bluuebunny/crossref_metadata_2025 huggingface dataset:
Radiotherapy and Oral Capecitabine in the Preoperative Treatment of Patients with Rectal Cancer: Rationale, Preliminary Results and Perspectives
Authors: Corvò Renzo , Pastrone Ilaria , Scolaro Tindaro , Marcenara Michela , Berretta Laura , Chiara Silvana
Published: April 2018

Preoperative radiotherapy alone or combined with chemotherapy increases the chances of tumor downstaging and down-sizing and facilitates sphincter-sparing surgical procedures, thereby improving survival and quality of life. Though several innovative agents are being investigated in combination with radiotherapy, 5-fluorouracil in continuous infusion remains the common schedule used in the preoperative chemoradiation setting. However, the protracted venous infusion of 5-fluorouracil requires specialized pumps and long-term venous access, which makes patients susceptible to infections or thrombosis. To overcome the 5-fluorouracil infusion-related problems, oral 5-fluorouracil precursors and inhibitors of 5-fluorouracil degradation have been developed and explored. These include oral fluoropyrimidines such as tegafur (ftora-fur), uracil plus tegafur (UFT), S-1, eniluracil and the oral carbamate capecitabine. Phase I trials have demonstrated the feasibility of the capecitabine-radiotherapy combination with respect to the bolus or infusion 5-fluorouracil-radiation approach and have defined the optimal dose of capecitabine during radiotherapy (825 mg/m2/day through a bid administration). Severe hand-foot syndrome occurred in 7-15% of patients, representing the most commonly observed toxicity. It is noteworthy that severe diarrhea with capecitabine during radiotherapy was not common. Leukopenia frequently occurred but was mild and reversible. Phase II trials, although limited in number, have evidenced a high probability of pathological complete response (up to 31%) with capecitabine and radiation, with an increased probability of sphincter-sparing surgical procedures. Although it is too early to assess whether oral capecitabine will be able to replace iv 5-fluorouracil in combination with preoperative radiotherapy, the NSABP will address this question in a large randomized trial. Finally, phase I-II trials evaluating escalating doses of capecitabine associated with oxaliplatin or irinotecan with radiotherapy are being carried out to assess the maximum-dose tolerance and efficacy in the preoperative setting. It is likely that these new chemoradiation associations might increase rectal cancer clearance, hopefully without increasing toxicity.
Sentinel Lymph Node Mapping in the Management of Colorectal Cancer: Preliminary Report
Authors: Roseano Mauro , Scaramucci Monica , Ciutto Tiziana , Balani Alessandro , Turoldo Angelo , Zanconati Fabrizio , Liguori Gennaro , Leggeri Aldo
Published: April 2018

Aim and background

The problem of understaging the lymph node status in colorectal cancer because of missed micrometastases led authors to investigate the role of sentinel node (SN) mapping also in colorectal malignancies. The aim of this study was to evaluate the feasibility of the technique and to correlate the results with some characteristics of the primary tumor.

Methods

Sentinel lymph node mapping was performed in 23 patients who underwent a standard lymphadenectomy for colorectal cancer. The vital dye Patent Blue had been injected into the peritumoral subserosa in vivo in 17 cases and ex vivo in seven, including one case where the in vivo method did not allow to identify the sentinel node. The nodes that took up the dye were removed and analyzed with standard hematoxylin-eosin staining in serial sections. Immunohistochemistry (AE1-AE3 cytokeratin markers) was performed in hematoxylin-eosin-negative nodes. SN status was related to the status of the other lymph nodes in the surgical specimen analyzed with the standard technique and to the following characteristics of the primary tumor: stage, grade and diameter.

Results

The in vivo technique allowed to identify the SN in 16/17 cases (94.1%), the ex vivo technique in 7/7. A total of 336 lymph nodes dissected from the surgical specimens was analyzed, with an average of 14.6 nodes per patient (range, 7-35). Of these nodes 58 were SNs, with an average of 2.5 nodes per patient (range, 1-8). In the 19 cases where the SN was tumor negative, the non-SNs were also negative (specificity: 100%), whereas in the four cases where the non-SNs were positive, in two cases the SN was positive and in two cases of pT3 rectal carcinoma the SN was negative (sensitivity: 50%). Immunohistochemistry did not modify the negative results of the standard hematoxylin-eosin evaluation.

Conclusions

The method used to identify the SN using vital dye proved to be easy to use both in vivo and ex vivo and allowed to identify the SN in all cases. The preliminary results indicate that there is a risk of false negative findings and therefore further studies are required to improve the sensitivity and the specificity of the technique and to evaluate the role of SN mapping in colorectal cancer management.
Mammographic and Sonographic Features of Tubular Breast Carcinoma
Authors: Daniele Santa , Imbriaco Massimo , Riccardi Albina , Selva Guerino , di Nuzzo Loredana , Salvatore Marco , Sodano Antonio
Published: April 2018

Aims and background

This study aimed to describe the mammographic and sonographic features of tubular carcinoma of the breast.

Methods

A retrospective review of 198 consecutive cases of surgically proven breast cancer revealed ten cases of tubular carcinoma of the breast. Only tumors with a tubular component of at least 75% were included in the study. Mean patient age was 56 ± 9 years, range 35 to 70 years.

Results

The mean size of the tumors was 11 ± 4 mm. On mammography, all tubular carcinomas appeared as an irregularly shaped mass with a central density in 6/10 cases. Eight tubular carcinomas were described as having spiculated margins. Microcalcifications were present in 4/10 cases. On ultrasound the tumor presented as a hypoechoic mass with irregular margins and posterior acoustic shadowing in 7/10 cases. In three cases the tumor presented as a hypoechoic mass with ill-defined margins and posterior acoustic shadowing.

