bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of Vindesine and Lonidamine in the Treatment of Elderly Patients with Advanced Non-small Cell Lung Cancer: A Phase III Randomized Fonicap Trial
Authors: De Marinis Filippo , Rinaldi Massimo , Ardizzoni Andrea , Bruzzi Paolo , Pennucci Maria Cristina , Portalone Luigi , D'Aprile Modesto , Ripanti Paola , Romano Francesco , Belli Massimo , Altavilla Giuseppe , Migliorino Maria Rita , Rosso Riccardo ,   Franco Salvati for the Italian Lung Cancer Task Force
Published: April 2018

Aims To evaluate the efficacy and treatment compliance in elderly patients with advanced non-small cell lung cancer (NSCLC) of two chemotherapeutic agents with mild toxicity, 153 previously untreated patients aged over 70 years were randomized to receive lonidamine (450 mg daily p.o. until progression), vindesine (3 mg/m2/daily i.v. weekly for 4 weeks and then every 2 weeks until progression), the combination of the two drugs at the same dose and schedule, or supportive therapy only in a four-arm factorial randomized trial. Methods 126 patients were included in the final analysis. Their median age was 75 years. Forty percent had stage IV disease and 60% stage III. Most patients were males (85%) and the majority had squamous histology (68%). Results Among 104 patients evaluable for response there were only 3 PRs (1/30 in the lonidamine arm and 2/33 in the lonidamine + vindesine arm). Overall, 8.7% and 9.5% of the patients, respectively, progressed or died early, before response evaluation; another 9.4% refused treatment continuation because of poor compliance with the study protocol. Eighty-five patients were fully evaluable for toxicity, which was generally mild. Leukopenia grade 1-3 was found in less than 30% of patients treated with vindesine or vindesine + lonidamine. The most common complaints associated with lonidamine treatment were myalgia (70% of patients), fatigue (55% and 83% of patients treated with lonidamine or lonidamine + vindesine, respectively) and testicular pain in nearly 40% of cases. The overall median survival was 170 days, with no significant impact on survival of either lonidamine or vindesine. Conclusions The low response rate and survival together with the poor treatment compliance, even in the presence of mild toxicity, do not support the usefulness of these “gentle” chemotherapies in elderly NSCLC patients. The standard management of advanced NSCLC in elderly patients remains to be defined. Specifically designed studies to address this issue are warranted.
Hyperthyroidism and Concurrent Thyroid Cancer
Authors: Vaiana Roberto , Cappelli Carlo , Perini Paola , Pinelli Domenico , Camoni Giuseppe , Farfaglia Roberto , Balzano Rino , Braga Marco 
Published: April 2018

Aims and Background The aim of this study was to analyze the frequency of coexisting hyperthyroidism and thyroid malignancy in endemic goiter areas and review the current literature on the subject. Methods During the period January 1984 to June 1998, 1853 patients were examined for hyperthyroidism at the Spedali Civili Hospital of Brescia, Italy; 512 (27.6%) subjects underwent surgery. Of these patients 108 (21%) had Graves’ disease, 251 (49%) multinodular toxic goiter (MTG) and 153 (30%) uninodular toxic goiter (UTG). Results Malignancy was found in 24 (4.7%) patients: 19 females and 5 males with a mean age of 52.2 years (range, 21-76 years). The frequency of cancer in Graves’ disease was 6.4%, 5 females and 2 males; in MTG 3.9%, 2 females and 8 males, and in UTG 4.4%, 7 females and 1 male. Conclusions Our data confirm previous reports on the frequency of thyroid cancer in hyperthyroidism. This association is more relevant than previously suspected. The frequent coexistence of hyperthyroidism and neoplasia, demonstrated by our study and the most recent literature, underlines the importance of studying and excluding the possibility of neoplastic degeneration by means of a systematic approach.
Clinical Relevance of Tumor Ploidy and Micronucleus Formation for Oral Cavity Cancer
Authors: Kolotas Christos , Tonus Carolin , Baltas Dimos , Cernea Marianne , Vogt Hans-Georg , Martin Thomas , Strassmann Gerd , Zamboglou Nikolaos 
Published: April 2018

