Two new Mo compounds, Tl2Mo9S11 and K2Mo9S11, have been found. The structure of these compounds is characterized by the presence of a completely new building block, Mo12S14, in addition to the well-known Mo6S8 unit as in the PbMo6S8-type compounds. The new cluster, Mo12, contained in the Mo12S14 unit can be considered as a one-dimensional condensation of three Mo6 octahedral clusters. These new materials, the structure of which resembles that of PbMo6S8, are metallic but are not superconducting above 2.1°K.

Fibrosis following breast radiotherapy for mammary cancer is a frequent undesired effect with objective (esthetic) and subjective (pain) consequences. Forty-four patients with clinical radiofibrosis following conservative treatment of breast cancer were evaluated for the local antifibrosis effect of copper zinc superoxide dismutase [SOD(Cu/Zn)]. Extracted SOD(Cu/Zn) in a concentration of 3,600 units/mg was applied as ointment to the fibrotic affected area, b.i.d. for 90 days, in a total dose of 40 mg. The radiofibrosis intensity was scored on the basis of clinical criteria (pain and the fibrosis area) before and after SOD(Cu/Zn) treatment. SOD(Cu/Zn) was found to be effective in reducing radiation induced fibrosis by a lowering pain score in 36/39 patients and a decrease of the fibrotic area size in half cases, after 6 months. The intensity and changes of breast fibrosis were assessed also by mammography and, for the topographical distribution of subcutaneous temperature, by infrared thermography. Mammography density suggested decreased fibrosis in one third of patients. Thermography showed that fibrosis was accompanied by two zones clinically indistinctive: a central area with maximum thermal activity, called "Maximal Thermic zone" (MTZ) and a peripheral area with less thermal activity but higher than in the surrounding normal tissue, "Transitional Thermic Zone" (TTZ). Both MTZ and TTZ were significantly decreased in 36/44 patients after SOD(Cu/Zn) treatment. Clinical changes persisted all along the study. Treatment was well tolerated except for one case of local allergic reaction, and no important side effects. Molecular mechanisms involved are discussed. Further studies are running to confirm and explain these results.

Fourty-two patients, presenting with clinically evaluable cutaneous fibrosis after radiotherapy for breast carcinoma, were treated for 3 months by a superoxide dismutase (SOD) topical preparation. Sequential cutaneous punch biopsies were performed before and 3 months after completion of the treatment. The histochemical grading, using an objective spectrometric method, showed a decrease of fibrosis in 74% of treated patients. The immunohistochemical expression of smooth muscle cells (SMC) α-actin, epidermal growth factor-receptor (EGFR) and transforming growth factor β1 (TGFβ1) was studied. SOD treatment resulted in an increase of SMC α-actin expressing fibroblasts in 79% and an increase of EGFR expressing epidermal cells in 67% cases. It did not modify the expression of TGFβ1. In conclusion, topical SOD appeared to reduce collagen accumulation in the dermis of irradiated skin and to ‘reactivate’ cellular functions in dermal fibroblasts and epidermal cells, as demonstrated by phenotypic changes.

Seventy-three patients with metastatic breast cancer, whose disease progressed on hormonal therapy with tamoxifen or aminoglutethimide, were treated with megestrol acetate, 160 mg/day. No complete responses were observed. Partial response was achieved in 3 patients (4%), for a median of 9 months (range 5-13). Thirty-five patients (48%) remained stable, for a median of 8 months (3-26). The remaining 35 patients (48%) had clear progression of their metastatic disease on therapy. Response to megestrol acetate was achieved in patients with metastases in bone and pleura only. There was no correlation between response to megestrol acetate and response to prior chemotherapy, prior tamoxifen therapy, previous treatment with aminoglutethimide, or hormone receptor status. The actuarial 24-month survival for all patients was 37%. The main side effects of megestrol acetate included weight gain (20% or over), pruritus, elevation of blood pressure, weakness, and vaginal bleeding; they were only occasionally observed. The objective improvement observed during this trial is disappointing; the only reasons to justify the use of megestrol acetate as second- or third-line hormonal therapy in patients with metastatic breast cancer, would be the relatively long duration of disease stabilization in a large proportion of patients, and the low toxicity observed with the drug.

Fourteen patients with testicular nonseminomatous germ cell tumor, clinical stage I were entered into a surveillance study. Median age was 31 (range 18-58). Three patients had pure tumor, and 11, mixed tumor. In 2 patients, vascular invasion was noted, and in 1, involvement of the spermatic cord. Serum alpha fetoprotein and beta subunit choriogonadotropin were high in 9 and in 3 patients, respectively. In median follow-up of 21 months (range 2-63), 3 patients relapsed: 1 had inguinal lymphadenopathy and 2 had lung metastases at 12, 4, and 16 months, respectively. Salvage chemotherapy PEB and PVB achieved complete response in the latter 2 patients for 6 and 49 months. Except for 1 patient lost to follow-up, all are alive.

