Abstract The incidence of associated esophageal carcinoma (EC) among patients with upper aerodigestive tract malignancies is high. Esophageal brush cytology, as developed and evaluated as a screening device for early detection of EC among villagers of northeastern Iran, 1 was employed to examine 56 clinic patients with known tumors of the upper aerodigestive tract on 106 occasions. Two asymptomatic EC were detected and are presented. The procedure was also used as an adjunct to endoscopy in order to monitor the response of tumors under treatment. Sensitivity of 40% and specificity of 90% were found and could be improved with more judicious application of the procedure. The use of this simple test for early detection of EC among this high risk subset of clinic patients is recommended.
We present our results regarding the cosmetic outcome achieved and the rate of infection using the MammoSite breast brachytherapy applicator to treat patients with partial breast irradiation. In addition, factors associated with cosmetic outcome and infection are analyzed. The study population consisted of 30 patients with early stage breast cancer treated using the MammoSite device from October 28, 2002, to February 13, 2004. Cosmetic outcome was analyzed for its association with the following parameters: volume of the balloon, balloon-to-skin distance, maximal skin point dose per fraction, V100 (percent of volume that received 100% of the prescription dose), V150 (percent of volume that received 150% of the prescription dose), and V200 (percent of volume that received 200% of the prescription dose). The occurrence of infection at the time of treatment and during follow-up was also recorded. At a median follow-up of 13 months (range 1-16 months), 53.3% of the patients (16/30) were reported to have an excellent cosmetic outcome and 40.0% (12/30) had a good cosmetic outcome. Excellent cosmetic outcome was associated with a greater mean balloon-to-skin distance compared to those who achieved a good cosmetic outcome (1.5 cm versus 1.2 cm) (p = 0.164). The mean V100, V150, and V200 of those in the excellent cosmetic outcome group were 92.1%, 34.5%, and 7.6% versus 93.0%, 34.7%, and 7.6% in the good cosmetic outcome group (p = 0.642, 0.926, and 0.853), The mean balloon volumes were 47.7 cm3 and 56.9 cm3, respectively (p = 0.063) in the excellent and good outcome groups. The mean maximal skin doses per fraction in the excellent and good outcome groups were 354.8 cGy and 422.3 cGy (p = 0.286), respectively. Infection occurred in 13.3% of the patients (4/30). An excellent or good cosmetic outcome was achieved in 93.3% of patients and infection occurred in 13.3% of patients treated with the MammoSite breast brachytherapy applicator. Excellent cosmetic outcome was associated with a greater balloon-to-skin distance, lower maximal skin dose per fraction, and smaller mean balloon volume; however, the results did not reach statistical significance.
General immune responses were studied in patients with esophageal carcinoma (EC) and were compared to those in normal individuals of similar age, sex and ethnic origin. There was a significant increase in the titer of background” antibodies in the sera of cancer patients; however, this elevation was not associated with an increase in the levels of serum immunoglobulin. EC patients had a diminished number of E rosetting lymphocytes but normal proportion of EAC rosetting cells. Lymphocytes from a small but significant number of patients showed decreased responses to PHA when cultured in medium containing fetal calf serum. Plasma sample from these patients were capable of inhibiting the in vitro proliferate responses of lymphocytes to PPD.
