bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of a who Protocol on Medical Therapy for Oncologic Pain in an Internal Medicine Hospital
Authors: Goisis Antonella , Gorini Maurizio , Ratti Riccardo , Luliri Patrizia
Published: April 2018

Pain symptomatology is present in 60 % – 80 % of patients affected by advanced cancer, but in most cases it is not adequately treated. Our series, composed of 45 patients affected by cancer in an advanced stage, demonstrates how the application of common concepts of pharmacotherapy, standardized according to a sequential scheme proposed by the WHO, makes it possible to reach total control (in 24.4 % of our cases) or only slight residual persistence (in 68.8 % of our cases) of pain from cancer, with scarce side effects that are easily controlled with symptomatic therapy. According to the type of pain, its behavior in relation to the therapy effected and any previous pharmacologic treatment, the proposed pharmacologic scheme foresees, as the first step, the use of nonnarcotic drugs, eventually associated or substituted with weak narcotics or finally with strong narcotics. Attention is given to modulation of the administration, to guarantee an analgesic effect throughout the day, thus preventing the pain. Irrespective of the analgesic scheme employed, it is more effective if patients affected by chronic oncologic pain (who present an important emotional component) are treated contemporaneously with ansiolytic and antidepressive drugs and those in which nerve structures are involved are treated with steroids. In conclusion, pain of an oncologic patient in an advanced stage can almost always be alleviated or often eliminated by the rigorous application of therapeutic concepts well known by physicians but for various reasons often neglected in clinical practice.
Fine-Needle Aspiration Cytodiagnosis of the « Cold » Thyroid Nodule
Authors: Giansanti Michele , Monico Silvio , Fugiani Paolo
Published: April 2018

The results of 1886 fine-needle cytoaspirations of solid, palpable thyroid nodules, « cold » on scintiscanning, performed between 1 January 1978 and 31 December 1986, were analyzed. In total 36 diagnoses of malignancy were made (1.9%). The results of cytologic and histologic examinations were compared in 114 cases to verify the diagnostic accuracy of this method; there was agreement in 98 cases and discordance in 16 consisting of 13 false negatives (11.4%) and 3 false positives (2.6 %). The sensitivity was 77.9 %, specificity 94.5 %, positive predictive value 93.8 %, negative predictive value 80 % and test efficiency 86 %. These values are in the range of those reported in the literature and confirm the validity of fine-needle aspiration cytology in the preoperative diagnosis of thyroid neoplasms.
Prognostic Significance of the Expression of Immuno-Histochemically Detectable Differentiation Markers in Laryngeal Carcinomas
Authors: Cortesina Giorgio , Cavallo Giovanni P. , Macario Massimo , Magnano Mauro , Roncaroli Federico , Cerrato Milena , Sapino Anna , Bussolati Gianni
Published: April 2018

Expression of immunocytochemically detectable markers in 100 cases of laryngeal carcinomas, homogeneous for staging and treatment, was correlated with clinical evolution of the disease. Follow-up for a minimum of 5 years was obtained in all cases. Paraffin sections were re-cut and stained in immunoperoxidase with monoclonal KL1, detecting medium-to-low molecular weight keratins, and with monoclonal HMFG2, revealing a surface glycoprotein. Expression of KL1-related antigen did not correlate with prognosis, whereas cases extensively positive for monoclonal HMFG2 (more than 50% cells stained) had a significantly better recurrence-free rate. In a group of tumors classified as Grade 3 (histologically poorly differentiated) and expressing a low degree of HMFG2-detectable surface glycoprotein (< 50 % cells stained), a high rate of recurrences (93%) was observed. This study indicates that the combined use of morphologic and biologic (immunohistochemical) criteria may constitute an independent parameter of primary importance in predicting the evolution of laryngeal carcinomas.
Serum Copper and Ceruloplasmin in Early and in Advanced Hepatocellular Carcinoma: Diagnostic and Prognostic Relevance
Authors: Casaril Massimo , Capra Franco , Marchiori Luigi , Gabrielli Giovanni Battista , Nicoli Nicola , Corso Flavia , Baracchino Fiorenza , Corrocher Roberto
Published: April 2018

To evaluate the prognostic value of serum copper (S-Cu) and ceruloplasmin and their pathophysiologic significance in human hepatocellular carcinoma (HCC), we studied 49 patients with HCC (20 of which were submitted to partial hepatectomy) compared with 110 patients with liver cirrhosis. In HCC both S-Cu and ceruloplasmin were higher than in cirrhosis; moreover, S-Cu was correlated with the extension of HCC, evaluated by instrumental data and by surgical inspection. In cirrhotic patients, mean S-Cu was 122.9 μg/dl (SD, 29.3), in early HCC, 153.0 μg/dl (SD, 34.5), and in advanced HCC, 193.1 μg/dl (SD, 37.7). Variance analysis gave F = 59.4. In HCC patients S-Cu was positively correlated with ceruloplasmin and with fibrinogen. Survival, evaluated by Mantel's test stratified for surgical therapy, was longer in patients with S-Cu levels lower than 175 μg/dl and in those at an earlier stage. We therefore conclude that S-Cu has a relevant diagnostic value in detecting HCC also in early stage and allows prognostic evaluation as regards survival.
Evidence for Altered Hypothalamic-Hypophyseal-Gonadal Axis in Untreated Patients with Testicular Germ-Cell Tumor
Authors: Crispino Sergio , Tancini Gabriele , Barni Sandro , Lissoni Paolo
Published: April 2018

