bluuebunny/crossref_metadata_2025 huggingface dataset:
Toxic and Therapeutic Activity of 4'-Epi-Doxorubicin
Authors: Bonfante Valeria , Villani Fabrizio , Bonadonna Gianni
Published: April 2018

A Phase I-II study with 4'-epi-doxorubicin (epi-DX) was performed in 108 patients with various types of advanced malignancy. The pattern of acute toxicity was similar to that of doxorubicin (DX). However, epi-DX was better tolerated than DX because of comparative lower incidence of vomiting, stomatitis, complete alopecia and severe myelosuppression. Cardiac toxicity was studied by utilizing noninvasive methods, and the electrocardiographic results suggested a slightly lower cardiac damage after epi-DX compared to DX. Antitumor activity was documented in a variety of neoplasms, and objective response was also observed in those considered refractory to DX such as malignant melanoma and renal cancer.
Combination Chemotherapy (CVP or Chop)-Radiotherapy Approach in Early Stage Non-Hodgkin's Lymphomas
Authors: Comella Pasquale , Scoppa Gianfranco , Abate Giuseppe , Comella Giuseppe , Apice Gaetano , Castello Giuseppe , Pergola Mario , Giordano Giovan Giacomo , Coucourde Francesco , Zarrilli Donate
Published: April 2018

From January 1978 to December 1980, 42 patients with early stage non-Hodgkin's lymphoma other than of the gastrointestinal tract were treated with radiotherapy and combination chemotherapy. Eighteen patients in stage I were submitted to locally extended-field radiotherapy up to a mean dose of 48 Gy with a Co60 source and, after a 3-week rest period, to 6 cycles of combination chemotherapy. Twenty-four patients in stage II received 3 cycles of combination chemotherapy before and after irradiation, the same as for stage I. Combination chemotherapy consisted of cyclophosphamide, vincristine and prednisone (CVP) for 15 cases with favorable histology (3 NWDL, 1 NPDI, 11 DWDL), whereas it included cyclophosphamide, adriamycin, vincristine and prednisone (CHOP) for 27 cases with unfavorable histology (20 DPDL, 3 DM, 4 DH). Complete remission (CR) was achieved in 35/42 (83%) patients, with a highly significant difference between stage I (100%) and stage II (71%). After 42 months of follow-up, the probability of survival for all patients was 72%. Survival was better for stage I (88%) than for stage II (68%) and for favorable histology (87%) as compared to unfavorable histology (70%). Furthermore, survival was highly influenced by response to therapy. Indeed, actuarial survival rate for CR was 91% as compared to a median survival time of 10.2 months for the remaining patients. Four patients, all with poor histology, relapsed after 5–24 (mean 11) months of CR. Only one of them had an extension in extranodal sites and eventually died, despite the salvage treatment utilized. In our experience, locally extended-field irradiation combined with chemotherapy gave a high proportion of CR and seemed to prevent relapses, particularly in extranodal sites.
Esophageal Involvement in Breast Cancer. Report of Six Cases
Authors: Boccardo Francesco , Merlano Marco , Canobbio Luciano , Rosso Riccardo , Aste Hugo
Published: April 2018

Six case reports are described which illustrate a uniform syndrome characterized by progressive dysphagia developing in postmenopausal breast cancer patients after a long disease-free interval following mastectomy. Literature cases are reviewed and treatment strategies are discussed. The authors recommend that, when possible, radiotherapy to the mediastinum and/or chemotherapy with dilation or positioning of an endoprothesis should be considered as the treatment of choice, whereas surgical intervention should be limited.
Bilateral Cancer of the Breast
Authors: Del Turco Marco Rosselli , Ciatto Stefano , Perigli Giuliano , Borrelli Domenico , Carcangiu Maria Luisa , Santucci Marco
Published: April 2018

The authors reviewed a series of 2311 primary breast cancers followed-up from 1 to 11 years after radical mastectomy. Twenty-eight simultaneous and 40 metachronous contralateral breast cancers were observed in the study period with an average annual incidence rate of 4.5%. Younger age and histologic evidence of lobular carcinoma at first cancer diagnosis was significantly associated with contralateral cancer, whereas first cancer stage did not seem to be a risk factor. Contralateral metachronous cancer significantly worsened the expected prognosis, which was not true for simultaneous bilateral cancers. The possible reasons for this negative prognostic influence of a second breast cancer and the role of preventive measures such as contralateral mastectomy are discussed. At the present time, an accurate annual clinicomammographic follow-up seems to be the most advisable course of action.
Clinical Response to Chemotherapy and Hormone Therapy as First Treatment after Therapeutic Ovariectomy in Advanced Breast Cancer Patients
Authors: Preda Ferdinando , Oriana Saro , Perozziello Federico , Botte Giovanna , Russo Vito Lo
Published: April 2018

The results of chemotherapy and hormone therapy, administered after relapse of the disease, were evaluated in 106 patients with homogeneous clinical characteristics who were subjected to bilateral ovariectomy for advanced breast cancer, whether the response to castration was favorable or not. In spite of an unfavorable response to the ovariectomy, 40.0% of the patients responded to hormone therapy, whereas 31.5% of the cases did not benefit from the successive hormone therapy, although they had responded to ovariectomy. In contrast, 65%, after favorably responding to ovariectomy, showed regression of the neoplasm after chemotherapy for the relapse. This apparent discordance of the results could be due to the fact that response to castration is not the only valid parameter to identify hormone dependence of a breast cancer and/or that the breast cancer is composed, in various proportions, of hormone-sensitive and chemo-sensitive cells. The predominance of one of these 2 components could determine the response of the neoplasm to therapy. The authors conclude that a more extensive and accurate hormone typing of the patient could give more precise indications for the appropriate therapy.
Report of two Cases of Leiomyosarcoma after Radiotherapy
Authors: Bardella Daniele , Jucker Carlo , Beccati Donatella , Cruciani Giorgio , Fiorentini e Gianmaria
Published: April 2018

