Beneficial Effects Of Immunotherapy (bacterial Toxins) On Sarcoma Of The Soft Tissues, Other Than Lymphosarcoma; End Results In 186 Determinate Cases With Microscopic Confirmation Of Diagnosis 49 Operable, 137 Inoperable
Cancer Research Institute Monograph 16: 1975; 219 pgs
View Original Source →Abstract
The purpose of this review is to analyze the effect of bacterial toxin therapy on patients with sarcoma of the soft tissues. It is hoped that the analysis of factors influencing success and failure in the following 186 cases will lead to more effective use of the method and to greater knowledge regarding this form of therapy and its effects, not only on sarcoma. The treatment of malignant tumors by injections of bacterial products is based on approximately 400 recorded cases of so-called “spontaneous regressions,” the great majority of which occurred in patients who concurrently developed an acute infection, principally streptococcal or staphylococcal. The present report consists of all the microscopically proven cases of operable and inoperable sarcoma of the soft tissues in which Coley toxins were administered.
Case Details
Personal Characteristics
Mrs. M.s., female, aged 29, of hartford, connecticut
Clinical Characteristics
Very large recurrent inoperable fibrosarcoma of the gluteal region and thigh, confirmed by microscopic examination. Pain developed in the upper left thigh, noticed a growth the size of her hand a little above and posterior to the great trochanter. There was a constant ache in the leg. The growth gradually increased in size for four years. In october 1891 it had attained a diameter of 15 by 20 centimeters. Three months later a recurrence developed further up in the gluteal region. This increased in size and caused a great deal of pain. The tumor was so extensive that any attempt to remove it by further operation was out of the question. Pain was very severe.
Remission Characteristics
The pain ceased but improvement was very slow. On june 30, 1894 at the end of nearly three months’ treatment the patient left the hospital. While there had been considerable decrease in size, there still remained a large tumor. This continued to decrease in size without further treatment. Examination by coley five years later showed two small, hard movable masses at the site of the original tumor. On april 29, 1899, coley operated at memorial hospital. The fibrous remains were separated from the surrounding tissue down to their connection with the bone, and this was cut through. Microscopic examination of the tissue showed it to be fibrous stroma, all the malignant cellular elements having been absorbed.
Treatment & Mechanisms
Proposed Remission Mechanisms
The toxins caused regression of the malignant elements of the growth, but there remained a residue of hard fibrous tissue.
Clinical Treatment
Surgery: it was then removed by dr. Charles mcburney at roosevelt hospital in new york. The wound healed in six weeks. The patient was then referred to dr. W.b. Coley. Physical examination at the time the toxins were begun showed a very large tumor occupying the left gluteal region, involving the muscles and fascia of the upper thigh, posteriorly. On april 29, 1899, coley operated at memorial hospital. The fibrous remains were separated from the surrounding tissue down to their connection with the bone, and this was cut through.
Non-Clinical Treatment
Toxin therapy (type IV): injections were begun by coley at new york postgraduate hospital on april 7, 1894. They were made locally and the dose was gradually increased to the point of producing a marked reaction.
Additional Notes
The patient remained in good health and was examined periodically by Coley. She was presented before the Clinical Congress of Surgeons of North America in November 1912, and before the American College of Surgeons in 1932. Her family physician, Dr. Philip G. McClellan, reported on October 10, 1939: “She is now 77 years old and at the site of the original lesions in the buttock there is nothing but a very pliable scarring. Her only symptoms are of a cardiac nature.” She died on February 2, 1941, of coronary heart disease, at the age of 77. This was 51 years after onset and 47 years after toxin therapy.