To investigate the function of the hypothalamic-hypophyseal-gonadal axis in testicular germ cell tumors, we evaluated gonadotropin responses to gonadotropin-releasing hormone (GnRH) in 12 untreated patients with testicular cancer (5 seminomas and 7 non-seminomas). GnRH was given i.v. at a dose of 100 μg as a bolus, and venous blood samples were collected at 0, 20, 60, and 120 min. As controls, 14 healthy males were studied. Basal levels of testosterone, estradiol and prolactin were also detected in each patient. Hormonal serum concentrations were measured by the radioimmunoassay. Mean basal testosterone, estradiol and prolactin levels were not significantly different from those of controls. Patients had a lower FSH and LH peak after GnRH than controls, without, however, any significant difference. As regards histology, nonseminoma patients lacked an FSH response to GnRH and had statistically lower mean peak levels than controls. Moreover, non-seminoma patients had statistically lower mean peak values of LH after GnRH than controls. These data show that patients with testicular germ cell tumor, and more particularly those with non-seminomas, have an altered function of the hypothalamic-hypophyseal-gonadal axis, which is already present prior to therapy. Further studies, particularly in stage I patients treated only with orchiectomy, should be performed to confirm and better define the Physiopathologic significance of the altered hypothalamic-hypophyseal-gonadal axis in testicular cancer and to clarify the alteration of fertility, which is frequently present before treatment.
Carcinoma of the Urachus. Report of a Case
Authors: Boscaino Amedeo , Sapere Patrizia , Marra Bruno
Published: April 2018

The authors report a case of urachal carcinoma of a 60 year old woman of particular interest because of the clinical history, biological behavior and histotype. The tumor presented as an umbilical mass of 25 cm which had slowly increased during 20 years without evident clinical signs or infiltration of the peritoneum and abdominal organs. Histologic findings revealed an adenosquamous carcinoma, which represents less than 5 % of urachal neoplasms. Surgical excision is the treatment. The prognosis is poor because of regional recurrence and metastases. The authors review the literature analyzing the criteria for differential diagnosis between adenocarcinoma of vesical and of urachal origin.
Breast Cancer Screening in an Urban Population in Northern Italy
Authors: Alghisi Aimo , Donato Francesco , Lucini Laura , Marcianò Paolo , Miccichè Carmelo , Nardi Giuseppe , Nardi Maria Elena , Pasini Mario , Spiazzi Raffaele
Published: April 2018

A mammographic and clinical screening for breast cancer started in June 1987 in the Health District of Brescia, Northern Italy, including the town and 23 surrounding municipalities. This paper describes the organization and the results of the first 12 months of screening. Of 7791 invited women aged 50–60 years, 5217 (67 %>) agreed to participate. There was a trend for response rates to decline with increasing age and education. Of the 5217 women examined, 66 (1.3%) were referred for biopsy and 64 (1.2%) underwent this procedure. A histologically confirmed malignancy was found in 42 women, corresponding to a prevalence of 8.1/1000. Positive predictive value of the screening was 65.6 %. Among the 42 breast cancers, 4.8% were carcinoma in situ and 42.9 % invasive tumors up to 10 mm in size. According to the p-TNM classification, 92.9 % of all cancers were either TIS or in stage T1, 4.8 % were in T2 and one tumor was classified in T4. Lymph node involvement was assessed in 41 cases, and 71.4% of all cancers detected by screening were negative for lymph node metastasis. In comparison, the classification of tumors found in women of the same age group and living in Brescia, histologically diagnosed in the urban hospitals during 1986, one year before the beginning of the screening, was as follows: 7.1 % carcinoma in situ, and 16.7 % invasive tumors up to 10 mm in size. 38.1%, 2.4% and 2.4% of all tumors were in stages T2, T3 and T4 respectively.
Vinblastine and Interferon-Alpha-2a Regimen in the Treatment of Metastatic Renal Cell Carcinoma
Authors: Palmeri Sergio , Gebbia Vittorio , Russo Anna , Gebbia Nicola , Rausa Luciano
Published: April 2018

Thirteen patients with histologically proven advanced and/or metastatic renal cell carcinoma (RCC) were treated with vinblastine (Velbe, Eli Lilly, Sesto Fiorentino, Italy) and interferon-alpha-2a (Roferon-A, Roche, Milan). Eleven out of 13 patients were evaluable. Eighteen percent of patients had partial response, 46 % stable disease (SD), and 36 % progressive disease (PD). The mean survival of responders was 228+ days, whereas the patients showing SD and PD had a mean survival of 154+ and 107+ days respectively. Toxicity, including influenza-like syndrome, fever, neurological and gastrointestinal side effects, was generally mild. However, medication with paracetamol was required in 82 % of cases. Our small study confirms that VBL and IFN-2a regimen is moderately active in RCC.
Improvement of Radioactive Colloid Binding by Tumor Cells
Authors: Anghileri Leopold J. , Marchal Christian , Maincent Phillip , Robert Jacques
Published: April 2018

Treatment of P388 leukemia cells with poly-DL-lysine (Poly-lys) considerably increases the binding of colloidal chromic phosphate (32P). This augmentation of the number of particles that are bound is in direct relationship with Poly-lys concentration, and very significantly with its degree of polymerization. Treatment with Poly-lys molecular weight 77,000 shows a 100% increase of binding with 200 μg and of 50% with 100 μg. Poly-lys M.W. 8,000 presents no significant increase, and for the other molecular weights the binding is intermediate.
Intestinal-Type Adenocarcinoma of the Nasal Cavity and Paranasal Sinuses. A Clinicopathologic Study of 6 Cases
Authors: López José I. , Nevado Manuel , Eizaguirre Beatriz , Pérez Agustin
Published: April 2018

