bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Volumetric Modulated arc Radiotherapy in Patients with Early Stage Glottic Cancer
Authors: Atalar Banu , Gungor Gorkem , Caglar Hale , Aydin Gokhan , Yapici Bulent , Ozyar Enis 
Published: February 2018

Aims and background We compared conformal, intensity-modulated radiotherapy (IMRT) and intensity-modulated arc therapy (IMAT) in early stage glottic cancer in terms of dosimetric features as target coverage, dose to the organs at risk and total treatment time. Methods and materials Five consecutive T1 glottic squamous cell carcinoma patients were selected for the study. Three-dimensional conformal radiotherapy (3D-CRT), 3-field or 5-field intensity-modulated radiotherapy (3F-IMRT and 5F-IMRT), or IMAT, which was in 2 different forms – a regular IMAT (R-IMAT) and an alternative IMAT (A-IMAT) with an unirradiated section, was planned for each patient. The prescribed dose was 63 Gy in 28 fractions. The minimum dose for 95% of the clinical target volume (D95), maximum dose point at clinical target volume (Dmax), total monitor units, left and right carotid artery doses (V35 and V50 – percentage of volume receiving 35 Gy and 50 Gy), and total treatment time were calculated for each plan. Results Median D95 values in the 5 plans studied with each technique ranged between 63 and 63.3 Gy (P = NS). Median Dmax values for each technique ranged between 65.4 and 70.8 Gy. The number of hot spots with IMRT and IMAT was significantly higher than with 3D-CRT plans. Conformal radiotherapy plans median V35 (93.6%) and V50 (76.6–83.3%) values for carotid arteries were significantly higher than with IMRT and IMAT (2.9%-11.4% and 0.0%). Average treatment times for 3D-CRT, 3F-IMRT, 5F-IMRT, R-IMAT and A-IMAT techniques were calculated as 64, 119, 147, 39 and 32 seconds, respectively. Conclusions IMAT has significantly decreased the treatment time compared to IMRT and 3D-CRT with acceptable homogeneous clinical target volume coverage and low carotid dose.
Gastrointestinal Stromal Tumors: Prognostic Factors and Therapeutic Implications
Authors: Rosa Fausto , Alfieri Sergio , Tortorelli Antonio Pio , Di Miceli Dario , Papa Valerio , Doglietto Giovanni Battista 
Published: February 2018

Background Gastrointestinal stromal tumors (GISTs) are the most frequent mesenchymal tumors of the digestive tract. They have recently been recognized as a separate nosological entity and the literature on these stromal tumors has rapidly expanded. Materials and methods The surgical records of 50 patients with primary GISTs treated at the Digestive Surgery Department of the Catholic University of Rome from January 1993 to December 2010 were reviewed and the prognostic factors were analyzed. Results Surgery was performed in all patients with curative intent. The median age at presentation was 66.5 years (range, 28–81). Adjuvant therapy was administered in 26 (52%) cases. Median follow-up was 71 months (range, 5–208). There was an 8% recurrence rate. The actuarial 5-year overall and disease-free survival rates were 66.3% and 57.2%, respectively. High mitotic rate (P <0.001), tumor size greater than 10 cm (P = 0.007) and tumor rupture (P = 0.05) were the only prognostically significant negative factors for overall survival in multivariate analysis. Conclusions The present study confirmed the important role of aggressive surgical management of GISTs to offer these patients the most appropriate treatment for long-term survival.
Increased Diagnostic Yield of Small Bowel Tumors with Pillcam: The Role of Capsule Endoscopy in the Diagnosis and Treatment of Gastrointestinal Stromal Tumors (GISTs). Italian Single-Center Experience
Authors: Urgesi Riccardo , Riccioni Maria Elena , Bizzotto Alessandra , Cianci Rossella , Spada Cristiano , Pelecca Giorgio , Ricci Riccardo M , Costamagna Guido 
Published: February 2018

