bluuebunny/crossref_metadata_2025 huggingface dataset:
Lithium und seine Verbindungen ‐ Industrielle, medizinische und wissenschaftliche Bedeutung
Authors: Deberitz Jürgen , Boche Gernot
Published: August 2003

Der Aufsatz bietet eine kurze Zusammenfassung über die industrielle, medizinische und wissenschaftliche Bedeutung von Lithium und seinen Verbindungen. So ist Lithiumcarbonat von großer Wichtigkeit bei der Glas‐, Email‐ und Keramikherstellung; verschiedene anorganische Lithiumverbindungen dienen als Zementverfestiger, und Lithium‐Fette, d. h. Schmieröle mit Lithiumsalzen von langkettigen aliphatischen Carbonsäuren, sind aus der modernen Technik genauso wenig wegzudenken, wie LiOH als CO2‐Fänger, LiCl (LiF) in der Aluminiumverarbeitung und gewinnung oder LiBr (LiCl) in Kühlanlagen. Bei der Behandlung manisch‐depressiver Erkrankungen haben sich Lithium‐Salze einen festen Platz gesichert. Metallisches Lithium findet zunehmend Anwendung in Batterien. Dass es ohne 6 Lithium keine Wasserstoffbombe gäbe, ist auch nicht allgemein bekannt. Ein Abfallprodukt: der billige Zugang zu 6 Lithium und die daraus entwickelte 6 Li‐NMR‐Spektroskopie. Schließlich einige Hinweise auf Lithium‐organische Verbindungen und ihre große Bedeutung in der modernen (organischen) Synthese, sowohl in Labors als auch in der Technik (z.B. anionische Polymerisation). Ein besonders wichtiges Kapitel stellt die stereoselektive Synthese mit Hilfe von Lithium‐organischen Verbindungen dar.
Woher kommt das Wasser der Erde? ‐ Urgaswolke oder Meteoriten
Authors: Müller Jörn , Lesch Harald
Published: August 2003

Wasser ist eines der häufigsten Moleküle im Universum. Nachdem der Wasserstoff bereits kurz nach dem Urknall entstand, wurde der für Wasser nötige Sauerstoff erst viel später in den Sternen fusioniert. In den staubbeladenen Wolken des interstellaren Mediums verbanden und verbinden sich noch heute diese Elemente zu Wasser. Wie aber kam das Wasser auf die Erde? Entweder hat es die Erde bei ihrer Entstehung aus einer Gasscheibe mitbekommen oder es wurde durch Kometen auf die Erde gebracht. Ob beide Prozesse oder nur einer Anteil am Wasser der Erde haben, ist gegenwärtig noch nicht entschieden. Menge an Staub ist der ideale Untergrund für die Bildung von Molekülen und vor allem auch vom Wassermolekül.
Die Reaktivdestillation: Moderne Trenn‐ und Reaktionstechniken
Authors: Sundmacher Kai , Ivanova Mariyana
Published: August 2003

Die Reaktivdestillation beruht auf der Integration der chemischen Umsetzung eines Eduktgemisches und der stofflichen Aufarbeitung des Produktgemisches in einem einzigen Apparat, der in der Regel als Gegenstromkolonne ausgeführt ist. Die Motive für den Einsatz dieser Technologie sind vielfältig. Bei der Durchführung von Gleichgewichtsreaktionen können häufig deutlich höhere Umsätze als in konventionellen einphasigen Reaktoren erreicht werden. Unerwünschte Folgereaktionen können durch eine verbesserte Konzentrationsführung der Reaktivdestillation unterdrückt werden, so dass die Selektivität bezüglich der Zielprodukte erhöht wird.Bei stark exothermen Umsetzungen ist der Temperaturanstieg in einer reaktiven Destillationskolonne besser kontrollierbar. Darüber hinaus können auch solche Mischungen, die durch konventionelle Destillation nicht oder nur sehr schwer in ihre Einzelkomponenten trennbar sind, aufgearbeitet werden. Diese Vorteile führen zur signifikanten Reduzierung von Investitions‐und Betriebskosten. Infolge der synergetischen Wechselwirkungen von chemischer Reaktion und Destillation in einem Apparat zeigen Prozesse der Reaktivdestillation häufig komplexes Betriebsverhalten. Daher ist die Auslegung dieser integrierten Prozesse deutlich anspruchsvoller als die Auslegung konventioneller Reaktor‐Separator‐Sequenzen.
Bakterien für den Denkmalschutz
Authors: Jacoby Petra
Published: August 2003

Saurer Regen und andere Folgen der wachsenden Umweltverschmutzung schädigen immer stärker wertvolle Kunstwerke aus Kalkstein. Eine neue Methode, bei der Bakterien verlorengegangenes Material wieder auffüllen, könnte Denkmäler in Zukunft möglicherweise vor dem schleichenden Verfall retten.
Polymere Linse mit Wirkstoffdepot
Authors: Feil Sylvia
Published: August 2003

Der Graue Star lässt die Linsen im Auge eintrüben. Der Katarakt kann zu einer Erblindung führen, die nur durch eine Operation zu behandeln ist. Dabei wird die trübe Linse entfernt und eine künstliche in den Kapselsack, also intraokular, implantiert. Bei einem ausgeprägten Grauen Star lässt sich die Linse nur schwer vollständig entfernen. Einzelne Epithelzellen verbleiben und können wieder vom Rand des Linsensackes zur Mitte der implantierten polymeren Linse hin wachsen. Diese Proliferation kann zu einem Nachstar führen, der behandelt werden muss. Dabei werden derzeit die aufgewachsenen Zellen mit einem Laser mechanisch entfernt. Eine nicht‐invasive Methode zur Nachbehandlung des Grauen Stars entwickeln nun die Arbeitsgruppen von Andreas Greiner und Norbert Hampp an der Universität Marburg [1‐3].
Reaktionssteuerung am Einzelmolekül
Authors: Groß Michael
Published: August 2003