The clinical and pathologic features of 6 cases of intestinal-type adenocarcinoma of the sinonasal region are presented. These cases were collected in a 17 year period (1972-1988) and account for less than 4% of malignancies of this region in our records for this period. All of the patients were men aged 48 to 82 years (mean, 54 years). Previous exposure to wood dust was reported in 1 case. Radiographic studies, especially computerized tomography, were of critical importance to delineate the extent of tumors. Nasal obstruction was the most common compliant. Duration of symptoms prior to diagnosis is available in 5 cases and ranged from 5 to 36 months (mean 18 months). Surgical treatment was performed in 4 patients (of palliative type in 2) followed by radiotherapy in 3. Histo-pathology revealed tubulo-papillary (5 cases) and mucinous (1 case) patterns. Follow-up is available in all patients (range 0 to 108 months), 50% of whom are still alive. In our series, only 1 patient has survived more than 5 years. Data pooled from the literature reveal that 53% of patients have experienced local recurrences following therapy, and 60% have died of their disease. Of these deaths, 80% occurred within 5 years of diagnosis.
Ganglioneuroblastoma and Urticaria by Physical Agents
Authors: Razon Sultana , Vegni Maria , Schiaffino Eugenio , Castiglioni Valter
Published: April 2018

A case is reported of ganglioneuroblastoma in a 5-year-old boy, who had urticaria syndrome by physical agents (water, light, cold) in the last 2 years, associated with an apparent splenomegaly. A sonography and a CT scan showed a large cystic mass with calcification near the left kidney. After surgery, it was possible to diagnose left adrenal ganglioneuroblastoma (Evans's first stage). Complete regression of urticaria syndrome was obtained after mass removal.
Clinical Characteristics, Diagnosis and Treatment of Elderly Patients with Lung Cancer at Non-Surgical Institutions: A Multicenter Study
Authors:   North-Eastern Italian Oncology Group (Chairman S. MONFARDINI M.D.),   Neoplasms of the Elderly Committee (Chairman U. TIRELLI M.D.), Veronesi Andrea , Zagonel Vittorina , Serraino Diego , Ardizzoni Andrea , Franceschi Silvia , Errante Domenico , Tirelli Umberto , Amichetti Maurizio , Bagozzi Bruna , Bolzicco Giampaolo , Bullian Pierluigi , Graiff Claudio , Lanfranco Claudio , Leoni Maurizio , Marezzato Giorgio , Mazza Francesco , Nascimben Ottorino , Bian Alberto Rosa , Rosso Riccardo , Santandrea Giuseppe , Trovò Mauro Gaetano , Monfardini Silvio
Published: April 2018

A multicenter retrospective study was undertaken in northern Italy to assess clinical characteristics and pattern of care of elderly patients (> 70 years) with lung cancer seen in 1984, at 14 non-surgical institutions. Overall, 1 out of 5 patients with lung cancer was elderly. Eighty-four percent of the 264 elderly patients under study were males, and overall, their median age was 76 years. Squamous cell carcinoma was the most frequent histologic type (53%), and most of the patients (61%), after a rather intensive diagnostic workup, had loco-regional disease. Sixty-three percent of patients underwent radiotherapy, which was mostly classified as palliative. Chemotherapy was given to 13% of patients, mostly with small cell histology. Response to radiotherapy and chemotherapy was observed in about 50% of the patients; however, 3 out of 34 (10%) patients treated with chemotherapy died from toxicity. The median survival time from diagnosis was 9.9 months; survival time was not related, in this population of elderly patients, to age. Throughout the study, the quality of data recording during the patient's illness was often found to be suboptimal. In conclusion, elderly patients with lung cancer appear to be actively staged and treated outside a protocol context in the clinical practice of cooperating nonsugical institutions in northern Italy. This stresses the importance of prospective studies aimed to evaluate the cost/effectiveness of the various procedures used and the impact of treatments used (or even of a policy of no treatment) on the survival and quality of life of these patients.
The Influence of Female Hormones on Malignant Melanoma
Authors: Franceschi Silvia , Barón Anna E. , La Vecchia Carlo
Published: April 2018

Several lines of biological evidence have suggested a relationship between the behaviour of melanocytes and cutaneous malignant melanoma (CMM) and the action of female hormones. The present overview, however, indicates that the effect of reproductive, menstrual and hormonal factors, including oral contraceptives, on onset and outcome of CMM must be very weak, if any. The only consistent findings which may suggest a role of female hormones on CMM seem to be: 1) a different distribution by anatomic site in men and women, and 2) a more favorable outcome of CMM in women as compared to men. Neither of them, however, necessarily implies a direct effect of female hormones on CMM.
Cisplatinum-Based Alternating Non-Cross-Resistant Chemotherapy as a First-Line Treatment in Metastatic Breast Cancer. A Phase II Study
Authors: Kolarić Krsto , Tomek Rudolf
Published: April 2018

Exposure to multiple non-cross-resistant drugs should increase cell kill and the chance of achieving more complete and partial responses. Our earlier study in breast cancer showed that second-line CAP (cyclophosphamide, adriamycin, cis-platinum) treatment was not cross-resistant to the CMFVP (cyclophosphamide, methotrexate, 5-fluorouracil, vincristine, prednisolone) regimen and produced a 51% response rate. These facts initiated a phase II study which used an alternating CMFVP/ CAP regimen. Altogether, 49 patients entered the study and 45 were evaluated (> 2 cycles). The CMFVP regimen consisted of cyclophosphamide (200 mg/m2 on days 1, 2, 3, 4 and 5), methotrexate (30 mg/m2 on days 2 and 4), 5-fluorouracil (500 mg/m2 on days 1, 3 and 5), vincristine (1.4 mg/m2 on days 1 and 5), and prednisolone (40 mg p.o. on days 1-5), and was alternated with the CAP schedule (300 mg/m2 cyclophosphamide on days 1, 3 and 5, 50 mg/m2 adriamycin on day 1, and 30 mg/m2 cis-platinum on days 1, 3 and 5). Overall response was high, and 37 patients out of 45 responded (82%), with a 28% CR rate (13/45). A particularly high response rate was observed in soft tissues (86%, 18/21) and visceral organs (84%, 16/19). Only 1 patient progressed (3%). The duration of remission was 4-21+ months (median, 12 months). Six of 13 CR patients were still disease free 15 months after the treatment was stopped. The duration of survival was 5-25+ months (median, 15+ months). Toxicity was moderate (myelosuppression in 53% of patients, mainly grade I-II; stomatitis in 11%, except for 100% alopecia and 90% nausea and vomiting). One drug-related death (bone marrow aplasia) was recorded. The high antitumorigenic activity of the alternating regimen used is encouraging and may call for a randomized study for the ultimate evaluation of this treatment approach.
Diagnostic Efficacy of Physical Examination, Mammography, Fine Needle Aspiration Cytology (Triple-Test) in Solid Breast Lumps: An Analysis of 1708 Consecutive Cases
Authors: Martelli Gabriele , Pilotti Silvana , de Yoldi Gianfranco Coopmans , Viganotti Giovanni , Fariselli Giuseppe , Lepera Paolo , Moglia Daniele
Published: April 2018

