bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alcohol, Tobacco and Genetic Susceptibility in Relation to Cancers of the Upper Aerodigestive Tract in Northern Italy
Authors: Canova Cristina , Richiardi Lorenzo , Merletti Franco , Pentenero Monica , Gervasio Carmine , Tanturri Gabriella , Garzino-Demo Paolo , Pecorari Giancarlo , Talamini Renato , Barzan Luigi , Sulfaro Sandro , Franchini Giovanni , Muzzolini Chiara , Bordin Sandro , Pugliese Gaetano Natale , Macrì Ettore , Simonato Lorenzo 
Published: February 2018

Aims and background Each year in Italy there are approximately 14,000 new cases and 7,000 deaths from cancer of the upper aerodigestive tract, which includes malignant tumors originating from the oral cavity, pharynx, larynx and esophagus. Established etiological factors include tobacco consumption and heavy alcohol drinking. The study of single nucleotide polymorphisms in upper aerodigestive tract cancer etiology may help to identify high-risk subgroups and to better understand the pathways leading to the development of these cancers. Methods Italian results on about 500 cases and 500 controls from a large case-control study (ARCAGE) conducted in 10 European countries are presented with the major objectives of updating results on the effects of alcohol and tobacco consumptions in northern Italy, investigating the role of genetic variation with regard to the metabolism of alcohol and carcinogens from tobacco smoke, and evaluating possible interactions of these single nucleotide polymorphisms with these carcinogens. Results The present study confirmed the importance of tobacco smoking and alcohol drinking as the main risk factors for upper aerodigestive tract cancers, indicating that about 68% of cancers among populations in northern Italy can be attributed to the combination of these risk factors. Significant associations between metabolizing phase I genes (CYP1A1 and CYP2A6), phase II genes (GSTA2) and upper aerodigestive tract cancers were found. A polymorphism of ADH1C has been associated with an increased risk of upper aerodigestive tract cancers, suggesting that the less rapid alcohol metabolizers are more susceptible to upper aerodigestive tract cancer risk. Conclusions Our results suggest that the ADH1C allele modifies the carcinogenic dose response for alcohol in the upper aerodigestive tract, giving rise to a gene-environment interaction. The role of genes as possible modifiers of life-style risks seems the most reliable.
Image-Guided Robotic Radiosurgery as Salvage Therapy for Locally Recurrent Prostate Cancer after External Beam Irradiation: Retrospective Feasibility Study on Six Cases
Authors: Vavassori Andrea , Jereczek-Fossa Barbara Alicja , Beltramo Giancarlo , De Cicco Luigi , Fariselli Laura , Bianchi Livia Corinna , Possanzini Marco , Bergantin Achille , DeCobelli Ottavio , Orecchia Roberto 
Published: February 2018

Aims and background Technological advances in treatment planning and execution are providing new potential opportunities in the treatment of recurrent prostate cancer. This study was conducted to evaluate the feasibility and safety of reirradiation with image-guided radiosurgery using CyberKnife, a robotic arm-driven compact linear accelerator, for intraprostatic recurrence after external beam radiotherapy (EBRT). Methods Between September 2007 and May 2008, 6 patients diagnosed with locally recurrent prostate cancer after EBRT were treated using the CyberKnife system. The total reirradiation dose was 30 Gy in five fractions. Prior to radiosurgery four patients were treated with androgen-deprivation therapy. Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria and the Houston-Phoenix definition (PSA nadir + 2 ng/mL) were used for toxicity and biochemical failure evaluation, respectively. Results After a median follow-up of 11.2 months (range, 9.6–18.6 months), all patients are alive with no evidence of severe urinary or rectal acute morbidity. Local control cannot be exactly determined due to the short follow-up and the bias of the use of androgen ablation. Four patients had biochemical failure, three of them with clinical failure evidence (lymph node, bone and lung metastasis, respectively): none of these patients had clinical evidence of tumor persistence in the prostate. Conclusions Salvage radiosurgery with CyberKnife after irradiation is feasible with low urinary and rectal morbidity. A longer follow-up and a larger number of patients are necessary to evaluate its effectiveness and optimal patient selection criteria.
Prognostic Factors in Follicular Lymphoma: The Importance of beta-2 Microglobulin
Authors: Cánovas Araceli , Alonso Juan J , Barreiro Guillermo , Aguirre Ciriaco 
Published: February 2018