Im Modellbaukasten geht es so einfach. Man nimmt ein Molekül in die Hand, stöpselt ein paar Bindungen um, und schon hat man es in ein anderes Molekül umgewandelt. Was wäre, wenn man echte Moleküle ebenso leicht gezielt herausgreifen und zur Stoffumwandlung zwingen könnte? Erste zaghafte Schritte in dieser Richtung sind bereits möglich.
CAS bringt Übersicht in die publizierte Chemie
Authors: Hübner Karl
Published: August 2003

Seit 1907 gibt es die Chemical Abstracts. Heute bietet der Chemical Abstracts Service die vermutlich umfangreichsten chemischen Datenbanken. Ganz nebenbei ist mit dem CAS Registry auch ein Register entstanden, das jederzeit die bekannte stoffliche Vielfalt widerspiegelt. Im Juni 2003 wurde die 50.000.000ste Substanz registriert. Der Zuwachs ist rasant. Noch zum Jahrtausendwechsel kannte die Menschheit nicht einmal halb so viele Stoffe.
Höhepunkte aus Liebigs Experimentalvorlesung
Authors: Schwedt Georg
Published: August 2003

Am 12. Mai 1803 wurde Liebig in Darmstadt geboren. Aus Anlass seines 200. Geburtstages wurden Experimente aus seiner in Gießen entwickelten Experimentalvorlesung ausgewählt. In diesem Beitrag wird aus Liebigs Vorlesungsbuch das Metall Kupfer anhand heute klassischer Reaktionen vorgestellt. Als Ergänzung werden auch Zitate aus Kekul?s Mitschrift verwendet.
Kosmetik ‐ Chemie mit Charme?
Authors: Hildebrandt Henry
Published: August 2003

Chemie hat in der Öffentlichkeit Imageprobleme ‐ darüber herrscht wohl Einigkeit. Genauso einig sind sich die mit Chemie befassten Personen, dass dieser Zustand unhaltbar ist. Weniger Einigkeit besteht darüber, was die Ursachen sind sowie darüber, wie Öffentlichkeitsarbeit für Chemie betrieben werden kann. Vielleicht kann das Internet hier Hinweise geben.
Psychological well being and quality of life in ovarian cancer survivors
Authors: Ferrell Betty , Smith Stephany L. , Cullinane Carey A. , Melancon Cindy
Published: August 2003

BACKGROUND

This report offers a unique analysis of the psychological distress associated with ovarian cancer in a review of natural correspondence between ovarian cancer survivors and an ovarian cancer newsletter.

METHODS

A review of 21,806 letters, cards, and e‐mails reflecting correspondence from January 1994 to December 2000 between ovarian cancer survivors and the founding editor of Conversations!: The International Newsletter for those Fighting Ovarian Cancer was performed using ethnographic qualitative research methods. Statements related to the impact of disease were bracketed and coded within physical, psychological, social, and spiritual domains according to the City of Hope Quality of Life Ovarian Cancer instrument. Statements that reflected psychological well being were then evaluated with respect to the disease trajectory (i.e., diagnosis, treatment, remission, recurrence, and advanced disease/end of life).

RESULTS

A total of 1282 communications were identified that pertained to psychological well being. Findings based on major themes derived from the analysis included descriptions of stressors associated with disease status. Significant stressors were identified within all phases of diagnosis, treatment, remission, and recurrence. Women described both positive and negative effects of disease and frequently demonstrated resourcefulness and perseverance by sharing coping mechanisms and survival strategies.

CONCLUSIONS

The natural correspondence from women with ovarian cancer provided a rare opportunity to capture the psychological concerns of women throughout all stages of the cancer trajectory. Health care professionals' awareness of the common psychological stressors throughout the ovarian cancer trajectory may allow them to identify more readily the needs for support, leading to improvement in overall quality of life. Cancer 2003;98:1061–71. © 2003 American Cancer Society.

DOI 10.1002/cncr.11291
A Phase II study of intravenous exatecan mesylate (DX‐8951f) administered daily for 5 days every 3 weeks to patients with metastatic breast carcinoma
Authors: Esteva Francisco J. , Rivera Edgardo , Cristofanilli Massimo , Valero Vicente , Royce Melanie , Duggal Anil , Colucci Philippe , DeJager Robert , Hortobagyi Gabriel N.
Published: August 2003

BACKGROUND

The objective of the current study was to determine the antitumor activity, safety, and pharmacokinetic (PK) profile of exatecan mesylate in patients with anthracycline‐resistant and taxane‐resistant, metastatic breast carcinoma.

METHODS

All patients had clinical evidence of metastatic breast carcinoma; disease resistance or progression after chemotherapy that included anthracyclines and taxanes; no prior chemotherapy with camptothecin derivatives; and bidimensionally measurable disease. The starting dose of exatecan mesylate was either 0.5 mg/m2 per day or 0.3 mg/m2 per day, depending on prior chemotherapy exposure. PK blood samples were collected from each patient during the first course of therapy.

RESULTS

Thirty‐nine patients received a total of 172 courses of therapy (median, 4 courses; range, 1–16 courses). Three patients (7.7%) had a partial response, and 20 patients (51.3%) had either a minor response or stable disease. Approximately 20% of patients had stable disease for 6 months or longer. The median time to disease progression was 3 months, and the median survival was 14 months. The most frequent severe adverse event was neutropenia. The most frequent severe (Grade 3–4) nonhematologic toxicities were fatigue, nausea, headache, myalgia, constipation, emesis, and paresthesias in 28%, 10%, 10%, 8%, 8%, 5%, and 5% of patients, respectively. Exatecan mesylate displayed linear PK characteristics at the doses administered. The average plasma clearance, total volume of distribution, and terminal elimination half‐life were approximately 1.4 L per hour per m2, 12 L/m2, and 8 hours, respectively.

