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Thirty patients with advanced breast cancer, previously treated with anthracycline and 5 fluorouracil in bolus administration, were evaluated with a chemotherapy regimen generally used in head and neck cancer. Treatment schedule consisted of: cisplatin 100 mg/m2 on d 1 and 5 fluorouracil 1000 mg/m2 continuous infusion on d 2-3-4-5 every 21 d. With all measurable lesions and 27 evaluable patients, the response rate was 29% (95% confidence interval: 12-47%), with 5 complete responses (3 soft tissue - 2 lung) and 3 partial responses (1 lung - 2 liver). The median duration of response is 4.5 months (range 2-11 months). The 30 patients (93 courses) are evaluable for toxicity. Hematologic toxicity was mild: anemia 68% grade 0, neutropenia 68% grade 0 and thrombocytopenia 83% grade 0. Nausea and vomiting were severe 83% grade 3 + 4 at d 1. Others side effects were mild including 5/91 mucositis grade 2 + 3, peripheral neuropathy 1/31 grade 2 and 2/91 reversible rise in serum creatinine greater than 1.5 mg/dl.

One hundred and thirteen patients with advanced squamous cell cancer of the head and neck were entered into a multicenter trial. Median age was 54 yr (range: 33-74 yr). Median Karnofsky index was 70 (60-100). Thirty-five patients had had prior induction chemotherapy. The first schedule was carboplatin 300 mg/m2, dl and fluoro-uracil 1000 mg/m2/d administered in continuous IV infusion for 96 h every 4 weeks (group 1). The second schedule was carboplatin 350 mg/m2, dl and fluoro-uracil administered at the same dose every 3 weeks (group II). Median number of cycles was 3 (range: 1-16). Seven patients were not eligible. The response rate was 26% (95% confidence limits: 18-34). Nine patients had a complete response. The median duration of response was 6 months (2-16+). The response rates in the 2 groups were not statistically different (21 and 31%) but disease progression was more frequent in group I (61%) than in group II patients (25%). Six early deaths occurred, without sign of drug toxicity. Grade 2 hematological toxicity between or before any cycle was more frequent in group II patients, in particular for leucopenia (13 vs 42%, P less than 0.05). One death was related to granulopenia. Grade 2 or 3 gastric toxicity was observed in 43 patients. No other major toxicity was observed. In our study, combination therapy with carboplatin and fluoro-uracil was found to be moderately active but myelotoxic.

A case of B.C.G. osteitis occuring after an attempt at the restoration of immune function in a patient with Hodgkin's disease. The diagnosis was based upon histological study of a biopsy specimen and the discovery of a B.C.G. strain. Tuberculostatic therapy resulted in local healing. The various complications and side-effects of B.C.G. immunotherapy are reported in the discussion: local reactions, regional lymphadenopathy, systemic infections, hypersensitivity phenomena, pulmonary, bone marrow and hepatic involvement.

The great number of topical preparation containing neomycin and their frequent use for a long period induce a lot of contact dermatitis. It is interesting to detect the importance of cross sensitivity between aminosides among the patients whose dermatitis was caused by neomycin. 15 neomycin eczematous patients were investigated. The research about cross-sensitivity concerned 6 antibiotics: streptomycin, framycetin, ribostamycin, gentamycin, kanamycin, tobramycin. Patch-tests (20 p. 100 in petrolatum) were used in order to show this cross-sensitivity. The results of these tests are nearly the same as in the other studies, as for 5 of the antibiotics; but it is the first time, to our knowledge, that a cross-sensitivity between ribostamycin and neomycin is observed. The cross-sensitivity between these two aminosides can be explained by their chemical structure. There are four rings in neomycin: the main components are neamin and neobiosamin. Only three rings are found in ribostamycin: ribostamycin is constitued of neomycin lacking neosamin of neobiosamin. Thus the structure of the 3 rings of ribostamycin is identical with the structure of 3 out of 4 rings of neomycin. The study about cross-sensitivity between aminosides suggests two conclusions: 1. The use of local antibiotics must be prescribed only when is it really necessary. 2. It seems wise to avoid all systemic aminosid antibiotics for patients who are sensitized by neomycin ointment.

Fourteen cases with a malignant dysembroma of the ovary were treated by resection, postoperative radiotherapy and/or chemotherapy. Eight of the 14 patients survived 2 years and 2 out of 7 are still alive 5 years later. The prognosis depends mainly on the initial stage of the disease. Radiotherapy but most of all chemotherapy may improve the survival rate even in the advanced forms of the disease. The proposed therapy is initial extensive surgery followed by chemotherapy in all cases. Also radiotherapy in those cases in which the resection was considered incomplete.

A retrospective analysis of 95 treated nonseminomatous germinal testicular tumors is made. The primary treatment consisted of orchidectomy with high ligation of the cord. A histological study disclosed 53 embryonal cell carcinomas (56%), 21 chorioepithelionas (22%), 7 teratocarcinomas (7%) and 14 complex composite tumors which were predominantly dysembryomatous (15%). Forty-three patients were classified as stage I, 13 as stage II and 39 as stage III. Retroperitoneal pelvic and peri-aortic lymphadenectomy performed in patients with a testicular dysembryoma classified as stage I, had a survival of 70% 5 years postoperatively versus only 46 when treated solely with radiotherapy. Stage III cases with choriocarcinoma did not survive 3 years. These results are compared with those reported in the literature. The presently applied therapeutic scheme is described.

Results of treating superficial human cancerous tumors by ultrasound (1-3 MHz) or microwave (434 MHz) hyperthermia, alone or combined with radiotherapy or chemotherapy are presented according to the heating method. The comparison of in vivo thermal distributions obtained at depth with these two techniques could partially explain their different therapeutic efficiency.

Results of treating superficial cancerous nodules by hyperthermia, alone or combined with radiotherapy or chemotherapy, over a period of one year, are presented. Twenty-five patients with multiple cutaneous or subcutaneous metastatic tumors were treated by 1 to 3 MHz ultrasound hyperthermia or 434 MHz microwave hyperthermia. Good local tolerance was observed, even in regions previously treated with high doses of irradiation. Regression of the tumors was assessed by comparison with unheated nodules. Two out of 11 tumors treated by hyperthermia alone, 10 out of 17 tumors treated by conventional chemotherapy combined with hyperthermia showed significant regression.

Surgical treatment of metastasis disease of the humerus was applied for 46 lesions among 42 patients, i-e 22% of overall osteosyntheses for skeletal metastasis. Two patients only are still alive at 3 and 4 years. The mean survival time is 8.1 months and at 3 months 50% died. Metastasis disease of the humerus becomes evident late during the evolution of the primary cancer, but 26% are revealing lesions. For 9.5% the primary tumor remains unknown. After review of the surgical methods generally used, indirect osteosynthesis by intra-medullary pinning according to Hackethal, without bone cement, is alleged. So the arm is immediately mobilized and a complementary irradiation is applied in post-operative. Prophylactic fixation of impending fractures is encouraged in order to suppress pain, and for better function. This paper demonstrates the changing concept of internal fixation of pathologic fractures and recommends intra-medullary nailing or pinning.