The clinical-radiologic-cytologic triplet was used for diagnostic evaluation in 1708 women over 30 years old with a breast lump. All the lumps were subjected to surgery except for 258 cases in which clinical resolution took place within 1-2 months. Seven-hundred and ninety-three out of 1450 nodules removed were cancers. Sensitivity of the clinical, mammographic and cytologic examinations was 82%, 73% and 68%, respectively. It increased to 95% when they were as sociated. Specificity was 63%, 80% and 97%, respectively. The predictive value of positive results of the triple test was 100%. No patient with malignant cytology was subsequently shown to have benign disease. The systematic use of the triple test in solid breast lumps for the early detection of cancer is recommended as a routine procedure. However, participation of experienced radiologists and pathologists as well as physicians skilled in fine needle puncture is required.
Male Breast Carcinoma: Review of a Multicenter Series of 150 Cases
Authors: Ciatto Stefano , Iossa Anna , Bonardi Rita , Pacini Paolo ,   Coordinating Center and Writing Committee of FONCAM (National Task Force for Breast Cancer), Italy, Berardi T. , De Leo G. , Punzo C. , Amadori D. , Barni S. , Rulli A. , Decembrini P. , Schincaglia P. , Del Rio S. , Mansutti M. , Sandri P. , Cassandrini P. , Griso C. , Massocco A. , Modena S. , Molino A.M.
Published: April 2018

The authors report on a consecutive retrospective series of 150 male breast cancers. Clinical, diagnostic and therapeutic features are compared over time and with respect to a large consecutive series of female breast cancers. Both age at diagnosis and tumor stage were more advanced in males than in females. Poor alertness of both men and doctors for this unfrequent disease may account for such a delay in diagnosis. The use of mammography increased over time and sonography or cytology were frequently and successfully employed in the last decade. Unfortunately no improvement of tumor stage at diagnosis was observed over time in the present series. A time trend was also evident for the type of surgical and postoperative treatment. Modified radical mastectomy and adjuvant chemo- or hormone therapy were increasingly adopted, although Halsted operation and postoperative radiotherapy were still common in the last decade due to the relatively high proportion of locally advanced T3-4 cancers. Both disease-free and overall survival were worse in men than in women, even after adjustment by stage at diagnosis. This study suggests that male breast cancer has a worse prognosis with respect to female breast cancer and provides no complete explanation of this finding, except for an intrinsic higher aggressivity. No evidence was found which may justify a different diagnostic or therapeutic approach with respect to female breast cancer.
Local Adoptive Immunotherapy of Advanced Head and Neck Tumors with Lak Cells and Interleukin-2
Authors: Squadrelli-Saraceno Massimo , Rivoltini Licia , Cantù Giulio , Ravagnani Fernando , Parmiani Giorgio , Molinari Roberto
Published: April 2018

Since October 1987 a pilot phase I-II study on the effect of loco-regional injections of recombinant interleukin 2 (rIL-2) in association with LAK cells has been performed in advanced, recurrent head and neck cancer patients. Fourteen patients were treated with autologous LAKs and rIL-2 (Glaxo) given peritumorally and in the mastoid region (rIL-2 only in the latter site). LAKs (2-70 × 107) + rIL-2 were injected on the first day of therapy, followed by 9 daily injections of rIL-2 only. The total daily dose of rIL-2 was escalated from 2,400 to 1.8 × 106 IU. Clinical evaluation was performed 30 days from the onset of therapy; 3 partial (95%, 66% and 50% reduction) and 3 minor responses were seen in the evaluated patients. All the other patients with a progressive disease after the first cycle were shifted to palliative chemotherapy. The partial responses were found in patients with a tumor burden « 20 cm2. Cervical node metastasis did not respond to treatment. No relevant side effects occurred. These results indicate that loco-regional immunotherapy with rIL-2 and LAK cells can produce clinical responses in advanced head and neck cancer patients.
Thrombocytosis in Malignant Pleural Mesothelioma
Authors: de Pangher Manzini Vincenzo , Brollo Alessandro , Bianchi Claudio
Published: April 2018

The prevalence of thrombocytosis (defined as a platelet count above 400,000/mm3 in at least two examinations) and the prevalence of thromboembolism were retrospectively investigated in a series of 41 patients with malignant pleural mesothelioma and in 40 subjects with non small cell lung carcinoma. All the patients were examined at necropsy. The mesothelioma patients showed a higher prevalence of thrombocytosis (56.8% vs 24.2%; p < 0.01). However, the prevalences of thromboembolism were similar in the two groups of patients (36.6% and 32.5% respectively). Among those with mesothelioma the prevalence of thrombocytosis varied widely from one histological type to another (76.9% in mixed type, 57.1% in the epithelial, and 30% in the sarcomatous type), the difference between mixed and sarcomatous being statistically significant (p < 0.01). Moreover, the mesothelioma patients of under 70 years had thrombocytosis more often than those over 70 (80% vs 29.4%; p < 0.01).
Evaluation of the Cardiovascular Toxicity Related to Cancer Immunotherapy with Interleukin-2 by Monitoring Atrial Natriuretic Peptide Secretion: A Case Report
Authors: Lissoni Paolo , Barni Sandro , Cattaneo Giulio , Archili Caterina , Perego Maristella , Tancini Gabriele
Published: April 2018