CONCLUSIONS

Exatecan mesylate had moderate activity in patients with anthracycline‐refractory and taxane‐refractory, metastatic breast carcinoma. The toxicity profile of exatecan mesylate was acceptable, and it appeared to have linear PK characteristics on the basis of multiple dose administration. Cancer 2003;98:900–7. © 2003 American Cancer Society.

DOI 10.1002/cncr.11557
Histologic grade, stage, and survival in breast carcinoma
Authors: Earl Henson Donald , Chu Kenneth C. , Levine Paul H.
Published: August 2003

BACKGROUND

African American women have lower breast carcinoma survival rates than do Caucasian women. African American women often present with advanced‐stage disease and more aggressive tumors as shown by histologic and laboratory‐based prognostic factors. Aggressive tumor behavior may be responsible, at least in part, for the advanced stage and reduced survival rates.

METHODS

The authors investigated the correlation between survival and histologic grade, stage of disease, and tumor size for both African American and Caucasian women who were younger than age 50 years and age 50 years and older. The authors also investigated the distribution of grade within each stage group and the distribution of grade by tumor size. African American and Caucasian women were matched by stage, tumor size, and histologic grade. Survival was represented by 6‐year breast carcinoma–specific survival rates.

RESULTS

Compared with Caucasian women, African American women, regardless of age, had proportionally more Grade III tumors and fewer Grade I and II tumors for all stages combined and for each individual stage group. Similarly, matched for tumor size, African American women had more Grade III tumors and fewer Grade I and II tumors compared with Caucasian women, except for tumors smaller than 1.0 cm. For nearly all combinations of stage and grade regardless of age, the 6‐year breast carcinoma–specific survival rate was lower for African American women than for Caucasian women, although it did not always reach statistical significance.

CONCLUSIONS

Compared with Caucasian women, African American women, regardless of age, presented with proportionally more aggressive tumors for each stage of disease and for each tumor size above 1.0 cm as revealed by the histologic grade. Higher histologic grade may be a significant contributing factor to survival disadvantage for African American women. Cancer 2003;98:908–17. Published 2003 by the American Cancer Society.

DOI 10.1002/cncr.11558
Sentinel lymph nodes with technetium‐99m colloidal rhenium sulfide in patients with esophageal carcinoma
Authors: Kato Hiroyuki , Miyazaki Tatsuya , Nakajima Masanobu , Takita Junko , Sohda Makoto , Fukai Yasuyuki , Masuda Norihiro , Fukuchi Minoru , Manda Ryokuhei , Ojima Hitoshi , Tsukada Katsuhiko , Asao Takayuki , Kuwano Hiroyuki , Oriuchi Noboru , Endo Keigo
Published: August 2003

BACKGROUND

The authors assessed the detection of sentinel lymph nodes in patients with esophageal squamous cell carcinoma (SCC) using technetium‐99m colloidal rhenium sulfide. They studied whether an analysis of sentinel lymph nodes using cytokeratin (CK) immunohistochemistry increased the accuracy of staging.

METHODS

The authors observed 25 patients with thoracic esophageal carcinomas who underwent radical esophagectomy. The day before surgery, technetium‐99m colloidal rhenium sulfide was injected into the submucosa at four sites around the primary tumor. Lymphoscintigraphy was performed. Esophagectomy and regional lymph node dissection were performed 17 hours after the technetium‐99m injection. After surgery, the resected lymph nodes were evaluated by CK staining.

RESULTS

Lymphoscintigraphy detected sentinel lymph nodes in 92% of the patients (23 of 25 patients). The accuracy of sentinel lymph node was 91.3% (21 of 23 patients), the sensitivity was 86.7% (13 of 15 patients), and the false‐negative rate was 8.7% (2 of 23 patients). A comparison of the number of sentinel lymph nodes and clinicopathologic factors showed that there was a significant association between the number of sentinel lymph nodes and lymph node status (P < 0.01), pathologic stage (P < 0.05), and the number of metastatic lymph nodes (P < 0.05). Occult metastasis was detected by CK staining in 14 (56%) of the 25 patients and in 23 (1.7%) of 1406 lymph nodes. Because the 2 false‐negative (sentinel lymph node–negative and nonsentinel lymph node–positive) patients who had occult metastases in the sentinel lymph nodes, the accuracy of sentinel lymph node evaluation using CK staining was 100% (23 of 23).

CONCLUSIONS

Lymphatic mapping with technetium‐99m colloidal rhenium sulfide was used to identify the lymphatic basin and was feasible in patients with esophageal SCC. An analysis of sentinel lymph nodes using CK immunohistochemistry increased the accuracy of sentinel lymph node. Cancer 2003;98:932–9. © 2003 American Cancer Society.

DOI 10.1002/cncr.11559
Hiatal hernia, reflux symptoms, body size, and risk of esophageal and gastric adenocarcinoma
Authors: Wu Anna H. , Tseng Chiu‐Chen , Bernstein Leslie
Published: August 2003

BACKGROUND

Since the 1970s, incidence rates of esophageal and gastric cardia adenocarcinoma have risen substantially. Reasons for the increasing trends are not well understood.

METHODS

A population‐based, case–control study that included esophageal adenocarcinomas (n = 222), gastric cardia adenocarcinomas (n = 277), distal gastric adenocarcinomas (n = 443), and 1356 controls was conducted in Los Angeles County. Unconditional logistic regression was used to calculate odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for the 3 tumor types.

