Progress in treatment of cancer of the large bowel.
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Biomedical subjects
Publications and source records attributed to J Horton.
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The effectiveness of DTIC in the treatment of Grade III and IV astrocytomas was analyzed in two phases. In the first phase, 14 patients (Group A) with progressive neurologic dysfunction following primary treatment were treated with DTIC alone (8 patients) or in combination with CCNU or methyl CCNU (6 patients) and evaluated for change in neurologic status. Five of the 8 treated with DTIC responded symptomatically for a median duration of 18 weeks, and 3 of 6 treated with the combination of drugs responded for a median duration of 12 weeks. In the second phase, 15 patients (Group B) were treated within 4 weeks of surgical resection with radiation therapy and adjuvant chemotherapy with DTIC and/or MeCCNU. These patients were followed for survival and compared to a historical control group of 15 patients (Group C) treated with surgery and radiation only. The drug-treated group had a median survival of 55 weeks, compared to 35 weeks for the control group. Hematologic toxicity was life threatening in 2 of 14 patients treated with combination drugs, but mild with DTIC alone. DTIC appears to be active against malignant astrocytomas. Survival may be lengthened by combining chemotherapy with surgery and radiation therapy.
In a study conducted by the Eastern Cooperative Oncology Group, 51 evaluable women with advanced ovarian carcinoma were randomized to either abdominal radiation therapy alone, chlorambucil alone, or to a combination of radiation therapy and chlorambucil by members of the Eastern Cooperative Oncology Group. Provision was made for crossover therapy for patients who were nonresponders to a single modality of treatment. Parameters followed included objective and subjective response rates and patient survival. The total response rate was 51%, with no significant difference among the three treatment regimens. Regarding survival, radiation therapy alone was significantly superior to the other regimens, with an average survival of 94.9 weeks. Best results were obtained in patients with normal performance status; for this group, radiation therapy alone offered the best chance for prolonged survival.
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Numbness of the chin, an uncommon neurological symptom, was observed in 15 patients with cancer. Thirteen had breast cancer. This symptom usually heralded progressive involvement of the cranial nerves or cerebrum and denoted a poor prognosis in patients with a short `tumourfree interval'. The pathogenesis is commonly related to dural involvement of the Vth cranial nerve at the base of the brain, although metastasis to the mandible might sometimes be implicated. The reason for the peculiar predilection for the mandibular branch of the trigeminal nerve to be affected by breast cancer is not known.
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