bluuebunny/crossref_metadata_2025 huggingface dataset:
Central Neurocytoma. A Clinico-Pathologic study of Five Cases
Authors: Casadei Gian Piero , Arrigoni Gian Luigi , Versari Piero , Gambacorta Marcello , Giangaspero Felice
Published: April 2018

Five cases of central neurocytomas are described. The tumors occurred in relatively young patients (range 14 to 43 years; mean age, 27) with no predilection for sex. All the lesions were located in the anterior portion of the lateral ventricles or in the third ventricle, involving the septum pellucidum or the fornix. Histologically, they were composed of uniform cells with round nuclei and clear cytoplasm resembling oligodendrogliomas or, to a lesser extent, ependymomas. In 4 tumors, protein cell nuclear antigen immunostaining showed a low cell proliferation rate. All cases were positive for neuron-specific enolase. Four of the 5 cases were strongly immunoreactive for synaptophysin. The immunohistochemical data were consistent with neuronal differentiation. Resection was subtotal in 4 cases and total in one. Postoperative radiotherapy was given in only one case. The follow-up revealed a good prognosis: 4 patients were alive and had a long survival (from 2 to 8 years). Only one patient died after 14 months for causes unrelated to the neoplasm. The authors emphasize the importance of immunohistochemistry to recognize this benign intraventricular tumor.
Definitive Irradiation of Nasopharyngeal Carcinoma Analysis of Results and Failures in 103 Cases
Authors: Di Marco Adriano , Pradella Renato , Campostrini Franco
Published: April 2018

During the period 1975–1984, 103 patients were treated for nasopharyngeal carcinoma. Most of them presented with an advanced stage: 64 stage IV and 26 stage III. Sixty-one patients presented with neck nodes, which was the most frequent symptom of presentation. The histologic subtypes included 64 squamous cell carcinoma and 39 undifferentiated carcinoma. All patients were treated by high energy sources with portals encompassing the primary and the whole neck. Doses ranged from 50–55 Gy in T1 patients to 65–70 Gy in T4 patients. The mean survival was 58.5 months, and 31 patients were alive and disease free at 60 months from treatment. A clear difference in survival emerged among T1, T2-3, and T4 patients (p > 0.01), whereas there was no significant difference between T2 and T3 patients. Also, NO and N1 showed no significant difference in 5-year disease-free survival (38% and 41 %, respectively); only 20 % of N2 and 7 % of N3 patients survived for more than 5 years. As regards histology, 25% of patients with a squamous cell carcinoma and 36% of those with an undifferentiated carcinoma were alive at 5 years. The presence of distant metastases (in 20 patients) was not correlated with T stage but was strongly correlated with N stage; histology did not affect the development of metastases. There clearly was no correlation between T and N stage, a behavior which probably constitutes a characteristic of these tumors. From our analysis we can affirm that N stage has a greater influence on prognosis and final outcome than T stage, at least using the UICC staging criteria.
Malignant Myositis Ossificans. A Case Report
Authors: Allen Ace , Wetzel Louis , Borek Deborah
Published: April 2018

A patient presented with an ossifying thigh mass suggestive of myositis ossificans. He had no antecedent trauma to the area. The mass was found to be an ossifying soft tissue metastasis from an occult gastric adenocarcinoma primary. Malignancy, and especially metastatic malignancy, is rarely considered in the differential diagnosis of a radiographic presentation of myositis ossificans.
Adenocarcinoma of Unknown Primary Site with Bone Marrow and Orbital Metastases Suggestive of a Prostatic Origin
Authors: Di Leo Angelo , Bajetta Emilio
Published: April 2018

Prostate cancer may occasionally present as an adenocarcinoma with an undetermined primary site. We report a case in which bone marrow invasion and orbital metastasis were the first evidence of malignancy. Recognition of metastatic prostate cancer is important since it can be managed safely and effectively with hormonal therapy.
Role of Immune Response in the Prognosis of Carcinoma of the Uterine Cervix: Can in Vitro Analysis Provide a better Framework for more Effective Management?
Authors: Pillai Radhakrishna , Balaram Prabha , Nair M. Krishnan
Published: April 2018

Cancer of the uterine cervix is the single largest female malignancy in India and also remains a major problem facing oncologists in other parts of the world. While advances in radiation therapy and surgical techniques have made the treatment of cervical carcinoma impressive, limitations to successful management still remain. In fact, the 5-year survival rate, stage for stage, has not improved in the United States or world wide in the past 40 years. With an estimated half a million women developing this disease annually, this lack of improved survival poses an international unresolved health problem. Immune response has been shown to be a major factor involved In the course of the disease for this cancer. Immunologic monitoring was also shown to be of effective value in assessing the prognosis for cervical carcinoma. We studied the various immunologic abnormalities in cervical cancer, the effects of radiation therapy on immune function, prospects of an immunologic staging system, the relationship between human papillomavirus infection and the Immune response, and the possibility of using in vitro Immunologic assessment to provide a better framework for more effective management of cancer of the uterine cervix.
Single Brain Metastases from Breast Cancer: Remarks on Clinical Pattern and Treatment
Authors: Salvati Maurizio , Capoccia Giovanna , Orlando Epimenio Ramundo , Fiorenza Fabio , Gagliardi Franco Maria
Published: April 2018

Thirty-four breast cancer patients with single brain metastases were reviewed: 9 underwent surgical removal only and 25 surgical removal and radiotherapy. A longer survival was seen in patients who underwent surgical removal and radiotherapy, with a mean survival of 28 months. In the 9 patients who did not receive whole brain radiotherapy, the mean survival was 15 months and there was an higher frequency of brain relapse.
Intracavitary Administration of Interleukin-2 as Palliative Therapy for Neoplastic Effusions
Authors: Lissoni Paolo , Barni Sandro , Ardizzoia Antonio , Paolorossi Franco , Tisi Elisabetta , Crispino Sergio , Tancini Gabriele
Published: April 2018