Aims and background The Follicular Lymphoma International Prognostic Index (FLIPI) is a useful tool for the prognostic assessment of follicular lymphoma but beta-2 microglobulin (B2M) was not incorporated in this index. We aimed to compare the predictive value of B2M, FLIPI and other prognostic factors not included in the FLIPI index for overall survival (OS), complete remission (CR), and time to treatment failure (TTF) in a nonselected follicular lymphoma series. Methods and study design Retrospective univariate and multivariate analysis of the prognostic value (for OS, CR, TTF) of B2M, FLIPI and other prognostic variables in follicular lymphoma was conducted in a cohort of follicular lymphoma patients between 1987 and 2007. Results One hundred and six patients were studied. In univariate analysis B2M and B symptoms were significantly associated with OS, and FLIPI only detected two risk levels. In multivariate analysis of OS only two significant variables were found: FLIPI and B2M. Multivariate analysis of CR showed that normal B2M, absence of a bulky mass, uninvolved bone marrow, and chemotherapy with rituximab were significant predictors of CR. FLIPI (three levels), B2M, bone marrow infiltration, and chemotherapy with rituximab were significantly associated with TTF. Conclusions We found a high predictive value of B2M for OS, CR, and TTF. B2M and FLIPI were the most important variables to predict OS. However, in our series FLIPI differentiated only between two mortality risk levels.
Vincristine, Doxorubicin, Cyclophosfamide, Actinomycin D, Ifosfamide, and Etoposide in Adult and Pediatric Patients with Nonmetastatic Ewing Sarcoma. Final Results of a Monoinstitutional Study
Authors: Ferrari Stefano , Palmerini Emanuela , Alberghini Marco , Staals Eric , Mercuri Mario , Barbieri Enza , Longhi Alessandra , Cantero Laura , Cesari Marilena , Abate Massimo , Balladelli Alba , Picci Piero , Bacci Gaetano 
Published: February 2018

Aims and background To investigate a six-drug combination in patients with non-metastatic Ewing sarcoma, focusing on chemotherapy-induced necrosis and chemotherapy toxicity in adult and pediatric patients. Methods and study design Alternating cycles of vincristine (1.5 mg/m2), doxorubicin (80 mg/m2) and cyclophosfamide (1200 mg/m2) (weeks 0, 6, 13, 22a nd 31), ifosfamide (9 g/m2), vincristine (1.5 mg/m2), and actinomycin D (1.5 mg/m2) (weeks 3, 16, 25 and 34), and ifosfamide (9 g/m2) and etoposide (450 mg/m2) (weeks 9, 19, 28 and 37) were administered. Primary chemotherapy-induced necrosis was graded: G3 (complete necrosis), G2 (microfoci of tumor cells) and G1 (macrofoci of tumor cells). Results From 1996 to 1999, 50 patients with Ewing sarcoma were enrolled. The median age was 23.5 years (range, 4–56). Chemotherapy-induced necrosis (in 28 patients) was G3 in 36%, G2 in 21% and G1 in 43%. At a median follow-up of 110 months (range, 36–129), 5-year overall survival and event-free survival were 72% and 66%, respectively. According to histologic response, 5-year event-free survival was 90% in G3, 83% in G2, and 42% in G1 (P = 0.02). In adult and pediatric (<18 years) patients, the incidence of G4 leukopenia was 62% and 74%, respectively, with febrile neutropenia in 13% and 21%, respectively. G4 thrombocytopenia occurred in 3% of cycles in adults and in 7% in pediatric patients. Platelet and red blood cell transfusions were required respectively in 1% and 11% of cycles in adults and in 6% and 24% of cycles in pediatric patients. Conclusions The six-drug combination can be administered safely in adult and pediatric populations. About 40% of patients have a poor chemotherapy-induced tumor necrosis, leading to poor probability of survival. New strategies are recommended to improve survival of poor responders to the six-drug combination.
Management of Patients with Gastrointestinal Stromal Tumor in Clinical Practice in Italy: A Critical “Event Tree Model” Analysis of Decision-Making Processes and Outcomes
Authors: Pantaleo Maria Abbondanza , Di Battista Monica , La Rovere Stefano , Astorino Maria , Catena Fausto , Lolli Cristian , Saponara Maristella , Maleddu Alessandra , Nannini Margherita , Di Scioscio Valerio , Santini Donatella , Ceccarelli Claudio , Paterini Paola , Castellucci Paolo , Astolfi Annalisa , Mandrioli Anna , Fusaroli Pietro , Tomassetti Paola , Pinna Antonio Daniele , Biasco Guido 
Published: February 2018

