bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of Colorectal Cancer in the Umbria Region of Italy: Prescreening Period
Authors: Cassetti Tiziana , Stracci Fabrizio , Canosa Antonio , Minelli Liliana , Scheibel Massimo , Romagnoli Carlo , La Rosa Francesco 
Published: February 2018

Aims and background The epidemiology of colorectal cancer in Umbria, Italy, was evaluated, and data were analyzed in the pre-screening period to better understand the etiology of the disease and to develop screening strategies. Materials and methods Incident data were collected by the Umbrian Population Cancer Registry and mortality data by the Nominative Regional Mortality Registry from 1994 to 2002. The survival rates relative to Italian cancer registries were derived from the Italian Associations of Cancer Registries publications. Time trends were analyzed by joinpoint regression. The follow-up for survival rates referred to December 31, 2005. Results The trend of colorectal cancer age-adjusted incidence showed a slight, constant, but non significant increase over time. The mortality trend showed a slight, constant, but non-significant decrease. Age at diagnosis remained constant in males, whereas in females it showed a significant increase of about 1.5 years. In the last period, all incidence rates increased with age, but in males they presented a rapid increase in the 55-74 age group, levelled and declined up to 84 and after again reached, which could be a consequence of opportunistic screening practice, probably undergone by males. Mortality in both sexes increased with age, whereas survival rates fell. Comparison of survival rates in some Italian cancer registries showed that the Umbria region, in the 1994-1996 period, was the zone with the highest relative survival; in the 1996-1999 period, the rate stopped, differently from other Italian zones. In the last period, the highest survival rates were recorded by registries covering zones with active screening programs. Conclusions The present reduction of mortality in Umbria, as in other Italian areas, is dependent on the natural behavior of the disease, which is linked to a birth cohort-related effect of stabilization and decrease in exposure to risk factors.
Efficacy of Different Regimens of Adjuvant Radiochemotherapy for Treatment of Glioblastoma
Authors: Scheda Antonella , Finjap Janvier Kaba , Tuettenberg Jochen , Brockmann Marc Alexander , Hochhaus Andreas , Hofheinz Ralf , Lohr Frank , Wenz Frederik 
Published: February 2018

Aims and background We retrospectively analyzed the impact of different adjuvant chemotherapy regimens in a group of patients treated for glioblastoma compared to patients receiving only postoperative radiotherapy. Material and methods Eighty-six consecutive patients underwent radiotherapy between January 2000 and December 2003: 52 patients received radiotherapy alone, 17 patients radiochemotherapy with low-dose temozolomide (20 mg/m2) + cyclooxygenase-2-inhibitors (200 mg), 6 patients radiochemotherapy with high-dose temozolomide (50 mg/m2). Eleven patients, with unfavorable prognostic factors, were treated with imatinib and 55/2.5 Gy. Results The groups treated with high- and low-dose temozolomide showed the longest overall survival (median, 21 months and 17 months, respectively). Median overall survival was 9 months for radiation alone and 4 months for the imatinibtreated group. The same positive trend of temozolomide on prolonged overall survival was confirmed when only patients submitted to maximally radical resection or patients with KPS >70 were considered. Differences in progression-free survival were not statistically significant. Conclusions Patients treated with adjuvant temozolomide either inside or outside of study protocols had survival times similar to other reports or randomized studies. The absence of a significant influence of temozolomide on progression-free survival could depend on the unavoidable drawbacks and biases of retrospective investigations or on the definition of relapse used. The unsatisfactory results of radiotherapy plus imatinib may have been due to a high prevalence of unfavorable prognostic factors in the respective patients. The ongoing controlled trial will further define the efficacy of adjuvant/concomitant imatinib.
Three-Dimensional Conformal External Beam Radiotherapy versus the Combination of External Radiotherapy with High-Dose Rate Brachytherapy in Localized Carcinoma of the Prostate: Comparison of Acute Toxicity
Authors: Soumarová Renata , Homola Luboš , Perková Hana , štursa Miroslav 
Published: February 2018