Cytokines have recently appeared to be effective in the palliative therapy of neoplastic effusions. The present study was carried out to evaluate the efficacy and the tolerability of an intracavitary injection of IL-2 in patients with neoplastic effusion due to solid tumors. The study included 14 patients with cytologically positive effusion (pleura, 11; peritoneum, 2; pericardium, 1). Tumor histotypes were: mesothelioma, 5; non-small cell lung cancer, 3; breast cancer, 2; ovarian cancer, 2; cervix carcinoma, 1; unknown primary tumor, 1. The efficacy was evaluated according to the criteria of Paladine et al. (Cancer 38: 1903, 1976). An objective response was achieved in 10/14 (71 %) patients (4 CR, 6 PR), with a median duration of 4 months (range, 2-8). No important toxicity was seen. This preliminary study showed that low dose IL-2 given intracavitarily is an effective and well-tolerated therapy in patients with neoplastic effusions.
Limited Small Cell Lung Cancer of the Lung Treated with Combination Chemotherapy and Radiotherapy: A Retrospective Analysis
Authors: Bardella Daniele , Giannini Massimo , Minguzzi Nadia , Zanchini Roberto , Emiliani Ermanno , Fiorentini Gianmaria
Published: April 2018

We assessed the outcome in 65 patients with limited small cell lung cancer (SCLC) treated from 1980 through 1989 with combination chemotherapy and chest and cranial irradiation. Of the 65 patients, 32.3 % (21/65) achieved a complete remission (CR) prior to radiation therapy; six additional cases achieved a CR after radiotherapy with an improvement of 10% in the incidence of CR. In our group, 8 patients were alive and free of disease at 30 months (12.3 %). We think that a combination of local thoracic irradiation in SCLC limited disease plus chemotherapy yields more CR and improves survival, especially in the group of patients who obtained the CR after initial induction chemotherapy.
The Role of Fine Needle Aspiration Cytology in the Diagnosis of Lesions of the Head and Neck excluding the Thyroid and Salivary Glands
Authors: Oyafuso Marina Suheko , Filho Adhemar Longatto , Ikeda Mauro Kasuo
Published: April 2018

Fine-needle aspiration cytology (FNAC) was performed in 273 cases with suspicious masses of the head and neck, excluding the thyroid and salivary gland, at the A.C. Camargo Hospital from 1983 to 1989. The most frequently punctured site was the lymph nodes (n = 178), and the most common histologic diagnosis of malignancy was squamous cell carcinoma (n = 43). FNAC results were: 105 positive, 6 suspicious, 135 negative, and 27 unsatisfactory cases. There was a correlation between cytology and histology in 217 cases, with 102 true-positive, 76 true-negative, 1 false-positive, and 7 false-negative cases. Suspicious and unsatisfactory cases were not considered for this index. Analysis of the results showed an efficiency of 95.6%, sensitivity of 93.5%, and specificity of 98.7 %. Positive and negative predictive values were respectively 99.0 % and 91.5 %.
Plasma Steroid Transport in Subjects with Tumors of Hormonal Target Organs: A Review
Authors: Borsellino Giovanni , Buonaguidi Arturo , Baroni Mario , Elli Gaetano , Sonato Augusta , Poma Silvano , Rescalli Stefania , Mondina Roberto
Published: April 2018

Tumors derived from a hormonal target organ are assumed to be stimulated by the same hormone that stimulates the normal target tissue. In spite of attempts to acquire direct indications of a correlation between hormones and cancer, none have been definitive because studies of total and free hormone levels have given contradictory results. For this reason, attention has shifted to the study of plasma binding and transport of hormones, that is, of the proteins responsible for modulation of the hormone effect and thus of hormone bioavailability. The data reviewed indicate that in-depth study of the transport and binding system of sex steroids would give new information about the endocrine characteristics of cancer patients.
Osteosarcoma of the Extremity Metastatic at Presentation: Results Achieved in 26 Patients Treated with Combined Therapy (Primary Chemotherapy Followed by Simultaneous Resection of the Primary and Metastatic Lesions)
Authors: Bacci Gaetano , Picci Piero , Briccoli Antonio , Avella Maddalena , Ferrari Stefano , Femino Frank P. , Monti Carlo , Ruggieri Pietro , Rizzente Armando Guido , Casadei Roberto
Published: April 2018

From September 1986 to December 1989, 26 selected patients with high-grade osteosarcoma of the extremities metastatic at presentation were treated with primary chemotherapy (high doses of methotrexate, -cisplatinum and adriamycin) followed by surgery. Twenty-one cases underwent resections of the primary and metastatic tumor at the same time; owing to the disappearance of lung metastases after preoperative chemotherapy in 3 cases, only the primary tumor was operated on. Due to progression of the disease in 2 patients, no surgery was performed. Histologic examination of the resected specimen was performed to evaluate the percentage of necrosis produced by chemotherapy on the primary and metastatic tumor. After surgery, the patients received further chemotherapy with the same drugs used preoperatively plus ifosfamide and VP-16. The histologic response of the primary tumor was good (> 90 % tumor necrosis) in 25 % of the cases; in the resected metastatic nodules, 23 % had good responses. A discrepancy between the histologic response of the primary and secondary tumor was observed in only 15 % of the cases. These results seem to confirm the validity of the strategy (widely used today in the neoadjuvant treatment of non-metastatic osteosarcoma) of changing the postoperative treatment when the histologic response of the primary tumor is poor. At an average follow-up of 3.5 years, only 6 patients remained disease-free; 19 patients relapsed and 1 patient died for adriamycin cardiotoxicity. Of the 19 relapsed patients, 16 died and 3 are still alive but with uncontrolled disease. These results are much worse than those obtained in 144 cases of non-metastatic osteosarcoma of the extremities treated in the same period with the same preoperative chemotherapy (77 % with good response in the primary tumor and 78 % with continues disease-free survival). The data suggest that a very effective neoadjuvant chemotherapy for nonmetastatic osteosarcoma of the extremities gives disappointing results in osteosarcoma of the extremities which is metastatic at presentation.
Case Report: A Patient with Hodgkin's Disease after Treatment for Testicular Cancer
Authors: Fiorentino Mario V. , Soesan Marcel , Piazza Mario , Sperandio Paola , Lise Mario , Pagano Francesco
Published: April 2018