RESULTS

After adjustment for demographic factors, smoking, and body size, both hiatal hernia and reflux symptoms emerged as significant independent risk factors. Risk of esophageal adenocarcinoma was increased 3‐fold (adjusted OR, 3.61; 95% CI, 2.49–5.25) among those who had reflux symptoms but did not have hiatal hernia, 6‐fold (adjusted OR, 5.85; 95% CI, 3.18–10.75) among those who had hiatal hernia but did not have reflux symptoms, and 8‐fold (adjusted OR, 8.11; 95% CI, 4.75–13.87) among those who had both reflux symptoms and hiatal hernia. A similar risk pattern was found in relation to history of hiatal hernia and other reflux conditions. A more modest but still significant risk pattern was observed for gastric cardia adenocarcinoma. Among control subjects, there was a significant and positive association between increasing body mass index and history of hiatal hernia and/or reflux symptoms.

CONCLUSIONS

Hiatal hernia, in combination with other reflux conditions and symptoms, was associated strongly with the risk of esophageal adenocarcinoma. These associations were more modest for gastric cardia adenocarcinomas. A significant and positive association between body size and history of hiatal hernia/reflux symptoms also was observed. Cancer 2003;98:940–8. © 2003 American Cancer Society.

DOI 10.1002/cncr.11568
Natural history of surgically treated bladder carcinoma with extravesical tumor extension
Authors: Quek Marcus L. , Stein John P. , Clark Peter E. , Daneshmand Siamak , Miranda Gus , Cai Jie , Groshen Susan , Lieskovsky Gary , Quinn David I. , Raghavan Derek , Skinner Donald G.
Published: August 2003

BACKGROUND

The current TNM classification for bladder carcinoma stratifies extravesical extension into microscopic (pT3a) and macroscopic (pT3b) tumor involvement. The authors evaluated the outcomes of patients with pT3a and pT3b disease after radical cystectomy.

METHODS

Patients (n = 129) with transitional cell carcinoma of the bladder treated with radical cystectomy alone demonstrated pathologic extravesical tumor extension: 37 (29%) had pT3a disease and 92 (71%) had pT3b disease. No patient received any adjuvant therapy. With a median follow‐up of 13.6 years, the presence of lymph node involvement, margin positivity, local (pelvic) and distant disease recurrence, and clinical outcomes were determined.

RESULTS

Of the 129 patients, 43 (33%) had lymph node tumor involvement: 13 of 37 patients with pT3a disease (35%) and 30 of 92 patients with pT3b disease (33%). The 10‐year recurrence‐free and overall survival for the entire group was 54% and 20%, respectively. No statistical difference between pT3a and pT3b disease was observed with regard to recurrence‐free (P = 0.54) and overall (P = 0.66) survival. Lymph node involvement was predictive of a significantly worse 10‐year recurrence‐free survival (32%) compared with lymph node‐negative disease (60%; P = 0.003). Local disease recurrence was reported to occur in 12 patients (9%), whereas 37 patients (29%) were reported to develop distant metastases. Among those who had disease recurrence, the type of disease recurrence (local or distant) was not found to be associated with tumor stage (pT3a vs, pT3b, P = 0.47).

CONCLUSIONS

This cohort of surgically managed patients provided insight into the long‐term natural history of pathologically confirmed extravesical bladder carcinoma after radical cystectomy. There was no important difference in the incidence of lymph node involvement, survival rates, and disease recurrence rates between patients with microscopic and macroscopic extravesical extension. Adjuvant protocols should be undertaken for these high‐risk patients to further improve on these clinical outcomes. Cancer 2003;98:955–61. © 2003 American Cancer Society.

DOI 10.1002/cncr.11569
Zoledronic acid delays the onset of skeletal‐related events and progression of skeletal disease in patients with advanced renal cell carcinoma
Authors: Lipton Allan , Zheng Ming , Seaman John
Published: August 2003

BACKGROUND

The objective of this study was to assess the efficacy and safety of zoledronic acid in patients with bone metastases secondary to renal cell carcinoma (RCC).

METHODS

A retrospective subset analysis of patients with RCC enrolled in a multicenter, randomized, placebo‐controlled study of zoledronic acid was performed. Patients were randomized to receive zoledronic acid (4 or 8 mg as a 15‐minute infusion) or placebo with concomitant antineoplastic therapy every 3 weeks for 9 months. The primary efficacy analysis was the proportion of patients with one or more skeletal‐related events (SREs), which were defined as pathologic fracture, spinal cord compression, radiation therapy, or surgery to bone. Secondary analyses included time to first SRE, skeletal morbidity rate (events per year), disease progression, and multiple event analysis.

RESULTS

In this subset of 74 patients with RCC, zoledronic acid (4 mg) was found to significantly reduce the proportion of patients with an SRE (37% vs. 74% for placebo; P = 0.015). Similarly, zoledronic acid significantly reduced the mean skeletal morbidity rate (2.68 vs. 3.38 for placebo; P = 0.014) and extended the time to the first event (median not reached vs. 72 days for placebo; P = 0.006). A multiple event analysis demonstrated that the risk of developing an SRE was reduced by 61% compared with placebo (hazard ratio of 0.394; P = 0.008). The median time to progression of bone lesions was significantly longer for patients who were treated with zoledronic acid (P = 0.014 vs. placebo). Zoledronic acid appeared to be well tolerated; the most common adverse events in all treatment groups included bone pain, nausea, anemia, and emesis.

CONCLUSIONS

Zoledronic acid (4 mg as a 15‐minute infusion) demonstrated significant clinical benefit in patients with bone metastases from RCC, suggesting that further investigation of zoledronic acid in this patient population is warranted. Cancer 2003;98:962–9. © 2003 American Cancer Society.