Two cases of leiomyosarcomas occurred as a rare complication, after megavoltage treatment. The latent period was of 17 and 9 years, respectively. The two malignant neoplasms arised within the treatment fields and each of these neoplasms differed histologically from the original tumor.
Cerebellar Balloon-Cell Metastasis of a Melanoma
Authors: Ferracini Romano , Manetto Valeria , Minghetti Giuliano , Lanzanova Giuseppe
Published: April 2018

The authors describe a cerebellar balloon-cell metastasis of a cutaneous melanoma. The authors explain this phenomenon according to the theory of cellular differentiation of the component vertical-growth phase of Clark.
Relationships between Morphology and Viral Etiology in Mammary Tumors of BALB/cfC3H and BALB/cfRIII Mice
Authors: Pingitore Raffaele , Squartini Francesco
Published: April 2018

The morphologic patterns of mammary tumors induced by milk-transmitted C3H and RIII murine mammary tumor viruses (MuMTVs) in BALB/c hosts infected by foster nursing were investigated further and compared taking into account several tumor and host variables. Comparison of BALB/cfC3H and BALB/cfRIII mammary tumors under identical tumor and host conditions showed highly significant differences in subgross morphology and histologic structure. Differences in cytology were also observed. Data suggest that mammary tumor morphology in high cancer strain mice is controlled by the causative MuMTV.
Estradiol and Progestin Receptors, 17-β-Hydroxysteroid-Dehydrogenase and Histopathologic Grade in Endometrial Carcinoma1
Authors: Ciuffi Mario , Savino Luciano , Santini Donatella , Buzzoni Paolo , Scarselli Gianfranco , Mazzei Teresita
Published: April 2018

The possible correlations between steroid receptor systems, 17-β-HSD and histopathologic examinations were investigated. The well-differentiated tumors showed higher steroid receptor and 17-β-HSD values than undifferentiated carcinomas. The steroid receptors did not present a statistically significant correlation with 17-β-HSD. Nevertheless, some neoplastic endometria (29%) show higher values of progestin receptors and 17-β-HSD, with a progestin: estrogen receptor ratio greater than one.
Local Microwave Hyperthermia in Cancer Therapy. Preliminary Report
Authors: Valdagni Riccardo , Amichetti Maurizio , Dell'Orsola Giorgio
Published: April 2018

From February 1981 to September 1981, 16 patients (19 fields) with histologically proven malignancy (10 squamous carcinoma, 4 melanoma, 1 adenocarcinoma, 1 chordoma) were treated with hyperthermia combined with radiotherapy or chemotherapy (1 patient). There were 5 females and 11 males; average age was 65 years, range 45 to 94 years; 15 patients had a Karnofsky index greater than 50%. Hyperthermia (42.5 44.0 °C) was induced by 250 MHz to 1 GHz microwaves (BSD - 1000 Unit). Thermometry was performed by means of non-perturbing probes placed in intratumorally inserted catheters and by measurement of skin temperatures. After hyperthermia plus radiotherapy (18 fields), 9 patients showed 100% response, 5 a volume regression of more than 50%, 3 less than 50% and 1 no change. After chemotherapy plus hyperthermia, 1 patient showed no change. No significant side effects were observed (3 skin burns in 147 hyperthermia treatment sessions).
Solitary Plasmacytoma of the Vertebral Column. A Report of 15 Cases
Authors: Bacci Gaetano , Savini Roniolo , Calderoni Pierina , Gnudi Saverio , Minutillo Angelo , Picci Piero
Published: April 2018

The clinical features and the treatment results of 15 patients with solitary plasmacytoma of the spine observed in a 28-year period (1950–1977) are reported. The signs at presentation were back pain in 4 cases and spinal cord compression in 11 cases. Three of these patients had paraplegia. Radiologically, the alteration encountered was an osteolytic lesion in all cases. The local treatment was radiotherapy in 11 cases and surgery plus radiotherapy in 4 cases. In 3 patients systemic chemotherapy was also employed. Seven patients are alive without signs of disease 3 to 9 years (mean 6 years) after diagnosis. Eight patients developed multiple myeloma in a period ranging from 1 to 8 years (mean 3.5 years). The relationship between multiple myeloma and solitary plasmacytoma of the spine, as well as the best treatment for the latter, are discussed.
The Lai Test in Specific Immune-Reactivity Studies of Fibrocystic Breast Disease
Authors: Cavallini Giorgio , Berti Gilberte
Published: April 2018

Sixteen cases of fibrocystic breast disease at different histopathologic stage were examined with the leukocyte adherence inhibition assay. Skeletal muscle and gastric carcinoma extracts were used as controls. The glass adherence of leukocytes from patients affected by fibrocystic breast disease was more inhibited when extracts from breasts with fibrocystic disease were used rather than control extracts. Nonadherence indexes (NAIs) were high in 8 cases, around 20 in 4 cases, a little above zero in 2 cases and below zero in 2 cases. NAIs were related to the histopathologic stage: the highest NAIs were found in 8 cases of classic fibrocystic disease, the lowest in 1 case of simple breast fibrosis.
Role of Calcitonin Assay as Neoplastic Marker
Authors: Parazzi F. , Giusti M. , Gori E. , Mazzocchi G. , Zucchi M. , Contessini M. , Macciolli D.
Published: April 2018

Serum immunoreactive calcitonin (hCT) was measured in 75 neoplastic patients and in a control group of normal adults. The level of hCT was found increased in a number of patients. This result suggests how the measurement of hCT may represent a useful neoplastic marker.
Investigation of Possible Changes in the Detection of Cervical Carcinoma in Patients of Dutch General Practitioners
Authors: Boon M.E. , Rietveld W.J. , Kirk R.S.
Published: April 2018