A young patient developed Hodgkin's disease 11 years after surgical, chemotherapeutic and radiation treatment for stage IIIA embryonal carcinoma of the testis. The importance is stressed of establishing a tissue diagnosis when there is an unexpected course of the disease.
Adjuvant Chemotherapy for Cancer of Gastrointestinal Tract: A Critical Review
Authors: de Braud Filippo , Bajetta Emilio , Di Bartolomeo Maria , Colleoni Marco
Published: April 2018

Surgery is the only curative therapeutic approach for gastrointestinal tumors. If the tumor is deeply Infiltrating through serosa or invading regional lymph nodes, the 5-year patient's survival is about 60 % and < 40 %, respectively. The natural history and prognosis of neoplasms from colon, rectum and stomach are different. Despite the unsatisfactory results obtained with radical treatment of advanced disease, there are positive studies on adjuvant treatment of colon and rectal cancer, whereas the role of such an approach is still controversial for gastric cancer. The combination of fluorouracil containing chemotherapy with radiotherapy was suggested as the most effective adjuvant treatment for patients with Dukes’ B and C rectal cancer. However, the choice of chemotherapeutic regimen is still debated. A recent report, from the North Central Cancer Tumor Group, stated survival and disease-free survival advantages for patients with Dukes’ C colon cancer treated with FU + levamisole for 1 year after radical surgery. Since this regimen was not proven effective in advanced disease, ongoing adjuvant trials are comparing it with the combination of FU + biochemical modulator. The role of adjuvant therapy for gastric cancer is debated. The recent development of regimens active on advanced disease result in more promising future adjuvant trials.
Peripheral Neurotoxicity following High-Dose Cisplatin with Glutathione: Clinical and Neurophysiological Assessment
Authors: Pirovano Carlo , Balzarini Augusta , Böhm Silvia , Oriana Saro , Spatti Gian Battista , Zunino Franco
Published: April 2018

The use of high-dose cisplatin is limited by development of severe peripheral neurotoxicity and gradual worsening of renal function. In an ongoing study of high-dose cisplatin glutathione has been employed with the aim of preventing major cisplatin-induced toxicities. Neurotoxicity was examined in detail in 32 patients with ovarian cancer treated with cisplatin (160 mg/m2) and cyclophosphamide (600 mg/m2) every 3-4 weeks for five courses. In addition to serial complete neurological examination, sensory action potentials (SAPs) and motor conduction velocities (MCVs) were also assessed. We confirmed the development of a predominant sensory involvement, characterized by mild distal paresthesias and decrease in vibratory sensibility and in deep tendon reflexes, with a slight reduction of SAPs, observed after three courses of treatment. After five courses, distal paresthesias and disesthesias, decreased proprioception and loss of vibratory sensibility with ataxic signs, absence of deep tendon reflexes, unobtainable SAPs and only moderately reduced MCVs were seen. We did not observe any case of disabling neuropathy. There was a tendency to a more severe involvement of peripheral nerves in patients aged more than fifty. The 3 patients presenting the most serious neuropathy were the oldest in the whole group. Low degree of neurotoxicity observed in this study supports a glutathione protection against cisplatin-induced neurotoxicity. As the urinary excretion of platinum indicated no changes in the renal clearance of cisplatin following repeated courses, the lack of drug accumulation and high plasma peak due to preserved renal function might explain the reduced neurotoxicity observed.
Deflazacort and Fluoximesterone in Advanced, Pretreated Breast Cancer
Authors: Fornasiero Adriano , Ferrazzi Eros , Aversa Savina M. Luciana , Daniele Otello , Ghiotto Cristina , Sileni Vanna Chiarion , De Besi Pietro , Fiorentino Mario V.
Published: April 2018

A very simple, low dose, orally administered regime (10 to 15 mg of fluoximesterone + 6 mg of deflazacort daily for periods of 1 to several months) resulting in mild-acceptable toxicity (essentially some weight gain) determined subjective improvement In 2/3 of 34 evaluable patients (out of 36 treated) and an objective measurable tumor reduction in 1/3, although most patients had been previously treated with chemotherapy and hormone treatment and proved primarily or secondarily refractory. The receptor status at the beginning of fluoximesterone + deflazacort treatment was not known, except in one negative-receptor patient, who responded to the combination after becoming resistant to tamoxifen (see photo). In some patients the condition of hormone refractoriness would suggest a no-treatment policy, but a trial with this regime is always convenient as it may improve both duration and quality of life.
Hyalinizing Trabecular Adenoma of the Thyroid. Report of two Cases, with Cytologic, Immunohistochemical and Ultrastructural Studies
Authors: Cerasoli Serenella , Tabarri Bruna , Farabegoli Patrizia , Vascotto Lucia , Lanzanova Giuseppe , Pasquinelli Gian Andrea , Tison Vittorio
Published: April 2018

