phosphorus-radioisotopes and Fever

The frequent side effects of Hydroxy-Urea and the non-exceptional risk of leukemia and cancer in Polycythemia Vera treated for a long time by Hydroxy-Urea allow to conclude that Hydroxy-Urea is not an innocent drug. In a prospective trial of 150 patients with a median follow up of nine years, Hydroxy-Urea given alone induced side effects in 29% of patients necessitating to stop treatment in half of cases. The percentage of leukemia or myelodysplasia is 6.7% with an actuarial risk of leukemic transformation of 10% at 13 years. In an other prospective trial in 181 aged patients Hydroxy-Urea was given as maintenance therapy after 32P treatment. The median follow-up in that study is also of nine years. Side effects are observed in 13% of cases. A two fold increase of the leukemic risk was observed in the maintenance arm of the trial: 11 versus 19% at ten years, 14 vs 30% at 12 years, 16 vs 35% at 15 years because of the leukemogenic effect of Hydroxy-Urea in maintenance therapy we stopped including new patients in this arm of the trial.

Topics: Aged; Alopecia; Combined Modality Therapy; Cystitis; Erectile Dysfunction; Female; Fever; Follow-Up Studies; Humans; Hydroxyurea; Incidence; Leg Ulcer; Leukemia; Lymphoma, Non-Hodgkin; Male; Middle Aged; Neural Tube Defects; Phosphorus Radioisotopes; Pipobroman; Polycythemia Vera; Prospective Studies; Risk; Safety; Stomatitis, Aphthous

The phosphorus-32 glass microspheres(32P-GMS) is a new radioembolizer for cancer therapy. From March 1994 to April 1995, 24 patients with unresectable hepatocellular carcinoma and 3 patients with cavernous hemangioma received internal radiation treatment of 32P-GMS. The clinical results demonstrated that hepatic arterial instillation of 32P-GMS appeared to be safe and effective for hepatocellular carcinoma. There was no significant bone marrow or renal toxicity or liver to pulmonary bypass. A transient change of liver function and fever occurred in almost all patients. Significant liver toxicity and gastrointestinal tract reaction were seen when radiation dose > 50 Gy or microspheres > 3 g, and then various postoperative complications occurred.

Topics: Adult; Brachytherapy; Carcinoma, Hepatocellular; Embolization, Therapeutic; Female; Fever; Glass; Hemangioma, Cavernous; Hepatitis; Humans; Liver Neoplasms; Male; Microspheres; Middle Aged; Phosphorus Radioisotopes; Radiation Dosage

Topics: Animals; Body Temperature; Fever; Hypothermia; Phosphorus; Phosphorus Radioisotopes; Phosphorus, Dietary; Radioactivity; Rats