Luteinizing hormone-releasing hormone agonist therapy for prostate cancer is a new method of management for metastatic disease. During the initial 1 to 2-week period of administration an increase in serum testosterone concentration can lead to an exacerbation of clinical symptoms (flare phenomenon). Two patients are summarized who received luteinizing hormone-releasing hormone agonist therapy without flare blockade and died suddenly during month 1 of therapy. A review of 765 patients in 9 series found 10.9% who suffered disease flare and 15 who died during disease flare. Of these 17 patients 12 were similar to our 2. These data suggest that any patient placed on luteinizing hormone-releasing hormone agonist therapy for prostate cancer merits some form of flare blockade during the initial 1 or 2 months of therapy.
LIPUS application may affect mandibular growth pattern in rats acting at the cartilage and bone level. The effect of LIPUS on the growing condyle is expressed through a variation in trabecular shape and perimeter. A greater response is achieved when stimulated for 20 minutes instead of 10 minutes daily.
Local radiotherapy plus intratumoral syngeneic dendritic cell injection can mediate apoptosis/cell death and immunological tumor eradication in murine models. A novel method of coordinated intraprostatic, autologous dendritic cell injection together with radiation therapy was prospectively evaluated in five HLA-A2+ subjects with high-risk, localized prostate cancer, using androgen suppression, 45 Gy external beam radiation therapy in 25 fractions over 5 weeks, dendritic cell injections after fractions 5, 15 and 25 and then interstitial radioactive seed placement. Serial prostate biopsies before and during treatment showed increased apoptotic cells and parenchymal distribution of CD8+ cells. CD8+ T-cell responses to test peptides were assessed using an enzyme-linked immunosorbent spot IFN-γ production assay, demonstrating some prostate cancer-specific protein-derived peptides associated with increased titer. In conclusion, the technique was feasible and well-tolerated and specific immune responses were observable. Future trials could further test the utility of this approach and improve on temporal coordination of intratumoral dendritic cell introduction with particular timelines of therapy-induced apoptosis.
The records of 386 patients with diagnosed transitional cell carcinoma of the bladder were reviewed to determine a correlation between smoking history, and stage, grade and number of recurrences of transitional cell carcinoma. A significant association was detected between smoking history and all 3 variables. Within this military population 79 per cent of the patients were noted to have a smoking history, which is higher than most previously studied groups. These data further confirm the association between cigarette smoking and transitional cell carcinoma of the bladder, and suggest that cigarette smoking within the military population may portend a much higher cancer risk in this group.
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