In a prospective multicenter study, 186 patients with squamous cell esophageal carcinoma, who after evaluation were considered suitable for surgery, were randomized to 4 treatment groups: Group 1, surgery alone; Group 2, pre-operative chemotherapy (cisplatin and bleomycin) and surgery; Group 3, pre-operative irradiation (35 Gy) and surgery; Group 4, pre-operative chemotherapy, radiotherapy, and surgery. Three-year survival was significantly higher in the pooled groups receiving radiotherapy as compared with the pooled groups not receiving radiotherapy. Comparison of the groups having pre-operative chemotherapy with those not having chemotherapy showed no significant difference in survival. Female patients had a significantly better survival than males. The results indicate that pre-operative irradiation had a beneficial effect on intermediate term survival, whereas the chemotherapy regime used did not influence survival.
One hundred and sixty-two patients treated for hypopharyngeal cancer during the 25-year period 1958-1982 were reviewed retrospectively. Of the 162 patients, 29 received combined treatment with surgery and postoperative irradiation, 106 received radical radiotherapy alone, and 27 palliative radiotherapy. The 5-year survival rate was 28% for the patients treated with combined therapy and 16% for the patients treated with radical radiotherapy. There were no long-term survivors in the palliatively treated group. The major cause of death was tumour (102 patients) while 40 patients died of intercurrent diseases.
The effect of intratumoral recombinant interferon y (rIFN-y) as adjuvant to open cytoreduction and external irradiation of 60 Gy on survival in adults with a newly diagnosed high-grade cerebral glioma was studied. The patients were randomised during surgery into the rIFN-y group (n = 14) or the control group (n = 17), and the latter received a subcutaneous reservoir of rIFN-7 injections. Intratumoral rIFN-y was given three times a week for 4 weeks until radiotherapy, escalating the dose from 5 gig to 50;Lg. Both groups received external whole-brain irradiation of 40 Gy and a local boost of 20 Gy. After radiotherapy, rIFN-y was continued with 50 iLg twice a week up to 9 weeks. The patients received no chemotherapy. Intratumoral rIFN-7 was tolerated well with transient fever only. There were 12 glioblastomas (GBs) in the control group and nine in the rIFN-7 group with completed irradiation. The patients were followed clinically and by computerised tomography (CT) every third month until death. Tumour responses were seen in three interferon-treated (one still alive 45 months after operation) and in two conventionally treated patients. The progression of the tumour volumes on CT did not differ between the IFN-treated and control groups. There were no differences in the survival times. Median survival of the rIFN-^-treated patients was 54 weeks (95% CI 35-68) and of the control patients 55 weeks (95% CI 41-77). Intratumoral rIFN-y given in the study doses does not seem to inhibit tumour growth or improve the prognosis of patients with high-grade glioma.
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