Background Gastrointestinal stromal tumors (GISTs) are rare tumors, accounting for 1–3% of all gastrointestinal malignancies; they are, however, the most common gastric and small bowel mesenchymal tumors. The length and relative inaccessibility of the small bowel have long constrained the diagnosis of GISTs mainly presenting with chronic or intermittent bleeding as the sole clinical manifestation. Aim To report on the prevalence of small bowel GISTs in a prospectively recorded series of patients undergoing capsule endoscopy (CE). Patients and methods Between 2001 and 2007 five hundred patients were referred to our endoscopy unit for small bowel evaluation with capsule endoscopy. We retrospectively evaluated all charts. The main indications for CE were obscure-occult or obscure-overt bleeding. Two hundred eighty-nine patients underwent CE for either obscure-occult or obscure-overt bleeding and 211 for other indications. Patient outcome and care processes were measured by follow-up telephone interviews and chart review. Statistical computations were performed using Fisher's exact test and Student's t-test. Results CE identified a small bowel tumor in 20 patients (4.0%) and 9 tumors turned out to be GISTs (45.0%). Traditional endoscopic and radiological imaging failed to detect the GIST in all these cases. In one case a small bowel GIST was diagnosed by angiography and CE proved false negative. Overall, CE was able to diagnose a small bowel GIST in 9 out of 10 cases. All patients underwent surgical treatment and showed normalized hemoglobin levels at follow-up. The main limitation of this study is the small number of cases. Conclusions CE is an effective and sensitive diagnostic device compared with conventional radiology and plays an important role in the algorithm for the diagnostic work-up of suspected small bowel tumors.
Downregulating PRL-3 Inhibit Migration and Invasion of Lung Cancer Cell via RhoA and mDia1
Authors: Jian Ming , Nan Liu , Guocheng Jiang , Qingfu Zhang , Xueshan Qiu , Enhua Wang 
Published: February 2018

Aims and background The overexpression of phosphatase of regenerating liver-3 (PRL-3) affects the migration and invasion of epithelial cells. Little is known about the substrates or pathways that PRL-3 interacts with. Methods We studied the action and the mechanism of PRL-3 in migration and invasion of lung cancer. We detected the expression of PRL-3 in lung cancer cell lines and normal human bronchial epithelial cell. Results We found that PRL-3 expression was high in lung cancer cells. Knockdown of PRL-3 by siRNA inhibited cell migration and invasion and reorganizated the cytoskeleton. Furthermore, blocking PRL-3 decreased RhoA activity and mDia1 expression. Blocking RhoA or mDia1 showed the similar changes of cytoskeleton and suppression of migration and invasion as inhibiting PRL-3 expression. Blocking RhoA inhibited the expression of mDia1. Conclusions These data indicate that downregulating PRL-3 inhibit cell migration and invasion by inactivating RhoA to downregulate mDia1 to reorganizate cytoskeleton of lung cancer cells.
Temperament and Character Traits Associated with Health-Related Quality of Life in Cancer Patients
Authors: Bonacchi Andrea , Miccinesi Guido , Guazzini Monica , Rossi Alessandra , Bacci Silvia , Toccafondi Alessandro , Martire Mariangela , Bellotti Laura , Perfetto Roberta , Catanzaro Paolo , Adamo Vincenzo , Cascinu Stefano , Doni Laura , Di Costanzo Francesco , Rosselli Massimo 
Published: February 2018

Background There is an increase in the attention to factors influencing the quality of life of cancer patients. The aim of the present study was to evaluate temperament and character traits related to health-related quality of life (HRQoL) in patients with cancer. Methods Two hundred and three inpatients from three Italian oncology departments filled in the Temperament Character Inventory (TCI-140) based on Cloninger's personality model, the SF-36 questionnaire assessing HRQoL, and the Hospital Anxiety and Depression Scale (HADS). Eighty percent of patients were undergoing chemotherapy. Results Lower levels of harm avoidance and higher levels of self-directedness were significantly correlated with a better HRQoL. Regression analysis controlling for psychopathology (anxiety and depression symptoms) showed that the influence of temperament and character traits on quality of life seemed to add little to the influence of psychopathology. Conclusions The present study demonstrates the existence of some relations between HRQoL and temperament and character traits assessed using the TCI-140 questionnaire. However, among the psychological factors, psychopathology seems to retain more influence on HRQoL of cancer patients.
The Management of Skin Toxicity during Cetuximab Treatment in Advanced Colorectal Cancer: How much does it Cost? A Retrospecive Economic Assessment from a Single-Center Experience
Authors: Giuliani Jacopo , Indelli Monica , Marzola Marina , Raisi Elena , Frassoldati Antonio 
Published: February 2018