Aims and Background To study the clinical relevance of tumor ploidy and micronucleus formation as prognostic factors. Methods and Study Design Twenty-eight patients with squamous cell carcinoma of the oral cavity were treated with primary radiochemotherapy consisting of irradiation up to 70 Gy in combination with cisplatin. Cell cycle distribution, micronucleus formation and ploidy were evaluated by flow cytometry of biopsies taken before treatment and after irradiation to 10 Gy (5 × 2 Gy). Sexteen out of 28 patients relapsed after a minimum follow-up period of two years. Results Flow cytometry of the recurrence biopsy showed hyperpentaploid (5c exceeding) cells in 13/16 (81%) of the relapsed patients. In 7 patients the hyperploid clone was not present in the flow cytometry of the primary tumors. Ploidy could retrospectively be determined also by image cytometry in archival tumor material of the pretreatment specimens. Patients with a level below 100 5c cells per 10,000 cell nuclei were shown to have a significantly better prognosis than patients with more than 100 hyperpentaploid tumor cells. The micronucleus formation was 2-5 times higher in tumors showing a good response to treatment than in carcinomas relapsing within two years. Conclusions The 5c-exceeding ratio measured by image cytometry and micronucleus formation proved to be good prognostic parameters for the clinical outcome of patients with locally advanced head and neck carcinomas.
Endoscopic Treatment of Carpet-Like Adenomas of the Rectum
Authors: Spinelli Pasquale , Calarco Giuseppe , Gallo Cirino , Rigante Antonella , Schicchi Angelo Aldo 
Published: April 2018

Background Transanal microsurgery, endoscopic laser photocoagulation and snare resection have all been used to treat large sessile adenomas of the rectum alternatively to a surgical approach. However, such modalities are often defective due to the carpet-like shape and the frequently large extension of the lesions. Methods Ten patients with carpet-like adenoma were submitted to transanal endoscopic resection by urological resectoscope. Results Complete eradication was obtained in all lesions. The mean number of treatment sessions was 3 (range, 1-5). The mean time between the first treatment and the complete eradication was 6 months (range, 1-18). The only complications were an intraoperative and an early postoperative bleeding. There was no early or late mortality related to the procedure. Conclusions Transanal endoscopic resection by urological resectoscope appears to be a suitable therapeutic approach for sessile and carpet-like adenomas of the rectum or for pTI cancer in patients who refuse major surgery.
A Case of Primary Small Cell Carcinoma of the Cervical Esophagus with Long-term Survival following Concurrent Chemoradiotherapy: Case Report and Review of the Literature
Authors: Hama Yukihiro , Uematsu Minoru , Ichikura Takashi , Tamura Etsuyo , Aida Shinsuke , Kohno Masashi , Kusano Shoichi 
Published: April 2018

The authors describe a case of small cell carcinoma of the esophagus that was treated by concurrent chemoradiotherapy. Both the esophageal tumor and the regional lymph node metastases disappeared after this treatment. The patient is alive and disease free after more than five years. Primary small cell carcinoma of the esophagus is a rare and aggressive neoplasm with a very poor prognosis, and the treatment modality is controversial. This case illustrates the possibility of treating this tumor type with concurrent chemoradiotherapy.
Cancer Prevalence in Italian Cancer Registry Areas: The Itapreval Study
Authors: Micheli Andrea , Francisci Silvia , Krogh Vittorio , Rossi Annia Giorgi , Crosignani Paolo ,   The ITAPREVAL WORKING GROUP: Project Co-ordination, Data Management and Analysis: A Micheli (Project Leader), Gatta G , Sant M , Rossi A Giorgi , Francisci S , Saltarelli S , Dell'Era L , Gasparre N , Verdecchia A , Capocaccia R , Mariotto A , Dally L , Corazziari I ,   Composition of group, Conti E , Ramazzotti V , Caperle M , Vercelli M , Caselli C , Parodi S , Crosignani P , Tagliabue G , Berrino F , Federico M , Mangone L , Santacroce M , de Leon M Ponz , Roncucci L , Benatti P , Zanetti R , Rosso S , Patriarca S , Falchi F , Milandri C , Vattiato R , De Lisi V , Serventi L , Barili A , Gafà L , Tumino R , La Rosa E , Barchielli A , Balzi D , Crocetti E , Paci E , Guzzinati S , Simonato L , Bovo E 
Published: April 2018

