phosphorus-radioisotopes and Peritoneal-Neoplasms

Topics: Alkylating Agents; Antineoplastic Agents; Cyclophosphamide; Dactinomycin; Doxorubicin; Drug Therapy, Combination; Fluorouracil; Gold Colloid, Radioactive; Humans; Mesothelioma; Methotrexate; Nitrogen Mustard Compounds; Palliative Care; Peritoneal Neoplasms; Phosphorus Radioisotopes; Pleural Neoplasms; Radiotherapy Dosage; Thiotepa

Topics: Antigens, Neoplasm; Carcinoembryonic Antigen; Drug Therapy, Combination; Female; Humans; Immune Sera; Male; Melphalan; Neoplasm Staging; Ovarian Neoplasms; Peritoneal Neoplasms; Phosphorus Radioisotopes; Radiotherapy Dosage

Peritoneal seeding remains a prominent failure pattern in patients with invasive epithelial ovarian cancer, even following a pathologically negative second-look laparotomy (2LL). In an attempt to decrease the risk of peritoneal recurrence, we have treated patients with no clinical or histopathologic evidence of disease at 2LL with 15 mCi of chromic phosphate suspension intraperitoneally (32P).. Between 1973-1987, 69 patients with stages I-III invasive epithelial ovarian cancer in complete clinical remission were found to have no evidence of disease at 2LL. Fifty-one patients received intraperitoneal 32P. Thirty-five patients, otherwise eligible for 32P, did not receive it primarily due to other treatment protocols, peritoneal adhesions, or the recommendation that no further therapy be given following a negative 2LL. Patients in both groups were comparable with regard to stage, histology, grade, median age, residual disease following initial surgery, and chemotherapeutic regimen. The median follow-up for uncensored patients is 58 months (minimum, 18 months).. The 5-year actuarial disease-free survival rate from the date of 2LL was 86% for those receiving 32P and 67% for those not receiving 32P (P = 0.05). The corresponding 5-year overall survival rates were 90 and 78%, again favoring patients treated with 32P.. There were minimal acute side effects from 32P. Late adverse effects were similar in the two groups. Bowel complications were seen in 3 of 51 patients receiving 32P and 1 of 18 patients not receiving 32P.. We have found intraperitoneal 32P administration immediately after 2LL to be a safe and well-tolerated therapy. Our data suggest that 32P confers a survival advantage to patients with a pathologically negative 2LL. These findings suggest a continued role for second-look laparotomy with the use of 32P in selected patients.

Topics: Chi-Square Distribution; Epithelium; Female; Follow-Up Studies; Humans; Infusions, Parenteral; Instillation, Drug; Laparotomy; Ovarian Neoplasms; Peritoneal Neoplasms; Phosphorus Radioisotopes; Regression Analysis; Reoperation; Retrospective Studies; Survival Analysis; Survival Rate

alpha-Emitting radionuclides such as 211At have a number of physical characteristics which make them attractive for the treatment of micrometastases. 211At was bound to polymer microspheres and its efficacy was compared with the beta-emitting 32P and 90Y colloids for the treatment of intraperitoneally growing K13 hybridoma tumors in mice. Single graded doses of 0.1-2.5 MBq 211At microspheres injected intraperitoneally 24 hr after inoculation of the hybridoma cells improved survival and produced higher cure rates than 32P colloid, 90Y colloid, or no treatment. One of the most striking contrasts between 211At microspheres and 90Y or 32P colloids was the ability of relatively low doses 211At to affect cures. When comparing the groups with the highest survival rate for each radionuclide (0.1-1 MBq 211At, 2.5 MBq 90Y, and 2.5 MBq 32P), 211At treatment resulted in an improved survival over that with 32P therapy, but the difference was not significant between 211At and 90Y. Toxicity studies with 211At microspheres showed that dosages up to 17 MBq per mouse were not lethal. In conclusion, the present study suggests that the high-energy transfer and the short-range cytotoxicity of the alpha-emitter 211At might be of benefit for intracavitary radiotherapy.

Topics: Animals; Astatine; Colloids; Female; Injections, Intraperitoneal; Mice; Mice, Inbred BALB C; Microspheres; Peritoneal Neoplasms; Phosphorus Radioisotopes; Yttrium Radioisotopes

Details of the Intraperitoneal P-32 administration are presented. Rationale, general instructions, technique, infusion of P-32, orders and Radiation Safety instructions are discussed.

Topics: Brachytherapy; Humans; Infusions, Parenteral; Peritoneal Neoplasms; Phosphorus Radioisotopes

Single photon emission computed tomography (SPECT) has been shown to be of value in estimating the radiation dose to the peritoneum from 32P therapy. Simple dosimetry calculations, assuming uniform irradiation of tissue, indicate that radiation doses of approximately 40 Gy to the peritoneal surface are achieved. However, the images show that the radionuclide distribution is non-uniform, giving rise to radiation dose variations of at least a factor of 10.

Topics: Chromium; Chromium Compounds; Female; Humans; Ovarian Neoplasms; Peritoneal Neoplasms; Peritoneum; Phosphates; Phosphorus Radioisotopes; Radiation Dosage; Tomography, Emission-Computed

Malignant peritoneal cytology in patients with endometrial carcinoma is a poor prognostic feature, identifying patients at high risk for early intra-abdominal recurrence. Between 1977 and January, 1983, 65 women with endometrial carcinoma who had malignant peritoneal cytology were treated with adjuvant intraperitoneal radioactive chromic phosphate P 32 suspension. Fifty-three patients (80%) were clinical Stage I, nine (14%) were Stage II, and three (7%) were clinical Stage III. Life-table estimates of disease-free survival were 89% for clinical Stage I patients and 94% for surgical Stage I patients beyond 24 months. One patient developed an intraperitoneal recurrence, four had simultaneous intraperitoneal and extraperitoneal recurrences, and six developed recurrences outside of the peritoneal cavity. Few significant acute complications occurred after therapy with radioactive chromic phosphate P 32 suspension. Chronic intestinal morbidity that required surgical correction was encountered in five of 17 patients (29%) who received adjuvant pelvic radiation, compared to none of the 48 patients (0%) who received only radioactive chromic phosphate P 32 suspension (p less than 0.001). Intraperitoneal instillation of radioactive chromic phosphate P 32 suspension is effective therapy for patients with malignant peritoneal cytology from endometrial carcinoma. Caution should be exercised when radioactive chromic phosphate P 32 suspension and external radiation therapy are combined.