In a series of 430,015 cervical smears made by general practitioners and coming from all regions of the Netherlands in the period 1972–1980, no significant changes were noted in the rates of positive smears (Papanicolaou IV and V). These data are especially relevant in deciding the age limits for the cytology health service programs. Women aged more than 55 years contribute only 5% of the smears made by house doctors; nevertheless, this group had just as many cases of invasive carcinoma as the younger group. Since 1974 there has been an increase in the diagnosis of adenocarcinoma in situ of the endocervix, probably due to better knowledge of the cytologic and histologic criteria of this lesion. The effects of under-diagnosis of this carcinoma precursor are stressed. It is concluded that it is more important at present to concentrate any additional cytological screening on the « forgotten group » of women aged over 55 years and not yet to extend health survey programs to women under 35 years. However, this policy may need to be reviewed if increased rates of preinvasive tumor in the future lead to an earlier average age for invasive tumor.
Follow-Up of Pathological Stage I and IIA Supradiaphragmatic Hodgkin's Disease Primarily Treated with Radiotherapy
Authors: Banfi Alberto , Zanini Marcello , Zucali Roberto , Ricci Sante Basso , Lattuada Angelo , Milani Franco , Rizzato Rosanna , Volterrani Fabio
Published: April 2018

One hundred and fifty-five consecutive previously untreated adult patients with supradiaphragmatic pathologic stage IA (71) and IIA (84) Hodgkin's disease treated only with radiotherapy (RT) at the Istituto Nazionale Tumori of Milano from 1970 to 1978 were reviewed. Staging procedures included lymphangiography and laparotomy in all cases. Most patients were irradiated with a conventional cobalt machine. Mantle fields were adopted for 36.8% of cases, mainly at stage I, whereas 63.2% received mantle plus paraaortal irradiation. Doses were above 40 Gy for involved sites and 35–40 Gy for prophylactically irradiated nodes. Minimum and median follow-up were 30 months and 6 years, respectively. All patients achieved complete remission at the end of RT. As of June 1981, 89 of 155 patients (57.5%) were alive and free from progression, 60.6% at stage I, and 54.8% at stage II. Relapses occurred in 54 of 155 cases (35%) after a median free interval of 21 months. Marginal recurrences accounted for 5.8%, true recurrences for 9%, nodal extensions for 8.4%, and extranodal extensions for 11.6%. Males older than 40 years and mediastinal involvement were correlated with higher relapse rates. Salvage treatment consisted of RT alone in 8 patients and chemotherapy plus or minus RT in 44, whereas 2 patients died before a new treatment could start. As of June 1981, 38 of 54 relapsed patients (70.4%) were alive and disease free, whereas 2 were alive with evidence of disease. Actuarial overall survival at 6 years was 90.3% for all cases, 97.1% for stage I, and 84.8% for stage II. Treatment toxicity was analyzed, and problems concerning surgical staging procedures, optimal RT and role of chemotherapy as primary or salvage treatment were discussed.
Phase II Evaluation of Vindesine in Mycosis Fungoides, Extraosseous Plasmacytoma and other Hematologic Malignancies
Authors: Ferrazzi Eros , Pappagallo Giovanni L. , Segati Romana , Vinante Orazio , Galligioni Enzo , Zagonel Vittorina , Salvagno Luigi , Fiorentino Mario V.
Published: April 2018

We conducted a phase II trial of Vindesine in 24 patients, mostly pretreated (23/24 fully evaluable for therapeutic response) with advanced hematologic malignancies. The drug was administered at weekly bolus doses of 3 mg/m2 i.v. Overall, objective tumor regressions were seen in 9 of 23 patients. The drug appeared effective in extraosseous plasmacytoma (1 complete response and 1 minor response in 3 patients) and in mycosis fungoides (1 complete response, 1 partial response and 1 minor response in 6 patients). Further phase II trials in these 2 diseases are justified. In addition, 3 partial responses in 7 patients with advanced lymphoma were also obtained. Previous vinca-alkaloid exposure did not adversely affect the response rate: 8 of 9 responsive patients had previously received vincristine and/or vinblastine. Drug-related toxic effects were mainly represented by manageable and reversible neurotoxicity and by moderate leukopenia with apparent lack of thrombocytopenia. In heavily pretreated patients, leukopenia may be occasionally severe: in these conditions a starting dose of 2 mg/m2 seems more appropriate.
A Case of Pancreatoduodenectomy as Resolutive Treatment for a Solitary Metastasis of Breast Cancer
Authors: Azzarelli Alberto , Clemente Claudio , Quagliuolo Vittorio , Baticci Fabio
Published: April 2018

A 49-year-old woman was hospitalized for obstructive jaundice 4 years after extended mastectomy for lobular infiltrating carcinoma. After routine investigations that detected a malignant lesion of the pancreas head, the patient underwent pancreatoduodenectomy. The surgical specimen revealed unexpected breast carcinoma metastatic to the pancreas and duodenum wall. The woman is alive and free of disease at 10 years from the mastectomy and 6 years from the pancreatoduodenectomy. This experience confirms the validity of a surgical radical treatment for metastatic lesions in selected cases.
Secondary Lung Cancer Resection with Curative Intent: Causes of Success and Failure, and Prognostic Factors
Authors: Valente Maurizio , Pastorino Ugo , Grandi Cesare , Luini Alberto , Milani Franco , Ravasi Gianni
Published: April 2018