Aim To present data on cancer prevalence for the areas covered by Italian cancer registries, by using a standardized set of data collection and elaboration criteria, and a single method of data analysis. Subjects and Methods Data on over 250,000 patients with cancer, diagnosed between 1978 and 1992, from 11 Italian cancer registries covering about 12% of the Italian population were collected, validated and analyzed according to the unified protocol of the ITAPREVAL project. The method implemented in the PREVAL computer program was used to provide prevalence estimates for the period covered by cancer registration. The total prevalence for each registry and for the pool of all registries was then estimated by correcting for incomplete observations due to the period in which the registration was not yet activated. All prevalence estimates were for 1992. Results Prevalence figures are presented by cancer site, age, sex, years from diagnosis and registry area. For all malignancies combined, total prevalence ranged from 1,350 per 100,000 inhabitants in Ragusa to 3,650 per 100,000 inhabitants in Romagna, the ratio between these two extremes being 2.7. For the pool of the areas covered by registration cancer prevalence was 3,100 per 100,000 females and 2,250 per 100,000 males. About a third of the total female cases and about half the male cases were diagnosed in the previous five years. Among those aged over 75 years, total prevalence was higher for males than for females: 11,300 versus 8,900 per 100,000 respectively. Conclusions This is the first large-scale estimate of the burden of cancer in Italy. It is also one of the first studies in the world which was aimed to study cancer prevalence in detail. These data are necessary for predicting health service needs and help in the evaluation of differences in health service demand by sex, age and Italian regions.
The Prevalence of Colorectal Cancer in Italy
Authors: Gatta Gemma , Francisci Silvia , De Leon Maurizio Ponz 
Published: April 2018

Aims To analyze the prevalence of colorectal cancer (CRC) in different areas of Italy by age, interval since diagnosis and disease stage at diagnosis, and to estimate the prevalence of CRC. These data provide estimates of patient demand on health resources. Patients and Methods Eleven Italian cancer registries (CRs) provided data on 33,740 patients observed for up to 15 years. For the 1,829 cases from the specialized colorectal cancer registry of Modena we analyzed prevalence by Dukes’ stage and family history. PREVAL software produced observed prevalence figures by time from diagnosis; to determine the total prevalence, correction factors were applied to the observed data. Results At the end of 1992, five-year CRC prevalence was high (close to 200 per 100,000) in Genova, Parma, Romagna and Firenze, and low (around 75 per 100,000) in the southern areas of Latina and Ragusa. For all CRs, 86 patients per 100,000 population were alive up to 2 years from diagnosis and 77 per 100,000 between 2 and 5 years from diagnosis. The 5-year prevalence of patients diagnosed with Dukes’ B or C (high risk of recurrence and requiring postoperative surveillance) was 152 per 100,000; that of Dukes’ A patients 36 per 100,000 (considered cured after surgery and not requiring intensive follow-up or care); that of unstaged patients plus those with distant metastasis at diagnosis was 28 per 100,000 at 5 years (requiring palliative care but not follow-up). The 12-year prevalence of HNPCC was 23 per 100,000, or about 7% of the total; for such patients knowledge of the long-term prevalence is important because they are diagnosed young and are at high risk of multiple tumor development. Conclusions 70% of the prevalent patients diagnosed within 5 years prior to the prevalence date were likely to require care for cancer recurrence, while 13% of the prevalent cases required care for distant metastases.
Nonmetastatic Osteosarcoma of the Extremity: Results of a Neoadjuvant Chemotherapy Protocol (IOR/OS-3) with High-dose Methotrexate, Intraarterial or Intravenous Cisplatin, Doxorubicin, and Salvage Chemotherapy Based on Histologic Tumor Response
Authors: Ferrari Stefano , Mercuri Mario , Picci Piero , Bertoni Franco , Del Prever Adalberto Brach , Tienghi Amelia , Mancini Antonia , Longhi Alessandra , Rimondini Simonetta , Donati Davide , Manfrini Marco , Ruggieri Pietro , Biagini Roberto , Bacci Gaetano 
Published: April 2018