Conclusions

Although some specific mammographic and sonographic features may suggest the presence of a tubular carcinoma, the final differential diagnosis from other spiculated lesions of the breast should rely on histologic evidence only. Therefore, surgical biopsy should be recommended in all cases of stellate lesions of the breast detected at mammography or ultrasonogram.
Redox Modulation of NF-κB Nuclear Translocation and DNA Binding in Metastatic Melanoma. The Role of Endogenous and γ-Glutamyl Transferase-Dependent Oxidative Stress
Authors: Dominici Silvia , Visvikis Athanase , Pieri Lisa , Paolicchi Aldo , Valentini Marta A , Comporti Mario , Pompella Alfonso
Published: April 2018

Aims and background

The transcription factor NF-κB is implicated in the expression of genes involved in cell proliferation, apoptosis and metastasis. In melanoma, high constitutive levels of NF-κB activation are usually observed. NF-κB is regulated by oxidation/reduction (redox) processes, and the occurrence of constitutive oxidative stress in melanoma cells has been documented. Recent studies of our laboratories showed that the membrane-bound gamma-glutamyl transferase (GGT) enzyme activity – expressed by a number of malignancies, including melanoma – can act as a basal source of superoxide, hydrogen peroxide and other prooxidants.

Methods

In the present study we utilized the 2/60 clone of Me665/2 human metastatic melanoma, which displays high levels of GGT activity, in order to verify if the presence of this enzyme - through the promotion of redox processes - may influence the activation status of NF-κB. The latter was evaluated by determining the nuclear translocation of the p65 subunit (by immunoblot), the DNA binding of NF-kB (by elec-trophoretic mobility shift assay) and its transcriptional activity (by gene transactivation studies).

Results

Me665/2/60 cells displayed a basal production of hydrogen peroxide. Stimulation of GGT activity by its substrates glutathione and glycyl-glycine caused additional production of hydrogen peroxide, up to levels approx. double the basal levels. Nuclear translocation of the NF-κB p65 subunit, DNA-binding and gene transactivation were thus investigated in Me665/2/60 cells whose GGT activity was modulated by means of substrates or inhibitors. Stimulation of GGT activity resulted in increased nuclear translocation of p65, while on the other hand NF-κB DNA binding and gene transactivation were paradoxically decreased. NF-κB DNA binding could be restored by treating cell lysates with the thiol-re-ducing agent dithiothreitol (DTT). Treatment of cells with exogenous hydrogen peroxide did not affect NF-κB activation status.

Conclusions

Altogether, the data obtained indicate that GGT activity may impair the redox status of thiols that is critical for NF-κB DNA binding and gene transactivation, through the production of prooxidant species allegedly distinct from hydrogen peroxide. GGT activity therefore appears to be an additional factor in modulation of NF-κB transcriptional activity in melanoma, capable of hindering NF-κB DNA binding even in conditions where continuous oxidative stress would favor NF-κB nuclear translocation.
Phosphoinositide 3-Kinase Signalling Pathways in Tumor Progression, Invasion and Angiogenesis
Authors: Brader Sharon , Eccles Suzanne A
Published: April 2018

Aims and background

The PI3 kinase signalling pathway is now accepted as being at least as important as the ras-MAP kinase pathway in cell survival and proliferation, and hence its potential role in cancer is of great interest1. The purpose of this review is briefly to examine evidence for an involvement of PI3K in human cancers, discuss the mechanisms by which its activation promotes tumor progression, and consider its utility as a novel target for anticancer therapy.

Methods and study design

A Medline review of recent literature concerning the role of PI3 kinase in tumor progression -mechanisms of action and clinical implications.

Results

Evidence is presented that misregulation of the PI3 kinase pathway is a feature of many common cancers, either by loss of the suppressor protein PTEN, or by constitutive activation of PI3 kinase isoforms or downstream elements such as AKT and mTOR. This activation potentiates not only cell survival and proliferation, but also cytoskeletal deformability and motility; key elements in tumor invasion. In addition the PI3K pathway is implicated in many aspects of angiogenesis, including upregulation of angiogenic cytokines due to tumor hypoxia or oncogene activation and endothelial cell responses to them. These cytokines signal though receptors such as VEGF-R, FGF-R and Tie-2 and potentiate processes essential for neoangiogenesis including cell proliferation, migration, differentiation into tubules and “invasion” of these capillary sprouts into extracellular matrix (ECM).

Conclusions

A more complete understanding of the role of the PI3 kinase pathway in cancer will lead the way to the development of more potent and selective inhibitors which should be a useful adjunct to conventional therapies, potentially interfering with tumor progression at several pivotal points; in particular cell survival, invasion and angiogenesis.
Percutaneous Kyphoplasty: Indications and Technique in the Treatment of Vertebral Fractures from Myeloma
Authors: Masala Salvatore , Fiori Roberto , Massari Francesco , Cantonetti Maria , Postorino Massimiliano , Simonetti Giovanni
Published: April 2018

Aims and background

The purpose of our research was to assess the effectiveness and safety of percutaneous kyphoplasty, the new method of treatment for pain deriving from vertebral compression fractures due to myeloma.

Methods

We treated 3 patients with pain refractory to conventional medical therapy (analgesics, bed-rest, bracing with orthopedic devices for more than 4 weeks), localized in the lumbar area, painful to the touch and in the absence of neurological signs.