Aims and background Skin rash is a predictable and manageable side effect of anti-EGFR therapy such as cetuximab. The aim of this study is to estimate the costs for the foreseeable management of skin toxicity in patients treated with cetuximab in our institute in order to assess the direct medical economic impact. Methods and study design We retrospectively analyzed all consecutive patients with advanced colorectal cancer treated with cetuximab at our institute from June 2006 to May 2011. We evaluated the severity and mean duration of skin rash for each grade and we identified the costs for the different therapeutic interventions. Patients were treated according to the general consensus management of skin toxicity associated with cetuximab treatment. Results We evaluated 31 patients. The median follow-up was 28.95 months (range, 1.84–75.49). At last follow-up 10 patients (32.3%) were alive with metastases, 18 patients (58.1%) had died, 1 patient (3.2%) was alive without evidence of disease, and 2 patients (6.5%) were lost to follow-up. The median progression-free survival was 8.26 months and the median overall survival 32.89 months. Nineteen patients (61.3%) developed skin toxicities: 7 patients (22.6%) grade 1, 9 patients (29.0%) grade 2, 3 patients (9.7%) grade 3; no grade 4 skin toxicity was observed. The median duration of grade 1 toxicity was 79 days (no specific treatments were started), of grade 2 toxicity 95 days (cost range, € 199.50–294.50) and of grade 3 toxicity 64 days (cost range, € 159.42–233.90). Conclusions Our experience, through the analysis of nonselected cases, showed that the management of skin toxicities related to cetuximab is not so expensive. We recommend proper care of low-grade toxicities in order to reduce progression to highgrade toxicities and the resulting risk of hospitalization, which really impacts on costs.
Sentinel Node Biopsy in Early Breast Cancer: Lessons Learned from More than 1000 Cases at a Single Institution
Authors: Fancellu Alessandro , Cottu Pierina , Feo Claudio F , Bertulu Daniele , Giuliani Giuliana , Mulas Silvia , Sanna Valeria , Mura Silvia , Madeddu Giuseppe , Spanu Angela 
Published: February 2018

Aims The aims of this paper are to report the development of sentinel node biopsy (SNB) in breast cancer at a single institution and to discuss the relevant issues on SNB still to be elucidated. Patients and methods From 1998 to 2010, 1021 SNBs with frozen section examination were carried out in patients with breast cancer. In the early period (1998–2002) SNB was always combined with axillary lymph node dissection (ALND). From 2002 onwards, only patients with a positive SNB result underwent ALND (late period). The characteristics of patients with infiltrating carcinoma (IC) and ductal carcinoma in situ (DCIS) and the histological status of the sentinel nodes were examined. The survival outcomes of node-negative patients were compared between patients submitted to SNB and ALND (ALND group) during the early period and patients who underwent only SNB during the late period (SNB group). Results The sentinel node was identified intraoperatively in 98.3% of cases. During the early period the overall accuracy of SNB was 97.0%. During the late period, 700 patients with IC and 140 with DCIS underwent SNB. In the IC group, 149 patients (21.3%) had sentinel node macrometastases and 36 (5.1%) micrometastases; of that subgroup, 21 underwent ALND and no other metastatic lymph nodes were found, and 15 underwent SNB only. Axillary recurrences were observed in 4 patients (0.77%) with negative SNB; none of these were among the patients with micrometastatic SNB. Two patients (1.4%) with DCIS had a positive SNB. In node-negative patients the 5-year overall survival was 96.7% in the ALND group and 96.5% in the SNB group (P = 0.63). The 5-year disease-free survival was 93.8% and 93.2% in the ALND and SNB groups, respectively (P = 0.77). Conclusions Overall and disease-free survival in patients with a negative SNB result and no further axillary surgery were equal to those in patients with negative ALND. Intraoperative assessment of the sentinel node in expert hands has a low false-negative rate and allows immediate ALND in patients with sentinel node metastases, avoiding the need for a second operation. ALND for sentinel node micrometastases may be safely omitted in most patients with early stage breast cancer.
The Impact of Multiple Recurrences in Disease-Free Survival of Breast Cancer: An Extended Cox Model
Authors: Gohari Mahmood Reza , Khodabakhshi Reza , Shahidi Javad , Fard Zeinab Moghadami , Foadzi Hossein , Soleimani Farin , Biglarian Akbar 
Published: February 2018