Observed and disease-free survivals were evaluated in a consecutive series of 46 resections of pulmonary metastases, with major chance of being an unique phenomenon. Survival curves were computed both since the treatment of primary tumors and since resection of lung metastases. From the treatment of primary tumors, median disease-free interval was 33 months, and rised to 66 months after resection of lung metastases. From the treatment of secondary lung cancers the observed survivals at 1, 3 and 5 years were respectively 60%, 41% and 26%. Survival was clearly affected by development and resectability of post-thoracotomic recurrence (100% without recurrence, 50% with resectable recurrence and 4% with unresectable recurrence). Recurrence rate was related to the first disease-free interval and to the anatomical extent (particularly for nodal status) of secondary lung cancer. This fact suggests that the failure of secondary lung cancer resection may arise either from the primary cancer (poor selection) or from the secondary cancer (delay in treatment).
Acute Bleomycin and Methotrexate Toxicity: Report of Two Cases
Authors: Porcile Gianfranco , Brema Fulvio , Stefani Giuseppe , Campora Elisabetta , Rosso Riccardo , Santi Leonardo
Published: April 2018

Two clinical cases of acute and severe toxicity after bleomycin and methotrexate administration are described. In both cases toxicity became evident 2 to 3 days after chemotherapeutic treatment and consisted of ulceronecrotic mucositis, leuko- and thrombocytopenia and hypotension; one patient died 13 days after. Toxicity is quite unexpected in relation to the drug dosages and time of onset. Some pathogenetic hypotheses are discussed.
Lung Asbestos Bodies and Pulmonary Cancer in Subjects without Occupational Exposure
Authors: Andrion Alberto , Pira Enrico , Fadda Tiziana , Mollo Franco
Published: April 2018

Lung asbestos bodies were searched for in 65 subjects with pulmonary cancer and without occupational exposure and in 65 matched controls. No significant association between the presence of asbestos bodies and occurrence of lung cancer was found. Nevertheless, adenocarcinoma was significantly associated with the presence of lung asbestos bodies in men. The latter result suggest that, even in non-professionally exposed subjects, the possibility of relationships between asbestos exposure and lung cancer cannot be excluded.
Mammary Tumors in BALB/cfC3H and BALB/cfRIII Virgin Female Mice Bearing Hypophyseal Isografts
Authors: Pingitore Raffaele
Published: April 2018

The behavior and morphology of mouse mammary tumors in high cancer strain mice are controlled by the causative murine mammary tumor viruses (MuMTV). However, relationships also exist between mammary tumors and other factors such as host genotype, other etiologic agents (chemicals, X-rays), and hormones. Among the latter, prolactin has been particularly studied. The aim of this investigation was to test whether the mammary tumor morphology controlled by C3H and RIII MuMTVs is in any way influenced by continuous prolactin secretion. A total of 28 BALB/cfC3H and 24 BALB/cfRIII virgin female mice was implanted with 2 hypophyseal isografts under the kidney capsule. Mice were of the same BALB/c genotype and carried respectively C3H and RIII MuMTV infection. The biologic and morphologic characterization of the tumors observed showed that several differences previously reported between mammary tumors in breeding female mice of the 2 strains persisted in virgins bearing hypophyseal isografts. These data confirm that the mammary tumor characters in high cancer strain mice are mainly carried out and controlled by the causative MuMTVs but also suggest that different MuMTVs may show different sensitivity to continuous prolactin secretion.
Effects of Opiates and Naloxone on Certain Enzymes of Carbohydrate Metabolism in Human Breast Carcinomas
Authors: Di Martino Luciano , Tarquini Achille , Mitchell Irene , Deshpande Nagesh
Published: April 2018

The effects of administration of opiates and naloxone on the activities of PFK, 6PGDH and α-GPDH and α-GPDH/6PGDH ratios in human breast carcinomas were investigated in patients awaiting mastectomy. Injection of naloxone or fentanyl into an antecubital vein resulted in a statistically significant reduction in the activity of α-GPDH. Fentanyl was also effective in reducing the activity of 6PGDH. Injection of morphine into a branch of the internal mammary artery during mastectomy failed to induce changes in the activities of any of the enzymes but injection of naloxone resulted in a significant rise in the activity of 6PGDH. It is postulated that these alterations in the activities might not be associated with the binding of these drugs to opiate receptor proteins in the carcinoma. Furthermore opiate agonists or antagonists might not produce the required changes in the activities of any of the enzymes.
Variations According to Patient-Age in Certain Histopathological Parameters in Cancer of the Breast
Authors: Migliori Elena
Published: April 2018

The bimodal five-year distribution curve of cancer of breast observed in this Institute from January 1970 to May 1976 has been partly explained as a result of a two-peak curve of comedocarcinoma, two unimodal early curve of solid and cribriform carcinoma and a late unimodal curve or « plateau » of papillary carcinoma. The association with the mammary lobules of these tumors is discussed.
Phase II Study of 4'Epi-Doxorubicin
Authors: Ferrazzi Eros , Nicoletto Ornella , Vinante Orazio , Pagnin Piero , Maraglino Giuseppe , Ganzina Fabrizio , Fiorentino Mario V.
Published: April 2018

Sixty-five patients with advanced solid tumors were treated with 4'epi-doxorubicin, a new analogue of doxorubicin (DXR). Forty-three of 61 evaluable patients had not received previous chemotherapy and/or hormonal treatment. 4'Epi-doxorubicin has been administered at the dose of 75 mg/m2 i.v. once every 21 days, for a minimum of 2 courses. The pattern of acute toxicity was similar to that of DXR. Transient electrocardiographic abnormalities were found in about 50% of patients. The ratio of pre-ejection period to the left ventricular ejection time (PEP/LVET) increased within 1 h after drug injection and returned to near basal values after 24 h. Three patients received a total dose of more than 550 mg/m2, still maintaining a baseline PEP/LVET ratio near to pretreatment values. Up to now, no patient has developed clinical signs of heart failure. Partial responses were seen in patients with tumors generally sensitive to DXR such as breast carcinoma (6 of 14) and soft tissue sarcomas (2 of 6), and in patients with tumors generally resistant to DXR such as melanoma (1 of 9), colorectal carcinoma (3 of 18) and pancreatic carcinoma (1 of 2). These data suggest that 4'epi-doxorubicin may have a broader spectrum of antitumor activity than DXR.
Interaction between Doxorubicin and Mitomycin C on Mortality and Myocardial Contractility in Guinea PIG
Authors: Monti Elena , Bossa Rosaria , Galatulas Iraklis , Favalli Luigia , Villan Fabrizio , Piccinini Francesco
Published: April 2018