Results

The method demonstrated a swift pain relief associated with an evident augmentation in the resistance and restoration of the vertebral body's physiological shape. Polymethylmethacrylate leaks were not observed in the epidural or foraminal area, nor were complications such as pulmonary embolism for involvement of the venous plexus or related to phenomenon of infections due to the procedure, or toxicity due to the polymethylmethacrylate.

Conclusions

Kyphoplasty was found to be an effective alternative, simple and safe in the treatment of vertebral collapse consequent to multiple myeloma. The same injection of polymethylmethacrylate can be done before the radiotherapy treatment, thereby synergizing its delayed analgesic action to pain, or after the failure or in the case of local recurrence.
Paclitaxel Administered Weekly in Patients with Docetaxel-Resistant Metastatic Breast Cancer: A Single-Center Study
Authors: Sawaki Masataka , Ito Yoshinori , Hashimoto Daigo , Mizunuma Nobuyuki , Takahashi Shunji , Horikoshi Noboru , Tada Keiichiro , Kasumi Fujio , Akiyama Futoshi , Sakamoto Goi , Imai Tsuneo , Nakao Akimasa , Hatake Kiyohiko
Published: April 2018

Aims and background

We evaluated retrospectively the efficacy and toxicity of paclitaxel in patients with docetaxel-resistant metastatic breast cancer.

Study design

Paclitaxel (80 mg/m2) was administered weekly to 44 patients who had previously received chemotherapy regimens for metastatic breast cancer. All patients had progressive disease in spite of having received docetaxel therapy.

Results

Treatment was repeated until there was evidence of disease progression. Objective responses were obtained in 14 of 44 assessable patients (31.8%; 95% confidence interval, 17.5–46.1). Fourteen patients had partial responses; none responded completely. Seven of 14 responders had primary resistance to docetaxel therapy. The median duration of response was 6.1 months (range, 2.1–12.7). The median time to progression was 5.0 months. Clinically severe adverse events (grade 3 or 4) included neutropenia (27.2%), leukopenia (25.0%), neuropathy-sensory (13.6%), febrile neutropenia (6.8%), anemia (2.2%), constipation (2.2%), and edema (2.2%). Treatment was generally well tolerated and could be continued on an out-patient basis.

Conclusions

Weekly paclitaxel is effective in patients with docetaxel-resistant metastatic breast cancer. This observation suggests partial cross-resistance between paclitaxel and docetaxel. There was no evidence for additive cumulative toxic effects of the two taxanes.
Prognostic Value of Different Factors in Breast Carcinoma
Authors: Hlupić Ljiljana , Jakić-Razumović Jasminka , Božikov Jadranka , Ćorić Marijana , Belev Borislav , Vrbanec Damir
Published: April 2018

Introduction

The aggressive biological behavior of invasive and metastatic cancer is considered to be the most insidious and life-threatening aspect for breast cancer patients. It is mostly the result of changes in many molecular characteristics of tumor cells, including alterations in the mechanisms controlling cell growth and proliferation.

Aim

The aim of this retrospective study was to identify predictors of aggressive biological behavior and metastatic potential in breast carcinoma among a number of intrinsic bio-markers of tumor cells such as steroid receptors and oncogene and tumor suppressor gene products.

Methods

Routine formalin-fixed, paraffin-embedded tumor samples were used and sections were stained immunohistochemically with the DAKO Strept ABC method to determine the expression of estrogen receptors (ER), progesterone receptors (PgR), HER-2/neu, bcl-2, Ki-67, p53 and nm23 in 192 consecutive breast carcinoma patients. The results of the quantitative immunohistochemical assays were correlated with clinical and histological data such as patient age, overall survival, tumor size, axillary lymph node status, hystological type, tumor grade, Nottingham prognostic index (NPI) and therapeutic regimens.

Results

Univariate analysis revealed that survival was significantly longer for patients with small tumors (P = 0.007), lower tumor grade (P = 0.021), negative axillary lymph nodes (P = 0.002), presence of nm23 protein (P = 0.002), and for patients treated with adjuvant hormonal therapy (P = 0.010). In multivariate analysis the independent factors positively affecting survival were absence of axillary lymph node metastases (P = 0.002), nm23 expression (P = 0.009) and hormonal therapy (P = 0.050). Among patients with positive axillary nodes there was a significantly higher survival rate in patients with nm23 expression compared with nm23-negative patients (P <0.001).

Conclusion

Identification of a subset of node-positive breast cancer patients with a more favorable prognosis according to nm23 expression might be clinically useful.
Raltitrexed plus Oxaliplatin in the Treatment of Metastatic Colorectal Cancer
Authors: Cortinovis Diego , Bajetta Emilio , Di Bartolomeo Maria , Dognini Giuseppina , Beretta Elena , Ferrario Erminia , Ricotta Riccardo , Buzzoni Roberto
Published: April 2018

Aims and background

As raltitrexed and oxaliplatin (L-OHP) are both effective in the treatment of colorectal cancer but have different mechanisms of action, we studied the antitumoral activity and safety of their combined use in patients with advanced colorectal cancer.

Methods

A 15-min intravenous infusion of raltitrexed (2.5 mg/m2) and a 180-min infusion of oxaliplatin (100 mg/m2) were administered on day 1 every three weeks for a maximum of six cycles.

Results

The study involved 51 patients (27 males and 24 females) with a median age of 65 years (range, 43-78); 28 were aged ≥65 years. The primary tumor site was the colon in 35 patients and the rectum in 16. Thirty-four patients had received prior chemotherapy: 20 as adjuvant treatment and 14 as pretreatment. The most frequent metastatic sites were liver (18 cases), lung (10 cases), liver + lung (8 cases) and lymph nodes (3 cases). Twenty-four patients completed the entire treatment plan. The most common toxicities were transaminitis (16 patients, grade 3-4), diarrhea (six patients, grade 3), nausea/vomiting (one patient, grade 4), and asthenia (one patient, grade 3). The treatment was stopped in one patient because of prolonged grade 4 transaminitis. The adverse event profile was similar in the patients aged >65 years and <65 years. Complete responses were observed in 2 patients, partial responses in 12, stable disease in 23, and progression in 8.

