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The oral carriage of yeasts and eoliforms in a healthy adult population and a group of patients with malignancies, undergoing cytotoxic therapy was investigated. A quantitative increase in the intra-oral carriage of Candida species and coliforms was observed during cytotoxic therapy. The most frequent yeast and the coliform isolated were Candida albicans and Escherichia coli, respectively. Thus, the oral Ciivity may constitute a reservoir of potentially pathogenie flora in patients on cytotoxic therapy.

Pretreatment serum levels of neurone specific enolase (NSE) were measured in patients with small cell lung cancer (SCLC). Median values were significantly higher in patients with extensive compared with limited stage disease (48 ng ml-1 v. 17 ng ml-1: P less than 0.001). Serial NSE levels paralleled the clinical response to treatment. In 37 patients with limited SCLC, receiving identical chemotherapy, the pretreatment NSE level was of prognostic significance: with an approximate reduction in median survival of 10% for each 5 ng ml-1 incremental rise in NSE (P = 0.004).

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Sunmary Bolus infusional 5-fluorouracil (5-FU) and folinic acid (FA) is reported to be highly active [partial response (PR) al., 1958), forming an irreversible ternary complex with TS and the co-factor 5,10-CH,-tetrahydrofolate (5,10-CH,-FH4). Reduced intracellular concentrations of 5,10-CH,-FH4 may therefore limit the formation of the ternary complex and hence limit the cytotoxicity of 5-FU. This hypothesis provides the rationale for the use of 5-FU in combination with folinic acid (5-CHO-FH4), which is readily converted to 5,10-CH2-FH4, increasing the formation of ternary complex. A number of clinical studies have shown that the combination of 5-FU with folinic acid enhances the activity of 5-FU in patients with metastatic colorectal cancer (Grem et al., 1987).Although the addition of folinic acid to 5-FU has been shown to improve response rates, this may occur at the expense of increased toxicity. In the initial reports of a widely used 5-FU/folinic acid combination administered to outpatients at weekly intervals [2 h infusion of folinic acid (500 mgm-2) with a bolus dose of 5-FU (600 mg m-2) administered 1 h into the folinic acid infusion] a high incidence (40%) of dose-limiting diarrhoea was observed (Petrelli et al., 1987).An alternative approach to the combination of 5-FU and folinic acid has been developed (De Gramont et al., 1988). In this regimen a 2 h infusion of folinic acid (200 mg m-) is followed by both a bolus (300-500 mg m-2) and 22 h infusion (300-500 mg m-2) of 5-FU. This schedule is repeated on day 2 and repeated at 2 weekly intervals. Preliminary results demonstrated good activity (response rate = 54% CI 38-70%) and the regimen was well tolerated. In the initial 37 patients reported no WHO grade 3 toxicities were noted. A second study confirmed that the regimen is well tolerated, although response rates were lower: overall response=24% (95% CI 11-37%) (Johnson et al., 1991); overall response = 30% (n = 82) (Seymour et al.. 1994).Because it is well tolerated and apparently active, the 'De Gramont' regimen is used frequently as initial therapy for metastatic colorectal cancer within the UK. However, in Glasgow the regimen has required 48 h in-patient admission in addition to the financial cost of folinic acid and therefore we considered it necessary to confirm the activity of the regimen before adopting it as standard practice. Therefore, we performed a retrospective analysis of all patients receiving bolus/infusional 5-FU/folinic acid for metastatic colorectal cancer at the Beatson Oncology

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A case of familial polyposis coli in association with hepatocellular and gastric carcinoma is reported. No similar case has ever been documented in the world literature. This may be surprising as it is well known that familial polyposis has a potent oncogenicity not only in the colon but also in extracolonic organs.