Aims and background Even though the standard treatment of patients affected by gastrointestinal stromal tumors has been well defined by clinical trials and clinical guidelines, in practice it may be different from those proposed in the literature. This paper reports and comments on a critical picture of the management of patients with gastrointestinal stromal tumors who received at least one treatment before arriving at our GIST Study Group. Methods and study design Attention was focused on 60 patients from various hospitals. Retrospective clinical data were recorded and analyzed with the “event tree” model, which describes the algorithm of all treatment options that each patient received before. Responses from first to fourth line of therapy, time to progression, and survival analysis were also analyzed. Results Starting from the diagnosis of disease, seven possible therapeutic event trees were identified: one for 7 unresectable patients and six different trees for 53 recurred patients who initially underwent surgery. The event trees describe the multitude of different treatments that patients with gastrointestinal stromal tumors received during the course of their disease. Conclusions In clinical practice, the treatment of patients affected by gastrointestinal stromal tumor is still difficult, and the published recommendations often do not cover all therapeutic decisions for all clinical presentations of disease. Multidisciplinary dedicated teams are needed to offer the possibility to receive appropriate surgery and innovative medical therapies. The formation of formalized GIST Units is in progress in several parts of Italy. The GIST Units can be organized in a network to facilitate discussion and agreement for the wide variety of clinical presentation.
Epirubicin and Docetaxel as Neoadjuvant Treatment of Locally Advanced Breast Cancer: A Phase II Study
Authors: Lombardi Davide , Scalone Simona , Crivellari Diana , Magri Maria Donatella , La Mura Nicoletta , Miolo GianMaria , Murrone Antonio , Perin Tiziana , Coran Francesco , Candiani Ezio , Massarut Samuele , Veronesi Andrea 
Published: February 2018

Aims and background Neoadjuvant chemotherapy is the standard treatment for locally advanced breast cancer. The combination of anthracyclines and taxanes is considered the first choice chemotherapy in advanced breast cancer. We report here the overall results of a phase II study of epirubicin and docetaxel as neoadjuvant chemotherapy in advanced breast cancer. Patients and methods Forty-five patients with locally advanced, nonmetastatic breast carcinoma were treated with epirubicin, 90 mg/m2, docetaxel, 75 mg/m2, intravenously, every 3 weeks for 4 cycles before and 4 cycles after surgery, followed by tamoxifen for 5 years if estrogen receptor positive and radiation therapy if indicated. Patient characteristics included a median age of 45 years; pre/postmenopausal, 31/14 patients; T3-T4 in 33, N0/N1 in 12/33; ductal/lobular in 42/3; ER+ in 23; and HER2 overexpression in 23. Results Clinical response included complete remission in 7 patients and partial remission in 27 (response rate, 75%). All 45 patients underwent surgery (quadrantectomy in 7). Histological examination of the breast and lymph nodes revealed no signs of disease in 3 patients and ductal carcinoma in situ only in 2. Twenty-five patients completed the chemotherapy program. G3-G4 toxicity included neutropenia in 39 patients. No other G3-4 toxicity nor toxic deaths occurred. Median relapse-free and overall survival were 35 and 56 months, respectively. Conclusions The neoadjuvant treatment was active and well tolerated, but the incidence of pathologic complete remissions was relatively low.
Anti-Androgen Therapy Suspension following Prolonged Clinical and Biochemical Response: Outcomes in a Series of Elderly Patients with Advanced Prostate Cancer
Authors: Castagneto Bruno , Stevani Ilaria , Ferraris Valentino , Giorcelli Laura , Perachino Massimo 
Published: February 2018

