Prospective comparative trial of autologous versus allogeneic bone marrow transplantation in patients with non-Hodgkin's lymphoma
V. RatanatharathornJoseph P. UbertiChatchada KaranesEsteban AbellaLG LumFeroze MominGlenn CummingsLL Sensenbrenner
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Total body irradiation
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Ewing's sarcoma
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Objective To study the c urative effect of the combined use of chemotherapy and radiotherapy on non smal l cell lung cancer at advanced stage.Methods Fifty two patient s have been chosen and divided into two groups:the radiotherapy group and the co mbined group.The radiotherapy group employed routine concomitant radiotherapy,th e dosage was 60～68GY/6～7 weeks.The combined group was treated with radiotherap y,and chemotherapy(EP regimen),and the chemotherapy was given before,during or a fter radiotherapy.There were 3～4 periods of this treatment.Results The total remisson rate in raditherapy group was 45.5%.The median survival time was 11 months,one,two,and three years survival rate were 45.5%,18.2% and 4. 5% respectively.The total remisson rate in the combined group was 66.7%.The medi an survival time was 20 months,one,two and three years survival rate are 73.3%,2 6.7%,16.6% respectively.The curative effect in combined group was better than th e radiotherapy group(P0.05).The side effects in combined use o f radiotherapy and chemotherapy were higher than that in radiotherapy group.The major toxic effect included myelosuppression,which was bearable to patients.Conclusion The curative effect of the combined use of chemotherapy( EP regimen) and radiotherapy on non small cell lung cancer at advanced stage is better than that of radiotherpay,and the treatment could raise the living rate of one,two,and three years.
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Concomitant
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With the introduction of the T-7 chemotherapy regimen in 1976, all patients with primary osteogenic sarcoma were treated with preoperative chemotherapy [1]. The T-7 regimen also marked the commencement of the use of high-dose Methotrexate (HDMTX) at the doses of 12 gm/m2 for young children and 8 gm/m2 for adults. The T-7 regimen used HDMTX with Leucovorin rescue, the combination of Bleomycin, Cyclophosphamide, and Dactinomycin (BCD), and Adriamycin as a single agent, given at the dose of 90 mg/m2 over two days.
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Dactinomycin
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Conditioning protocols were tested for their efficacy in increasing the incidence of engraftment of histoineompatible dog bone marrow cells. Cyclophosphamide and total body irradiation (TBI), Corynebacterium parvum and TBI, a 3− or 5-day delayed transfusion of bone marrow cells after TBI, or an increase in the number of donor bone marrow cells or lymphocytes appeared to be ineffective. These protocols were previously reported to promote recovery of splenic hemopoiesis in mice in short-term assays. The noted discrepancy between studies with mice and dogs invalidated allogeneic resistance as measured in the mouse spleen assay as a model for bone marrow allograft rejection. Intravenous treatment with silica particles or L-asparaginase did improve the engraftment rate after 7.5 Gy TBI. Low efficiency and significant extra toxicity restrict the applicability of these procedures. The most promising conditioning schedule found appeared to be two fractions of 6.0 Gy TBI separated by a 72-hr interval. Prolonged survival was noted after transplantation of bone marrow cells from a one-DLA haplotype-mismatched donor. Possibilities for further improvement of this protocol are discussed.
Total body irradiation
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Total body irradiation
Lethal dose
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Total body irradiation
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Total body irradiation
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The results are presented of thirty-seven patients with Ewing's sarcoma; ten were treated by a combination of operation, radiotherapy and cyclic chemotherapy, the remainder by radiotherapy and chemotherapy but without operation. The drugs, vincristine, cyclophosphamide and adriamycin were used in combination and were continued for two years. The follow-up ranged from twelve to sixty-two months. The mortality rate and the incidence of metastases were both markedly lower than in a comparable previous series treated by radiotherapy alone, or by operation plus radiotherapy, but all without chemotherapy. The percentage of local recurrences and of metastases was much higher in the twenty-seven patients who had radiotherapy and adjuvant chemotherapy, than in the ten in whom operation was also performed. It is suggested that on the basis of these results (and on theoretical grounds) treatment should consist of radiotherapy combined with chemotherapy plus, whenever feasible, operative excision of the primary tumour.
Combination chemotherapy
Ewing's sarcoma
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