J. S. MITCHELL 



2. Therapeutic Experiments 



In tlie therapeutic experiments- to test radio-sensitization by tetra-sodium 

 2-meth\l-l : 4-naphthohydroquinone diphosphate (Compound I) of the 



Table III. — Clinical Therapeutic Trial of Compound I as a Radio-sensitizer 

 Summary of Results to 30th June 1954 



Treatment of inoperable cases of carcinoma of the bronchus with randomized allocation 

 to alternati\e treatments. X-ray therapy combined with intravenous Compound I (X-J-I-VS) 

 and X-ray therapy combined with intramuscular Compound I (X^I-MS) which is the 

 control group. Results assessed 30th June 1954. Cases No. 1-151 inclusive in which the 

 first X-ray treatment was given between 1st April 1951 and 31st December 1953. 



Treatable less advanced male cases 



Selected from these cases are those with no evidence of extra-thoracic spread, metastases 

 in ribs or the syndrome of superior mediastinal obstruction at the first X-ray treatment 

 and those in which the minimum tumour dose was not less than l,200r. For the 

 present purpose cases treated surgically at any stage, cases regarded as operable but not 

 treated surgically on account of poor general condition and female patients are excluded. 

 Survi\al is estimated in months to the nearest month from the first X-ray treatment 

 and also from the first symptom. 



Number of cases sursiving 8 months 

 or more after first X-ray treatment/ 

 Total number of cases in each group 

 Group X+I-VS X+I-MS 



(a) Histology positi\e for carcinoma of the bronchus (one 



p.m. and sputum, all others bronchial biopsy) . . 7/11 3/15 



(b) Conclusive e\idence of malignant cells in sputum 



and/or bronchial aspirate, or probable malignant 

 cells in sputum and/or bronchial aspirate, together 

 with subsequent development of definite metastases 5/7* 0/6 



(c) Reasonably certain diagnosis with typical broncho- 



scopic and radiological appearances and clinical 

 course, including subsequent development of 

 definite metastases . . . . . . . . . . 3/3 0/4 



15/21 3/25 



Pooled groups (a), (b) and (c) 



* In this group is included one case surviving 4 months from the first X-ray treatment 

 and 10 months from the first symptom who was given intramuscular compound because of 

 incorrect suspicion of cerebral metastases ; for calculation of mean survival times, this case 

 is transferred to the group X+I-MS. 



Mean survival times {to date) from first X-ray treatment : 10-2 months for X— I-\"S, and 



4-8 months for X+I-MS. The 

 difference is significant ; for 44 

 d.f., t = 4-448, and P-::0-001. 

 from first symptom : 15-8 months for X-f-I-VS, and 



11-2 months for X+ I-MS. The 

 difference is significant ; for 44 

 d.f.. t=2-520 and P=0-0163. 



It is to be noted that at the date of assessment, 4 patients were still li\ing in the series 

 X— I-VS and one patient was li\ing in the series X-rl-MS. 



Walker carcinoma 256, in the rat, a number of experiments have been carried 

 out which are not included in this paper and which will be reported else- 

 where, together with further experiments in progress. 



The increased proportion of tumours showing permanent retrogression in 

 Group D of Table I (page 175), that is with intravenous Compound I and 



183 