Aims and background Radiotherapy represents one of the basic therapeutic methods in treatment of localized carcinoma of the prostate. Optimal irradiation dose is the cornerstone of a successful treatment. Along with local control of the disease and overall survival of the patient, possible acute and long-term side effects need to be monitored very closely. Methods A non-randomized prospective study comparing the acute genitourinary and gastrointestinal toxicity in patients irradiated for localized carcinoma of the prostate. Fifty-seven patients were treated with three-dimensional conformal external beam radiotherapy alone, and in the second treatment arm a combination of external beam radiotherapy and high-dose rate brachytherapy was employed in 40 patients. Results Three-dimensional conformai external beam radiotherapy. Acute G1 genitourinary toxicity was recorded in 35.1% of patients, G2 in 22.8%, and G2-3 in one patient (1.7%). Acute gastrointestinal toxicity was experienced by 54.4% of patients, G1 in 28.1%, G2 in 17.5%, and G3 in 8.8%. Three-dimensional conformal external beam radiotherapy + brachytherapy. Acute G1 genitourinary toxicity was recorded in 37.5% and grade 2 in 15% of the patients. Only G1 acute gastrointestinal toxicity was recorded in 40% of the patients. Conclusions Acute G1 genitourinary toxicity was experienced by a similar percentage of patients in both treatment arms. Acute G2 genitourinary toxicity was more frequent in the three-dimensional conformal radiotherapy arm. Higher acute genitourinary toxicity, G3 or G4, was recorded only in one patient per treatment arm. Acute gastrointestinal toxicity was more frequent in the three-dimensional conformal radiotherapy arm. Higher acute gastrointestinal toxicity, G2 and G3, was only observed in the three-dimensional conformal radiotherapy arm. The acute toxicity observed was of a low grade. The combination of external beam radiotherapy with brachytherapy resulted in a lower incidence of gastrointestinal toxicity than external beam radiotherapy alone.
Postoperative Radiotherapy for Synovial Sarcoma of the Head and Neck during Pregnancy: Clinical and Technical Management and Fetal Dose Estimates
Authors: Orlandi Ester , Zonca Giancarlo , Pignoli Emanuele , Stucchi Claudio , Borroni Marta , Collini Paola , Cantù Giulio , Casali Paolo G. , Grosso Federica , Cerrotta Annamaria , Fallai Carlo , Olmi Patrizia 
Published: February 2018

Aims and background In vivo and phantom dosimetry is reported to estimate the fetal dose and evaluate the effectiveness of a special shielding device to reduce fetal exposure in a woman undergoing postoperative radiation therapy for synovial oral cavity sarcoma at the 30th week of pregnancy. Methods In vivo measurements were performed by placing thermoluminescent dosimeters on 3 points for fetal dose estimation: uterine fundus, umbilicus and pubis. A Rando anthropomorphic phantom was used to simulate radiotherapy. We also performed off-axis dose measurements for wedged beams to estimate the dose contribution of this accessory used in the treatment. Results The special shielding device reduced the fetal dose by 70% on average, despite the presence of wedges, which increased the dose by a factor of about 2.5. Before delivery the patient received 48 Gy, and from the in vivo measurements a fetal dose of 8.5, 1.7 and 0.7 cGy was estimated to the uterine fundus, umbilicus and pubis, respectively. Conclusions Pre-treatment simulation in the same irradiation conditions is the only reliable approach to predict the fetal dose. By using a special shielding device, radiotherapy can be optimized while keeping the fetal exposure below the risk of deterministic damage.
Skeletal Involvement in Infants with Neuroblastoma a Quality Control Attempt
Authors: Angelini Paola , De Bernardi Bruno , Granata Claudio , Villavecchia Giampiero , Morbelli Silvia , Luksch Roberto , Di Cataldo Andrea , Garaventa Alberto , Castellani Rita 
Published: February 2018