Topics: Adenocarcinoma; Brachytherapy; Catheters, Indwelling; Chromium; Chromium Compounds; Female; Follow-Up Studies; Humans; Hysterectomy; Injections, Intraperitoneal; Neoplasm Recurrence, Local; Neoplasm Staging; Peritoneal Neoplasms; Phosphates; Phosphorus Radioisotopes; Prognosis; Uterine Neoplasms

Radionuclide peritoneoscintigraphy has been used prior to chromic phosphate P-32 (P-32CP) intraperitoneal therapy to assure proper placement of the catheter in the peritoneal cavity, to exclude loculation, and to predict inadequate distribution of P-32CP. This is a case report of the detection of a peritoneal catheter improperly placed into the bowel lumen by pretherapy radionuclide peritoneoscintigraphy, and this case demonstrates the distinguishing characteristics of the radiocolloid distribution secondary to an intraluminal injection relative to an intraperitoneal injection.

Topics: Adenocarcinoma; Brachytherapy; Catheterization; Chromium; Chromium Compounds; Colonic Neoplasms; Female; Humans; Middle Aged; Peritoneal Cavity; Peritoneal Neoplasms; Phosphates; Phosphorus Radioisotopes; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

Malignant peritoneal mesothelioma remains a therapeutic problem. A review of the use of intraperitoneal 32P and a review of the status of therapy for this disease are presented. Six patients treated with 32P and combinations of external radiation therapy, surgery, and chemotherapy are reviewed with survival times from 5 months to 18 years. Overall survival in this disease is poor, about 44.2 months. This series suggests that with combined therapy with intraperitoneal 32P and chemotherapy, longer survivals can be achieved.

Topics: Adolescent; Adult; Colloids; Combined Modality Therapy; Female; Humans; Male; Mesothelioma; Middle Aged; Peritoneal Neoplasms; Phosphorus Radioisotopes

Basis, indications and results of the endolymphatic therapy with radionuclides, of the selective therapy with radiophosphorus and radiostrontium and of the intraarticular and endocavitary therapy with radiocolloids are described. Future scientific engagement and intensive basic research in radionuclide therapy is required. However, because of the expected therapeutic profit the efforts seem to be justified.

Topics: Adolescent; Adult; Aged; Arthritis, Rheumatoid; Child; Child, Preschool; Female; Gold Colloid, Radioactive; Humans; Infant; Iodine Radioisotopes; Male; Middle Aged; Neoplasms; Peritoneal Neoplasms; Phosphorus Radioisotopes; Polycythemia Vera; Radioisotopes; Radiotherapy; Radiotherapy Dosage

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: Animals; Chromium; Dogs; Female; Lymphatic Metastasis; Neoplasm Metastasis; Ovarian Neoplasms; Peritoneal Neoplasms; Phosphates; Phosphorus Radioisotopes; Radiography; Tissue Distribution

Topics: Animals; Cobalt Radioisotopes; Disease Models, Animal; Female; Injections, Intraperitoneal; Mammary Neoplasms, Experimental; Mice; Mice, Inbred C3H; Neoplasm Metastasis; Neoplasm Transplantation; Osteosarcoma; Ovarian Neoplasms; Peritoneal Neoplasms; Phosphorus Radioisotopes; Radioisotope Teletherapy; Sarcoma, Experimental

A case of diffused malignant mesothelioma of the peritoneum in a 64-year-old man is presented. This mesothelioma, of the papillary type, was complicated, after a year without significant clinical symptoms, by the development of ascites and obstructive upper bowel ileus. Physiological-anatomical and clinical aspects, as well as special radiologic findings and therapeutic regimens, are discussed in the light of the literature. It is recommended that all patients with malignant mesothelioma of the peritoneum be treated by total abdominal irradiation and intreperitoneal instillation of colloid P32.

Topics: Ascites; Humans; Intestinal Obstruction; Male; Mesothelioma; Middle Aged; Peritoneal Neoplasms; Phosphorus Radioisotopes

Loculation of instilled 99mTc-sulfur colloid solution in the peritoneal cavity was observed in a patient being considered for intracavitary therapy with 32P-chromic phosphate. Since intracavitary instillation of a therapeutic dose of a radiopharmaceutical agent into a loculated space would risk therapeutic failure and tissue necrosis, prior instillation of a tracer nuclide is recommended to insure adequate dispersion before beginning such therapy.

Topics: Child, Preschool; Colloids; Humans; Male; Peritoneal Cavity; Peritoneal Neoplasms; Phosphorus Radioisotopes; Radionuclide Imaging; Rhabdomyosarcoma; Sulfur; Technetium

Topics: Ascitic Fluid; Chromium; Colloids; Humans; Male; Middle Aged; Peritoneal Neoplasms; Phosphates; Phosphorus Radioisotopes; Pleural Neoplasms; Sulfur; Technetium

Topics: Humans; Neoplasms; Peritoneal Neoplasms; Peritoneum; Phosphorus; Phosphorus Radioisotopes; Phosphorus, Dietary; Radioactivity