Aims and background Identifying the risk factors of recurrence of breast cancer is important for both the physician and patient. Analysis of the first recurrence may lead to an inaccurate evaluation of the factor's effects because it does not completely reflect the history of the disease and may result in the loss of valuable information. The present study aimed to determine the factors that influence breast cancer recurrence and to estimate disease-free survival, adjusting for multiple metastases in breast cancer patients. Methods and study design Patients were selected from a longitudinal study carried out at Fayazabakhsh Hospital in Tehran, Iran. Women who were diagnosed with breast cancer and who underwent either modified radical mastectomy or breast-conserving surgery between January 2006 and April 2008 were recruited to take part in the study. Breast cancer recurrence was defined as the occurrence of a tumor in the contralateral breast, local-regional relapse, or distant metastasis to other organs. Using an extended Cox model, the effect of age, tumor size, estrogen receptors, HER2, progesterone receptors as well as lymph node ratio was analyzed. Results Over a 5833 person-month follow-up, 25 of 133 patients (18.8%) had died and 108 patients (81.2%) were still alive, 9 of them with metastasis. Thirty-four patients (25.6%) experienced their first disease recurrence. A total of 11 patients had a second metastasis. The mean time to first metastasis was 19.93 months, and mean gap time between two metastases was 7.15 months. Risk of experiencing a metastasis or death in the third and fifth year after surgery was approximately 22% and 28%, respectively. Fitting multiple recurrent regression shows that high lymph node ratio, high histologic grade, large tumor size and HER2-positive tumors are prognostic factors for shorter disease-free survival. Conclusions Our novel approach might be helpful in clinical practice to predict breast cancer recurrence after surgery and might be adapted to be used in other malignancies as well.
Retrospective Analysis of Patients with Esophageal Cancer Treated with Radiotherapy and/or Chemoradiotherapy
Authors: Kandaz Mustafa , Ertekin Mustafa Vecdi , Bilici Mehmet 
Published: February 2018

Aims and background Esophageal cancer consists of 5% of all cancers. In Eastern Anatolia region of Turkey, the rate was found to be 16%. The primary aim of the study was to evaluate effect of the localization and histologic type of tumor, stage of cancer and treatment modality, patient's sex, age and smoking status, Karnofsky performance score, and family history on survival. Methods and study design A total of 135 patients with locally advanced esophagus cancer were enrolled into the study. The factors (sex, age, Karnofsky performance status, localization, histology, stage of the disease, treatment modality) on survival were evaluated. Results After the end of treatment, overall survival was 20 months, median survival period was 13 months. The survival rates at 1, 3 and 5 years were 51.3%, 20.1% and 13.4%, respectively. Conclusions For patients with esophageal cancer, age, Karnofsky performance score, stage, treatment modality applied, chemotherapy protocol, number of cures and general survival rate were found to be the prognostic factors related to survival (P <0.05) in univariate analysis. At the same time, the study showed that gender, smoking status, family history, localization of the tumor and histologic type had no effect on the survival. The best survival in patients with esophageal cancer which cannot be operated is obtained by 50.4 Gray radiotherapy with concurrent chemotherapy.
Vinorelbine-Based Chemo-Radiotherapy in Non-Small Cell Lung Cancer
Authors: Scotti Vieri , Saieva Calogero , Di Cataldo Vanessa , Bruni Alessio , Desideri Isacco , Bertocci Silvia , Meattini Icro , Livi Lorenzo , Simontacchi Gabriele , De Luca Cardillo Carla , Bendinelli Benedetta , Bastiani Paolo , Mangoni Monica , Agresti Benedetta , Biti Giampaolo 
Published: February 2018