The cytologic, histologic, immunocytochemical and ultra-structural features of 2 cases of hyalinizing trabecular adenoma (HTA) of the thyroid are described. The difficulty of a cytologic diagnosis and the need for an immunohistochemical profile of the lesions for a final histologic diagnosis are emphasized.
The Effect of Cytological Screening on Cervical Neoplasia in the Italian Province of Varese
Authors: Gatta Gemma , Bottini Gian Mario , Lampertico Pietro , Sant Milena , Lualdi Maria , Berrino Franco
Published: April 2018

In the Varese province (409,142 female inhabitants in 1981), which has been covered by a cancer registry since 1976, cytologic screening for cervical cancer began in the early sixties in the municipality of Busto Arsizio (41,818 female inhabitants in 1981) and subsequently spread to the rest of the province. The distribution by age of cytologic smears and of detected in situ cancer reveals a more frequent attitude to be screened for women aged between 25 and 54 years. Overall, the incidence rate (world standardized) for invasive cancer in the province decreased from 10.3/100,000 women-year in the period 1976-81 to 7.5/100,000 in 1982-87. In Busto Arsizio a survey of the hospital archives has been carried out to identify the cases of cervical cancer diagnosed from 1966 to 1985: in this 20-year period, the incidence of cervical cancer decreased markedly, but only in those ages frequently screened. In the rest of the province, for the first period of cancer registration (1976-81), the incidence was significantly higher than in Busto Arsizio, especially for ages 35-64. Subsequently, between 1982-87, the cervical cancer incidence was low in both areas. For the period 1976-87, no difference for carcinoma in situ registration rates was observed between the two populations studied. Actually by 1976, when the Lombardy Cander Registry began its activity, the screening was diffuse throughout the province. These observations are consistent with the preventive effect of screening activity.
Epirubicin, Methotrexate and Bleomycin (EMB) in the Treatment of Recurrent Epidermoid Cancer of the Head and Neck
Authors: Baroncelli Giovanni , La Monica Maria Maddalena
Published: April 2018

During the period May 1989 to November 1990, at the « O. Alberti » Radium Institute of Brescia's General Hospital, 35 patients affected by epidermoid head and neck carcinoma were treated every 28 days with the salvage chemotherapy regimen EMB (epirubicin, 50 mg/m2 i.v. day 1; methotrexate, 40 mg/m2 i.v. days 1, 18; bleomycin, 10 mg/m2 i.v. days 4, 11, 18). Sixteen patients had been previously treated with surgery, 15 with radiotherapy and 4 with chemotherapy. Six patients (Group A) received only 1 cycle of chemotherapy because of disease progression and subsequent death. In another 15 patients (Group B) it was possible to administer 2 cycles of EMB, and 9 of them showed local disease progression and died. Among the remaining 6 patients, evaluated as PR, 1 refused further therapy and 5 were amenable to a previously impossible radiotherapy (4 of them are still alive). Fourteen patients received 3 or more cycles of EMB (Group C): 8 subjects showed progression and died; 1 reached CR and is alive without any evidence of tumor; 5 are in PR (3 of them underwent subsequent radiotherapy and 1 chemotherapy with CDDP). Out of 35 patients, 12 (34 %) reached a favorable response (CR or PR) and 8 (22 %) are still alive. As regards toxicity, the following adverse events were recorded (≥ 2 Miller's scale): leukopenia (8.5 %), thrombocytopenia (5.7 %), anemia (14.2 %), stomatitis (5.7 %), vomiting (5.7 %), alopecia (8.5 %), and fever (11.4 %). It can be concluded that the EMB regimen is very well tolerated and shows good effects in the treatment of patients with relapsed head and neck carcinoma.
Phase I Study of Fudr Continuous Infusion with Circadian Variability in Advanced Cancer Patients
Authors: Tralongo Paolo , Aiello Rosa , Ferraù Francesco , Marino Orazio , Cosentino Francesco , Veroux Pier Francesco , Failla Giuseppe
Published: April 2018

A phase I study of floxuridine circadian infusion was performed in 14 patients with advanced solid tumors (9 colonic, 1 gastric, 4 renal). The starting dose was 0.15 mg/kg/day for 14 days followed by a 14-day therapy-free interval. Sixty-eight percent of the daily dose was infused between 3pm and 9pm. The dose was increased by 0.025 mg/kg/day for each successive course. Eighty-one cycles of therapy were given for a total of 1134 days of treatment. The mean dose intensity was 0.868 mg/kg/day for the entire group. The highest dose achieved (maximum tolerated dose) was 0.325 mg/kg/day. The most frequent toxicity was diarrhea (4.9 % of all courses) and nausea-vomiting (3.7 % of all courses). These side effects were of a low grade and all were resolved without hospitalization. Our results suggest the circadian modulation of floxuridine infusion.
Weekly Doxorubicin Chemotherapy for Breast Cancer in Pregnancy. A Case Report
Authors: Barni Sandro , Ardizzoia Antonio , Zanetta Gerardo , Stracchi Elena , Lissoni Paolo , Tancini Gabriele
Published: April 2018

The simultaneous occurrence of breast cancer and pregnancy is rare. Little data are available about cytostatic treatment in patients with breast cancer during pregnancy. We report on a 31-year-old woman with a 28-week pregnancy and a T3 N+ Mx breast cancer treated with weekly doxorubicin chemotherapy. This was a well tolerated treatment without toxicity or complications for the mother. A partial response of the tumor was observed after 4 treatment courses. A normal baby was delivered. Doxorubicin and its metabolites were not detected in amniotic fluid collected through amniocentesis. Macroscopic and pathologic examinations of the placenta were normal. Although larger experiences are needed, weekly doxorubicin seems to yield satisfactory results without additional risks of fetal distress or malformations when given in women during the second and third trimester of pregnancy.
Hypertriglyceridemia during Long-Term Interferon-Alpha Therapy: Efficacy of Diet and Gemfibrosil Treatment. A Case Report
Authors: Berruti Alfredo , Gorzegno Gabriella , Vitetta Graziella , Tampellini Marco , Dogliotti Luigi
Published: April 2018