The present investigations were carried out in guinea pig to ascertain whether mitomycin C has a direct cardiotoxic effect or interacts with doxorubicin-induced cardiotoxicity. I.p. administration of mitomycin C did not modify the survival rate up to 30 days, whereas the combined administration of doxorubicin and mitomycin C significantly decreased the survival time in comparison to the doxorubicin-treated group. On isolated atria, mitomycin C did not cause significant inhibition of the contractile force or an enhancement of the doxorubicin-induced negative inotropic effect. These results do not support the possibility that mitomycin C potentiates the acute cardiotoxic effects produced by doxorubicin.
Acute Myeloblastic Leukemia after Adjuvant Chemotherapy with Melphalan in Breast Cancer. Case Report with Cytogenetic Analysis
Authors: Gori Stefania , Donti Emilio , Venti Giovanna , Mecucci Cristina , Crinò Lucio , Tonato Maurizio
Published: April 2018

Therapy of solid and hematologic tumors with alkylating agents appears to increase the frequency of acute non-lymphocytic leukemia (ANLL), as indicated by the cases reported in the literature. The carcinogenetic mechanism of alkylating agents seems related to their ability to damage DNA, and this is supported by the findings of multiple cytogenetic abnormalities in these patients. We report a case of ANLL secondary to therapy with melphalan, which was utilized on an adjuvant basis for breast cancer. ANLL developed 24 months after chemotherapy was discontinued. Results of the cytogenetic analysis in our patient showed multiple rearrangements and marker chromosomes. Among these was a large metacentric chromosome, identified in 6 of 8 karyotypes, in the size range of group A, which probably resulted from a translocation t(7;14) (7qter→7p11::14p11-→14qter). The natural history of the underlying disease and of the ANLL in our patient and data from chromosomal analysis seem to confirm the hypothesis that alkylating agents are potentially leukemogenic in man, probably through genetic damage. This possibility should be considered when such cytotoxic drugs are used in an adjuvant setting.
The Evaluation of Fibrinogen Behavior in Hodgkin's Disease: Correlation with Clinical Stage
Authors: Pengo Vittorio , Cartei Giuseppe , Casara Dario , Daniele Otello , Fiorentino Mario V.
Published: April 2018

Forty-four patients (9 stage II, 15 sage III, 7 stage IV, and 13 in complete remission) with Hodgkin's disease without any clinical coagulation disorder were studied. Fibrinogen behavior was evaluated by measuring fibrinogen level and using 1251-fibrinogen, the half-life, survival and fibrinogen turnover. Platelet count and fibrinogen/fibrin degradation products (FDP) were also assayed. The fibrinogen half-life, survival and turnover were significantly longer and faster, than those found in 10 healthy subjects, in stage II, III and IV subjects (p < 0.001, p < 0.001, p < 0.05 for stage II; p < 0.001, p < 0.001, p < 0.001 for stage III; p < 0.005, p < 0.005, p < 0.001 for stage IV, respectively). In most cases, FDP values were within the normal range, although they were significantly higher than those of control group in stages III and IV. Intravascular coagulation and fibrinolysis were not found in the 13 patients with complete remission. In these patients, the behavior of fibrinogen was normal, suggesting that the parameters studied are related to the presence of the tumor, and can be useful in monitoring the state of remission.
The Role of Chest X-Ray in the Follow-Up of Primary Breast Cancer
Authors: Ciatto Stefano , Herd-Smith Andrea
Published: April 2018

The results of chest X-ray (CXR) survey in the follow-up of 1697 breast cancer patients are reviewed. Intrathoracic metastases (ITM) accounted for 26% of total first recurrences, but the rate dropped to 13% if isolated ITM and to 7% if asymptomatic isolated ITM were considered. Thus the role of CXR survey was limited to the detection of 39 cases of isolated ITM in the asympatomatic phase out of 7100 patients-year for a total number of 11,543 CXR examinations. Moreover, no difference in mean survival was observed if symptomatic and asymptomatic ITM were considered and survival was calculated from the time of first treatment. A small gain of 3 months, not statistically significant, of mean life from metastases diagnosis was recorded for asymptomatic cases, which is probably entirely due to the lead time effect of anticipated diagnosis. CXR survey in breast cancer follow-up may add to the knowledge of the natural history of the disease, but it appears worthless for other purposes. Thus the high costs related to CXR survey may be unacceptable, and a randomized study on the role of CXR is suggested and justified.
Empiric Therapy of Infections in Hematologic Malignancies: A Prospective, Randomized Trial
Authors: Cetto Gian Luigi , Todeschini Giuseppe , Caramaschi Giacomo , Vinante Fabrizio , Benini Fabio , Perona Giuseppe
Published: April 2018