Conclusions

The results of the study suggest that the raltitrexed plus oxaliplatin regimen is feasible and clinically active in advanced colorectal cancer.
Successful Pregnancy after Vaginal Cancer Treated with Interferon
Authors: Murta Eddie Fernando Candido , Murta Beatriz Martins Tavares
Published: April 2018

A 25-year-old white woman with a vaginal invasive epidermal carcinoma was treated with interferon-α 2b (3,000,000 U intralesional, every two days for a total of 18 applications). Follow-up with Papanicolaou and colposcopy showed complete regression of the vaginal lesion. After three years the patient got pregnant. The prenatal course was uneventful and a vaginal delivery was performed. She is currently in follow-up without any signs of recurrence.
Cigarette Smoking as a Risk Factor for Cancer of the Thyroid in Women
Authors: Zivaljevic Vladan , Vlajinac Hristina , Marinkovic Jelena , Paunovic Ivan , Diklic Aleksandar , Dzodic Radan
Published: April 2018

Aims and background

Thyroid cancer, whose etiology is largely uncertain, has been negatively associated with cigarette smoking in a several studies. We examined the association between cigarette smoking and risk for female thyroid cancer.

Methods

A case-control study including 204 histologically verified female thyroid cancer patients and an equal number of hospital controls individually matched with cases by sex, age (± 2 years), place of residence and time of hospitalization was carried out during the period 1996-2000. In the analysis of data, univariate and multivariate conditional logistic regression methods were applied.

Results

According to univariate analysis, female thyroid cancer was negatively associated with the initiation of smoking at a younger age, before the age of 20 (OR = 0.66, 95% CI = 0.50-0.90). None of the smoking habits remained independently related to female thyroid cancer after adjustment for other factors which were significantly associated with thyroid cancer in the present study.

Conclusions

The results of the study do not suggest a role of cigarette smoking in the development of thyroid cancer in women.
Neoadjuvant Chemotherapy Followed by Radiotherapy in Epidermoid Carcinoma of Anus
Authors: Chie Eui Kyu , Wu Hong Gyun , Heo Dae Seog , Bang Yung-Jue , Kim Noe Kyeong , Ha Sung W
Published: April 2018

Aim and background

The purpose of this study was to analyze the efficacy of neoadjuvant fluorouracil-cisplatin chemotherapy combined with radiotherapy for anal cancer.

Methods

Fourteen patients with epidermoid carcinoma of the anal canal were analyzed. Treatment consisted of three cycles of 5-fluorouracil (1000 mg/m2 bolus on days 1-5) and cisplatin (60 mg/m2 bolus on day 1) followed by 50.4 Gy to the pelvis and perineum over 5.5 weeks. Both inguinal lymphatics were irradiated with an identical dose schedule. The median follow-up was 78 months.

Results

Five-year overall survival rate and sphincter preservation rate was 85.1% and 85.7%, respectively. Response to chemoradiotherapy was the only significant factor with univariate analysis (P = 0.031). There were no complications of RTOG grade 3 or higher.

Conclusions

Neoadjuvant chemotherapy with a cisplatin-based regimen rather than concurrent regimen plus radiotherapy may decrease complications without compromising survival or sphincter preservation.
How Does Dna Methylation Mark the Fate of Cells?
Authors: Macaluso Marcella , Giordano Antonio
Published: April 2018

Since every cell of a multicellular organism contains the same genome, it is intriguing to understand why genetically homogenous cells are different from each other and what controls this. Several observations indicate that DNA methylation has an essential regulatory function in mammalian development, which is to establish the correct pattern of gene expression, and that DNA methylation pattern is tightly correlated with chromatin structure. Various physiological processes are controlled by specific DNA methylation patterns including genomic imprinting, inactivation of the X chromosome, regulation of tissue-specific gene expression and repression of transposons. Moreover, aberrant methylation could confer a selective advantage to cells, leading to cancerous growth. In this review we focus on the epigenetic molecular mechanisms during normal development and discuss how DNA methylation could affect the expression of genes leading to cancer transformation.
Comparison of Clinical Outcomes of Different Erythropoietin Usage Strategies
Authors: Arslan Murat , Evrensel Turkkan , Kurt Ender , Demiray Mutlu , Gonullu Guzin , Kanat Ozkan , Manavoglu Osman
Published: April 2018

Aim

There is no comprehensive study that compares the different usage strategies of recombinant human erythropoietin (rHuEPO) in platinum-induced anemia. In order to clarify this issue, we conducted a prospective clinical study.

Material and methods

Seventy-seven patients were studied in three main groups. Group 1 (n = 17) consisted of cancer patients without anemia. These patients received rHuEPO starting from the first chemotherapy cycle. Group 2 (n = 26) consisted of patients whose hemoglobin (Hb) values decreased by at least 1 g/dL after the first cycle of chemotherapy. Group 3 (n = 34) consisted of patients whose Hb values dropped below 10.5 g/dL after the second chemotherapy cycle. Groups 2 and 3 were each divided into two subgroups. In groups 1, 2A and 3A rHuEPO (5000 U/day subcutaneously three times a week) treatment was continued until three weeks after the completion of chemotherapy. In groups 2B and 3B, rHuEPO was given for 12 weeks only.