DOI 10.1002/cncr.11571
Gemcitabine added to doxorubicin, bleomycin, and vinblastine for the treatment of de novo Hodgkin disease
Authors: Friedberg Jonathan W. , Neuberg Donna , Kim Helen , Miyata Sarah , McCauley Mary , Fisher David C. , Takvorian Tak , Canellos George P.
Published: August 2003

BACKGROUND

Gemcitabine is an effective treatment for recurrent Hodgkin disease (HD), with relatively minimal associated toxicity. The authors conducted a trial substituting this drug for dacarbazine in the standard regimen to form ABVG (doxorubicin, bleomycin, vinblastine, gemcitabine) for patients with newly diagnosed, high‐risk HD.

METHODS

Twelve patients (median age, 34 years) with advanced‐stage de novo HD were enrolled. Standard doses of doxorubicin, bleomycin, and vinblastine were given for six cycles. Cohorts of three patients were enrolled and the dose of gemcitabine was escalated to identify the maximally tolerated dose in this combination.

RESULTS

The maximally tolerated dose of gemcitabine was determined to be 800 mg/m2 in this combination. Five patients developed clinically significant pulmonary toxicity. Three required hospitalization during the final two cycles of treatment. Pneumonitis could not be predicted with serial diffusion capacity for carbon monoxide (DECO) evaluations, and reversed after discontinuation of bleomycin in three patients and steroid therapy in two patients. All 12 patients are alive to date, and 4 patients have experienced disease progression.

CONCLUSIONS

The bleomycin/gemcitabine combination should not be pursued for de novo HD due to significant pulmonary toxicity. Cancer 2003;98:978–82. © 2003 American Cancer Society.

DOI 10.1002/cncr.11582
Differential gene expression in leiomyosarcoma
Authors: Skubitz Keith M. , Skubitz Amy P. N.
Published: August 2003

BACKGROUND

Leiomyosarcomas (LMS) are a common subtype of soft tissue sarcoma. The molecular causes of the disease remain unclear.

METHODS

In the current study, gene expression in LMS, leiomyomas, and normal myometrium was examined. RNA was prepared and gene expression was determined using microarray analysis arrays containing approximately 12,000 known genes and 48,000 expressed squence tags (ESTs).

RESULTS

A number of genes were found to be differentially expressed in these sample sets, and six genes including cyclin‐dependent kinase inhibitor 2A, diaphanous (Drosophila homolog) 3, doublecortin, calpain 6, interleukin‐17B, and proteolipid 1 were found to be overexpressed in LMS compared with normal myometrium and 18 other tissues. Sets of genes were identified whose expression could be used to cluster samples with either LMS, leiomyomas, or normal myometrium.

CONCLUSIONS

The authors concluded that differences in gene expression can be detected between LMS and leiomyomas, normal myometrium, and other tissues, and that these changes in gene expression may yield clues with regard to the pathophysiology of leiomyosarcoma. Cancer 2003;98:1029–38. © 2003 American Cancer Society.

DOI 10.1002/cncr.11586
Multicenter study of pegylated liposomal doxorubicin in patients with cutaneous T‐cell lymphoma
Authors: Wollina Uwe , Dummer Reinhard , Brockmeyer Norbert H. , Konrad Helga , Busch J.‐O. , Kaatz Martin , Knopf Burkhard , Koch Hans‐Jürgen , Hauschild Axel
Published: August 2003

BACKGROUND

In single center studies and case reports, it was shown that pegylated liposomal doxorubicin (PEG‐DOXO) was effective as second‐line therapy for patients with cutaneous T‐cell lymphoma (CTCL). The objective of this study was to evaluate the efficacy and toxicity of single‐agent PEG‐DOXO as second‐line chemotherapy in patients with CTCL.

METHODS

A retrospective, multicenter study was performed evaluating 34 patients (31 male patients and 3 female patients). Twenty‐seven patients received PEG‐DOXO 20 mg/m2, 5 patients received PEG‐DOXO 20–30 mg/m2, and 2 patients received PEG‐DOXO 40 mg/m2. PEG‐DOXO was administered intravenously every 2 weeks in 6 patients, every 2–3 weeks in 4 patients, and every 4 weeks in 23 patients. One patient received only a single course of PEG‐DOXO. Outcomes were evaluated, and adverse effects were recorded.

RESULTS

Thirty‐four patients received at least 1 cycle of PEG‐DOXO. Disease was classified as mycosis fungoides in 28 patients, mycosis fungoides with follicular mucinosis in 2 patients, small or medium‐sized pleomorphic CTCL in 2 patients, Sèzary syndrome in 1 patient, and CD30 positive CTCL in 1 patient. Fifteen patients achieved a complete response (CR), including patients who achieved a CR and patients who achieved a CR defined by clinical criteria only with no biopsy (CRu), and 15 patients achieved a partial response (PR), resulting in a response rate (CRs, CRus, and PRs) of 88.2%. Two patients dropped out: one patient after a single PEG‐DOXO infusion because of Grade 3 capillary leakage syndrome and one patient after two cycles because of a suicide attempt that was not related to treatment or to CTCL. All other patients received at least four cycles of PEG‐DOXO. Overall survival was 17.8 months ± 10.5 months (n = 33 patients), event‐free survival was 12.0 months ± 9.5 months, and disease‐free survival was 13.3 ± 10.5 months (n = 16 patients). Adverse effects were seen in 14 of 34 patients (41.2%); they were temporary and generally mild. Only 6 patients had Grade 3 or 4 adverse effects.

CONCLUSIONS

This multicenter study provided evidence of high efficacy of PEG‐DOXO monotherapy with a low rate of severe adverse effects compared with other chemotherapy protocols in patients with CTCL. Cancer 2003;98:993–1001. © 2003 American Cancer Society.

DOI 10.1002/cncr.11593
Heat shock proteins HSP27, HSP60, HSP70, and HSP90
Authors: Lebret Thierry , Watson R. William G. , Molinié Vincent , O'Neill Amanda , Gabriel Christophe , Fitzpatrick John M. , Botto Henry
Published: August 2003

BACKGROUND

Heat shock proteins (HSPs) are synthesized by cells in response to various stress conditions, including carcinogenesis. The expression of HSPs in neoplasia has been implicated in the regulation of apoptosis, and HSPs also can act by increasing immunity. In the current study, the authors attempted to clarify the significance of HSPs in bladder carcinoma and their effect on tumor behavior.

