phosphorus-radioisotopes and Adenocarcinoma--Papillary

Thirty-four patients with fallopian tube cancer were evaluated at the Mayo Clinic between 1964 and 1985 and received radiation therapy postoperatively. Employing a system analogous to FIGO ovarian cancer staging, there were 9 patients with stage I disease, 13 with stage II, and 12 with stage III/IV. Residual disease was present in 15 patients and absent in 19. Nodal metastases were documented in 12 patients or 35% (10 at presentation, two at relapse), with para-aortic nodes most commonly involved (67%) and 7 of the 12 having disease otherwise limited to the pelvis at presentation. Fifteen of 34 (44%) patients survived disease-free until intercurrent death or to a median follow-up of 70 months. Seven patients were treated with palliative intent for massive disease, and 27 patients were treated with curative intent (21 radiation alone, six radiation plus chemotherapy). Of those treated with curative intent, 15 patients received pelvic irradiation (with or without para-aortic nodal irradiation), 10 received whole abdominal irradiation, and 2 received intraperitoneal radiophosphorus. In the potentially curative group, seven of nine (78%) patients with stage I disease, five of 12 (42%) with stage II, and 2 of 6 (33%) with stage III have remained disease-free. Among the 21 patients with stage I or II disease, only four of the 11 (36%) patients who received pelvic irradiation alone were disease-free, but four patients had an isolated upper abdominal failure. In contrast, eight of 10 (80%) patients receiving treatment to the entire abdomen (including two patients who received 32P) were disease-free.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adenocarcinoma; Adenocarcinoma, Papillary; Evaluation Studies as Topic; Fallopian Tube Neoplasms; Female; Humans; Neoplasm Recurrence, Local; Neoplasm Staging; Phosphorus Radioisotopes

A 64-year-old patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy in October, 1978 for a Stage IA, grade 2 papillary adenocarcinoma of the endometrium. Peritoneal washings contained numerous malignant cells, although the tumor invaded the myometrium only superficially. Two weeks after operation, 12 mCi of P32 were instilled into the peritoneal cavity. In May, 1979, laparotomy was performed for clinical obstruction of the small intestine and revealed diffuse peritoneal, omental, and hepatic metastases. Radiation changes involved the terminal ileum, ascending and sigmoid colon; an ileorectal fistula was also identified. The factors that might cause malignant cells to be present in the peritoneal cavity and the ideal treatment of such patients have yet to be determined. THe risk of intraperitoneal P32 might outweigh its benefits.

Topics: Adenocarcinoma, Papillary; Ascitic Fluid; Female; Humans; Liver Neoplasms; Middle Aged; Peritoneal Neoplasms; Phosphorus Radioisotopes; Uterine Neoplasms

Topics: Adenocarcinoma, Papillary; Adenosine Diphosphate; Adenosine Monophosphate; Adenosine Triphosphatases; Adenosine Triphosphate; Allosteric Regulation; Ammonia; Animals; Binding Sites; Biological Transport; Catalysis; Cesium; Chemical Phenomena; Chemistry; Enzyme Activation; Ethacrynic Acid; Guinea Pigs; In Vitro Techniques; Kidney; Kinetics; Ligands; Magnesium; Microsomes; Models, Biological; Molecular Conformation; Nucleotides; Ouabain; Phosphates; Phosphorus; Phosphorus Isotopes; Phosphorus Radioisotopes; Potassium; Protein Binding; Protein Conformation; Quaternary Ammonium Compounds; Rubidium; Sodium; Time Factors