Results

There were no prominent differences between the Hb values of these groups throughout the chemotherapy cycles. Transfusion rates and the number of patients who became anemic were also not different between groups.

Conclusion

No rHuEPO usage strategies are superior to others in terms of Hb levels and transfusion requirements. The decision as to when rHuEPO is to be added to platinum-containing therapy should be tailored to the health conditions of individual patients.
Treatment of Desmoplastic Small round Cell Tumor with Image-Guided Intensity Modulated Radiation Therapy as a Component of Multimodality Treatment
Authors: Jahraus Christopher D , Glisson Shawn D , Clair William H St
Published: April 2018

Aims and background

The authors report the case of a 31-year-old black male diagnosed with a pelvic desmoplastic small round-cell tumor who was treated with a unique radiotherapy approach incorporating intensity-modulated radiotherapy and daily ultrasound localization to ensure accurate tumor targeting. Desmoplastic small round-cell tumor is a very rare tumor, most commonly presenting in the abdominopelvic regions of adolescents and young adults. It has generally been associated with a very poor prognosis.

Methods

The patient initially underwent biopsy of the mass and omentectomy for mesenteric implants followed by chemotherapy. Chemotherapy resulted in tumor shrinkage and was followed by a second-look laparotomy. Additional omental nodules were resected, but the primary tumor was adherent to the rectum and seminal vesicles. A radiation oncology consult was obtained, and a course of image-guided intensity-modulated radiotherapy ensued with daily ultrasound localization. This resulted in shrinkage of local disease, but a new lesion was identified. The patient was subsequently started on further chemotherapy, which has maintained the disease in a stable state for several months.

Conclusions

Image-guided intensity-modulated radiotherapy is a feasible option in the treatment of pelvic desmoplastic small round-cell tumor. Such therapy may permit escalation of conventional radiotherapy doses and could have a favorable impact on local control of disease. Confirmation of this belief will require additional data in the form of case reports like this. Pending such confirmation, we continue to be of the impression that desmoplastic small round-cell tumor has an overall unfavorable prognosis, regardless of treatment modalities employed.
Irinotecan, Fluorouracil and Folinic ACID (FOLFIRI) as Effective Treatment Combination for Patients with Advanced Gastric Cancer in Poor Clinical Condition
Authors: Beretta Elena , Di Bartolomeo Maria , Buzzoni Roberto , Ferrario Erminia , Mariani Luigi , Gevorgyan Arpine , Bajetta Emilio
Published: April 2018

Aims and Background

Irinotecan (CPT-11) has been tested as a single agent in several studies, and response rates of 18-23% have been reported in first-line gastric cancer therapy. In the present study we report the safety and efficacy results combining CPT-11 with 5-fluorouracil (5-FU) and folinic acid (FA).

Patients and Methods

Thirty consecutive patients with metastatic gastric cancer, considered in poor clinical condition, were treated with CPT-11 and 5-FU/FA according to the FOLFIRI regimen. All enrolled cases were evaluable for toxicity and drug activity.

Results

The main grade 3-4 toxicity (according to the NCI-CTC criteria) was neutropenia (16%, grade 4 in 1 patient); nonhematological grade 3 toxicity consisted mainly in vomiting and diarrhea reported in 1 patient. No treatment-related serious adverse events were observed. Response was obtained in 12 patients (40%), stable disease in 2 patients (7%), while progression was documented in 16 patients (53%).

Conclusions

These results are very promising, and suggest that the combination of CPT-11 plus 5-FU/FA is active and well tolerated and can be considered as useful treatment in patients with metastatic gastric cancer in poor clinical condition.
Capecitabine and Mitomycin c May be an Effective Treatment Option for Third-line Chemotherapy in Advanced Colorectal Cancer
Authors: Scartozzi Mario , Falcone Alfredo , Pucci Francesca , Braconi Chiara , Pierantoni Chiara , Cavanna Luigi , Franciosi Vittorio , Berardi Rossana , Beretta Giordano , Masi Gianluca , Allegrini Giacomo , Zaniboni Alberto , Labianca Roberto , Cascinu Stefano
Published: April 2018

Aims and Background

We evaluated the activity in terms of time to progression (TTP) of mitomycin C and capecitabine in patients with advanced colorectal cancer who progressed after 2 lines of chemotherapy.

Methods

Patients with advanced colorectal cancer undergoing third-line chemotherapy after failure of 5-FU with CPT-11 or oxaliplatin-based chemotherapy regimens were treated with capecitabine and mitomycin C.

Results

Sixty-one patients were enrolled in this study. The median age was 55 years (range, 26-78 years) and the male:female ratio 21: 40. We observed partial remissions in 5 patients (8%), stable disease in 25 patients (40%) and progression of disease in 31 patients (52%). Median TTP was 3 months and median survival was 6 months. Global toxicity was mild and entirely acceptable. Grade 3-4 hematological toxicity occurred in 12 patients and grade 3-4 nonhematological toxicity in 5 patients.

Conclusions

The combination of capecitabine and mitomycin C could represent an effective and manageable treatment option for colorectal cancer patients failing previous chemotherapy regimens.
Inflammatory Myofibroblastic Tumor of the Larynx with Anaplastic Lymphoma Kinase (ALK) Protein Overexpression. A CASE Report
Authors: Bellezza Guido , Cavaliere Antonio , Del Sordo Rachele , Sidoni Angelo
Published: April 2018

Inflammatory myofibroblastic tumor is an uncommon lesion which mainly develops in the lung and is extremely rare in the larynx. It may be easily misinterpreted as a malignant epithelial or mesenchymal spindle cell neoplasm. Histological and clinical knowledge of this lesion is important to exclude misdiagnosis and inappropriate treatment.

