The authors report two cases of multiple cancers (three and four) and precise the criterions of multiplicity of cancers, their frequency and their localizations. The factors incriminated in multiple carcinogenesis, often not well known and complicated, are also studied, such as family ground, age, blood groups, hormones, viruses, immunologic deficiencies and some carcinogenic drugs. Moreover, the actual progress in therapy, leading to the healing of the first tumor, may favour the secondary supervening of one or more cancers, as the survival is longer.

In order to study the response of patients with multiple myeloma of the bones (MM) to various anti-cancer drugs (Melphalan M, Cyclophosphamide Cy, Nitrosourea NU, Vincristine V, Adriamycine A and Prednisone P), 70 MM received the following treatment : 1) Induction therapy : a) M and P or b) M and Cy and P ; 2) Levelling with partial or complete response : V Cy P (in case a) or V M Cy P (in case b) ; 3) Relapse : A and NU. The following results were obtained : 1) Only 42.6% of patients respond to induction therapy ; 2) Fewer than 10% of patients showing a response reach a second levelling with Vincristine ; 3) 50% of those not showing a response reach a levelling between --20 and --50 and have prolonged survival ; 4) Only 20% of non responders are improved by Cy P or A and NU. The median actuarial survival is 42 months. Among the responders two poor prognosis factors must be underlined : hypercalcemia and the speed of response.

A report of two cases of acute leukaemia discovered during pregnancy. The first was treated from the 24th week with cytosine arabinoside, daunorubicine and vincristine and then rubidazone. Only an incomplete remission was obtained. The pregnancy ended with the birth at the 36th week of a normal child, which remains well at the age of 13 months. The second patient received during the 29th week of pregnancy chemotherapy combining cytosine arabinoside and daunorubicine. Signs of foetal distress appeared at 31 weeks. Delivery took place during the 33rd week in a phase of aplasia. The child was born apparently dead and was resuscitated. A complete remission of the leukaemia was obtained. The child was well at the age of 13 months. A transient neutropaenia was noted at the age of 2 months in both children.

Between 1964 and 1978, 21 patients with locally extensive soft tissue sarcoma received intal-arterial regional chemotherapy (IAC), combined with radiotherapy. Some patients were also submitted to conservative surgery. Although there were three serious accidents, one of which was lethal, the tolerance was considered acceptable. Tumor regression of more than 50 per cent was observed in 9 of the 21 patients after chemotherapy. Overall, the addition of IAC to radiation therapy gave satisfactory local control. Recurrent local disease occurred in only four patients. On the basis of these results IAC can be considered as an important element of combined treatment methods to achieve local control in locally extensive soft tissue sarcomas, which are generally not very responsive to systemic chemotherapy.

Taking into account the evolutive features of anaplastic cancers, the authors used four-drug combination chemotherapy with adriamycin, vincristine, methotrexate and cyclophosphamide applied to 55 patients. Treatment was administered in courses of 3 weeks at 15-day intervals and consisted of 3 days of treatment/week, repeated every 15 days. On the whole the treatment was well tolerated; however, the use of adriamycin was restricted because of its cumulative toxicity. Immediate objective responses were observed in 48 patients (87% of the cases) with 32 tumor regressions < 50 per cent (58%), 14 of which were complete remissions. The effects were most distinctive in distant lymph node metastases (78%). In the majority of cases the effects were of brief duration. Whether or not radiotherapy was associated, the overall course of the disease was not significantly influenced. The authors point out that patients responding to this protocol did not achieve the median survival, whereas the median survival was 17 months for an identical period of observation with varied treatments used priorly. The authors conclude that this chemotherapeutic protocol needs to be reinforced and readjusted in order to improve long term results.