Increased capillary permeability and severe hypotension represent the two major cardiovascular complications of IL-2 immunotherapy. The mechanisms responsible for IL-2 cardiovascular toxicity are still obscure. Since increased vascular permeability and vasodilatation may be also induced by the cardiac hormone atrial natriuretic peptide (ANP), we have evaluated ANP concentrations in relation to mean arterial pressure in one patient with metastatic renal carcinoma, treated with a 24-h intravenous infusion of IL-2 at a dose of 3 × 106 Cetus U/m2/day for 5 days. The results showed that episodes of important hypotension were associated with abnormally high plasma levels of ANP. Owing to its vasodilator activity, exagerated ANP secretion, perhaps due to an inappropriate cardiac endocrine function in response to hemodynamic changes induced by IL-2, may play a role in hypotension, which occurs during IL-2 immunotherapy for cancer.
Endobronchial Metastasis of Ovarian Cancer. A Case Report
Authors: Merimsky Ofer , Greif Joel , Chaitchik Samario , Inbar Moshe
Published: April 2018

An 83 years old woman with known ovarian carcinoma complained of dyspnea, dysphagia and hoarseness. Clinical and radiological investigations revealed a mediastinal metastasis involving and penetrating the right main bronchus. Palliation of dyspnea was achieved by laser therapy.
Frequent Occurrence of Ha-rasl Allelic Deletion in Human Ovarian Adenocarcinomas
Authors: Viel Alessandra , De Pascale Luca , Toffoli Giuseppe , Tumiotto Loretta , Miotto Ermes , Boiocchi Mauro
Published: April 2018

Fourteen human adenocarcinoma specimens were analyzed for somatic abnormalities affecting genes of the ras family. No amplification of the 3 ras genes was detected. Allelic deletion of the Ha-rasl gene (11p15.5) was found to be a very common abnormality in human ovarian adenocarcinomas (4 out of 7 informative cases). However, in these neoplasm deletion of a presumed normal Ha-rasl allele is not a contributory factor in strengthening the tumorigenic effect of a mutated allele. More probably, Ha-rasl allelic losses are markers of larger chromosomal deletions. Analyses at γ globin loci (11p15.5) and int-2 locus (11q13) provided evidence that the deletions may extend from Ha-rasl locus towards the centromere but never involve loss of the entire chromosome 11. These findings may suggest that a putative tumor suppressor gene closely linked to Ha-rasl in 11p15.5 is involved in ovarian cancerogenesis.
Cisplatin as a Radiosensitizer in Clinical Practice: A Pilot Study
Authors: Yunhua Bao , Xiaochao Yuan , Jindong Wu , Weijing Zhang , Zefei Jiang
Published: April 2018

Fifty-four patients with Inoperable cancers were treated with a combination of cisplatin and radiotherapy from May 1984 to February 1989. Cisplatin was administered at a dose of 40 mg/week, for a total dose of 160-320 mg, during radiation therapy. In 4 cases with brain metastases, the cisplatin dose was 40 mg/m2. Cisplatin concentration in blood was measured using the flameless atomic absorption spectrophotometric method. Radiation therapy was delivered by a 6 MV X-ray or a cobalt-60 unit up to a total dose of 50-70 Gy. Among the 54 patients, 89% (48) responded to the treatment regimen; complete responses (CR) and partial responses (PR) were 56% and 33%, respectively. Six patients were stable in their disease. Among the 30 patients who had CR's, the 1-year survival rate was 88% (21/24). Two patients (7%) had local relapse. However, among PRs, the 1-year survival rate was 33% (4/12) and local failure (61%) (11/18). Objective tumor response was observed in 4 cases with brain metastasis, 2 of the 4 patients were alive for more than 6 months. Toxic effects were moderate and consisted of emesis and myelosuppression. Grade III bone marrow suppression amounted to 11%, and the interval of recovery was relatively long compared with that reported in the literature. Further prospective controlled studies are recommended.
The Monocyte/Macrophage Infiltrate in 35 Medulloblastomas: A Paraffin-Wax Study
Authors: Rossi Marco L. , Buller Jackie R. , Heath Shirley A. , Carey Martyn P. , Carboni Paulo , Koutsoubelis George , Coakham Hugh B.
Published: April 2018

We have studied formalin fixed, paraffin-wax embedded tissue from 35 medulloblastomas, collected over 23 years (27 non-desmoplastic and 8 desmoplastic) with KP1 and Mac387 two monoclonal anti-monocytes/macrophage (M/Ms) antibodies recommended for use on paraffin wax embedded tissue. In non-desmoplastic medulloblastomas, outside areas of necrosis, M/Ms were detected in 50% of cases with KP1 and 52% with Mac387. M/Ms were seen In 100% of desmoplastic medulloblastomas with both antibodies. Semiquantitative assessment revealed that, on average, desmoplastic tumors had at least three times as many Infiltrating M/Ms as non-desmoplastic tumors. There was no significant difference in the findings with the two antibodies or, between recently embedded and « older » tumors. The findings may be indicative of the presence of a host M/Ms immune response in medulloblastoma, which may be more accentuated in desmoplastic medulloblastomas. Furthermore, we conclude that these antibodies are quite suitable for the study of infiltrating M/Ms, thus lessening (but not obviating) the need for frozen tissue for immunohistological studies.
Lonidamine in Non-Small-Cell Lung Cancer: A Phase II Study
Authors: Contu Antonio , Olmeo Nina Antonina , Pani Paola , Deriu Antonia , Ortu Salvatore , Paga Cosimo
Published: April 2018