The antiemetic response and side effects resulting from treatment with methylprednisolone (MPA) given on two different dose schedules were evaluated in 20 women with breast cancer who were undergoing chemotherapy consisting of cyclophosphamide, methotrexate and 5-fluorouracil (CMF). This randomized, crossover, double-blind study compared the antiemetic efficacy of a single dose of 125 mg MPN with that of two such doses. The study demonstrated the superiority of the latter protocol in preventing CMF-induced nausea and vomiting. The rate of antiemetic response to single vs double doses was as to follows: complete protection, 17% vs 30%; partial and minimal protection, 39% vs 55%; and no protection, 44% vs 15% of the courses, respectively (P=0.0087). No difference in the antiemetic response rate was found between the first and the second course. Treatment with MPN was well tolerated, and no difference in the incidence of side effects was found between the single-dose and the double-dose schedule. We recommend the use of two doses of 125 mg MPN as prophylactic antiemetic treatment in breast-cancer patients receiving CMF chemotherapy.

Primary extranodal lymphoma of the salivary gland is an extremely rare disease. In this report we describe twelve cases of primary lymphoma of the parotid gland seen at a single centre, and review the relevant literature. The 12 cases were treated in different departments and did not receive a uniform therapeutic approach. All three patients with Hodgkin's disease are still alive and two are in complete remission after initial radiotherapy. One of these cases developed stage 4 disease and had to receive combination chemotherapy subsequently. Of the 9 non-Hodgkin's lymphoma (NHL) patients, four had low grade NHL and 5 intermediate or high grade NHL. Of these, 2 died with disseminated disease. However, 6 are still alive and well from 1 to 5 years after therapy. These cases were treated with surgery alone, radiotherapy alone or combination chemotherapy with an anthracycline-bearing regimen. Consequently, we are unable to draw any conclusions relating the success of therapy in these cases, nor can we suggest therapeutic guidelines on the basis of this study alone. The treatment of parotid lymphoma is discussed briefly in the light of the available literature. In most cases, symptoms related to an enlarging mass in the parotid region, were evident. In the light of the above data, we suggest that, despite its rarity, lymphoma of the salivary gland should always be considered in the differential diagnosis of a parotid mass. No correlation between lymphoma and Sjogren's syndrome was noted in the present study.

Acute pericarditis following bleomycin treatment is extremely rare. A case report and analysis of the literature are presented.

Nineteen women receiving their first cycle of adjuvant chemotherapy for early breast cancer were randomized between two antiemetic drugs: methylprednisolone (MPN) 125mg and metoclopramide (MCP) 20mg, both given by intravenous push as a single dose. The chemotherapy included: cyclophosphamide, methotrexate and 5-fluorouracil (CMF). The total response rates for MPN and MCP were: complete protection 11% versus 0% and partial protection 63% versus 11% of the patients, respectively (P = 0.007). Eighteen patients (95%) preferred MPN over MCP. Common side effects with both drugs were: drowsiness, headache and diarrhea. MPN is recommended as an antiemetic in patients receiving CMF adjuvant chemotherapy.

Seventy-six consecutive patients receiving chemotherapy were evaluated for the antiemetic efficacy and side-effects of the combination of chlorpromazine (CPM) and methylprednisolone (MPN). All patients had previously received the same chemotherapy with metoclopramide in conventional dosage and experienced severe emesis. A significant antiemetic response was achieved in 70% of the patients, and in 28% of them the antiemetic protection was complete. The most common side effects were drowsiness, dry mouth and headache. The combination of CPM and MPN is effective, well tolerated and is recommended for outpatients receiving chemotherapy for cancer.

Sixty-nine patients with malignant tumors receiving cancer chemotherapy, 90% including cis-platinum, were evaluated in a randomized crossover study for the antiemetic efficacy and the side effects of two antiemetic regimens: chlorpromazine (CPM) 2.5 mg/kg in 5 doses plus dexamethasone (DXM) 0.2 mg/kg in 2 doses, and high-dose metoclopramide (HD-MCP) 10 mg/kg in 5 doses plus the same dose of DXM. In 69% of 173 courses of chemotherapy, antiemetic response was achieved, and in 26% emesis was completely prevented. There was no statistical difference in the response to the antiemetic regimens, but 65% of the patients who completed 3 courses of chemotherapy preferred HD-MCP plus DXM. The main side effects of the treatment were drowsiness, nervousness, diarrhea and extrapyramidal reactions. HD-MCP plus DXM is recommended as a first line antiemetic treatment in patients receiving cancer chemotherapy. Patients resistant to this treatment should receive CPM plus DXM treatment.