Aims and background In 1994, French authors hypothesized that positive skeletal mIBG spots in infants with stage 4 neuroblastoma were not prognostically unfavorable unless associated to abnormal standard X-ray or CT findings. In 1999, the European Infant Neuroblastoma Study adopted this definition, indeed reducing the number of patients candidate to chemotherapy. Such an approach requires high quality scans and standardized procedures. The present study critically reviewed and assessed the quality of mIBG scans performed in Italian patients enrolled in the European Infant Neuroblastoma Study. Methods Three independent nuclear medicine specialists reviewed scans of 25 Italian patients enrolled in Trials 99.2, 99.3, and 99.4 of the European Infant Neuroblastoma Study between January 2000 and September 2002. An arbitrary quality score was attributed to each mIBG scintigraphy, ranging from 1 (less than adequate) to 3 (excellent). One radiologist and 2 oncologists reviewed the X-rays and CT scans and correlated the results with clinical assessment. Results The quality of mIBG scans was rated from good to excellent in 15 of 25 cases, poor in 4, and inadequate for diagnostic evaluation in 6. X-rays confirmed the presence of metastases in 3 of 7 cases with mIBG bone uptake. CT scan confirmed skull metastases in 6 of 9 mIBG-positive cases. Discrepancies in scan interpretation, making trial and stage attribution questionable, were found in 2 patients and are discussed. Conclusions The quality of mIBG scans proved to be at least acceptable in most Italian pediatric oncology centers. Efforts should be made to further standardize evaluation of the scans. Additional techniques (99mTc scintigraphy, MRI, SPECT) might be useful to help understand the most complex cases.
Role of Computed Tomographyand [18F] Fluorodeoxyglucose Positron Emission Tomography Image Fusion in Conformal Radiotherapy of Non-Small Cell Lung Cancer: A Comparison with Standard Techniques with and without Elective Nodal Irradiation
Authors: Ceresoli Giovanni Luca , Cattaneo Giovanni Mauro , Castellone Pietro , Rizzo Giovanna , Landoni Claudio , Gregorc Vanesa , Calandrino Riccardo , Villa Eugenio , Messa Cristina , Santoro Armando , Fazio Ferruccio 
Published: February 2018

Aims and background Mediastinal elective node irradiation (ENI) in patients with non-small cell lung cancer candidate to radical radiotherapy is controversial. In this study, the impact of co-registered [18F]fluorodeoxyglucose-positron emission tomography (PET) and standard computed tomography (CT) on definition of target volumes and toxicity parameters was evaluated, by comparison with standard CT-based simulation with and without ENI. Methods CT-based gross tumor volume (GTVCT) was first contoured by a single observer without knowledge of PET results. Subsequently, the integrated GTV based on PET/CT coregistered images (GTVPET/CT) was defined. Each patient was planned according to three different treatment techniques: 1) radiotherapy with ENI using the CT data set alone (ENI plan); 2) radiotherapy without ENI using the CT data set alone (no ENI plan); 3) radiotherapy without ENI using PET/CT fusion data set (PET plan). Rival plans were compared for each patient with respect to dose to the normal tissues (spinal cord, healthy lungs, heart and esophagus). Results The addition of PET-modified TNM staging in 10/21 enrolled patients (48%); 3/21 were shifted to palliative treatment due to detection of metastatic disease or large tumor not amenable to high-dose radiotherapy. In 7/18 (39%) patients treated with radical radiotherapy, a significant (≥25%) change in volume between GTVCT and GTVPET/CT was observed. For all the organs at risk, ENI plans had dose values significantly greater than no-ENI and PET plans. Comparing no ENI and PET plans, no statistically significant difference was observed, except for maximum point dose to the spinal cord Dmax, which was significantly lower in PET plans. Notably, even in patients in whom PET/CT planning resulted in an increased GTV, toxicity parameters were fairly acceptable, and always more favorable than with ENI plans. Conclusions Our study suggests that [18F]-fluorodeoxyglucose-PET should be integrated in no-ENI techniques, as it improves target volume delineation without a major increase in predicted toxicity.
Induction Therapy with Paclitaxel and Carboplatin Followed by Hyperfractionated Radiotherapy plus Weekly Concurrent Chemotherapy and Subsequent Consolidation Therapy in Unresectable Locallyadvanced Non-Small-Cell Lung Cancer
Authors: Cortesi Enrico , Moscetti Luca , Nelli Fabrizio , De Marinis Filippo , De Paula Ugo , Bangrazi Caterina , Migliorino Maria Rita , Donato Vittorio 
Published: February 2018