Patients with hematologic malignancies were randomly assigned to receive cefuroxime (group A) or tobramycin plus ampicillin (Group B) during 86 febrile episodes. In both regimens carbenicillin was added during neutropenia (71% of all episodes: groups C and D). The most common type of infection was pneumonia (48% alone; 72% with other sites involved), which accounted for a high fatality rate (15%); the highest rate occurred during septicemia with pneumonia (50%). The overall response rate to initial therapy was 63% without significant differences among the four regimens. The worst prognosis was observed in neutropenic patients without granulocyte recovery. When initial and cross-over trials were combined, there were favorable outcomes in 90% of all cases. Cefuroxime alone seems to be as effective as tobramycin plus ampicillin in the treatment of infections in hematologic malignancies. No side effects could be attributed to the cefuroxime-containing regimens.
Leukemia in a Child with Wilms' Tumor
Authors: Tamaro Paolo , Zanazzo Giulio Andrea , Violino Marco
Published: April 2018

A case is described which illustrates an acute non-lymphocytic leukemia following multimodal control and apparent cure of Wilms' tumor. Literature cases are reviewed, and therapeutic inadequacies according to present protocols and their importance for the subsequent development of secondary leukemia are discussed.
Morphologic Study of Carcinoid-Like Tumors and Their Relation to True Carcinoids, Using Tumors of the Breast as a Model
Authors: Forouhar Faripour A.
Published: April 2018

Two cases of an unusual type of infiltrating ductal carcinoma of the breast are presented. Both cases demonstrated a carcinoid-like pattern and were indistinguishable from carcinoid tumors of the breast by light microscopy. However, Grimelius stains and electron microscopic evaluation showed no evidence of membrane bound secretory granules. In regard to the prognostic significance and proper classification of carcinoids of the breast, awareness of carcinoid-like morphologic variants of infiltrating ductal or lobular carcinoma is important. It is also apparent that there is a spectrum of tumors which demonstrate some properties of true carcinoids, however, only the true carcinoids show a better prognosis and it serves no useful purpose to separate the rest of these tumors. The diagnosis of carcinoid tumors requires demonstration of secretory granules on electron microscopic examination or in special stains; conventional light microscopic studies alone are insufficient for this diagnosis. All these principles may be applied to carcinoid like tumors of other sites.
Infiltration of Liver and Brain by Tumor Cells in Leukemic Mice: Prevention by Dimethyltriazenes and Cyclophosphamide
Authors: Sava Gianni , Giraldi Tullio , Perissin Laura , Zorzet Sonia , Maliardi Franco , Grill Vittorio
Published: April 2018

The dimethyltriazenes p-(3,3-dimethyl-1-triazeno)benzoic acid potassium salt (DM-COOK) and 5-(3,3-dimethyl-1-triazeno)-imidazole-4-carboxamide (DTIC) increase, unlike cyclophosphamide (Cy), the survival time of mice bearing L1210 lymphoid leukemia, P388 lymphocytic leukemia and TLX5 lymphoma with a mechanism unrelated to cytotoxicity for tumor cells. The in vivo bioassays of brains, and the histologic examinations of the livers of leukemic mice show that DM-COOK and DTIC prevent leukemic infiltration in these organs at dosages devoid of cytotoxic effects for peritoneal tumor cells. At a dosage equitoxic with that of dimethyltriazenes, cyclophosphamide causes the absence of tumor cells in the peritoneal cavity and in the brains and livers of mice bearing P388 and L1210 leukemias. DM-COOK and DTIC thus possess a mild or insignificant cytotoxic action together with antimetastatic properties also on mouse transplantable leukemias. The use of DM-COOK appears advantageous over that of cyclophosphamide and DTIC because of a reduced host toxicity, which is particularly evident for cyclophosphamide and DTIC on liver parenchyma and bone marrow.
Myxoid Leiomyosarcoma of the Uterus -A Case Report with Light Microscopic and Ultrastructural Appraisal
Authors: Shroff Chandralekha P. , Deodhar Kamalakar P. , Bhagvvat Arvind G.
Published: April 2018

A case of an infiltrating myxopolypoid tumor of the uterus is presented. Histologically, the tumor revealed spindle-shaped cells with mitotic counts ranging between 1–4/hpf, myxoid stroma, and multinucleated giant cells mimicking syncitial giant cells of pregnancy trophoblast. Conventional light microscopic methods failed to establish the histogenesis of the tumor. At the ultrastructural level the tumor showed three main cellular components; myoblasts, myofibroblasts and collagen-producing fibroblasts. On the basis of light microscopic and electron microscopic findings, the tumor was labelled myxoid leiomyosarcoma. This variant of leiomyosarcoma is rare. This is the seventh case reported in the international literature.
Primary Malignant Fibrous Histiocytoma of Storiform-Pleomorphic Type: A Case Report of an Ano-Rectal Localization
Authors: Spagnoli Luigi G. , Dell'Isola Carlo , Sportelli Giuseppe , Mauriello Alessandro , Rizzo Franz , Casciani Carlo U.
Published: April 2018

Among the various localizations of primary malignant histiocytoma, the ano-rectal one is exceedingly rare. In this paper we report a case characterized by a storiform-pleomorphic pattern of the tumor and a rapid fatal course of the disease with metastasis in the lungs. The prognostic value of the histologic features is briefly discussed.
Discovering Asymptomatic Non-Precancerous Lesions with Cervical Cytologic Mass-Screening Campaigns: Is it a Benefit or a Cost?
Authors: Almasio Piero , Chiappa Liliana , Duca Piergiorgio , Turolla Enrico
Published: April 2018