The activity of lonidamine (a derivative of indazole-carboxylic acid and a new drug with a characteristic antitumor activity) was evaluated In non-small-cell lung cancer (NSCLC). Twenty-five patients with NSCLC with or without prior treatment received lonidamine at the dose of 450 mg/daily p.o. up to progression. Objective responses obtained were: 3 (12%) partial responses and 3 (12%) minor responses with a mean duration of 13.7 weeks for partial responses. Mean duration of treatment was 20 weeks (range 4-97+). During to the drug's characteristics, bone marrow toxicity was not observed; myalgia and mild testicular pain were the most significant side effects.
Radiation Therapy Combined with Chemotherapy for Inoperable Pancreatic Carcinoma
Authors: Boz Giovanni , De Paoli Antonino , Roncadin Mario , Franchin Giovanni , Galligioni Enzo , Arcicasa Mauro , Bortolus Roberto , Gobitti Carlo , Minatel Emilio , Innocente Roberto , Trovò Mauro G.
Published: April 2018

From March 1985 to July 1989, 22 patients with unresectable pancreatic adenocarcinoma entered the study to receive external beam irradiation with chemotherapy. Radiation therapy consisted of 60 Gy in 3 courses (20 Gy each course) delivered over a period of 2 weeks, with a 2-week rest between the courses. Chemotherapy consisted of 5 fluorouracil, 500 mg/m2, plus cisplatinum, 20 mg/m2, administered on days 1,2 and 3 of each radiation therapy course. Of the 22 evaluable patients, 10 were males and 12 females; their median age was 63 years (range, 32-77), and their median performance status was 80 (range, 60-90). After treatment, 12 partial remissions and 6 no changes were reported. In 4 cases, abdominal progression of disease during treatment required interruption of the therapy program. At the start of treatment, abdominal pain was the most important symptom in 17 patients; improvement of abdominal pain was observed in 10 cases (76%) after treatment and lasted for a median of 5 months. Median survival time was 7.5 months, and time to progression was 6.2 months. Median follow-up was 7 months (range, 14 days -38). In 2 cases, persistent hematologic toxicity did not permit completion of therapy, and in another 3 cases grade II hematologic toxicity required a 2-week rest period over the normal split-course program. In another 4 cases, grade I hematologic toxicity did not require any delay in the therapy program. Our results are comparable with those achieved in other major studies and are acceptable in terms of survival time, palliation of symptoms and toxicity. In our experience, the combination of radiotherapy plus 5-fluoro-uracil and cisplatinum does not seem to offer any advantage over the combination of radiation therapy and 5-fluorouracil.
Focal Epithelial Hyperplasia (Heck's Disease): The First Reported Case from Italy
Authors: Ficarra Giuseppe , Adler-Storthz Karen , Galeotti Flavio , Shillitoe Edward
Published: April 2018

A case of focal epithelial hyperplasia (Heck's disease) of the oral mucosa observed for the first time in Italy is reported. The patient was of Italian extraction. The lesions, represented by soft nodules, were multiple and located on the vestibular and labial mucosa. Biopsy tissues were studied for the presence of human papilloma virus (HPV) by electron microscopy, in situ hybridization and immunoperoxidase staining to HPV group antigens. No viral particles consistent with HPV were found in the epithelial cells. The tissues were positive for HPV antigen by immunoperoxidase staining and hybridized to the HPV 13 probe. In situ hybridization to the HPV 6, HPV 11, HPV 16, HPV 18 and 32 probes was negative. Our study substantiates that focal epithelial hyperplasia, although rare, may be observed in Whites and that HPV 13 in associated with the disease.
Lymphangitic Carcinomas of the Lung as Presentation of Prostatic Cancer. A Case Report
Authors: Miseria Salvatore , Torresi Umberto , Menichetti Ettore Tito , Tummarello Diego , Baldelli Stefano , Murer Bruno , Cenerino Riccardo
Published: April 2018

Lymphangitic carcinomatosis of the lung Is a late and often fatal manifestation of cancer. We describe a case of a biopsy-proved pulmonary lymphangitic carcinomatosis in an asymptomatic 61-year-old man. The pulmonary picture proved to be the initial sign of a prostatic cancer. Therapy with LH-RH analogues and antiandrogens achieved a complete clearance of lung involvement.
Chromosomal Characterization of Methotrexate-resistant Human T-lymphoblast Leukemia Cells (CCRF-CEM) with Impaired Polyglutamylation
Authors: Mini Enrico , Stanyon Roscoe , Coronnello Marcella , Gerli Alessandra , Mazzei Teresita , Periti Piero
Published: April 2018

Two sublines of the human T-lymphoblast leukemia cell line CCRF-CEM, which were resistant to methotrexate (MTX) due to defective MTX polyglutamate synthesis, were karyologically characterized. No statistically significant differences in the modal number of chromosomes were noted in resistant cells (CCRF-CEM/P) as compared to parent cells (91, range, 86-123; and 93, range; 78-103, respectively). Fifteen marker chromosomes were identified and their origins at least partially established. An isochromosome 7q, (marker 13) was present in all MTX-resistant cells but was not found in any sensitive cell karyotype. This marker chromosome may be involved in the emergence of drug-resistant cells from the parental population of CCRF-CEM cells. In all cell lines, chromosomes 8, 9 and 14 appear to be highly unstable and are involved in the genesis of many marker chromosomes. These chromosomes are also implicated in the in vivo genesis of various leukemias and lymphomas, which suggests that both in vivo tumor progression and in vitro cellular adaptation are marked by chromosome mutations that may activate multiple oncogenes.
Differential Alteration of Cellular Lipids in Drug Sensitive and Resistant P388 Leukemia Cells by Clofibrate: Effects on Mitoxantrone Cytotoxicity
Authors: Parekh Hemant , Chitnis Manik
Published: April 2018