METHODS

Expression levels of the 27‐kilodalton HSP (HSP27), HSP60, HSP70, and HSP90 were studied using immunohistochemistry on tissue sections from 42 transitional cell carcinomas of the bladder (14 Grade 1 tumors; 13 Grade 2 tumors; 15 Grade 3 tumors, including 3 tumors associated with carcinoma in situ; 30 Stage Ta tumors; 7 Stage T1 tumors; and 5 Stage T2 tumors). Bladder specimens from 10 healthy patients were used as controls in the study. The selected patients had a mean follow‐up of 52 months (range, 24–78 months). Among the 37 patients with superficial bladder carcinoma, 17 patients did not have any recurrence after undergoing primary resection, and 20 patients developed recurrent disease, including 4 recurrences with muscle invasion. HSP expression was evaluated according to the percentage of positively stained cells, and loss of expression was defined as < 80% of stained cells.

RESULTS

In normal bladder specimens, all four HSPs (HSP27, HSP60, HSP70, and HSP90) were expressed strongly in the cytoplasm and membrane from the basal cell layer to the superficial cell layer. Loss of expression was detected in tumors: respectively, 45.2%, 38.1%, 69.0% and 23.8% of tumors showed a loss of immunostaining for HSP27, HSP60, HSP70, and HSP90. No correlation between HSP expression and grade was found. Low expression levels of HSP27 and HSP60 were correlated with higher tumor stage (87% vs. 6% [P < 0.001] and 78% vs. 9% [P < 0.01], respectively). HSP60 and HSP90 expression levels were correlated with final outcome for patients with superficial bladder carcinoma: loss of expression was associated with the risk of developing an infiltrating recurrence (97% vs. 6.0% [P < 0.001] and 88.2% vs. 52.5% [P = 0.02] for HSP60 and HSP90, respectively).

CONCLUSIONS

HSPs were expressed in normal urothelium, and the current results indicated that loss of HSP60 and HSP90 expression may have prognostic relevance in patients with bladder carcinoma. The authors believe that HSP60 may be a very useful marker for patients with superficial bladder carcinoma and may be used for predicting disease progression. If these data are confirmed, low HSP60 expression levels may be usable as a prognostic marker to identify patients for whom local treatment would be insufficient. Cancer 2003;98:970–7. © 2003 American Cancer Society.

DOI 10.1002/cncr.11594
Late genitourinary and gastrointestinal toxicity after magnetic resonance image‐guided prostate brachytherapy with or without neoadjuvant external beam radiation therapy
Authors: Albert Michele , Tempany Clare M. , Schultz Delray , Chen Ming‐Hui , Cormack Robert A. , Kumar Sanjaya , Hurwitz Mark D. , Beard Clair , Tuncali Kemal , O'Leary Michael , Topulos George P. , Valentine Kristin , Lopes Lynn , Kanan Angela , Kacher Daniel , Rosato James , Kooy Hanne , Jolesz Ferenc , Carr‐Locke David L. , Richie Jerome P. , D'Amico Anthony V.
Published: August 2003

BACKGROUND

This study was designed to estimate the rates of late genitourinary (GU) and rectal toxicity after magnetic resonance image (MRI)‐guided prostate brachytherapy exclusively or in conjunction with external beam radiation therapy (EBRT).

METHODS

Between November 1997 and April 2002, 201 patients with category T1C prostate carcinoma (according to the 2002 American Joint Committee on Cancer staging criteria), prostate specific antigen levels < 10 ng/mL, and biopsy Gleason score 3 + 4 disease were treated with MRI‐guided brachytherapy exclusively or in conjunction with EBRT. The MRI‐guided technique was designed to spare the urethra based on delivery of the prescription dose to the peripheral zone exclusively. The Kaplan–Meier method was used to estimate rates of freedom from late GU and rectal toxicity. Comparisons were made using a log‐rank test.

RESULTS

At a median follow‐up of 2.8 years (range, 0.5–5.0 years), the 4‐year estimates of rectal bleeding requiring coagulation for patients who underwent implantation therapy, compared with patients who received combined‐modality therapy, were 8% versus 30%, respectively (log‐rank P value = 0.0001). Although erectile dysfunction was common (range, 82–93%), with the use of sildenafil citrate (Viagra®), it was estimated that at least two‐thirds of patients had erectile function comparable to or superior to baseline function, independent of whether they received monotherapy or combined‐modality therapy (P = 0.46). The 4‐year estimate of freedom from radiation cystitis was 100% versus 95% (P = 0.01) for patients who received monotherapy and patients who received combined‐modality therapy, respectively. No urethral strictures were observed, and no patients underwent postimplantation transurethral resection of the prostate.

CONCLUSIONS

In the current study, rectal bleeding after MRI‐guided prostate brachymonotherapy was infrequent, and urethral and bladder toxicity is reported to be rare and may be attributed to the urethral‐sparing technique of the MRI‐guided approach. Cancer 2003;98:949–54. © 2003 American Cancer Society.

DOI 10.1002/cncr.11595
Evaluation of dietetic intervention in children with medulloblastoma or supratentorial primitive neuroectodermal tumors
Authors: Bakish Jaimie , Hargrave Darren , Tariq Nauman , Laperriere Normand , Rutka James T. , Bouffet Eric
Published: August 2003

BACKGROUND

Malnutrition is a common complication of cancer treatment; it can affect energy levels and, as a consequence, quality of life. The goal of the current study was to evaluate the effect of dietetic intervention in a cohort of children treated for medulloblastoma and supratentorial primitive neuroectodermal tumors (PNET) over a 10‐year period.