A total of 3357 women (88.1 % married, 82.0 % parous) were examined at least once in the mass-screening program carried out by the Legnano Hospital Screening Center in Nerviano (a small town near Milan with 15,600 inhabitants) in 1974, 1977 and 1980. Married women with visible portio and adequate smear were 2758: a visibly healthy cervix was found only in 1143 subjects (41.4 %). A total of 1516 married women were examined at least in 2 consecutive campaigns: 1279 (84.4 %) reported « no gynecologic treatment in the previous 5 years » at the first campaign, and 899 (59.3 %) reported « no gynecologic treatment in the previous 3 years » at their second one. Of 350 women with « medical lesions » and 525 with « surgical lesions » recorded at the first visit, 111 (31.7 %) and 232 (44.2 %) reported, respectively, a « medical treatment » or a « surgical treatment » at the second visit. In women with « medical lesions » at the first visit, at the second visit a healthy cervix was found in 66.2 % of the treated women and in 72.6 % of the untreated patients. In those with « surgical lesions » a healthy cervix was successively found in 91.6 % of treated and in 40.7 % of the untreated patients.
Immunohistochemical Reactivity of the Antimelanoma Monoclonal Antibody Mel-1
Authors: Clemente Claudio
Published: April 2018

The immunohistochemical reactivity of the monoclonal antimelanoma antibody MEL-1 was evaluated on frozen sections of 9 malignant melanomas, 5 nevi, 1 squamous cell carcinoma, 1 basal cell carcinoma, 2 benign dermal fibrous histiocytomas, 1 infiltrating ductal and 2 infiltrating lobular carcinomas of the breast, 1 primary squamous cell carcinoma and 1 adenocarcinoma of the lung, 1 lung metastasis of gastric adenocarcinoma, 1 adenocarcinoma of the large bowel, 1 lymph node, 1 case of malignant histiocytosis and one of lymph nodal immunoblastic lymphoma, and 1 biopsy of oral cavity mucosa. In primary and metastatic malignant melanoma, junctional nevi, and the upper half of compound and dermal nevi, the staining was intense. Also, benign dermal fibrous histiocytoma and the case of lymph nodal malignant histiocytosis showed an intense reactivity, whereas the immunostaining positivity of the squamous cell carcinoma of the skin, the lung adenocarcinoma, the squamous cutaneous and mucosal epithelium, and the sweat and sebaceous glands was slight. In ductal and lobular infiltrating carcinoma of the breast only focal areas or isolated tumor cells were positive. The lack of reactivity of deep dermal melanocytes of compound and dermal nevi may be correlated with a different antigenic phenotype of the melanocytes. After discussion of the technical problems, the application of MEL-1 was suggested, for diagnostic purpose, to identify lymph nodal metastases in cases of primary self regressed malignant melanoma and to detect lymph nodal metastatic microfoci of malignant melanoma.
Clinical Toxicity of 4′-Epi-Doxorubicin (Epirubicin)
Authors: Ganzina Fabrizio , Di Pietro Nicola , Magni Osvaldo
Published: April 2018

Epirubicin is a new derivative of doxorubicin characterized by an improved spectrum of activity and a better therapeutic index. At equimolar doses and in comparative studies, epirubicin proved to induce less acute toxicity than doxorubicin, in particular less vomiting, hair loss and myelotoxicity. While giving a comparable response rate in randomized breast cancer studies, epirubicin also proved to be less cardiotoxic than doxorubicin. The reduced potential for cardiac toxicity of epirubicin versus doxorubicin has been shown both by functional assessment (radionuclide cinecardioangiography) and by histopathologic evaluation (endomyocardial biopsies) at equally myelosuppressive doses or at equal doses (equimolar). The lessened cardiotoxicity of epirubicin versus doxorubicin can be explained by the different pharmacokinetic and metabolic properties of these two agents: epirubicin has been found to have a more rapid pharmacokinetic plasma clearance and an additional metabolic pathway (unique glucuronidation).
Comparison of Lipid Peroxidation and Myocardial Damage Induced by Adriamycin and 4′-Epiadriamycin in Mice
Authors: Llesuy Susana F. , Milei José , Molina Hugo , Boveris Alberto , Milei Silvia
Published: April 2018

Adriamycin (ADM) and 4′-epiadriamycin (4′-ADM) were given to mice in a single dose of 15 mg/kg body weight (i.p.). Twenty-five mice were alloted to 3 groups. One group (Group I; n = 8) was given ADM; another group (Group II; n = 9) was similarly treated with 4′-ADM, and a control group (n = 8) received an equivalent volume of 0.9 % NaCl solution. Mice were sacrificed 4 days after the described treatment. A complete autopsy was carried out in each animal. Hydroperoxide-initiated chemihuninescence and malonaldehyde formation were measured in mouse heart homogenates. Control mice showed a maximal photoemission of 52 ± 2 (×10–3) (mean values ± S.E.M.) cpm/mg protein and a formation of 20 ± 4 nmol malonaldehyde/g organ after a 2 hr-incubation. The ADM-treated mice showed a 24 % enhanced hydroperoxide-initiated photoemission and a 370 % increased malonaldehyde formation. The 4′-ADM-treated mice showed a 15 % increased hydroperoxide-stimulated chemiluminescence and an 85 % increased malonaldehyde formation. Vitamin A (5000 IU), vitamin E (85 IU) and vitamins A and E (same doses as before) given as a single dose i.p. 1 day before doxorubicin administration were able to decrease the hydroperoxide-initiated chemihuninescence by 24 %, 26 % and 44 %, respectively. Microscopically, only scarce isolated microvacuolated subendocardial fibers were found in the ADM-treated animals. Our data showing that 4′-ADM lacks a statistically significant effect in increasing heart peroxidation as compared to ADM may explain its lower myocardial toxicity.
Inhibition of Macromolecular Synthesis in P388 Mouse Leukemia Ascites Cells by Bouvardin (NSC 259968)
Authors: Chitnis Manik , Menon Ravi , Adwankar Manohar , Satyamoorthy K.
Published: April 2018