Pericardial effusion caused by malignant disease is an uncommon disorder. We present a patient with rectal cancer who developed malignant pericardial effusion as the main site of relapse 18 months following surgery. We discuss the incidence and the therapy of this condition.

Between 1978 and 1983, 55 patients with advanced carcinoma of the prostate (38 with Stage C and 17 with Stage D) were treated with external beam MeV radiotherapy. In 29 patients radiotherapy was the first treatment modality, and 26 patients had previously received hormonal therapy. Both treatment modalities were continued simultaneously for Stage D and bulky Stage C of the disease. Severe urodynamic problems were the main treatment indications for patients with Stage D carcinoma. The treatment consisted of two courses each of 25 gray (Gy) whole pelvic irradiation, interrupted for 2 weeks to deliver a rotation field to the prostate at a dose of 20 Gy. Patients have been followed for a minimum of 36 months. For patients with Stage C disease the overall 3-year survival was 80%, with 55% disease-free survival. Palliative irradiation for Stage D prostatic carcinoma improves the quality of life and probably the survival rate. Acute minor complications were observed in 49% of the patients, and chronic complications occurred in 14% of the patients. The described MeV technique is well tolerated and effective for Stage C as well as for Stage D prostatic cancer patients.

A retrospective study of all cases of pure testicular seminoma treated at the Hadassah University Hospital in Jerusalem from 1978 through 1986 was conducted. Of the 22 patients, 15 (70%) presented in Stage I, 4 (18%) in Stage II, 2 (9%) in Stage III and 1 (4%) in Stage IV. The results of treatment were evaluable for 20 of these patients. After a median follow-up of 4 years, only the patient with Stage IV disease died of disseminated seminoma. The remaining 19 patients are all alive and disease free, including 3 after radiotherapy for recurrent disease. Elevated beta-human chorionic gonadotropin levels before treatment did not predict an unfavorable outcome. Our excellent results are similar to those obtained at larger treatment centers.

Twenty-seven adult patients with diffuse large cell lymphoma were treated with the M-BACOD regimen during the period 1980-86. Of these, 24 (89%) had advanced Stage III-IV disease by clinical staging and only 3 (11%) had limited disease. CR was achieved in 14 patients (52%), all of whom had advanced disease prior to therapy. The remaining 13 patients (48%) achieved only PR. Of the entire group of 27 patients, 11 (41%) died, 12 (44%) are still in CR, and 4 (15%) have relapsed and are still alive with PR. Of the 14 patients who achieved CR, 1 relapsed, but is currently in PR, showing minimal disease. All of these 14 patients are alive (11 months to 6 years post therapy), and 13 (93%) still remain in CR with a median time of CR of 45 months. Of the 13 patients who only achieved PR, 11 (85%) relapsed and died within a median time of 3.6 months, and 2 patients remain in PR. The above results are similar to those obtained in larger series recorded from other centers. In the light of improved results obtained with new regimens and ABMT, we have now adopted the MACOP-B regimen for treating aggressive lymphoma and have entered an ABMT program for patients with predictable poor prognostic features.

Forty-six outpatients with breast cancer who had experienced severe emesis as a result of chemotherapy were evaluated for the antiemetic efficacy of high-dose metoclopramide (HD-MCP) and dexamethasone (DXM). Chemotherapy consisted of: cyclophosphamide 600, methotrexate 40 and 5-fluorouracil 600 mg/m2 (CMF) given intravenously every 3 weeks. The dosage of antiemetic drugs was MCP 2 mg/kg and DXM 0.2 mg/kg given by slow intravenous drip 0.5 h before the administration of chemotherapy. 138 courses of combined chemotherapy--HD-MCP and DXM--were administered, with a mean of 3 courses and a range of 1-10 courses per patient. Complete protection--no nausea and no vomiting--was achieved in 17.7% of the courses. Partial protection--no vomiting with mild nausea or 1-3 episodes of vomiting--in 45.3% of the courses. The total antiemetic efficacy was 63%. The most common side effects were: drowsiness, dry mouth, restlessness and diarrhea. Sixteen patients (35%) refused to continue the antiemetic regimen because of the side effects. HD-MCP and DXM have antiemetic efficacy, but because of these side effects, further studies are required to determine the optimal dose of each of these drugs.