A new computer algorithm is described for liver and tumor volume determinations for patients with hepatoma and primary hepatic cholangiocarcinoma. The algorithm is based on global histograms of CT numbers of the liver and primary liver cancers. The algorithm includes computer-assisted definition of the liver boundary in each CT slice. Liver and tumor volumes of 10 patients calculated by the histogram method were compared with volumes obtained from CT slices that were manually contoured by experienced observers. A correlation coefficient of 0.995 was determined for these two methods of volume computations. Mean values of the differences in volumes obtained by the two methods were 6.7 and 8.0% for the liver and tumor, respectively. The computer algorithm was tested on CT scans for an additional 46 patients by highlighting regions corresponding to normal liver and tumor tissues in each CT slice and determined to be accurate by experienced observers. The computer software is being used clinically to assess tumor response in a new treatment program for primary liver cancers that includes radiolabeled antibodies.

Adenoma, Bile Duct↗

PubMedDate not supplied

Intensive induction chemotherapy in 54 patients with small cell carcinoma of the lung.

Fifty-four patients with localized and extensive small cell carcinoma of the lung and no prior therapy were treated with intensive induction chemotherapy. The induction regimen consisted of two courses of high-dose cyclophosphamide, doxorubicin, and VP-16-213. The objective response rate was 78% (42 responses among 54 patients), with 14 complete (26%) and 28 partial (52%) responses. The median survival time for the entire group of patients is 378 days, with a projected 2-year survival rate of 22%. The most significant determinant of survival was the attainment of a complete response. Tumor progression in most relapsing patients occurred at the sites of initial involvement. Toxicity was significant, as expected, but treatment-related mortality did not exceed that of less intense regimens. Despite the use of such intensive induction regimens, the major challenge in the therapy for small cell carcinoma remains the achievement of more durable complete remissions.

Adult↗

PubMedDate not supplied

Dosimetry of 131I-labeled antiferritin in hepatoma: specific activities in the tumor and liver.

Dosimetric studies are reported for 22 patients with hepatoma who received treatment with 131I-labeled antiferritin IgG. Studies included liver and tumor volume computations based on computerized axial tomographic scan analysis, in-vivo quantitation of the activity deposited in hepatic tumors and normal liver tissue, and effective half-life measurements of the activity in the tumor, liver, and total body. Administered activities of polyclonal and affinity-column purified 131I-labeled antiferritin IgG ranged from 32 to 157 mCi. Tumor volumes at the time of radioimmunoglobulin infusion ranged from 220 to 3020 cm3 and total liver volumes ranged from 900 to 4620 cm3. For tumor volumes ranging from 220 to 1700 cm3, the maximum tumor activity was linearly proportional to tumor volume, but independent of antiferritin preparations and administered activities. In this range of tumor volumes, the mean value of tumor-to-liver ratios of specific activities was 4.8:1. Hepatomas ranging from 2290 to 3020 cm3 had reduced tumor uptake of radiolabeled antiferritin IgG and had a tumor-to-liver ratio of specific activities of 1.6:1. For all patients studied there was a linear relationship between the volume of normal liver tissue and the maximum activity deposited. These data, in conjunction with toxicity studies and tumor effective half-life measurements, led to the present treatment regimen of administering 30 mCi of polyclonal antiferritin IgG on Day 0 and 20 mCi on Day 5 following the first injection. This has resulted in the same range of absorbed dose to the tumor as was achieved with larger administered activities, but with a significant reduction of total-body irradiation to the patient.

Animals↗