Photoradiation therapy for cutaneous and subcutaneous malignant tumors using hematoporphyrin.
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Biomedical subjects
Publications and source records attributed to L Tomio.
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Thirty Wistar albino rats with a subcutaneous Yoshida hepatoma AH-130 were exposed to 590 to 690 nm light from a high pressure Xenon arc-lamp 24 h after intraperitoneal injection of hematoporphyrin, 5 to 10 mg/kg. In all cases, the tumor decreased rapidly in size, due to necrosis caused both by direct action of the photoactivated porphyrin on the tumor cells and by secondary effects on blood vessels. No injury of normal tissues was detected. At 2 months after phototreatment, no recurrence had occurred and the skin over the tumor area was healed. Favourable therapeutic response was obtained in preliminary experiments by irradiating the Hp-injected tumor-bearing rats with 632.8 nm-light from an He/Ne laser source.
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Treatment of disrupted erythrocyte membranes with ionizing radiation induces a partial oxidation of -SH groups (as expected from reported data) and a loss of membrane phospholipids as confirmed by the decrease of membrane amino groups. The resulting disturbance of the membrane assembly strongly affects the membrane bound divalent cation-dependent ATPase activities, possibly by causing the formation of a dead-end enzyme complex unable to complete the ATP splitting cycle.
Different doses (0.5-20 mg/kg) of hematoporphyrin (HP) have been injected intraperitoneally into normal rats and rats affected by Yoshida ascites hepatoma. About 80% of HP reaching the liver was recovered in the extracellular compartment after liver perfusion, the ratio of extra- to intracellular HP being essentially independent of the administered dose. Similar data were obtained at different times after injection of 20 mg/kg HP. Intracellular HP largely accumulates in the mitochondria and in the membrane components of the nuclear fraction of isolated hepatocytes. Kinetic studies suggest that the cell receptors of highest affinity for HP are present in the external membrane. The latter result obtains for ascites hepatoma cells in an even more evident way, although the latter cells exhibit secondary HP binding sites probably constituted by cytoplasmatic proteins. Moreover, the clearance of intracellular HP from malignant cells occurs at a remarkably lower rate as compared with HP clearance from liver cells.
Serum selenium levels were measured in 38 patients with malignant lymphoproliferative diseases (MLD) and in 34 non-hospitalized healthy individuals. Selenium was determined by proton induced x-ray emission. In Hodgkin's disease and non-Hodgkin malignant lymphoma the mean serum levels of selenium were not different from those of the control group. On the contrary lowered mean serum selenium concentrations were observed in the group with chronic lymphocytic leukaemia (5.2 +/- 0.7 microgram/100 ml) as compared to normal individuals (7.9 +/- 0.3 microgram/100 ml). The difference is highly significant (P less than 0.005). A second selenium test was made in 11 out of the 38 patients within 8 weeks from the beginning of radiotherapy or chemotherapy; unchanged levels were found.
The effectiveness of neuramide as an analgesic was assessed in 71 patients with neuritic pain in an oncological radiotherapy ward. 1-2 vials i.m. twice a day for results in 54%, poor results in 13%, and nil results in 21%. The degree of analgesia was that the drug is useful as an analgesic, anti-inflammatory, cell membrane stabilising, and neurotrophic preparation in certain well-defined pain syndromes, especially those of a secondary nature. Attention is also drawn to its excellent tolerance and the complete absence of side-effects.
The distribution of hematoporphyrin was determined in normal rats and in rats bearing ascites hepatoma as a function of time after i.p. injection of 10-20 mg/kg of dye. In both cases, hematoporphyrin displayed a high affinity for the tumor cells. At 20 mg/kg, the maximum difference between the amount of hematoporphyrin accumulated in the tumor and in the liver was obtained at 12 h after injection (tumor/liver ratio = 28). Our results suggest that hematoporphyrin is almost exclusively metabolized in the liver and excreted via the biliary tract, whereas only minor amounts are metabolized in the tumor cells. Moreover, the binding between the porphyrin and tumor cells is competitive with serum protein binding.
Choroidal metastasis from primaries other than breast or lung cancer is a rare event. There is no documented case in the literature of choroidal metastases in patients with hypopharynx carcinoma. Early treatment with radiation therapy provides effective palliation by preserving visual function and preventing the need for enucleation. Chemotherapy alone does not seem to be as effective as radiation therapy for patients with choroidal metastases. In this paper a case of choroidal metastasis arising from a primary hypopharynx carcinoma is presented.
Genital tract lymphoma is a rare disease; information on diagnosis, treatment and outcome are limited. We report on eight patients affected by non-Hodgkin's lymphoma of the genital tract, five from the cervix, two from the vagina and one from the vulva collected between 1987 and 1998. Age at presentation ranged from 36 to 82 (median 67) years. The commonest initial symptom was vaginal bleeding, post coital in 1 patient. Three patients complained of vescical symptoms. Ann Arbor classification was stage IAE for 6 patients. Histology, according to the IWF, was either intermediate grade (4 patients), or high grade (3 patients), not evaluable in one case. Seven patients were treated with chemotherapy (anthracycline based in four) followed by pelvic radiotherapy in five; one patient received irradiation alone. Five patients are currently alive and free of disease with follow-up ranging from 8 to 126 months. Based on our experience in this series, we support a management scheme of combination chemotherapy and radiotherapy for patients with non-Hodgkin's lymphoma of the genital tract.
Pancreatic cancer is a highly lethal disease either for the high incidence of distant metastases or for the frequent local recidive also after potentially curative resection. For this reason new multimodality approaches have to be investigated. Intraoperative radiotherapy (IORT) permits to administer a high dose to the tumor or to the retropancreatic tissues and to the regional lymph nodes. Literature data suggest it is possible a better local control and perhaps a better survival than the surgery alone or the palliative treatments by the use of schedules with IORT. Anyway they are retrospective data and IORT is an investigational method which has to be indagate in the combined modality approaches to this disease.
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