Aims and Background From 1986 to 1989, a study for the treatment of nonmetastatic osteosarcoma of the extremity (IOR/OS-2) was carried out at the Rizzoli Institute. The cumulative dose of doxorubicin delivered was 480 mg/m2, and severe heart failure developed in 5 (3%) of the 164 treated patients. The specific aim of the subsequent study was to assess the efficacy of a protocol, similar to IOR/OS-2, but with a reduced cumulative dose of doxorubicin (390 mg/m2). Additional aims were to assess the role of the route of infusion (intraarterial or intravenous) of cisplatin on histologic response of the primary tumor and the use of ifosfamide as salvage chemotherapy in poor responders. Methods The new chemotherapy regimen (IOR/OS-3) was comprised of a preoperative phase with methotrexate (10 g/m2), cisplatin (120 mg/m2 intraarterially or intravenously), and doxorubicin (60 mg/m2). After surgery, the same drugs were administered, with the addition of ifosfamide (10 g/m2) in patients who had a poor histologic response to primary chemotherapy. Results Ninety-five patients entered the study. The rate of good histologic response was 64% with intraarterial cisplatin and 43% with intravenous cisplatin (P = 0.05). The 8-year event-free survival and overall survival were 54% and 61%, respectively, with no significant difference according to the histologic response. No cases of clinical doxorubicin-induced cardiopathy were recorded. Event-free and overall survival did not significantly differ from those achieved with IOR/OS-2 (8-year disease-free and overall survival, respectively 63% and 72%). Conclusions The reduction in the doxorubicin cumulative dose avoided episodes of cardiotoxicity, without consequences on the efficacy of treatment. The addition of ifosfamide was an effective “salvage” therapy for poor responders. A better histologic response with intraarterial cisplatin was observed, but owing to the availability of an effective salvage therapy for poor responders, the advantages in terms of histologic response did not compensate for the cost and discomfort for the patients of this modality of infusion of cisplatin.
Concurrent Modulation of 5-Fluorouracil with Methotrexate and L-leucovorin: An Effective and Moderately Toxic Regimen for the Treatment of Advanced Colorectal Carcinoma a Multicenter Phase II Study of the Southern Italy Cooperative Oncology Group
Authors: Cornelia Pasquale , Lorusso Vito , Casaretti Rossana , De Lucia Luigi , Cartenì Giacomo , Menzione Luigi , Mancarella Sergio , De Lena Mario , Cornelia Giuseppe 
Published: April 2018

Aims and Background Methotrexate (MTX) and leucovorin (LV) can enhance the cytotoxicity of 5-fluorouracil (5FU) by modifying its metabolic pathway inside target cells. Some preclinical studies and clinical trials have suggested that the concurrent or sequential double modulation of 5FU by means of MTX and LV may give a higher activity than single biochemical modulations. The purpose of our phase II study was to assess the activity and toxicity of a biweekly regimen including MTX, levo-LV and 5FU in colorectal cancer patients. Methods From July 1994 to May 1997, 100 consecutive patients affected by advanced or metastatic colorectal carcinoma were given MTX, 750 mg/m2 iv (2-h infusion) on day 1, and levo-LV, 250 mg/m2 iv (2-h infusion) followed by 5FU, 800 mg/m2 iv bolus on day 2, every two weeks. Patients were treated until complete response or progressive disease was documented, or for a maximum of 16 courses. Results Among 97 eligible patients, 5 complete and 25 partial responses were obtained, giving an overall response rate of 31% (95% exact confidence limits, 22-41%). Response rate was significantly higher in patients with a good (ECOG scale 0) than with a poor (ECOG scale 1 or 2) performance status (40% versus 17%, P <0.02). Median time to treatment failure was 27 weeks, median survival time was 63 (95% confidence limits, 54-71) weeks, and 2- and 3-year probability of survival were 34% and 12%, respectively. Performance status was the only pretreatment characteristic significantly affecting the outcome of patients. Indeed, median survival time was 94 weeks for patients with a performance status = 0 and 37 weeks for patients with a performance status ≥ 1 (P < 0.05). Toxicity of the treatment was low and manageable; grade 3 to 4 leukopenia affected 8% of patients, whereas grade 3 diarrhea and mucositis occurred in 5% and 4%, respectively. Conclusions The double biochemical modulation of 5FU by MTX and levo-LV is at least as effective as, and probably more effective than, the single modulation by MTX or by LV. It may therefore represent a therapeutic option for the palliative treatment of patients with advanced colorectal carcinoma.
A Spindle Cell Tumor of Unknown Origin and Diffuse Bone Marrow Involvement in a Patient with Hypercalcemia
Authors: Yim Jae-Joon , Kang Gyeong Hoon , Heo Dae Seog , Kim Noe Kyeong 
Published: April 2018

