Phase I trials of chemotherapy using bleomycin and bleomycin/cyclophosphamide combined with...
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(51) A NEW APPROACH TO ADJUVANT RADIOTHERAPY IN BLADDER CANCER M. Mohiuddin, M,D. and S. Kramer, M.D. Department of Radiation Therapy and Nuclear Medicine Thomas Jefferson University Hospital Philadelphia, Pennsylvania 19107 A sandwich technique of adjuvant radiotherapy was used to treat twenty- five patients with bladder cancer. In this technique low dose preoperative irradiation (500 rads in one treatment) was given to all patients followed by immediate surgery (usually total cystectomy), and then on the basis of histo- pathological findings, patients with stages Bl (Gr. III/IV), B2 and C were selectively given 4500 rads in 5 weeks postoperative irradiation. Eight patients had early lesions (stage A and B,) and did not receive postoperative irradiation. Fourteen patients had high grade stage Bl or stages B2 or C disease and hence received the full course of postoperative irradiation. Three patients had stage D disease at the time of surgery and hence receivedonly palliative therapy. Follow-up in these twenty-five patients ranges from 8 months to 22 months with a median follow-up of 17 months Treatment was well tolerated with few side effects. Only one of the twenty-three patients treated for cure has failed to date. This patient had stage B2 squamous cell carcinoma and failed with distant metastasis 2 months post-treatment. As yet, no patient has failed in the pelvis. We feel this technique of adjuvant therapy is a logical approach to the treatment of bladder cancer and has potential for improving survival. The rationale for this approach to adjuvant radiotherapy will be discussed together with details of treatment technique, normal tissue reactions and implications of the improved local control of tumor on survival of patients. (52) GROWTH, FUNCTIONAL AND STRUCTURAL EFFECTS OF ACTINOMYCIN-D, VINCRISTINE AND RADIATIONIN THE IMMATURE MOUSE KIDNEY Peter S. Moskowitz' , Sarah S. Donaldson', and Luis F. Fajardo' 1 Department of Radiology 2 Department of Pathology Stanford University School of Medicine, Stanford, California 94305 Recent reports have drawn attention to adverse long-term effects of radia- tion/chemotherapy on renal growth and function in children. Little is known of the effects of combined modality therapy on critical normal tissues such as the kidney, particularly in growing, immature animals. We studied the ef- fects of Actinomycin-D (AMD), Vincristine (VCR) and irradiation (RAD) on the rate of compensatory growth, function and structure in the immature mouse kidney. Weanling BLcF i female mice underwent left nephrectomy. Left kidney and in- itial body weigh s were recorded. Starting immediately post nephrectomy ex- perimental animals received minimal lethal doses (LD peritoneally, and 1000 rads single-fraction irradiat 164’ ) of AMD or VCR intra- to the remaining kid- ASTR Zlst Annual Meeting 93
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Transcript of Phase I trials of chemotherapy using bleomycin and bleomycin/cyclophosphamide combined with...
(51) A NEW APPROACH TO ADJUVANT RADIOTHERAPY IN BLADDER CANCER
M. Mohiuddin, M,D. and S. Kramer, M.D.
Department of Radiation Therapy and Nuclear Medicine Thomas Jefferson University Hospital
Philadelphia, Pennsylvania 19107
A sandwich technique of adjuvant radiotherapy was used to treat twenty- five patients with bladder cancer. In this technique low dose preoperative irradiation (500 rads in one treatment) was given to all patients followed by immediate surgery (usually total cystectomy), and then on the basis of histo- pathological findings, patients with stages Bl (Gr. III/IV), B2 and C were selectively given 4500 rads in 5 weeks postoperative irradiation.
Eight patients had early lesions (stage A and B,) and did not receive postoperative irradiation. Fourteen patients had high grade stage Bl or stages B2 or C disease and hence received the full course of postoperative irradiation. Three patients had stage D disease at the time of surgery and hence receivedonly palliative therapy. Follow-up in these twenty-five patients ranges from 8 months to 22 months with a median follow-up of 17 months
Treatment was well tolerated with few side effects. Only one of the twenty-three patients treated for cure has failed to date. This patient had stage B2 squamous cell carcinoma and failed with distant metastasis 2 months post-treatment. As yet, no patient has failed in the pelvis.
We feel this technique of adjuvant therapy is a logical approach to the treatment of bladder cancer and has potential for improving survival. The rationale for this approach to adjuvant radiotherapy will be discussed together with details of treatment technique, normal tissue reactions and implications of the improved local control of tumor on survival of patients.
(52) GROWTH, FUNCTIONAL AND STRUCTURAL EFFECTS OF ACTINOMYCIN-D, VINCRISTINE AND RADIATION IN THE IMMATURE MOUSE KIDNEY
Peter S. Moskowitz' , Sarah S. Donaldson', and Luis F. Fajardo' 1 Department of Radiology 2 Department of Pathology
Stanford University School of Medicine, Stanford, California 94305
Recent reports have drawn attention to adverse long-term effects of radia- tion/chemotherapy on renal growth and function in children. Little is known of the effects of combined modality therapy on critical normal tissues such as the kidney, particularly in growing, immature animals. We studied the ef- fects of Actinomycin-D (AMD), Vincristine (VCR) and irradiation (RAD) on the rate of compensatory growth, function and structure in the immature mouse kidney.
Weanling BLcF i
female mice underwent left nephrectomy. Left kidney and in- itial body weigh s were recorded. Starting immediately post nephrectomy ex- perimental animals received minimal lethal doses (LD peritoneally, and 1000 rads single-fraction irradiat 164’
) of AMD or VCR intra- to the remaining kid-
ASTR Zlst Annual Meeting 93