Aims and background To describe the outcomes following the suspension of androgen-suppression therapy in a series of elderly patients in an advanced stage of prostate cancer and in prolonged clinical and biochemical response. Material and methods Of 371 consecutive patients with advanced prostate cancer and treated with androgen-suppression therapy, 44 older patients were defined as in stable response on the basis of the following: absence of noteworthy dysuria, normal prostate findings on digital rectal examination, and prostate-specific antigen values lower than 0.50 ng/ml. After suspending treatment, it was to be re-scheduled in case of onset of dysuria, evidence of a palpable lesion on digital rectal examination, or a rise in prostate-specific antigen above 10 ng/ml. Progression of disease was defined as a prostate-specific antigen level increase at two subsequent measurements, and/or the appearance of new lesions, and/or evidence of progression of disease on digital rectal examination. Results and conclusions Median age of patients was 78.5 years at the moment of therapy suspension. After a median follow-up of 93.9 months, fourteen patients (31.8%) showed progression of disease, but only 7 (15.9%) of these died. In 7 (15.9%) patients, serum testosterone levels did not exceed 0.5 ng/ml, indicating an absence of gonadal activity. The median time to progression was 138.2 months, and the median cumulative survival from the start and from the suspension of androgen-suppression therapy was 105.5 months and 64.1 months, respectively. The savings in drug costs amounted to 772,267 Euro. Taking into consideration these outcomes of survival and of savings in drug costs, we can conclude that in these selected elderly patients, this treatment option could be of interest.
Cisplatin plus Docetaxel Combination in the First-Line Treatment of Metastatic Non-Small Cell Lung Cancer
Authors:   the Anatolian Society of Medical Oncology (ASMO), Kaya Ali Osman , Buyukberber Suleyman , Dane Faysal , Isikdogan Abdurrahman , Ustaalioglu Basak Oven , Coskun Ugur , Yumuk Perran Fulden , Dogu Gamze Gokoz , Ozdemir Nuriye Yildirim , Sevinc Alper , Gumus Mahmut , Ozkan Metin , Yildiz Ramazan , Ozturk Banu , Yaman Emel , Benekli Mustafa 
Published: February 2018

Aims To evaluate activity and toxicity of cisplatin plus docetaxel combination in the first-line treatment of chemotherapy-naive patients with metastatic non-small cell lung cancer. Patients and methods Between October 2004 and July 2008, 186 patients with metastatic non-small cell lung cancer treated with first-line cisplatin plus docetaxel were retrospectively evaluated in 7 centers. The chemotherapy schedule consisted of cisplatin, 75 mg/m2 iv infusion, and docetaxel, 75 mg/m2 iv infusion on day 1, every 3 weeks. Results Median age was 56 years (range, 28–75). Eighteen patients (9.7%) were females and 168 (90.3%) were males, with a median ECOG performance status of 1 (range, 0–2). A total of 833 cycles of chemotherapy was administered (median, 4 cycles; range, 1–6). Two patients (1.1%) achieved clinical complete response, 77 patients (41.4%) partial response, and 66 patients (35.5%) stable disease. Median time to disease progression was 6 months (95% CI, 5.54–6.46). Median overall survival was 14.6 months (95% CI, 11.47–17.73). One- and 2-year overall survival was 55.2% and 19.7%, respectively. The most common grade 3–4 hematological toxicities were neutropenia (n = 32, 17.2%) and anemia (n = 4, 2.2%). Conclusions The cisplatin plus docetaxel combination was effective and safe in the first-line treatment of patients with metastatic non-small cell lung cancer.
Fixed-Dose-Rate Gemcitabine Infusion in Patients with Advanced Pancreatic or Biliary Tree Adenocarcinoma
Authors: Mané Joan M , Sancho Aintzane , Muñoz Alberto , Rubio Itziar , Fernández Ricardo , Carrera Sergio , Fuente Natalia , Ballesteros David , Casas Raquel , Marrodán Inés , Mielgo Xabier , López-Vivanco Guillermo 
Published: February 2018

Aims and background Gemcitabine is an effective agent in pancreatic adenocarcinoma. Fixed-dose-rate gemcitabine has an interesting biological and clinical rationale, with successful results in previous studies. We conducted a trial to confirm efficacy and toxicity of fixed-dose-rate gemcitabine in patients with pancreatic or biliary tree adenocarcinoma. Methods Eligible patients with locally advanced or metastatic pancreatic or biliary tree adenocarcinoma received fixed-dose-rate gemcitabine at a dose of 1500 mg/m2 at a rate of 10 mg/m2/min weekly for 3 weeks every 28 days. Efficacy measures were overall survival, response rate and progression-free survival. Results Sixty-two patients were enrolled, and 59 were assessable for response. Seven patients (11.3%) had a partial response, 26 stable disease (41.9%) and 26 progressive disease (41.9%). Median time to progression was 21 weeks and median overall survival, 37.71 weeks. Main toxicities were grade 3–4 neutropenia (45.2%) and grade 2–3 asthenia (54.8%). No toxic deaths were documented. Conclusions Fixed-dose-rate gemcitabine has a relevant antitumor activity but with significant toxicity. It represents an interesting schedule and could be combined with other biological or chemotherapeutic agents.
The Effects of Growth Inhibitory Peptide on Follicular Thyroid Cancer Cell Growth, Migration, and Invasion
Authors: Hua Shih-Che , Chen Syue-Yi , Lu Chieh-Hsiang , Kao Yu-Ting , Yu Hui-I , Chen Ping-Tzu , Lee Ying-Ray , Chang Tien-Chun 
Published: February 2018