METHODS

A retrospective chart review (1992–2002) of newly diagnosed cases of medulloblastoma/supratentorial PNET was performed. Hospital records were reviewed for data, including demographic characteristics, patient heights and weights, and information on treatment modalities and the use of dietetic intervention. Percent changes in body weight were calculated at time points associated with particular stages of treatment or dietetic intervention.

RESULTS

One hundred three of 112 cases were evaluable. Treatment methods included surgery only (7.8%), surgery + radiotherapy (16.5%), surgery + chemotherapy (14.5%), and surgery + radiotherapy + chemotherapy (61.2%). There was no significant change in patient weight due to surgery (median change in body weight [MCBW], −0.35%) or radiotherapy (MCBW, −0.78%). In contrast, children experienced significant weight loss (MCBW, −4.35%; P < 0.0001) 3 months after starting chemotherapy. A dietician saw 53 of the 103 children in the study cohort. There were 84 dietetic interventions (oral, 36%; parenteral, 27%; enteral, 37%) among these 53 patients. Oral diets did not result in weight gain. Parenteral nutrition was associated with significant weight gain at 1 month (MCBW, +2.7%; P = 0.03), but not at 3 months. The use of enteral feeds resulted in significant weight gain at 1 month (MCBW, +4.8%; P = 0.006) and at 3 months (MCBW, +11.8%; P < 0.0001).

CONCLUSIONS

Current multimodality treatment of intracranial PNET results in significant nutritional morbidity, primarily due to the use of intensive chemotherapy regimens. Dietetic input for pediatric patients with medulloblastoma/PNET is essential, and the implementation of enteral feeding in these children can help to reverse their nutritional morbidity. Cancer 2003;98:1014–20. © 2003 American Cancer Society.

DOI 10.1002/cncr.11598
Clinical implication and prognostic significance of the tumor suppressor TSLC1 gene detected in adenocarcinoma of the lung
Authors: Uchino Kazuya , Ito Akihiko , Wakayama Tomohiko , Koma Yu‐ichiro , Okada Tomoyo , Ohbayashi Chiho , Iseki Shoichi , Kitamura Yukihiko , Tsubota Noriaki , Okita Yutaka , Okada Morihito
Published: August 2003

BACKGROUND

Recently, the TSLC1 (tumor suppressor in lung cancer 1) gene has been identified as a novel tumor suppressor in human nonsmall cell lung carcinoma. To the authors' knowledge, the clinical relevance of TSLC1 gene expression has not been studied using patient data and surgical samples. The current study was designed to evaluate whether the TSLC1 gene can serve as a target for the prognostic determination of patients with pulmonary adenocarcinoma.

METHODS

A total of 38 patients who were surgically treated for proven primary lung adenocarcinoma were enrolled in the current study. Surgical specimens were examined for TSLC1 protein expression immunohistochemically and by Western blot analysis. The correlation between levels of TSLC1 expression and pathologic characteristics, as well as prognosis, was investigated.

RESULTS

All patients underwent a potentially curative resection of their tumor. TSLC1 antigen expression as evaluated by immunohistochemistry was confirmed by immunoblotting. The expression of TSLC1 protein was found to be inversely correlated with advanced disease stage, lymph node involvement, lymphatic permeation, and vascular invasion. The 4‐year overall survival rates of patients with a tumor demonstrating high (> 70% positive cells [n = 14 patients]), intermediate (20–70% positive cells [n = 10 patients]), and low (< 20% positive cells [n = 14 patients]) expression of the TSLC1 antigen were 84%, 28%, and 7%, respectively. In addition, the disease‐free survival of patients with a tumor that demonstrated a high percentage of TSLC1 protein‐positive cells was reported to be significantly better than that of patients with a tumor that showed a low percentage of TSLC1 protein‐positive cells.

CONCLUSIONS

The loss or reduction of TSLC1 expression in resected lung adenocarcinoma cases was associated with a poor prognosis, indicating that TSLC1 represents a central effector gene for controlling the biologic aggressiveness of the tumor and that it is an essential biomarker for predicting patient prognosis. These data may help to detect those patients at high risk for recurrence who might benefit from additional therapeutic strategies such as adjuvant therapy. Cancer 2003;98:1002–7. © 2003 American Cancer Society.

DOI 10.1002/cncr.11599
Head and neck cancer: Emerging perspectives
Authors: Gleich Lyon L.
Published: August 2003

DOI 10.1002/cncr.11602
Widening disparity in survival between white and African‐American patients with breast carcinoma treated in the U. S. Department of Defense Healthcare system
Authors: Jatoi Ismail , Becher Heiko , Leake Charles R.
Published: August 2003

BACKGROUND

In the U. S., age‐adjusted breast carcinoma mortality rates among white and African‐American women have been diverging during the last 20 years. Some investigators speculate that the widening disparity is due to inequalities in access to healthcare, with African Americans having less access to necessary healthcare and improved therapies. Others argue that differences in tumor biology or some extrinsic influences on cancer etiology and behavior may account for the widening disparity. To examine this issue further, the authors compared trends in survival among white and African‐American women diagnosed with breast carcinoma in the U. S. Department of Defense (DoD), an equal access healthcare system.

METHODS

The medical records of all women diagnosed with primary breast carcinoma between 1980–1999 were retrieved from the U. S. DoD Automated Central Tumor Registry (ACTUR). Variables selected for further analysis were date of diagnosis, date of birth, vital status and date of death if applicable, race (black, white, and others), and stage of tumor. Because the database does not contain causes of death, overall survival was investigated. The effect of year of diagnosis and race on overall survival was analyzed using the Cox proportional hazards model stratified by age at diagnosis (1‐year age groups). Calculations were performed separately by disease stage for all stages combined and stratified by stage. Statistical analyses were performed using the statistical software package SAS.