Background Metastasis of unknown origin in bone marrow is infrequent, although, when it occurs, adenocarcinoma is the most common histologic type. Involvement of bone marrow by a spindle cell tumor and presentation with hypercalcemia are very rare. Method This report describes a 21-year-old man with diffuse bone marrow involvement from a spindle cell tumor. Results The patient presented with low back pain, anemia, thrombocytopenia, azotemia, and hypercalcemia. Bone marrow biopsy revealed a spindle cell tumor that was positive for vimentin staining but whose primary site could not be identified. A bone marrow scan revealed absence of uptake, which suggested systemic disease. We treated this case as a type of sarcoma by giving combined chemotherapy consisting of vincristine, actinomycin-D and cyclophosphamide. The patient showed a clinical response for seven months, but the disease progressed despite chemotherapy and he died one year after diagnosis. Conclusions We have documented a rare case of spindle cell tumor involving bone marrow without evidence of the tumor's primary site.
Ecological Influences on Employees’ Workplace Sedentary Behavior: A Cross-Sectional Study
Authors: Wilkerson Amanda H. , Usdan Stuart L. , Knowlden Adam P. , Leeper James L. , Birch David A. , Hibberd Elizabeth E. 
Published: April 2018

Purpose: The purpose of this study was to explore the relationship between ecological factors and occupational sedentary behavior (SB). Design: Cross-sectional online survey. Setting: Participants were employees recruited from a large, public university in the Southeastern United States from August to November 2016. Participants: The final sample included 527 (56% response rate) employees. Measures: Data were collected through an 87-item survey using previously validated scales that assessed occupational SB, perceived behavioral control, barrier self-efficacy, self-regulation strategies, organizational social norms, office environment, and worksite climate. Analysis: One-way analysis of variance analyses were used to determine differences in occupational SB by demographic factors. A multivariate regression model was used to determine significant ecological determinants of occupational SB. Results: Mean SB was 342.45 (standard deviation = 133.25) minutes. Significant differences in SB were found by gender, education, and employment classification. Barrier self-efficacy and workplace connectivity, which evaluates the spatial layout of the office setting that may impact mobility within the workplace, were significant predictors of SB in the multivariate model. Conclusion: Results from this study provide new information regarding the potential impact of workplace barriers and connectivity on occupational SB. The findings from this study support the inclusion of intervention modalities to minimize workplace barriers and increase workplace connectivity to increase workplace mobility and decrease SB.
Next of Kin’s Notification of Patient’s Death: A Qualitative and Quantitative Preliminary Analysis
Authors: Menahem Sasson , Samson Tali , Shvartzman Pesach 
Published: April 2018

Background: There are no published studies on notification of death by a next of kin to the treating medical staff. Aim: To explore the content and circumstances of death notifications by next of kin to the treating medical staff in a palliative home care unit. Design: A cross-sectional study that combines qualitative and quantitative analysis. Setting: Assessment of 153 telephone death notifications by a next of kin to the treating medical staff. Results: The qualitative analysis of death notifications revealed 2 themes: direct and indirect death notifications. In direct notifications, death was portrayed by the notifier in direct and specific words such as death, the patient has died, or the patient is not alive. Indirect notifications included nonspecific or general descriptions of death such as breath cessation, it ended, or it’s over or finished. Direct notifications tended to include specific requests from the medical staff and expressed acceptance and closure, while indirect notifications tended to include more general requests and expressed more panic, distress, or doubt in death. Although spouses were more likely to serve as the primary caregiver, the children or other family members were more likely to notify the treating staff. In 30% of the notifications, there was an element of doubt or uncertainty. Emotions were expressed in 20% of the notifications. Cessation of breathing was the most common physical sign mentioned. Conclusion: Medical staff members who receive notifications of death should expect and be prepared for the expression of varied emotions and doubts as an integral part of the notification.