Aims and background Thyroid cancer is the most common endocrine neoplasm worldwide. Although differentiated thyroid cancers are associated with a favorable survival, the prognosis worsens dramatically for patients with distant metastasis. Metastases from follicular thyroid carcinoma (FTC) occur earlier and are more aggressive than those from papillary thyroid carcinoma. For FTC that is resistant to radioactive iodine, new treatments are urgently needed. Human alpha-fetoprotein (HAFP) is a tumor-associated fetal protein that has been demonstrated to regulate tumorigenesis. Growth inhibitory peptide (GIP), a synthetic 34-mer peptide isolated from the third domain of HAFP, has been shown to have antitumor growth ability in various human cancers. However, the effects of GIP in FTC have not yet been studied. The aim of this study was to investigate the antitumor ability of GIP in FTC. Methods and study design Using both PBS and GIP control peptide as a negative control, the antiproliferative activity of GIP in the WRO human FTC cell line was determined using a tetrazolium-based colorimetric assay. In addition, cell migration and invasion assays were used to measure tumor metastasis inhibition effects in vitro. Results GIP did not inhibit WRO cell proliferation in a time- or dose-dependent manner. However, in WRO cells treated with GIP for 4 days, migration was significantly inhibited at concentrations of 50 and 100 μM (33.3% and 19.5%, respectively; both P <0.05). Cell invasion was also significantly inhibited at 50 and 100 μM (67.1% and 39.0%, respectively; both P <0.05). Conclusions Although GIP failed to suppress FTC cell growth, it effectively interrupted both FTC cell migration and invasion abilities in vitro. Further validation in an animal model and elucidation of the underlying mechanisms will be required. GIP may potentially serve as an anti-FTC metastasis agent aiding current chemotherapy regimens.
Inflammatory Myofibroblastic Tumor of the Stomach in an Adult Woman: A Rare Intermittent Cause of Gastric Outlet Obstruction
Authors: Albayrak Fatih , Dursun Hakan , Albayrak Yavuz , Altas Sare , Uyanik Abdullah , Yildirim Rahsan 
Published: February 2018

Background Inflammatory myofibroblastic tumor is a neoplasm of intermediate biological potential that frequently recurs and rarely metastasizes. Case report We report a rare case of intermittent gastric outlet obstruction by an inflammatory myofibroblastic tumor of the cardia. Results A 56-year-old woman presented at the gastroenterology department with a two-day history of hematemesis and melena. She had intermittent nausea and vomiting complaints, which had manifested periodically for about five months. Upper gastrointestinal endoscopy demonstrated a mass of 6 cm in diameter, which was resected. Histological examination revealed ulcerated mucosal granulation-like tissue with myofibroblastic spindle cell proliferation in a storiform pattern. Conclusions In order to avoid unnecessary aggressive therapy, gastric IMT should be taken into account when a gastric mass accompanied by the various clinical manifestations of IMT is found in an adult.
Cervical Cancer Screening in Bulgaria - past and Present Experience
Authors:   on behalf of the EUROCHIP Working Group, Valerianova Zdravka , Panayotova Yulia , Amati Camilla , Baili Paolo 
Published: February 2018

Background In Bulgaria the previously (1970–1985) existing population based cervical cancer screening was replaced in the early 1990s with an opportunistic model due to political and socioeconomic reasons. As a result, in the last 20 years, cervical cancer incidence and mortality rates steady increased. The objective of the EUROCHIP project in Bulgaria was to evaluate the readiness of the health system as well as health providers' attitudes to implementation in the country of a population based screening program for cervical cancer. Methods Using a structured questionnaire, a convenience sample of medical specialists representing different actors involved in cervical cancer prevention, treatment, financing and policy were interviewed. Results The majority of interviewed practitioners worried that organization and implementation of an effective population-based cervical cancer screening program is not possible in the current unstable health system. A nostalgic attitude to the cervical cancer screening, performed in the past and pessimistic view on the capability of the current health system to cope are strong. As main barriers to implementation of an effective program were pointed financial and organizational ones. Motivation for gynecologists to perform smear test should include better information, organization and payment. Discussion Medical specialists in Bulgaria are aware of the alarming rates of cervical cancer incidence and mortality in the country. However, due to the insufficient communication and interaction between policy makers and front-line health care staff, they do not have enough information on the ongoing programs. Absence of health policy regarding screening is considered as main barrier for implementation of an effective screening program.