Bouvardin, a new antineoplastic plant product, inhibits macromolecular synthesis in P388 cells in a dose-dependent manner. At the same concentration of bouvardin, protein synthesis was inhibited to a greater extent than the synthesis of DNA and RNA. There was a reversal of inhibition of both DNA and RNA synthesis after the cells were washed free of bouvardin. However, there was partial reversal of inhibition of protein synthesis when the cells were washed free of the drug.
Serum Estrogen Level in Egyptian Breast Cancer Patients
Authors: El-Aaser Abdelbaset Anwer , El-Merzabani Mahmoud Mohamed , Abu-Bedair Farid Ahmed
Published: April 2018

In menstruating 20-29 year old breast cancer patients, the total estrogen level showed a significant increase in the early follicular phase compared to normal healthy subjects. Such a difference was not observed in 30-45 year-old patients. A nonsignificant decrease was observed in the estradiol level of premenopausal breast cancer patients compared to normal healthy subjects. However, in postmenopausal breast cancer patients, the total estrogen level as well as the estradiol level showed a signicant increase compared to that of normal healthy subjects.
Hodgkin's Disease Developing in A Patient with Angioimmunoblastic Lymphadenopathy with Dysproteinemia - A Case Report
Authors: D'Arrigo Attilio , Lazzari Giorgio , Fornari Gianni , Vineis Clemente , Costalaia Laura , Ajmone Franco
Published: April 2018

The case of a woman presenting the clinical and pathologic phenomena of angioimmunoblastic lymphadenopathy (AILD) with dysproteinemia is reported. The patient developed lesions in the lymph nodes, skin, lungs, liver and spleen, and her response to steroid and cyclophosphamide therapy was poor. At autopsy, microscopic findings in the mediastinal and abdominal lymph nodes were consistent with the diagnosis of Hodgkin's disease. Whereas the development of immunoblastic lymphoma is frequent in AILD, Hodgkin's disease is far less common. It is argued that malignant lymphoma in AILD may be the consequence of chronically depressed lymphocyte functions.
Mammary Carcinoma with Argyrophilic Cells: An Immunohistochemical and Ultrastrctural Study
Authors: Santini Donatella , Bazzocchi Floriano , Pileri Stefano , Govoni Edmondo , Taffurelli Mario , Grassigli Alberto , Marrano Domenico , Martinelli Giuseppe
Published: April 2018

The immunohistochemical and ultrastructural findings of 7 primary argyrophilic tumors of the breast are described. Five cases were selected because of a growth pattern reminiscent of a « carcinoid » tumor and 2 were obtained from 70 consecutive common carcinomas. All patients were females (mean age 68.8) and none had clinical evidence of hormonal secretion. On ultrastructural examination dense-core granules were seen in addition to findings more suggestive of a common carcinoma. Immunoperoxidase stainings for ACTH, calcitonin etc. were negative in all tumors. The authors believe that organoid growth pattern, argyrophilia and dense-core neurosecretory-like granules are not sufficient elements to demonstrate the endocrine nature of a breast neoplasm.
Staging, Therapy and Prognosis of Primary Non-Hodgkin's Lymphoma of Bone and a Comparison of Results with Localized Ewing's Sarcoma: Ten Years Experience at the Istituto Ortopedico Rizzoli
Authors: Bacci Gaetano , Jaffe Norman , Emiliani Ermanno , Capanna Rodolfo , Calderoni Pierina , Picci Piero , Bertoni Franco , Gherlinzoni Franco , Campanacci Mario
Published: April 2018

Thirty consecutive cases of localized primary non-Hodgkin's lymphoma of bone (PNHLB) were treated in a 10-year period at the Istituto Ortopedico Rizzoli with localized radiation (4 cases) and localized radiation and adjuvant chemotherapy (26 cases). The doses of radiation varied from 3000-4500 rad. A variety of staging procedures evolving with new diagnostic techniques over the 10 years were performed. Adjuvant chemotherapy comprised two different regimens of vincristine, adriamycin and cyclophosphamide. Twenty-four of the 26 patients (92 %) have been free of disease with a median follow-up of 75.5 months (18-144 months). Two patients developed meningeal involvement and one patient, treated with radiation therapy only, developed a local recurrence. The results are compared to the management of 68 Ewing's sarcoma patients treated during the same period. Here, higher doses of localized radiation therapy (approximately 5000 rad) and similar adjuvant chemotherapy were administered. The survival was 32 % (22/68) with a higher incidence of local recurrence (21 %). These data indicate that PNHLB should be considered a separate entity from Ewing's sarcoma and can be treated successfully with lower doses of radiation to the primary tumor and adjuvant chemotherapy. The observations are also compared to a variety of other biological characteristics of Ewing's sarcoma. Since only two patients developed meningeal relapse, our experience does not permit a firm recommendation for routine prophylactic treatment of the central nervous system in PNHLB.
Hyperthermic Antiblastic Perfusion in the Treatment of Cancer of the Extremities
Authors: Vaglini Maurizio , Andreola Salvatore , Attili Angelo , Belli Filiberto , Marolda Raffaele , Nava Maurizio , Prada Augusto , Santinami Mario , Cascinelli Natale
Published: April 2018

From February 1982 to December 1983, 42 patients affected by neoplasms of the limbs were treated at the Istituto Nazionale Tumori of Milan by hyperthermic antiblastic perfusion in extracorporeal circulation at the temperature of 40-41 °C for 1 h. Thirty-two were affected by melanoma, 4 by osteogenic sarcoma, 2 by squamous-cell carcinoma, 1 by liposarcoma, 1 by hemangiopericytoma, 1 by clear-cell sarcoma and 1 by Kaposis's sarcoma. As regards the immediate response, a complete plus partial remission rate of 88 % without any major complication was obtained. The follow-up period is too short for any considerations about overall survival. However, because of these good clinical results we consider this method able to locally control the evolution of neoplasms of the extremities, allowing in many cases a limb salvage.