We report a case of inflammatory myofibroblastic tumor arising on the right vocal cord of a 23-year-old man. The tumor was composed of a mixture of spindle cells and inflammatory elements. Immunohistochemical investigation revealed that the neoplastic cells expressed anaplastic lymphoma kinase (ALK) protein.
Solid Papillary Neoplasm of the Pancreas: A Case Report
Authors: Catalano Giorgio , Puglisi Francesco , De Fazio Michele , Capuano Palma , Lograno Giuseppe , Gentile Antonia , Memeo Vincenzo
Published: April 2018

Solid pseudopapillary neoplasm of the pancreas, solid and cystic, is a rare disease compared to ductal adenocarcinoma. The tumor most often affects women of African race aged in their twenties or thirties. We report the case of a 48-year-old man affected by solid pseudopapillary neoplasm of the pancreas treated by distal splenopancreasec-tomy. The patient was discharged on the 10th postoperative day in good general condition, feeling normal and with blood chemistry values within normal limits. The main characteristic differentiating papillary tumors of the pancreas from ductal adenocarcinoma is that in the latter case surgical eradication is a definitive solution and no other treatment is required, as confirmed by our case and those reported in the literature.
Lo Studio del Nucleo Cellulare nei Tumori
Authors: Montella Giuseppe
Published: April 2018

The technique of « nuclear crushing » with acetic carmine stain has been adopted in 34 benign and malignant tumour types of different organs. 3 types of nuclei were distinguished: A type, with considerable bulk, approximately round-shaped, thick chromatinic network; B type with considerable bulk, less regular in shape and lesser amount of chromatin; and normal type.
Sarcomi Dell'Apparato Muscolare ed Accessorio del Tronco e Degli Arti
Authors: Umberto Ballarati
Published: April 2018

A large number of cases of sarcoma of muscles of the trunk and limbs is described. A comparison is made with similar French statistics. Some data of this statistics do not agree with those of the French authors. Both sexes are liable to such tumours. The most frequent localization is in the lower limbs, chiefly in the upper third of the thigh. Histologically they generally correspond to the type of the blastic sarcoma arising from the connective tissue of the muscles. The surgical treatment is extensively discussed.
Ricerche Elettroforetiche Su Estratti Proteici Di Organi Di Malati Di Emopatie Maligne
Authors: Gigante D. , Capone M. , Marinoni G. F. , Rossi-Espagnet A.
Published: April 2018

The electrophoretic fractionation of protein extracts from human lymph nodes, spleen and liver, has been studied in normal subjects and in patients suffering from malignant lymphogranuloma, lymphosarcoma, acute leukemia and chronic leukemic lymphoadenosis. The electrophoretic pictures have been compared with those obtained from sera of the same patients. Results are briefly discussed.
Tentativi Di Produzione Sperimentale Di Tumori Del Tessuto Linfatlco: Nota II - Esperienze con metil-bis-betacloroetilamina Ed Acetaminofluorene
Authors: Sirtori C. , Pizzetti F. , Leonardelli G. B. , Teatini G. P.
Published: April 2018

An atypical proliferation of the lympatic tissue has been obtained in rats by the combined administration of a lymphocytolytic substance (methyl-bis-beta-chloro-ethylamine) and a carcinogenic substance (acetaminofluorene).
Determinazioni Quantitative Di Massima Sensibilita’ Mediante Le Emulsioni Fotografiche Nucleari
Authors: Mayr G.
Published: April 2018

A method is described for detecting an element by exposure to an activating radiation and for making quantitative determinations by means of standard samplings. The method is applied to the detection of boron in tissues.
Un Tumore Primitivo Epatico a Diffusione Epizootica Nella Trota Iridea di Allevamento (Salmo Irideus)
Authors: Cudkowicz Gustavo , Scolari Clemente
Published: April 2018

Macroscopic and microscopie features, geographic distribution and incidence of a liver tumour in iridaceous trouts are described.

The tumour appeared first as a sporadic one in some breeding institutions of Italy and subsequently reached a high incidence rate (more than 50 per cent).

It has a hepatocellular trabecular structure with some scirrhoid patches.

Cholangiomatous and cholangio-carcinomatous areas are rare. Metastases were observed in the kidney, heart, gastric wall, and so on. No parasites and no cellular inclusions were found. Attempts to transmit the tumour to animals of the same strain by transplant of fragments or by injection of acellular extracts or by living together of affected animals with normal ones gave no results.

Genetic factors in some strains of iridaceous trouts bred in Italy may have played a role in the large diffusion of the tumour, through a high inbreeding. The traumatic lesion of the liver during the squeezing of the sexual product may represent an extrinsic factor realizing the carcinogenic potentiality through the nodular hyperplastic and regenerative processes produced by such manipulation.
Ricerche Comparative di Alcuni Cationi ed Anioni Nei Tumori Umani E Nel Tessuto Normale Omologo
Authors: Picco Augusto , Caldera Piero , Dogliotti Giacinto
Published: April 2018

The water, ashes and some cations and anions contents have been studied in 40 carcinomas and the values compared with those of the normal organs. Percentage increase of water, Ca, Mg, N, P and CI contents has been constantly observed, while a less constant increase has been seen for ashes, J, S, S04, Co, Mn and As.
Diagnosi Differenziale Fra Tecomi E Fibromi Ovarici in Base Alle Dimensioni Cellulari; Considerazioni Sull'Attivita’ Funzionale Dei Tecomi (11 casi)
Authors: Sirtori C. , Bianco R.
Published: April 2018

