Search

Carcinoembryonic antigen is elevated in the serum of approximately 35% (35/98) of patients with carcinoma of the uterine cervix. The incidence of elevated serum CEA is not related to stage of disease, histopathology, lymphangiogram and survival rate. Carcinoembryonic antigen levels return to normal after curative radiation therapy (25/32). Persistently high values after irradiation are indicative of residual disease (3/32). Reappearance of CEA, with a progressive rise evoke a recurrence, and may precede the clinical diagnosis.

Basing their indications on the histo-prognosis of Opperman and Bittard in malignant tumours of the bladder, the authors decided to irradiate before cystectomy those bladder tumours in which the histo-prognostic index indicated that it was a local disease with metastatic potential with a spontaneous life expectancy of 18 to 30 months. Radiotherapy was given spread over 23 or 27 fractions providing a total of 46 Gy. Four to 6 weeks later, cystoprostatectomy with trans-ileal cutaneous ureterostomy was performed, before chemotherapy for one year. Amongst 11 patients treated, in 6 cases the bladder was completely "sterilised" from a histological standpoint. However there was persistence of tumour in 5 bladders with an increase in the histo-prognostic index. Amongst these 11 patients, with a minimum follow-up of 18 months, there has been a pelvic recurrence in two cases and three developed fatal metastases. In the opinion of the authors, these preliminary results represent an encouragement to continue along the same lines.

An analysis of short effect of pelvic irradiation on cellular and humoral immunity was made in 24 patients treated by irradiation alone or a combination of surgery and irradiation for uterine carcinoma, at 2, 6, 12 months after loco-regional therapy. Twelve months later there is a decrease of T lymphocytes (P = 0.01), whereas the B lymphocytes count is normal; the percentage of T and B lymphocytes remains stable, but the lymphocyte response to PHA after 3 days is reduced (p = 0.03). A significant decrease of immunoglobulins G, A and M is observed.