Earlier Investigations have Indicated a difference in the lipid profiles of drug-sensitive and drug-resistant tumor cells. This study was undertaken to evaluate the effect of alterations in the cellular lipid compositions by clofibrate (CPIB), an anti-hyperlipidemic agent, on mitoxantrone (Mtn) cytotoxicity in murine P388 leukemia cells sensitive (P388/S) and resistant (P388/Adr) to adriamycin and in human chronic myeloid leukemia (CML) cells. CPIB did not elicit any significant alterations in the lipid levels of P388/S cells, whereas in the P388/Adr cells it brought about a 14% and 49% decrease in the levels of cholesterol and triglyceride respectively. Inhibition of 3H-thymidine incorporation was utilized as a measure of cellular cytotoxicity. CPIB caused a dose dependent inhibition of DNA and RNA biosynthesis in P388/S, P388/Adr and CML cells. The combination of CPIB and Mtn induced a greater cytotoxicity in P388/Adr cells as compared to P388/S cells, as shown by enhanced inhibition of 3H-thymidine incorporation in P388/Adr cells. Similar results were observed when 3H-uridine was used as a measure of cellular cytotoxicity. These observations were further confirmed in fresh CML cell samples, in which the combination of CPIB with Mtn induced an irreversible and synergistic Inhibition of DNA biosynthesis. Results warrant extensive studies on CPIB as a clinical modulator to enhance the antiproliferative activity of Mtn.
Carboplatin, Continuous Infusion Fluorouracil and Mid-cycle High-dose Methotrexate as Initial Treatment in Patients with Locally Advanced Head and Neck Cancer
Authors:   Hellenic Co-operative Oncology Group Study, Fountzilas George , Kosmidis Paris , Makrantonakis Paris , Sridhar Kasi S. , Banis Kostas , Themelis Christos , Kalogera-Fountzila Anna , Avramidis Vasilios , Beer Mario , Sombolos Kostas , Vritsios Aristotelis , Daniilidis John
Published: April 2018

Forty-nine patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN) were treated with 3 cycles of induction chemotherapy prior to definitive local treatment (surgery and/or radiation therapy). Chemotherapy consisted of carboplatin 300 mg/m2 on day 1, fluorouracil 1000 mg/m2 daily as a continuous infusion on days 1 to 5 and high-dose methotrexate 1.2 g/m2 with leucovorin rescue on day 14. After completing the induction chemotherapy, 9 patients (18%) achieved a complete remission (CR), 26 (54 %) a partial remission (PR), 7 had stable disease and 7 a progression. The response rates increased to 53 % CR and 18 % PR following locoregional treatment. Survival at 12 months was 61 % and its actuarial probability at 24 months 31 %. Median time to progression was 14 months. Toxicity from chemotherapy was generally mild. Nausea was observed in 35 %, vomiting in 26 %, stomatitis in 57 %, anemia in 22 %, leukopenia in 36%, thrombocytopenia in 26% and diarrhea in 6% of the patients. In conclusion, the combination of carboplatin, 5-day continuous-infusion fluorouracil and mid-cycle high-dose methotrexate is a moderately effective, well tolerated regimen in patients with SCCHN but does not seem superior to the combination of carboplatin and fluorouracil only.
Treatment of Advanced Colorectal Cancer with Mitoxantrone, High Dose Folinic ACID and Fluorouracil
Authors: Cornelia Giuseppe , Casaretti Rossana , Cornelia Pasquale , Daponte Antonio , Parziale Alberto , Iervolino Vincenzo , Santillo Gaetano , Zarrilli Donato
Published: April 2018

A new combination chemotherapy including mitoxantrone 10 mg/m2 i.v. on day 1 and 5-fluorouracil 400 mg/m2 i.v. plus folinic acid 200 mg/m2 i.v. on days 1-5 was administered every 28 days to 13 patients with locally advanced or metastatic colon (1 case), rectosigmoid colon (4 cases), or rectum (8 cases) carcinoma. The median number of cycles performed was 3 (range, 1-9). No patient achieved complete or partial remission with this regimen, whereas 5 showed a stable disease lasting 3-8 months. Acute toxicity was mild/moderate in intensity and comparable to that reported with the standard 5-fluorouracil + folinic acid combination. Since we observed no major responses in our 13 consecutive patients, we consider that the overall activity of our regimen, at the doses and schedule utilized, was only moderately effective in advanced colorectal carcinoma.
A Metastatic Breast Carcinoma Presenting as Autoimmune Hemolytic Anemia
Authors: Adorno Gaspare , Girelli Gabriella , Perrone Maria Paola , Arista Maria Cristina , Coluzzi Serelina , Masi Mario , Giudiceandrea Paolo , Papa Giuseppe
Published: April 2018

The authors describe the case of a 75-year-old female who was hospitalized for anemia of unknown origin. Physical examination revealed a swelling in the right mammary region, where a mastectomy scar was present from surgery for a breast carcinoma. On admission, laboratory tests disclosed anemia (Hb, 8.5 g/dl), with a reticulocyte count of 65,000/mm3 and slightly increased bilirubin. Immunohematologic study revealed the presence of a red cell autoantibody with anti-D specificity in the serum and in the eluate from the patient's erythrocytes. A biopsy of the swelling was performed and histologic examination showed the presence of metastatic cells of breast carcinoma. The patient was given chemotherapy and radiotherapy. At this writing the anemia was absent, the Immunohematologic study was negative, the swelling was greatly reduced, and no other metastatic lesions of breast carcinoma were present.
Description of a Home Care Service for Cancer Patients through Quantitative Indexes of Evaluation
Authors: Maltoni Marco , Derni Stefania , Innocenti Maria Paola , Rinaldi Antonio , Amadori Dino
Published: April 2018