Aims and Background The purpose of this pilot study was to determine the safety and feasibility of a complete integrated approach, including induction chemotherapy with carboplatin/paclitaxel followed by accelerated hyperfractionated radiotherapy with concurrent chemotherapy, and then by consolidation chemotherapy for locally advanced stage III non-small cell lung carcinoma. Methods Systemic doses of carboplatin AUC 6 and paclitaxel (200 mg/m2), 3 weeks out of 4, were planned as induction and consolidation chemotherapy. Weekly carboplatin AUC of 2 plus paclitaxel (50 mg/m2) were given during thoracic radiotherapy. Results Eighteen patients were enrolled: 10 were evaluated at the end of chemoradiation and 8 received consolidation chemotherapy. On an intent-to-treat basis, 55% of patients achieved a response after induction therapy, whereas chemoradiation and consolidation therapy increased the response rate by 33% and 16%, respectively. No patient experienced grade >3 acute hematologic toxicity during systemic-dose chemotherapy. With the exception of one episode of a severe cardiac adverse event, non-hematologic toxicity was similarly tolerable. Severe acute adverse events observed during concurrent chemoradiation were mainly represented by esophagitis, resulting in interruption of the radiotherapy in 25% of patients. More notably, only one patient experienced serious non-hematologic late toxicity. Conclusions Although the present approach seemed feasible, our data did not support any possible advantage in favor of this three-phase integrated treatment, and therefore the design will not be investigated in a subsequent phase II study.
Short Hydration Regimen and Nephrotoxicity of Intermediate to High-Dose Cisplatin-Based Chemotherapy for Outpatient Treatment in Lung Cancer and Mesothelioma
Authors: Tiseo Marcello , Martelli Olga , Mancuso Andrea , Sormani Maria Pia , Bruzzi Paolo , Di Salvia Roberto , De Marinis Filippo , Ardizzoni Andrea 
Published: February 2018

Aims and Background Cisplatin, a standard component of combination chemotherapy for several tumors, presents important anti-tumor properties but also several toxic effects. In particular, the major dose-limiting effect appears to be renal toxicity. In several countries, to reduce nephrotoxicity after cisplatin administration, a 24-h hydration is recommended following a chemotherapy treatment in a hospital regimen. In our Institutions, cisplatin chemotherapy is an outpatient treatment that provides adequate hydration with an NaCl solution plus furosemide and diuresis monitoring during treatment. Methods and Study Design To assess incidence of cisplatin nephrotoxicity using a short hydration regimen, which included 2000 ml of fluids with control of diuresis, individual outpatient data was pooled retrospectively from patients enrolled in large randomized studies regarding cisplatin-based chemotherapy in lung cancer and mesothelioma. From February 1999 to November 2002, 107 patients treated with cisplatin (≥75 mg/m2/cycle) were examined, monitoring serum creatinine and creatinine clearance levels. Results Five patients out of 107 (4.6%) were withdrawn from chemotherapy because of renal toxicity. For the other 102 patients, serum creatinine and creatinine clearance measurements were stable around the normal values during treatment. No time trends relating to serum creatinine levels or creatinine clearance and cycle numbers or cisplatin-cumulative doses were detected (P = 0.36 and P = 0.64, for the relationship with cycle number, and P = 0.39 and P = 0.65 for the relationship with cumulative dose, respectively, random effect model) after adjusting for the total number of cycles administered. Conclusions These observations indicate that intermediate to high-dose cisplatin administration is feasible in outpatient management with a short hydration regimen without high risk of nephrotoxicity.
A Pilot Study of a Day One and Eight Every Three Weeks Administration of Docetaxel in Metastatic Cancer Patients
Authors: Martella Francesca , Giannessi Pier Giorgio , Di Marsico Roberta , Coltelli Luigi , Safina Valentina , Giuntini Nicola , Falcone Alfredo 
Published: February 2018

Aims and Background Docetaxel is an active agent in metastatic cancers. The standard administration every 3 weeks frequently causes gastrointestinal toxicity and severe myelosuppression. These are rare with a weekly docetaxel regimen, which instead produces severe asthenia. To develop a new docetaxel schedule associated with mild myelosuppression and less fatigue, we conducted this pilot study to determine the feasibility and the maximum tolerated dose of a day one and eight every three weeks administration of docetaxel. Patients and Methods The first 3 patients were treated with a dose of 40 mg/m2 on day one and eight, which was then escalated by increments of 5 mg/m2 on both days up to determine the maximum tolerated dose, defined as the dose level associated with the same dose-limiting toxicity in at least 33% of patients. Results Twenty-one metastatic cancer patients entered the study, with a median age of 57 years and a median performance status of 1. The escalation of dose continued up to 55 mg/m2, where 2 of the 6 enrolled patients presented grade 3 diarrhea, which was our dose-limiting toxicity. Myelosuppression was mild, and no febrile neutropenia was observed. None of the patients showed grade 4 non-haematological toxicity. Only 9.5% of them presented grade 3 asthenia, whereas grade 3 diarrhea and mucositis were revealed in 19% and 9.5%, respectively. All grade 3 non-hematological toxicities were observed in heavily pretreated or elderly patients. Conclusions The recommended dose of docetaxel was 50 mg/m2, but the regimen could not be recommended in heavily pretreated patients. However, it could become an option in an outpatient setting after a phase II study that better defines its toxicity profile and evaluate its antitumor activity.
Significance of Suspicious Lesions at Transrectal Ultrasonography in Men with Serum Prostate-Specific Antigen Levels of <20 ng/ml
Authors: Shim Hong Bang , Lee Sang Eun , Park Hyoung Keun , Ku Ja Hyeon 
Published: February 2018

