University Of Texas MD Anderson Cancer Center Research Articles

Developing and evaluating a cancer prevention teaching module for secondary education: Project SAFETY (Sun Awareness for Educating Today's Youth).

The University of Texas M.D. Anderson Cancer Center (UTMDACC) is concerned with the meteoric rise in incidence of melanoma. As few as three episodes of blistering sunburns before age 20 increases two to three times an individual's risk for developing this malignancy. These statistics have compelled the UTMDACC to develop a comprehensive prevention program on skin cancer directed specifically to our youth. It is designed to be incorporated into the high school biology curriculum and is composed of three 50-minute teaching programs bound together with common themes, visuals, and treatment styles. The incorporation of prevention practices limiting damaging exposure to ultraviolet irradiation would significantly impact the future incidence of skin cancer in these individuals.

Hypofractionation: lessons from complications

Hypofractionation refers to irradiation schemes with less than 5 fractions per week and larger doses per fraction than 2 Gy. It was initiated around 1960 to ease the burden for patients who had to come to the hospital to be treated every day and to save machine time. In the treatment of breast cancer at the University of Texas M. D. Anderson Cancer Center (UTMDACC) in 1962, the acute reactions of the skin were matched in 3- and 5-day treatment. More severe late sequelae were observed in the 3-day-a-week treatment than in the 5-day treatment. In 1966 the NSD formula was published and from thereon was used to adjust the total dose based on the number of fractions. Later, the TDF and CRE formulae were used. In almost all publications, a high percentage of severe complications after hypofractionation have been reported. There is overwhelming evidence that fraction size of more than 2 Gy produces late unfavorable sequelae, and therefore, despite the inconvenience for patients and the taxing of machine time, hypofractionation should not be used, unless there is a specific rationale concerning the tumor characteristics of doing so. In that case the total dose must be corrected in order not to increase the late morbidity.

Treatment of malignant germ cell tumors of the ovary with bleomycin, etoposide, and cisplatin.

Since 1984, we have treated 26 patients with malignant ovarian germ cell tumors with a combination of bleomycin, etoposide (VP-16), and cisplatin (BEP) at The University of Texas MD Anderson Cancer Center (UTMDACC). The median age of the patients was 19 years (range, 8 to 32). All patients underwent initial surgery (unilateral salpingo-oophorectomy in 14, unilateral salpingo-oophorectomy plus abdominal hysterectomy in one, and bilateral salpingo-oophorectomy with or without hysterectomy in 11 patients). Twenty patients had no residual disease, three had less than or equal to 2 cm (one each, dysgerminoma, mixed, and immature teratoma), and three had more than 2 cm lesions (two dysgerminomas, one endodermal sinus tumor). Fourteen patients had pure dysgerminoma (five, stage I; one, stage II; six, stage III; and two, recurrent), and 12 had nondysgerminomatous tumors (five, stage I; two, stage II; three, stage III; and two, recurrent). All four patients with clinically measurable disease had a complete response. All four patients who underwent second-look laparotomy had negative findings. Twenty-five patients (96%) remain in sustained remission 10.4 to 54.4 months from the start of chemotherapy. One patient died of progressive disease 14 months after beginning chemotherapy. We conclude that the BEP regimen has excellent activity and acceptable toxicity in patients with malignant ovarian germ cell tumors.