A description is given of 8 cases of ovarian thecoma, two of which associated with endometrial cancer, and of 3 cases of thecomatosis, all associated with endometrial cancer. The possibility is pointed out of a differential histological diagnosis between thecomas and ovarian fibromas without any particualr staining methods: the nuclei of thecoma cells are thicker and larger (mean diameter 7 μ) and the nucleoli larger and more evident than those of fibromas.
I Sarcomi Della Mammella
Authors: Pricolo V.
Published: April 2018

Basing upon 20 cases observed in the Cancer Institute of Milan, the problem of breast sarcomas is shortly considered, particularly as regards clinico-statistical data, therapy and late results.
Considerazioni Critiche Sulla Malattia Di Brill-Symmers
Authors: Domenici A.
Published: April 2018

Basing on three personal cases and literature observations, it is stated that one can speak of Brill-Symmers disease only in those exceptional cases showing an histologically typical and persisting gigantofollicular adenopathy. In many other cases we are dealing with peculiar aspecific aspects of reactive lymphoreticular hyperplasia, which frequently have the meaning of a morphological « symptom » in the course of some tumours of the lymphoreticular organs.
Carcinomi Giovanili. A Proposito Di Un Caso Di Carcinoma Del Colon Discendente in Un Giovane Di 18 Anni
Authors: Gullino Domenico
Published: April 2018

The juvenile carcinomas of the large intestine do not show any peculiarities as regards symptomatology and histological pictures. The fatal outcome is to a great extent related to the young age which, by excluding, in the common mentality, the thought of cancer, brings about a delayed diagnosis. The relatively more rapid course of juvenile carcinomas is attributable to the anatomo-functional conditions and to the « ambiental congruence » of the involved ground.
Valutazione Dell'Attivita’ Estrogena Nel Cancro Della Mammella Dopo Ovaro-Surrenectomia (Nota preliminare)
Authors: Grattarola R. , Catania V.
Published: April 2018

Following ovaro-adrenalectomy, oestrogens are still present in the urine; the oestrogen amount is higher in the unfavorable cases than in cases with good result after the removal of the glands. However the oestrogen amount in the urine is not sufficient to predict the course of the disease; frequently low oestrogen values (10 gamma/24 hrs), some days after the surgery, become later very high (80-90 gamma/24 hrs).

With the cytological examination of the vaginal smear it is possible to have a real picture of the oestrogen activity in the organism; with a low (or absent) oestrogen activity all superficial and basal cells are disappeared in the vaginal smear, and appear particular basal cells with eosinophilic cytoplasm.

In favorable cases, with low (or absent) oestrogen activity following ovaro-adrenalectomy, it was observed the presence of other cells, of the intermediate zone, with large nuclei, which are suggestive of a new hormonal activity.
I Neurilemmomi Solitari Extracranici Dell'Estremo Cefalico: (Studio anatomo-clinico su 16 casi)
Authors: Pietrantoni L. , Leonardelli G. B.
Published: April 2018

16 cases of extracranial solitary neurilemmomas localized to the head and neck (middle ear, nose, parotid gland, lip, tongue, cheek, alveolar margin, laterocervical and frontoparietal regions) are referred.

From an anatomopathological standpoint it is mainly underlined:

1) the opportunity of considering two types only (benign and malignant neurilemmoma), as the Anthoni's « B » type results to be conditioned by regressive-involutive phenomena which easily occur in classical « A » neurilemmomas with active growth;

2) the rare and aspecific palisade arrangement of the tumour elements which, however, often occurs in other neoplasms (fibromas, myomas, fibrosarcomas, ablastic sarcomas, etc.);

3) the difficult recognition of the malignant varieties which frequently show histoarchitectonic as well as histocytologic hyperdifferentiation; so the biological malignancy of the tumour is based more on clinical than on histo-cytological aspects.

From a clinical standpoint, it is emphasized:

1) the seldom incidence of the extracranial solitary neurilemmoma at the level of the cephalic sector (derived from the analysis of more than 60,000 bioptical examinations);

2) the highest frequency in the 4th-5th decade of life, in female sex, and in oral and nasal regions;

3) the aspecificity of the symptomatological picture which is common to other neoplastic, dysplastic and phlogistic processes of this region, leading to difficulties of the diagnosis, which is relied upon the intraoperative microscopical observation;

4) the determinant value of an early and radical surgical treatment for a definitive clinical recovery.
Valore E Limite Della Valutazione Della Proteina Reattiva C in Oncologia Ginecologica
Authors: Samuel S.
Published: April 2018

Starting from recent immunological studies on reactive C protein (RCP) which pointed to the possibility of employing this reaction as a test for benign and malignant tumours, the problem was centered in respect of genital oncology. An investigation was carried out on 94 patients hospitalized in the Gynecological Department of the Cancer Institute of Milan. It is concluded that RCP, though representing theoretically an immunologic test of great interest, cannot be relied upon as a differentiating test between benign and malignant tumour; presumably, it may be only considered as the result of a particular behaviour of the electrophoretic pattern, susceptible of modifications also due to other causes.
Metodi Attuariali Applicabili Alla Statistica Clinica
Authors: Mustacchi P. O. , Pandolfi A. M.
Published: April 2018

Some concepts of clinical and epidemiological statistics such as frequency, incidence and prevalence are illustrated, and their limits and significance determined.