Interferon-alpha might increase triglyceride serum levels through the enhancement of hepatic lipogenesis and/or inhibition of the peripheral lipoprotein lipase. Hypertriglyceridemia during interferon-alpha therapy has been only recently described, mostly in patients with previous abnormalities of lipid metabolism. The authors report here a case of a 65-year-old male bearing advanced colon carcinoma who developed hypertriglyceridemia during long-term interferon-alpha treatment in association with 5 fluorouracil administration. Hypertriglyceridemia was maintained within acceptable levels, without adjusting the treatment plan, by an appropriate diet and gemfibrosil administration.
Morphogenesis of Epithelial Lesions in the Lymphoid Patches of Fischer 344 Rats during Cyclosporine-A-Induced Prolonged Immunosuppression
Authors: Bandaletova Tatiana Y.
Published: April 2018

Alterations of intestinal lymphoid patches induced by cyclosporine A (CS-A) were studied in male Fischer 344 rats. Continuous treatment with CS-A (10 mg/kg b.w. by gavage daily) resulted in lymphocyte deficiency of the intestinal lymphoid patches followed by progressive replacement of the lymphoid tissue by cystic and glandular epithelial structures and single cells positive for epithelium-associated immunohistochemical markers. Cessation of CS-A administration led to regression of the alterations and a moderate recovery of the lymphoid patches. Morphologic changes induced at the epithelial-lymphoid border may be a useful parameter to estimate immunotoxicity.
Adjuvant Radiotherapy of the Pelvis with or without Reduced Glutathione: A Randomized Trial in Patients Operated on for Endometrial Cancer
Authors: De Maria Dario , Falchi Anna Maria , Venturino Paola
Published: April 2018

A randomized pilot trial was performed to evaluate the feasibility of administration of glutathione (GSH, 1200 mg, i.v.) as a protector in preventing diarrhea in patients operated on for endometrial cancer and submitted to adjuvant radiotherapy of the pelvis. Diarrhea occurred In 52% of patients In the untreated control group and only in 28% of patients In the GSH-treated group. Our preliminary data indicate that GSH administered before radiotherapy reduced the occurrence of diarrhea from oxidative damage to the intestinal mucosa. A large-scale phase III study is required to obtain definitive conclusions on the protective potential of GSH.
Neoadjuvant Chemotherapy with Cisplatin, Epirubicin and VP-16 for Stage IIIA-IIIB Non-Small-Cell Lung Cancer: A Pilot Study
Authors: Gridelli Cesare , Iacobelli Stefano , Martino Teresa , Natoli Clara , Ferrante Giovanni , Gentile Maria , Irtelli Luciana , Beltrami Vanni , Rossi Antonio , Bianco Angelo Raffaele
Published: April 2018

Twenty patients with stage IIIA-IIIB non-small-cell lung cancer were treated with cisplatin, epirubicin and VP-16 (PEV) neoadjuvant chemotherapy (CDDP, 70 mg/m2, i.v., d 1; EDX, 60 mg/m2, i.v., d 1; VP-16, 100 mg/m2, i.v., d 1-2-3; every 3 weeks). A partial response was obtained In 11 cases (55%), stable disease in 3 cases (15%), and progressive disease in 6 cases (30%). After chemotherapy, 8 (40%) patients, all achieving a partial response, were elegible for surgery: 5 (25%) had a complete resection (4 IIIA and 1 IIIB) and 3 (15%) an incomplete resection. The treatment was well tolerated. These data show that PEV is an active regimen for neoadjuvant chemotherapy in NSCLC and recommend this therapeutic approach for stage IIIA patients.
Mitomycin C and Vindesine: An Ineffective Combination Chemotherapy in the Treatment of Malignant Pleural Mesothelioma
Authors: Gridelli Cesare , Pepe Rosario , Airoma Giuseppe , Incoronato Pasquale , Rossi Antonio , Palazzolo Giovanni , Bianco Angelo Raffaele
Published: April 2018

Twelve patients with malignant pleural mesothelioma were subjected to mitomycin C (MMC) and vindesine (VDS) chemotherapy (MMC 10 mg/m2, i.v., d 1; VDS, 3 mg/m2, i.v., d 1–8, every 4 weeks). No objective response was obtained; 3 (25%) patients had stable disease and 9 (75%) progression of disease. We conclude that MMC plus VDS is an ineffective combination chemotherapy in the treatment of malignant pleural mesothelioma.
Single Brain Metastases from Kidney Tumors. Clinico-Pathologic Considerations on a Series of 29 Cases
Authors: Salvati Maurizio , Scarpinati Marco , Orlando Epimenio Ramundo , Celli Paolo , Gagliardi Franco Maria
Published: April 2018

Twenty-nine cases of single cerebral metastases from renal carcinoma were the object of a retrospective and prospective study covering a period of 15 years (1975–1988). The best diagnostic means were NMR imaging with paramagnetic contrast medium and CAT scans after intravenous injection of a double dose of contrast medium. All patients underwent total surgical removal of the cerebral lesion. Radiotherapy was useful but had less influence on further reproduction than in metastases from tumors of other sites. The median survival was 28.1 months in patients who received radiotherapy and 23 months in the others. No significant difference in survival was found between the group of patients with unknown primary tumors and the other group with diagnosed primary neoplastic disease.
Simultaneous Occurrence of Monoclonal Gammopathy and Acute Secondary Leukemia with Overexpression of P-Glycoprotein
Authors: Stasi Roberto , Tribalto Maurizio , Venditti Adriano , Del Poeta Giovanni , Aronica Germano , Zaccar Giuseppe , Rossi Vincenza , Maffei Laura , Papa Giuseppe
Published: April 2018

