treatment may involve the use of radiation to kill the cancer cells, but the effectiveness of this strategy is controversial. To assess the effectiveness of local radiation in the treatment of advanced non-small cell lung cancer, 319 patients received either radiation, the cell killing agent vindesine, or the combination. The response rate for radiation therapy was 30 percent and was higher than the 10 percent response rate for vindesine alone. The response rate for the combination of radiation therapy and vindesine was 34 percent. But even though radiation therapy had a higher response rate, no improvement in short or long-time survival occurred. Therefore, this study indicates that patients with inoperable non-small cell lung cancer do not derive meaningful benefit from radiation therapy. These patients should be included in studies assessing the effectiveness of new drug or radiation therapies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prognosis, Radiotherapy, Lung cancer, Non-small cell, Non-small cell lung cancer

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Chemotherapy for advanced thymoma: preliminary results of an intergroup study

Article Abstract:

Thymoma is a tumor originating in the epithelial tissues lining the surface of the thymus gland. This gland is located in the mediastinal cavity, the space containing the organs and tissues separating the lungs. The thymus gland is important in the development of the immune response in newborns and is essential to the maturation of T cells, a type of immune cell. The effectiveness of a combined regimen of the anticancer agents cisplatin, doxorubicin, and cyclophosphamide in treating thymoma was assessed in 20 patients. Three patients underwent complete remission, and 11 patients experienced partial remissions. The response rate was estimated at 70 percent. Remission lasted 13 months in most patients, and three patients remained free of disease for more than two years. Most patients survived about 59 months. Infections developed in four patients and included infections of the meninges, the membrane lining the brain and spinal cord; yeast infections of the mucous and skin tissues; and infection of the lung by fungi. The development of infections indicated abnormalities in cell-mediated immunity. These findings indicate that a combined regimen of the chemotherapeutic agents cisplatin, doxorubicin, and cyclophosphamide can produce remission in patients with thymoma. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug therapy, Thymoma, Chemotherapy, Combination, Combination chemotherapy

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