Home care (HC) was created and developed in Romagna, as in other parts of Italy, thanks to the endeavor of a private Institution, the « Istituto Oncologico Romagnolo ». The care Is gratis to advanced cancer patients and is based on the palliative philosophy of treatment of the symptoms and the person within the framework of continuity of care permitted by the oncologic approach. To evaluate the intensiveness of the operation in terms of medical and nursing care by means of quantitative indexes, we examined several variables which emerged from a retrospective analysis of our case study. The average duration of care of the 484 patients in the program as of 31 December 1990 was 84.1 days. Four hundred and twenty-three patients of the 484 (87.1 % of the total) have died and 61 were still in the HC program at the time of this analysis. The 61 living patients were thus excluded from the descriptive analysis to give greater homogeneity to the study group. The average duration of care for the 423 decreased patients was 68.1 days. Out of a total of 28,759 days of HC for the entire group, the patients actually spent 23,534 days (81.8 %) at home. The average duration of hospitalization was 13.5 days, and in 33.2% of the cases it was motivated by psychologic and family causes. The place of death was the home in 44.3 % of the cases. A medical or nursing visit was made at the home every 1.4 days, and the average number of visits per patient was 39.0. Although none of the indexes alone can give overall indications of the intensiveness of a HC service, they may constitute a working proposal for the definition of the most objective criteria possible for the quantitative evaluation of such experiences.
An Efficient Method for Culturing Human Breast Epithelium: Analysis of Results
Authors: Volpi Annalisa , Savini Saverio , Zoli Wainer , Vasinl Mara , Morgagni Silvia , Amadori Andrea , Volpi Roberta , Amadori Dino
Published: April 2018

We have examined the possibility of obtaining primary cultures from breast tissue utilizing a method especially developed for breast epithelium. The number of specimens able to grow in culture was very high: 82.8%, 64.3 %, 75.0 % and 77.8 %, respectively, for primary breast cancer, skin recurrences, inflammatory breast cancer and normal breast tissue. In our experience, growth was not related to menopausal status or histopathologic type, whereas for skin recurrences, a prior pharmacologic treatment (chemotherapy) of the patient enhanced the growth capacity of the tissue. This culture method could help to study the basic biology of breast epithelia and to improve the chemotherapy approach of breast cancer patients.
Hysteroscopy and Endometrial Cancer Diagnosis: A Review of 2007 Consecutive Examinations in Self-Referred Patients
Authors: lossa Anna , Cianferoni Luciano , Ciatto Stefano , Cecchini Silvia , Campatelli Carlo , Stumbo Fernando Lo
Published: April 2018

The authors reviewed 2007 consecutive outpatient hysteroscopies performed in self-referred women to assess the detection rate of uterine cancer and the validity of different selection criteria for hysteroscopy. Thirty cases of uterine cancer (29 endometrial, 1 carcinosarcoma) were detected. Abnormal uterine bleeding was the indication most commonly associated with cancer (26 of 30 cases, cancer detection rate = 2.1 %), whereas the presence of cervical polyps had no predictive value. Patients age was correlated to cancer detection rate, and the investigation of uterine cancer under the age of 45 was poorly cost effective. Hysteroscopy and endometrial biopsy, performed by Permacurette or Novak curette immediately after hysteroscopy, missed respectively 8 and 2 of 30 cancers. Hysteroscopy should be employed in combination with endometrial biopsy as a standard outpatient investigation whenever endometrial cancer is suspected. These procedures are safe and accurate and rule out more aggressive and costly procedures, such as dilatation and curettage, in most cases.
Atypical Radiation Toxicity in Patients with Classical Kaposi's Sarcoma
Authors: Macklis Roger M.
Published: April 2018

The classical (non-AIDS-related) form of Kaposi's sarcoma (KS) typically affects older patients of Eastern European or Mediterranean ethnic background. Although radiotherapy is a standard part of the treatment armamentarium for KS patients, a high incidence of radiotoxicity has been reported in epidemic AIDS-related cases. In order to determine whether this radiotoxicity is observed only in patients with the epidemic form of the disease, we have conducted a retrospective chart review of 30 patients with classical KS treated with radiation for whom follow-up information was available. Seven out of 30 (23 %) were found to have unexpectedly high levels of radiotoxicity after tumor doses of 22–42 Gy. This toxicity consisted either of significantly increased edema or chronic skin break-down and severe radiodermatitis, in some cases requiring multiple surgical corrective procedures. We suggest that the abnormal lymphaticovenous development and chronic lymphokine stimulation associated with KS of both epidemic and classical forms may be responsible in part for the observed radiotoxicity.
Salvage Chemotherapy with Ccnu and Methotrexate for Small Cell Lung Cancer Resistant to Cav/Pe Alternating Chemotherapy
Authors: Gridelli Cesare , Contegiacomo Alma , Lauria Rossella , Gentile Maria , Airoma Giuseppe , De Placido Sabino , Perrone Francesco , Ferrante Giovanni , Bianco Angelo Raffaele
Published: April 2018

CCNU and methotrexate were employed as salvage treatment in 34 small cell lung cancer patients resistant to CAV/PE alternating Induction chemotherapy. In the 33 evaluable patients we observed an objective response rate of 21.2 % and 3 % complete response; median survival was 4 months with 2 patients alive 18 months from starting salvage chemotherapy. The treatment was well tolerated. CCNU and methotrexate has shown to be a moderately active and tolerable salvage treatment for small cell lung cancer after CAV/PE alternating first-line chemotherapy.