Two methods of actuarial type suitable to hospital casuistics are exposed, one for the study of the possible association of two morbid conditions and the other one for the determination of survival rates.
Il Cancro Del Moncone Cervicale (Studio su 125 casi)
Authors: di Re F. , Bianco R.
Published: April 2018

Out of 4493 cases of cervical carcinomas observed in the Cancer Institute of Milan, 125 involved the residual stump; 42 of them occurred in the first two years following sub-total hysterectomy (coexistent cancers), the other ones later (true cancers). In 4 cases the first symptoms occurred from 35 to 38 years after operation. The total 5-years survival is of the 34.9 per cent, but there is a remarkable difference between coexistent and true carcinomas (5-years survival of the 23.3 and the 41.5 per cent respectively). Parity does not seem to play an important role in the development of carcinoma of the residual stump.

After having discussed the doses and technique of radium- and roentgentherapy, the complications (fistulas in the 10 per cent about) and the results of these treatments in the different stages are surveyed. In the 1st stage the therapy of choice would be surgery associated with radium- and roentgentherapy, whereas in the 2nd and 3rd stage radium-roentgentherapy alone can attain good results. Finally, it is advised a larger indication of total histerectomy in those cases unfit for a more conservative operation (myomectomies, defundatio).
I Radionuclidi Nella Terapia e Nella Diagnosi Delle Neoplasie
Authors: Buraggi G. L.
Published: April 2018

The main techniques presently employed for the therapy and diagnosis of malignant tumours are reported.

Mention is given of the employ of the colloidal suspensions in the endocavitary. interstitial and internal therapy, of the radioiodine in the therapy of tumours and their metastases, of the radiophosphorus in the therapy of polycythemia and leukemias. Some methods of external and interstitial beta- and gamma-therapy carried out with P32, Y90, Sr90 + Y90, Au198, Co60, Ta182 are exposed.

As concerns diagnosis, mention is given of the I131 (thyroid tumours), of the compounds labeled with radioiodine (brain tumours etc.), of P32 (intraoperatory delineation of endocranial tumours), of K42 (brain and mammary tumours), of Ga66 and Ga72 (primary and metastatic bone tumours) etc

Information on the general precautions and on the equipment advisable for the execution of the exposed therapeutical techniques are briefly reported and some tables concerning the necessary precautional measures in the use of the two radionuclides more often employed (Au198 and I131) are presented.
I Tumori Maligni Del Testicolo
Authors: Bergonzini R. , Russo S. , Bassani G.
Published: April 2018

Data from a series of 90 patients affected with malignant tumours of the testis are reported. Most of them had undergone simple orchiectomy followed by roentgentherapy on the lymphatic way.

The statistical survival data may be summarized as follows: of the 90 patients 50 died, 39 are still alive, 1 could not be traced. The followup examination varies from 1 (for 5 patients) to 5–13 years (for 49 subjects).

The total average survival is of the 43.3 per cent; as for the 5-years observations, the survival rate for the seminomas without metastases is of 14 out of 16 cases, for the tumours with metastases is of 7 out of 24 cases. As concerns the so-called embryomas, results are really discouraging.

From the prognostical point of view, it has been observed that the presence of stroma and the lymphocitary infiltration are favourable elements and that the presence of glycogen may be an indication of slow tumour evolution. In addition, the amount of nucleic acids may indicate a greater or lesser radiosensitivity of the tumour elements, so allowing a prognosis of radiocurability.
Ulteriori Osservazioni Sul Comportamento Radiologico a Distanza Di Tempo Delle Metastasi Pleuro-Polmonari e Scheletriche da Cancro Della Mammella Dopo Ovaro-Surrenectomia Bilaterale
Authors: Bullo E. , Catania V. C.
Published: April 2018

The roentgenological observation is able to prove the benefits induced by bilateral oophoro-adrenalectomy in patients with metastatic spreading to the respiratory apparatus or to the skeleton. In fact, periodic roentgenological controls show a rapid and steady absorption of the pleural effusion and the disappearance (although less rapid and less frequent) of the lymphangitic processes, of the hilar adenopathies and of the lung metastases.

Of particular interest are the bone modifications, occurring at the level of the osteolytic neoplastic foci and. in the other sites of the skeleton; these ought to be studied not only periodically, but also with a systematic criterion.

The repairing phenomenas of the osteolytic foci are of various type: gradual reduction of the rarefaction focus with formation of a normal trabecular structure, processes of intense re-calcification with signs of osteosclerosis, evolution towards osteosclerosis followed, in some cases, by the formation of a normal bone structure.

The roentgenological findings appear to be very interesting as they show, concomitantly with the regression of osteolytic manifestations, the appearance of new bone pathological changes. Of particular relevance are the pictures of diffuse decalcification unrelated to metastases, which were found in some patients long after the surgical operation: these are supposed to be related, as well as the Cushing syndrome-like habitus, to conditions of hormonal imbalance.
Modificazioni Del Protidoplasma Dopo Trattamento Con Radio-Oro per Neoplasie Genitali
Authors: Samuel S. , Lorenzoni L.
Published: April 2018

Modifications in total protidemia, electrophoretic tracing, perchloro-soluble mucoproteins, colloidal lability and prothrombinemia have been studied in 10 subjects with genital tumours, three and six days after Au198 introduction (inoculation either into the neoplastic mass or endoperitoneally, in doses ranging between 19 and 108 mC). While the prothrombin level showed, after 3 days, a clear fall which became more manifest after 6 days, the serum level of total proteins, albumins, alpha1 and alpha2-globulins, was found to be increased on the 3d day, especially as concerns alpha2, and to return, towards initial values on the 6th day. Beta- and gamma- globulins remained unmodified, whereas the behaviour of serum lability was somewhat obscure.

In the light of the results obtained some hypotheses are advanced.