A phase II study of spirogermanium was conducted in a series of 15 patients with metastatic prostatic carcinoma. All the patients have previously received multiple hormonal therapies. The drug was administered at the dose of 200 mg/m2 by a continuous infusion for five days, and 120 mg/m2, three times a week subsequently. The side effects were mainly neurological toxicity and phlebitis at the injection points which were dose and schedule dependent. Only one partial response for two months was noted in this series. Thus, spirogermanium seems to have a limited value in patients with prostatic cancer.

A retrospective study of 135 patients with superficial transitional cancer of bladder (pTa - pT1) was conducted after follow-up for at least 3 years following treatment for 2 years at the "Instituto de Urología, Nefrología y Andrología (Fundación Puigvert)". Patients had been randomly allocated for treatment with: RTU alone, RTU + instillation of Thiotepa and RTU followed by instillations of Adriamycin. Chemotherapy was administered preventively. Recurrence after 3 years and possible progression towards infiltration during this period were evaluated, and the usefulness of this type of treatment questioned because of the cost/benefit ratio and small intergroup differences found.

Pulmonary toxicity associated with chemotherapy is still rare, but its incidence may increase with intensive and iterative regimens. Following a review of the four main drugs responsible for lung toxicity (bleomycin, methotrexate, busulfan and BCNU), the authors underline the risk of combined chemotherapy and radiotherapy. To recognize, at an early stage, the signs suggesting lung toxicity is essential to reduce its extent and, above all, to exclude other pathologies which often have the same clinical and radiological features. Only histological studies provide evidence of toxicity. Treatment is frequently disappointing; the only hope of regression lies in withdrawal of the responsible drug and corticosteroid therapy.

Autologous bone marrow transplantation (ABMT) is a new technique which is currently being evaluated in the treatment of leukemias, lymphomas, and a few solid tumors. In patients with acute leukemia (AL), high dose therapy + ABMT is of little benefit if done at time of relapse. On the other hand, when used for consolidation of remission, either with cleansed or non cleansed marrow, it may improve disease-free survival. In patients with acute myelocytic leukemia (AML) autografted during their 1st remission, the probability of remaining in remission at 2 years is 70 p. 100. It is slightly lower for patients with acute lymphocytic leukemia (ALL): 55 p. 100. The different techniques of cleansing the marrow, monoclonal antibodies, immunotoxins, drugs, are reviewed in this paper. A comparison of these techniques in term of tumor log cell kill is provided. ABMT is the best second line therapy for non-Hodgkin lymphomas (NHL), either after relapse after conventional chemotherapy or partial failure (partial remission). In these patients, the probability of remaining in remission at 3 years is about 50 p. 100. ABMT is currently under trial in the treatment of solid tumors and some success has been obtained in carcinoma of the ovary, non-seminomatous tumor of the testis, neuroblastoma, and some selected breast cancers.

Soft tissue sarcomas of adults represent an heterogeneous group of rare malignant tumors, for which clinical and histopathological prognostic factors are now well defined. The GTNM classification recommended by the UICC is effectively predictive for the metastatic potential of these diseases. Although chemotherapy still have limits in advanced sarcomas, the efficacy level reached allows to consider its use with a curative intend, in multidisciplinary therapeutic program. A critical analysis of the studies already published shows that adjuvant chemotherapy can reduce the distant metastases rate in patients presenting an operable primary tumor. Furthermore, the preliminary results of a study indicate that neoadjuvant (induction) chemotherapy may be of value for primarily inoperable patients. All these encouraging results remain to be confirmed by further studies with a long-term follow up of the patients.

One case of invasive aspergillosis in patient with myeloblastic leukemia probably induced by chimiotherapy is reported. Aspergillosis is a severe infection in immunodepressed host with 70 to 80% of mortality. Early diagnosis can be often carried by broncho-alveolar lavage, route of entry is always pulmonary one. Rapidly established antimycotic treatment can avoid death. Laminar air flow rooms and air spores numeration allow prevention of this infection in the immunodepressed host.

In spite of the progress achieved in endoscopic detection and surgical techniques, the prognosis of gastric adenocarcinomas remains poor. To improve the results obtained, one of the most important lines of research is chemotherapy, but its place in the management of these tumours is still controverted. Apart from 5-fluorouracil, other active drugs recently developed (e.g. adriamycin, mitomycin, nitroso-ureas and cis-platinum) have been entered into new protocols and tested. The results at present available in patients with metastases are 40 to 50% complete or partial objective responses lasting for 4 to 16 months. They justify the use of these drugs, provided the patients' comfort is improved after the first two cycles. The place of adjuvant chemotherapy after complete surgical resection of gastric adenocarcinomas is still debated. Only 3 out of 13 randomized trials have demonstrated a longer survival in the treated group. Further controlled trials are required, using the most effective protocols, to determine their advantages and to find out which subgroups of patients are likely to benefit from chemotherapy.

The aim of this study is to try to answer these two questions: is an intra-arterial chemotherapy of breast cancer technically possible? would such a treatment present a clinical interest? to this purpose, 12 tumoral breasts have been studied from a vascular, anatomic and arteriographic point of view; two of them were moreover subjected to scintigraphic and pathologic studies. The results seem to be encouraging, and studies are continued to specify different parameters of this therapeutic approach; then, the possibility of a clinical trial could be considered.