A 52-year-old woman, previously treated with chemo- and radiotherapy for Hodgkin's disease, developed an acute non-lymphoid leukemia and, contemporarily, an IgG-kappa paraproteinemia. Cytogenetic analysis showed a major clone, representing 90% of observed metaphases, with monosomy of chromosomes 5 and 14. In addition, leukemic cells exhibited a high expression of the P-glycoprotein, a transmembrane glycoprotein involved in the multidrug-resistance mechanism. Possible explanations for this cluster of findings are provided.
Cancer Research in the European Community and Other Non-EC Countries
Authors: Parodi Silvio , Parodi Anita , Lombardo Claudio , Santi Leonardo
Published: April 2018

Aims

We assessed the scientific productivity in the field of cancer research of countries in the European Community (EC) and the most important non-EC countries by counting the number of papers published during the period 1988-1990 in 15 of the top scientific journals (as defined by the Journal Citation Reports, Oncology). The global and per capita data are presented for each country.

Methods

Qualitative parameters like the impact factor and the half-life were also considered in the analysis. The selection of cancer journals with a high average quotation rate gave significant results. Introducing the average impact factor and half-life of each journal modified the results only slightly. The per capita data for each country were not corrected for the number of investigators working in oncology (a datum difficult to obtain). The parameters thus do not define the performance of the average investigator but are more « economic » parameters specifically related to the field of cancer research.

Results and conclusions

Small, wealthy Western countries tended to have an advantage over large, less developed countries, as expected. However, additional individual differences that could be of interest were present in the group of developed countries.
Endoscopic Treatment of Postradiation Strictures
Authors: Spinelli Pasquale , Milani Franco , Cerrai Federicp Giuseppe , Mancini Andrea , Ali Domenico Corrado , Palazzi Mauro , Pizzetti Paolo
Published: April 2018

Background

Esophageal stricture is a rare complication of radiotherapy: reports on its incidence and management are therefore anecdotal.

Methods

From January 1978 to September 1992, 44 patients presenting with an esophageal stricture related to a previous radiation treatment were endo-scopically dilated at the Endoscopy Division of the Istituto Nazionale Tumori of Milan.

Results

Esophageal recanalization was obtained in 95 % of the patients treated, and in 79 % of these normal eating habits were restored. No strict correlation was observed between radiation dose and severity of the stricture, or time elapsed between first treatment and endoscopic dilation.

Conclusions

In our experience, endoscopic dilation was a safe effective procedure and represented an effective palliative tool in dysphagic patients with esophageal strictures due to previous local radiotherapy.
Granulocytic Sarcoma with Myxoid Stroma. Report of a Case
Authors: Di Palma Silvana , Feudale Elisa
Published: April 2018

A granulocytic sarcoma with myxoid features simulating a chondrosarcoma was detected in the left arm of a 59 years old man. It is suggested that extramedullary hematopoietic neoplasms such as granulocytic sarcoma may display, similarly to malignant lymphomas, non-specific sarcoma-like features that obscure the usual diagnostic characteristics.
Sarcomas Involving the Abdominal and Pelvic Cavity
Authors: Fernández-Trigo Vicente , Sugarbaker Paul H.
Published: April 2018

The principles of management of all sarcomas that involve the abdominal and pelvic cavity are presented. The anatomic sites for the primary malignancy include retroperitoneal sarcomas, pelvic side-wall sarcomas, sarcomas arising from the abdominal viscera, and sarcomas arising from the pelvic organs. All histologic types of sarcomas may be considered together when therapeutic options are being discussed. This presentation stresses surgical removal with an adequate margin of resection as the principal goal of management. The curative treatment of these cancers places great emphasis on the surgeon's knowledge of anatomy, technical skills, innovation, and surgical courage. Systemic chemotherapy and radiotherapy have not shown reproducible efficacy. Complete resection in the absence of tumor spillage remains the only reliable treatment option. Possible benefits of induction chemotherapy and intraperitoneal chemotherapy using cisplatin and doxorubicin in the early postoperative period are presented.
Is Early Gastric Cancer, Diffuse Type, a Forerunner of Advanced Gastric Cancer?
Authors: Leocata Pietro , Gallo Pietro , Chiominto Alessandro , Saltarelli Solidea , Cioccocioppo Rachele , Saltarelli Patrizia , Di Giacomo Carlo , Ventura Luca
Published: April 2018

Aims and Background

Gastric cancer (GC) represents one of the most Important causes of death by malignancy world wilde. Our retrospective study was carried out on surgical stomach specimens obtained from a series of 552 consecutive cases of GC observed in the Departments of Surgical Pathology of the Public Hospitals of L'Aquila and Atri which cover the 17 % of the entire population of the Italian Region Abruzzo. The aim of the study was to compare the anatomo-clinical characteristics of early GC (EGC) and advanced GC (AGC).

Methods

The diagnosis was achieved by the criteria of the Lauren's histopathological classification (intestinal and diffuse types). Our study also stratified the cases by sex, age, lymph node metastases and associated lesions such as chronic atrophic gastritis, intestinal metaplasia and dysplasia.

Results

On an average, patients affected by EGC were 8.1 years younger than those with AGC. This age gap could support the hypothesis that early lesions represent the first stage of AGC. However, when patients were subdivided according to Lauren's classification, the mean age of patients with EGC, diffuse type, was 12.2 years less than that of AGC patients of the corresponding histological type. Furthermore, the subset of patients with EGC, diffuse type, and lymph node metastases was 17.8 years younger than patients affected by AGC diffuse type, with lymph node metastases.