Aims and background Concomitant radio-chemotherapy improves survival of patients with locally advanced non-small cell lung cancer, with a better local-regional control. Methods and study design We report our experience with vinorelbine-based chemotherapy in neoadjuvant and radical settings in 43 patients. Regimens consisted of cisplatin plus vinorelbine in 74.4% patients and carboplatin plus vinorelbine in 14.0%; 11.6% underwent mono-chemotherapy with oral vinorelbine. We estimated the crude probability of death or local recurrence by the Kaplan-Meier method. Cox regression models were used to identify the main significant predictors of death or local recurrence. Results A significant effect of the response to treatment was shown on both local disease free-survival (P = 0.004) and overall survival (P <0.0001). Patients with progressive disease after primary treatment had a significantly higher risk of further relapse at both univariate (P = 0.046) and multivariate regression analysis (P = 0.014) than patients with a complete response. They also showed a significantly higher risk of death at both univariate (P = 0.0005) and multivariate regression analysis (P <0.0001) than patients with a complete response. The most common toxicity was hematologic and gastroenteric. We recorded grade III/IV leukopenia in 11%, anemia in 6%, and esophagitis in 14% of the patients. Conclusions Our experience showed that vinorelbine-based chemotherapy is an effective and safe regimen, in association with a platinum compound and thoracic radiotherapy.
High-Dose-Rate Interstitial Brachytherapy in Early Stage Buccal Mucosa and Lip Cancer: Report on the Consecutive 12 Patients and Review of the Literature
Authors: Vavassori Andrea , Gherardi Federica , Colangione Sarah Pia , Fodor Cristiana , Cattani Federica , Lazzari Roberta , Calabrese Luca , Bruschini Roberto , Alterio Daniela , Jereczek-Fossa Barbara Alicja , Orecchia Roberto 
Published: February 2018

Aims and background To evaluate clinical outcome and toxicity using high-dose-rate brachytherapy as monotherapy in head and neck carcinomas. Methods Between September 2004 and April 2010, a series of 12 patients with lip (7 patients) or buccal mucosa (5 patients) cancers were treated by exclusive interstitial high-dose-rate brachytherapy. The median age of the patients was 71.5 years (range, 47–87). Stages were T1N0M0 and T2N0M0 in 6 and 6 patients, respectively. A dose of 27 to 54 Gy in 9 to 16 fractions, 3 to 4.5 Gy per fraction, 2 fractions per day with a minimal gap of 6 h in between was delivered. Results After a median follow-up of 46 months (range, 10–85), the disease-free and overall survival was 83% (10 of 12 patients) and 50% (6 of 12 patients), respectively. The crude local control in the lip cancer patients was 100% and in the buccal mucosa cancer patients was 60%. No severe toxicity was registered. Conclusions High-dose-rate brachytherapy is feasible and safe and offers the possibility to treat patients in an outpatient regimen.
Comparative Analysis of Immunohistochemical Markers for Differential Diagnosis of Hepatocelluar Carcinoma and Cholangiocarcinoma
Authors: Ryu Han Suk , Lee Kyounbun , Shin Eun , Kim Soo Hee , Jing Jin , Jung Hae Yeon , Lee Hyebin , Jang Ja-June 
Published: February 2018

Aims and background Differential diagnosis of hepatocellular carcinoma and intrahepatic cholangiocarcinoma is sometimes difficult to accurately perform. Methods Eight markers including cytokeratin 7 (CK7), cytokeratin 19 (CK19), MOC31, CD10, glypican 3 (GPC3), claudin 4, biglycan and high mobility group A1 (HMGA1) were immunohistochemically stained in samples from 179 surgically resected hepatocellular carcinomas and 127 intrahepatic cholangiocarcinomas, and the rates of marker expression were statistically compared. Results With the exception of biglycan, 7 of the 8 markers were found to have significantly different expression patterns when comparing the two types of cancer (P <0.05). In intrahepatic cholangiocarcinomas, the expression rates of CK7, CK19, MOC31, claudin 4 and HMGA1 were 83.4%, 89.0%, 88.2%, 69.2%, and 31.5%, respectively. These rates of expression in intrahepatic cholangiocarcinomas were all higher than in those in hepatocellular carcinomas (CK7, 31.3%; CK19, 10.1%; MOC31, 34.0%; claudin 4, 11.2%; and HMGA1, 19.5%). The expression rates of GPC3, CD10, and biglycan were 72.6%, 39.7% and 10.0%, respectively, in hepatocellular carcinoma. These were higher than the rates found in intrahepatic cholangiocarcinomas (GPC3, 7.0%; CD10, 18.1%; and biglycan, 7.0%). In a multivariate logistic regression analysis, GPC3, CK19, MOC31 and claudin 4 were found to be independent markers for differentially diagnosing intrahepatic cholangiocarcinoma. Conclusions Based on our results, GPC3 and CK19 can be used as first-line markers for differential diagnoses of hepatocellular carcinoma and intrahepatic cholangiocarcinoma (accuracy rate, 73.5%), and additional combined screening for claudin 4 and MOC31 markers in GPC3(-) and CK19(-) tumors might increase the accuracy rate for distinguishing hepatocellular carcinoma from intrahepatic cholangiocarcinoma to 88.5%.