RESULTS

After deleting observations with missing or implausible information regarding patient age, gender, and follow‐up time, the final dataset was comprised of 23,612 women with primary breast carcinoma. The survival of African‐American women compared with white women demonstrated an increasing ratio with calendar period. Although the hazard ratio was 1.269 for women diagnosed with breast carcinoma during the calendar period 1980–1984, it increased to 1.849 for those diagnosed between 1995–1999, which is a ratio of 1.46. For this period, the interaction between race and period was found to be significant (P = 0.04).

CONCLUSIONS

The results of the current study demonstrated that breast carcinoma survival rates among white and African‐American patients, adjusted for age and stage, are diverging in the U. S. DoD healthcare system. Thus, inequalities in access to healthcare most likely are not solely responsible for the widening racial disparities in outcome reported among women diagnosed with breast carcinoma. Cancer 2003;98:894–9. © 2003 American Cancer Society.

DOI 10.1002/cncr.11604
Routine mammography is associated with earlier stage disease and greater eligibility for breast conservation in breast carcinoma patients age 40 years and older
Authors: Freedman Gary M. , Anderson Penny R. , Goldstein Lori J. , Hanlon Alexandra L. , Cianfrocca Mary E. , Millenson Michael M. , von Mehren Margaret , Torosian Michael H. , Boraas Marsha C. , Nicolaou Nicos , Patchefsky Arthur S. , Evers Kathryn
Published: August 2003

BACKGROUND

Reduction in breast carcinoma mortality is a major benefit of screening mammography and has been demonstrated in multiple randomized clinical trials and service screening programs. Another benefit from screening is that it allows the patient a wider choice of treatment options, particularly the possibility of conservation surgery. The current study analyzed the impact of mammography in the staging and treatment of breast carcinoma.

METHODS

A total of 1591 women aged ≥ 40 years were treated for breast carcinoma between July 1995 and October 2001. Three subgroups were defined and compared. Group 1 had 192 patients with no previous mammography, Group 2 was comprised of 695 patients who underwent mammography on average less often than once yearly, and Group 3 was comprised of 704 patients who on average underwent mammography once yearly or more often.

RESULTS

The difference in tumor stage was found to be statistically significant between the groups (P < 0.0001). In Group 1, 15% of the patients had ductal carcinoma in situ (DCIS) compared with 21% of patients in Group 2 and 26% of patients in Group 3. In addition, 32% of patients in Group 1 had T1 tumors, whereas 50% of patients in Group 2 and 56% of patients in Group 3 had T1 tumors. The tumor size was ≤ 1 cm in 8% of the patients in Group 1 compared with 20–23% of patients in Groups 2 and 3 (P = 0.0092). Breast conservation was an option for 41% of the patients in Group 1 but mastectomy was recommended in another 41% of patients. However, in Groups 2 and 3, 61% of patients were offered breast conservation and mastectomy was recommended to 28% (P < 0.0001).

CONCLUSIONS

In the current study, women age ≥ 40 years with breast carcinoma who underwent mammography at least once yearly were diagnosed with DCIS more often compared with patients who underwent mammography less frequently or those who had no prior mammography. Women who underwent mammo‐graphic screening were found to have smaller tumors, which resulted in a majority of these patients being able to consider breast conservation as an alternative to mastectomy. Cancer 2003;98:918–25. © 2003 American Cancer Society.

DOI 10.1002/cncr.11605
Weekly chemotherapy with cisplatin, vincristine, doxorubicin, and etoposide is an effective treatment for advanced thymic carcinoma
Authors: Yoh Kiyotaka , Goto Koichi , Ishii Gen‐ichiro , Niho Seiji , Ohmatsu Hironobu , Kubota Kaoru , Kakinuma Ryutaro , Nagai Kanji , Suga Moritaka , Nishiwaki Yutaka
Published: August 2003

BACKGROUND

Thymic carcinoma is a rare neoplasm that often disseminates or metastasizes. The role of chemotherapy in treating this malignancy is unclear. The purpose of the current study was to determine the efficacy and tolerability of a weekly chemotherapy regimen consisting of cisplatin, vincristine, doxorubicin, and etoposide (CODE) for the treatment of advanced thymic carcinoma.

METHODS

The authors retrospectively reviewed 18 patients with thymic carcinoma who were treated between 1996 and 2002. Twelve of these patients had unresectable advanced diseases and received weekly chemotherapy according to the CODE regimen. The CODE regimen consisted of cisplatin (25 mg/m2, intravenously [i.v.]; weekly administration), vincristine (1 mg/m2, i.v.; administered during Weeks 1, 2, 4, 6, and 8), doxorubicin (40 mg/m2, i.v.; administered during Weeks 1, 3, 5, 7, and 9), and etoposide (80 mg/m2, i.v.; administered for 3 days during Weeks 1, 3, 5, 7, and 9).

RESULTS

The responses of all 12 patients to the CODE regimen were assessed. A partial response was achieved in 5 patients, and the overall response rate was 42%. Only one patient experienced disease progression. The median progression‐free survival period was 5.6 months (range, 2–39 months). The overall survival period ranged from 6 to 79 months, with a median survival period of 46 months. Based on the Kaplan–Meier method, the estimated 1‐year and 2‐year survival rates were 80% and 58%, respectively. The most common side effects were hematologic toxicities, and only mild nonhematologic toxicities were experienced.

CONCLUSIONS

Weekly chemotherapy treatments according to the CODE regimen were effective and tolerated by patients with advanced thymic carcinoma. Cancer 2003;98:926–31. © 2003 American Cancer Society.

DOI 10.1002/cncr.11606
Informing patients with cancer of ‘new findings’ that may influence their willingness to participate in research studies
Authors: Markman Maurie
Published: August 2003

DOI 10.1002/cncr.11607