Aims and Background The objective of the study was to evaluate the significance of suspicious lesions at transrectal ultrasonography for prostate cancer diagnosis. Patients and Methods A total of 1,009 men with a mean age of 65.0 ± 7.7 years (range, 40.0-79.0) constituted the study cohort and 265 (26.3%) were diagnosed with prostate cancer on initial biopsy. Results The cancer detection rate was higher in patients with suspicious lesions (33.2%) than in those with no suspicious lesion (21.5%) (P<0.001). Pathologic findings of the needle biopsy samples also showed more aggressive characteristics in men with suspicious lesions (P <0.05). Of 413 men with suspicious lesions, additional lesion-directed biopsies were performed in 133 patients. The positive predictive value of additional lesion-directed biopsy was 18.0%. Of patients who had positive cores on lesion-directed biopsies, all were also found to have positive cores on random biopsies, and no patient had positive cores only on lesion-directed biopsies. The Gleason score was not changed by the findings of lesion-directed biopsies in these patients. Conclusions Our findings do not provide a rationale to recommend the addition of lesion-directed biopsy in patients with suspicious lesions at transrectal ultrasonography. However, men with suspicious lesions at transrectal ultrasonography had a higher risk of being diagnosed with prostate cancer.
Mutational Analysis of the BH3 Domains of Proapoptotic Bcl-2 Family Genes Bad, Bmf and Bcl-G in Laryngeal Squamous Cell Carcinomas
Authors: Yoo Nam Jin , Soung Young Hwa , Lee Sang Hak , Jeong Eun Goo , Lee Sug Hyung 
Published: February 2018

Aims There is mounting evidence that deregulation of apoptosis is involved in the mechanisms of cancer development. Somatic mutations of apoptosis-related genes have been reported in many human cancers. The aim of this study was to explore the possibility that mutation of the BH3 domains of the proapoptotic Bcl-2 genes Bad, Bmf and Bcl-G might be involved in the development of laryngeal cancer. Methods We analyzed the BH3 domains of Bad, Bmf and Bcl-G for the detection of somatic mutations in 33 squamous cell carcinomas of the larynx by a polymerase chain reaction-based single-strand conformation polymorphism assay. Results There were no somatic mutations of the BH3 domains of Bad, Bmf and Bcl-G in the laryngeal squamous cell carcinoma samples. Conclusions The data presented here indicate that BH3 domain mutation of the proapoptotic genes Bad, Bmf and Bcl-G is rare in laryngeal squamous cell carcinoma and may not contribute to the apoptosis-resistance mechanisms of laryngeal squamous cell carcinoma.
Incidence of Multiple Primary Bladder and Prostate Cancer in a Central Region of Italy. Umbria, 1994-2004
Authors: Cassetti Tiziana , Scheibel Massimo , Stracci Fabrizio , Minelli Liliana , La Rosa Francesco 
Published: February 2018

The aim of this study was to determine the incidence of multiple bladder-prostate cancers in the population of the Italian region of Umbria and to clarify some diagnostic aspects. Prostate and bladder cancer incidence data in Umbria were obtained from cancer registry records. In the period from 1994 to 2004, 3,470 new patients with bladder cancer and 5,430 new patients with prostate cancer were registered. Among these patients there were 238 who presented multiple bladder and prostate cancers. Synchronous cancers were detected in 74 of these patients. Fifty-four of them had simultaneous tumors (diagnosed during the same hospitalization), while in 16 patients bladder cancer was detected earlier than prostate cancer and in 4 patients the opposite occurred. This study confirmed an increase in prostate cancer diagnoses in patients with bladder cancer. The increase was mainly accounted for by the detection of prostate cancers during cystectomies performed for bladder carcinoma.