Conclusions

The present study offers an original survey on GC in a defined Italian population. As far as the intestinal histotype is concerned, the slight age difference between EGC and AGC suggests that these tumors are different steps of the same process. On the contrary, the age distribution suggests that EGC, diffuse type, has a different biological behaviour.
Infections in Patients with Acute Non-Lymphocytic Leukemia Nursed with Central or Peripheral Venous Access
Authors: Fasola Gianpiero , Savignano Chiara , Revignas Maria Gloria , Virgolini Luigi , Baccarani Michele
Published: April 2018

Aims and Background

Infections are a major problem in patients undergoing induction chemotherapy for acute leukemia. Granulocytopenia is the single most imporant risk factor, but the pattern of infecting organisms can change according to nursing facilities or bacterial and fungal prophylaxis.

Methods

We reviewed the patterns and types of infections in 30 patients with acute non-lymphocytic leukemia. Eighty-nine periods of neutropenia following chemotherapy were evaluated: in 60 courses patients had central and in 29 had peripheral venous access.

Results

Almost all patients (97 %) became febrile after the 1st course of therapy, but one-third remained apyretic after the fourth course (P = 0.002). In this series, the incidence of gram-positive, gram-negative and mycotic isolations were respectively 76 %, 18 % and 6 %. The need for antimicrobic treatment varied in relation to the course of chemotherapy.

Conclusions

We conclude that in acute non-lymphocytic leukemia the first neutropenic period following the onset of disease is the most critical regarding infectious problems. Both quinolonic prophylaxis and central venous access could be responsible for the microbiologic findings.
Nasopharyngeal Carcinoma in Children and Adolescents Successful Role of Retrieval Therapy
Authors: Zaghloul Mohamed S. , Dahaba Nader M. , Wahab Amina Abdel , Hussein M. Hany , El-Koutbey Montasser
Published: April 2018

Background

The nasopharyngeal carcinoma in children and adolescents usually presents in advanced locoregional stages.

Methods

Seeventeen patients, below the age of 18 years, with the diagnosis of nasopharyngeal carcinoma were diagnosed and treated at the National Cancer Institute (NCI), Cairo, Egypt, during the period 1982-1987. These 17 patients were selected from 28 patients of the same age group to whom the diagnosis of nasopharyngeal malignancies were established. This diagnosis was confirmed morphologically and with immunostaining using antibodies against leucocyte common antigen (LCA), epithelial membrane antigen (EMA), cytokeratin and vimentin.

Results

Eighty two percent of our patients were in T3 + T4 and 94 % had N 1-3 nodal status. The loco-regional control was 94 % with adequate conventional radiotherapy, while the distant metastasis rate was also high (81 %). The 5-year actuarial survival rate was 47 ± 11 % and the survival worsened with the advancement in T stage. However, the present study did not show any influence of N stage on survival. The relatively high survival rate depended mainly upon successful retrieval therapy with radiochemotherapy.

Conclusions

This emphasizes the role of combination chemotherapy in the treatment of relapsing nasopharyngeal carcinoma in young patients.
Hepatoma Today: Therapeutic Experiences of Multimodal Approach
Authors: Tang Zhao-You , Fiorentini Giammaria
Published: April 2018

Aims and Background

Hepatocellular carcinoma (HCC) ranks third of cancer deaths in China, it kills 100,000 patients every year. In Italy HCC is an increasing malignant tumor and kills about 7000 patients every year. Fortunately, due to a multimodal approach to the treatment of this fatal disease, HCC has been changed from « Incurable » to « partly curable ». The authors report and comment the methods and the strategies that have been used to increase the cure-rate of HCC.

Methods

The actual approaches, developed in the last thirty years mainly in China, included: screening of cirrhotic patients, early resection, new surgical criteria for cirrhotic liver, early detection of subclinical recurrence and re-resection, multimodality treatment for cytoreduction of huge HCC, sequential resection after cytoreduction of unresectable HCC, targeting therapy using radiolabelled antibodies and lipiodol, transarterial embolization, radiotherapy combined with Chinese herbs, other regional cancer therapy and biological response modifiers.

Results

Are that these methods have reached a marked increase series 5-year survival rate and number of 5-year survivors in more expert institutions.

Conclusions

We conclude that further biological and genetic studies on HCC are warranted and that it is mandatory to perform large clinical randomized trials comparing the more promising treatments.
M-Veca (Methotrexate, Vinblastine, Epidoxorubicin and Carboplatin) in the Treatment of Advanced Urothelial Carcinoma
Authors: Lorusso Vito , Berardi Francesco , Brandi Mario , Mastria Antonella , Paradiso Angelo , Catino Anna Maria , Tatuili Corrado , De Lena Mario
Published: April 2018

Aims and Background

Urothelial cancer is a chemosensitive disease. However, cisplatin or anthracycline-containing regimens still provoke severe toxicity mainly due to reduced renal function and poor performance status (PS) of patients. The aim of this study was to verify the possibility of substituting carboplatin for cisplatin and epirublcin for doxorubicin in the M-VAC regimen in order to reduce toxicity and improve patient tolerance.

Methods

Twenty patients with advanced urothelial tract tumors were treated with a chemotherapeutic regimen composed of methotrexate (30 mg/mq iv on days 1, 15, 22), vinblastine (3 mg/m2 iv on days 2, 15, 22), epidoxorubicin (35 mg/m2 iv on day 2) and carboplatin (250 mg/m2 iv on day 2) every four weeks (M-VECA). All patients had bidimensionally measurable disease.

