British journal of cancer
-
British journal of cancer · Apr 1998
Multicenter Study Clinical TrialImproving survival in recurrent medulloblastoma: earlier detection, better treatment or still an impasse?
Early detection of relapse has been advocated to improve survival in children with recurrent medulloblastoma. However, the prognostic factors and the longer term outcome of these patients remains unclear. Pattern of recurrences were analysed in three consecutive protocols of the Société Française d'Oncologie Pédiatrique (1985-91). ⋯ The median survival time after progression was 5 months (<1-41 months), and only two patients remained alive at time of follow-up. Length of survival is primarily related to some specific patterns of relapse (time from diagnosis to recurrence, circumstances of relapse, extent of relapse) and to the response to salvage therapy. No evidence of long-term benefit appeared from any form of treatment.
-
British journal of cancer · Apr 1998
Randomized Controlled Trial Clinical TrialCombined intravenous and intraperitoneal chemotherapy with fluorouracil + leucovorin vs fluorouracil + levamisole for adjuvant therapy of resected colon carcinoma.
Adjuvant chemotherapy with fluorouracil (FU) and levamisole or FU/leucovorin (LV) has been established as effective adjuvant treatment for patients with stage III colon cancer. Among several other promising treatment strategies in resected colon cancer, intraperitoneal anti-cancer drug administration with its appealing rationale of counteracting microscopic residual disease on peritoneal surfaces and occult metachronous liver metastases by achieving high intraportal drug concentrations has not yet undergone sufficient clinical evaluation. To determine whether a combination of this locoregional therapeutic concept with systemic intravenous administration of FU/LV would yield better results than conventional adjuvant chemoimmunotherapy with FU/levamisole, the present randomized study was initiated. ⋯ In agreement with its theoretical rationale, combined intraperitoneal and intravenous FU/LV was particularly effective in reducing locoregional tumour recurrences with or without liver or other organ site involvement (9 vs 25 patients in the FU/levamisole arm; P = 0.005). Treatment-associated side-effects were infrequent and generally mild in both arms, although a lower rate of severe (WHO grade 3) adverse reactions was noted in patients receiving locoregional plus intravenous chemotherapy (3% vs 12%; P = 0.01). The results of this trial suggest that combined intraperitoneal plus systemic intravenous chemotherapy with FU/LV is a promising adjuvant treatment strategy in patients with surgically resected stage III colon carcinoma.
-
British journal of cancer · Apr 1998
Chromosome division figures reveal genomic instability in tumorigenesis of human colon mucosa.
A variety of chromosomal gains and losses has been detected with comparative genomic hybridization during tumorigenesis in the colon mucosa. The aim of this investigation was to corroborate increasing genomic instability and to elucidate those lesions in which the record from comparative genomic hybridization has remained unexpectedly negative. Replicate paraffin-embedded samples were investigated in detail using image microphotometry. ⋯ The DNA content of chromosome division figures was measured with a mean 4.5 c exceeding rate of 25.8 +/- 4.4% standard error in 12 cases of high-grade dysplasia and of 62.1 +/- 7.1% in colon carcinoma (16 cases). The chromosome division figures were considered to be the first morphological manifestation of genomic instability attending precancerous conditions in the colon. Telophase-like chromosome division figures with unequal amounts of DNA in their hemispheres revealed gross somatic mutations before clonal selection.