Results

Of the 18 evaluable patients, 3 (17 %) obtained complete response and 7 (33 %) obtained partial response (50 % overall response). The median duration of response was 50 weeks (range, 28-88+). Grade III-IV toxicity (leukothrombocytopenia and mucositis) was observed in 20 % of cases. Nevertheless, recovery was prompt in all but 2 patients with poor PS who died of nadir sepsis.

Conclusions

M-VECA was an effective regimen for the treatment of patients with metastatic urothelial tumors and was safely employed in patients with a good PS. However, the possibility of substituting carboplatin for cisplatin as neoadjuvant therapy for less advanced stages needs further investigation in randomized studies.
Combined Use of Interferon Alpha-2, Chlorambucil and Prednisone in Previously Treated Patients with Low-Grade Non-Hodgkin's Lymphomas. Results of a Phase II Study
Authors: Molica Stefano , Tucci Luigi , Levato Domenico , Levato Luciano , Manfredi Luciano
Published: April 2018

Aims and Background

To investigate therapeutic activity and safety of alpha-interferon (alpha-IFN) in combination with chlorambucil (CLB) and prednisone (PDN), we treated 9 low-grade non-Hodgkin lymphoma patients with clinical evidence of relapsed (5 cases) or resistant (4 cases) disease with such an association.

Methods

In all instances, treatment consisted of alpha-2a IFN administered by subcutaneous route thrice weekly for 3 weeks, CLB, 5 mg/day for 21 days, and PDN, 30 mg three times a week for 3 weeks. Cycles were repeated every 28 days.

Results

A well-documented clinical response was observed in 6 (4 CRs+2 PRs) of 9 patients. Interestingly, 3 of 4 CRs were achieved in patients with histologically proven bone marrow involvement. Median duration of response was 18.5 months (range, 4-29 months). Myelosuppression was a common side effect. Two patients experienced grade 3 hematologic toxicity which did not preclude continuation of therapy.

Conclusions

As new purine analogues are not currently available, the combination of alpha-IFN, CLB, and PDN may represent, in our opinion, a valid therapy for patients not eligible for aggressive therapy such as autologous bone marrow transplantation.
Clinical Evaluation of Serum Aminoterminal Propeptide of Type III Procollagen as Tumor Marker in Gynecologic Malignancies
Authors: Aziz Mohamed Talaat Abdel , Wassef Mohamed Abdel Aziz , Kamel Maha , Zein Mona El , Hassan Hany El
Published: April 2018

Aims

The aim of this study was to determine the possible usefulness of the assay of the aminoterminal propeptide of type III procollagen and fibronectin in detecting connective tissue changes associated with gynecologic malignancies.

Study Design

Serum aminoterminal propeptide of type III procollagen and plasma fibronectin were measured in 36 women with gynecologic malignancies, 20 women with benign gynecologic tumors and 10 healthy women serving as controls.

Results

A significant serum propeptide was significantly high In the group with gynecologic malignancies and normal in the benign tumor group. The serum propeptide levels were related to of disease stage and presence of ascites in patients with ovarian carcinoma but not in those with cervical or endometrial carcinoma. In the follow-up study, a favorable clinical response was associated with normalizing propeptide levels whereas in rapidly progressive disease the levels fell initially but rose again. In partial response with ultimate progression, the propeptide concentration decreased but remained clearly above the normal range. No difference in plasma fibronectin was found among the malignant tumor, benign tumor and control groups.

Conclusions

The present study indicates that the aminoterminal propeptide of type III procollagen could serve as an additional, non specific marker to follow the clinical behavior of gynecologic malignancies and consequently of connective tissue metabolism reflecting tumor matrix interaction.
A Calcitonin-Producing Neuroendocrine Tumor of the Larynx: A Case Report
Authors: Insabato Luigi , De Rosa Gaetano , Terracciano Luigi Maria , Lupoli Giovanni , Montedoro Daniela , Ravetto Carlo
Published: April 2018

A moderately differentiated neuroendocrine carcinoma of the larynx is described. Although the patient had normal serum calcitonin level 36 months before, its level was elevated at the time the neck node was removed. This study supports the hypothesis that a diagnosis of calcitonin-producing neuroendocrine tumor of the larynx with increased plasma calcitonin is possible and should be considered to avoid unnecessary thyroidectomy.
Post-Paget Osteosarcomas of the Skull. Remarks on Five Cases
Authors: Salvati Maurizio , Cervoni Luigi , Raguso Michele , Raco Antonino
Published: April 2018

We report our experience with 5 cases of post-Paget osteosarcoma of the skull, a rare lesion of the neurocranium. Four patients were treated by surgery and radiotherapy and one by surgery alone. Two patients received chemotherapy. Histologically, the tumor was found to be an osteosarcoma, fibroblastic in 2 cases, mixed in 2, and osteoblastic in 1. Combined treatment (surgery, radiotherapy and chemotherapy) positively influenced survival (median survival, 6 months). The prognosis for post-Paget osteosarcomas of the skull seems to be worse than for primary sarcomas, probably due to their intense vascularization. This facilitates the spread of tumor cells to other organs (as observed in our cases) and reduces the reduced effectiveness of chemotherapy. Although the latter lengthens survival and reduces the incidence of metastases, it is not as efficacious as in primary sarcomas.
Giant Cell Fibroblastoma of the Scrotum. A Case Report
Authors: DeSanctis Domenico Potito , Maglietta Rocco , Miranda Rocco , Betta Pier-Giacomo
Published: April 2018

A case of giant cell fibroblastoma occurring in the scrotum of a 21-year-old male is described. It may have been a recurrence of a previous lesion in the same region, which was only clinically diagnosed as fibrolipoma when excised 10 years before. Giant cell fibroblastoma is a benign, locally recurrent tumor of youth and childhood which arises from superficial soft tissue. To our knowledge, only 2 other cases of scrotal involvement by this neoplasm have been reported.