bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cisplatin and VP16 in Metastatic Breast Carcinoma as a Third-Line Chemotherapy: A Randomized Study Comparing Low versus High Doses of Cisplatin
Authors: Ceci Guido , Bisagni Giancarlo , Cocconi Giorgio , Rodinò Carmelina , Belsanti Virginio , Bertusi Maurizio , Buzzi Franco , Bacchi Marisa 
Published: April 2018

Aims and background The study was designed to define the activity of the combination of cisplatin and etoposide as third-line chemotherapy for advanced breast cancer and to investigate the role of the dosage of cisplatin on the effectiveness of the combination. Methods Ninety-five eligible patients with advanced breast cancer who had failed or relapsed on two previous lines of chemotherapy were randomized to receive cisplatin at a high dose (100 mg/m2 i.v. day 1, arm A) or a low dose (60 mg/m2 day 1, arm B), combined with etoposide (100 mg/m2 i.v. days 4, 6 and 8). Cycles were repeated every 3 weeks. Results Of the 78 patients evaluable for response (39 in arm A and 39 in arm B), 9 (12%) showed complete or partial response, 5 (13%) in the high-dose arm and 4 (10%) in the low-dose arm. One complete response was seen in the high-dose arm and none in the low-dose arm. The only 2 patients with brain involvement showed an objective response (one CR in arm A and one PR in arm B). Median time to progression was 14 weeks in arm A and 10 weeks in arm B, median duration of remission 28 and 34 weeks, and survival 36 and 35 weeks, respectively. The differences were not significant. As expected, the patients in the high-dose arm experienced more severe toxicity. One toxic death was observed in each arm due to sepsis in agranulocytosis. The difference was statistically significant regarding nausea and vomiting. Neurotoxicity and ototoxicity were not relevant problems in this patient setting. Conclusions Considering the very poor prognostic factors presented by these patients, the combination showed a certain activity, and further evaluation in earlier stages of disease is warranted. A particular responsiveness on brain metastases is suggested. The dose of cisplatin was not proven to be of significant importance.
Surgery Followed by Intracavitary plus Systemic Chemotherapy in Malignant Pleural Mesothelioma
Authors: Colleoni Marco , Sartori Francesco , Calabrò Francesco , Nelli Patrizia , Vicario Giovanni , Sgarbossa Gigliola , Gaion Fernando , Bortolotti Luigi , Tomolo Lamberto , Manente Paolo 
Published: April 2018

Aims and background Malignant mesothelioma is associated with a median survival of 4 to 12 months. Data from the literature indicate that single modality treatment (surgery or intrapleural and/or systemic chemotherapy) does not significantly affect survival. Methods We therefore evaluated a combined approach consisting of surgery (pleurectomy + diaphragmatic or pericardial resection), intrapleural chemotherapy with cisplatin (100 mg/m2) and cytarabine (1,000 mg/m2) for 4 h immediately after pleurectomy, and systemic chemotherapy consisting of epirubicin (60 mg/m2) and mitomycin-C (10 mg/m2) day 1 every 4 weeks for 4 cycles. Results Twenty patients were enrolled in the study and were evaluable. Thirteen cases had residual gross disease after pleurectomy and 7 patients only minimal disease. Median time to disease progression was 7.4 months, and median survival was 11.5 months (range, 2-25+). No treatment-related death have been observed. Side effects after intracavitary chemotherapy included renal toxicity, anaemia and pain. Myelosuppression and alopecia were recorded during systemic chemotherapy. Conclusions The results of the study indicate that the schedule is feasible, with encouraging results in terms of survival for patients with minimal residual disease after surgery.
How Thick Should CT/MR Slices be to Plan Conformal Radiotherapy? A Study on the Accuracy of Three-Dimensional Volume Reconstruction
Authors: Somigliana Anna , Zonca Giancarlo , Loi Gianfranco , Sichirollo Adele Emilia 
Published: April 2018

Aim and background The aim of this experimental study was to correlate the thickness of acquired CT slices (2, 4 and 8 mm) or MR slices (4 and 7 mm) with the accuracy of three-dimensional volume reconstruction as performed by a commercially available radiation therapy planning system. Methods We used a cylindrical phantom, with a 15-cm diameter and 20-cm height, containing 5 spheres (12.7-31.8 mm diameter) of solid Plexiglas sunk in a 3% agar jelly solution. The phantom was scanned by the CT scan with 3 different slice thicknesses (2, 4 and 8 mm and a distance of 0 mm between the slices). Two different acquisition techniques (slice thickness of 4 and 7 mm with 0.8 and 1.4 mm slice distance, respectively) were compared in the MR study. The volume values calculated from measurements were compared with the known true volume values of the spheres. Results The average percentage volume difference between calculated and true values for the smaller spheres reconstructed with CT images 2 and 4 mm thick was generally less than 8%, whereas the error for volumes reconstructed with 8-mm-thick CT slices was more than 20%. For the larger spheres, the error was generally less than 5%. The data produced by MR acquisition agreed with those obtained using CT sections. Conclusions For targets less than 1.5 cm in diameter on our system it is reasonable to acquire CT images with the smallest thickness available. For targets between 1.5 and 3 cm, it seems sufficient to acquire the localization images with a slice thickness of 4 mm. For targets more than 4 cm in diameter, considering that with our radiation therapy planning system the time spent for manual contouring and for isodose calculation highly increased with the number of acquired images, we suggest that the acquisition of CT-MR slices 8-10-mm thick is totally adequate even for Conformal radiotherapy treatments.
Cancer Mortality in Italy, 1992
Authors: Decarli Adriano , La Vecchia Carlo 
Published: April 2018

Background Data and statistics are presented on cancer death certification in Italy, updating previous publications covering the period 1955-1991. Methods Data for 1992 subdivided into 30 cancer sites are presented in 8 tables, including age- and sex-specific absolute and percentage frequencies of cancer deaths, and crude, age-specific and age-standardized rates, at all ages and truncated for the 35-64 year age group. Male to female ratios have also been tabulated, and trends in age-standardized rates for major cancer sites plotted from 1955 to 1992. Results Age-adjusted death certification rates (on the world standard population) for all neoplasms declined from 193.4 in 1991 to 189.8/100,000 males in 1992, and from 100.1 to 99.5/100,000 females. The favorable trends were even more marked in middle and younger age, but not in children below age 15, whose overall age-standardized cancer mortality rates were higher in 1992 than in 1989. Lung cancer was by far the leading site of cancer mortality, with over 30,700 deaths. For the fourth subsequent year, its rates in males declined, to reach 57.0/100,000, but continued to rise in females, to reach 8.0/100,000. Rates for other major cancer sites (intestines, stomach, female breast, prostate, pancreas) were stable or moderately favorable, but some increase was apparent also in 1992 for non-Hodgkin's lymphoma death rates. Conclusions Italian cancer mortality rates in 1992 were moderately favorable, with the major exception of the persistent spread of the tobacco-related lung cancer epidemic in females.
In Situ and Very thin Melanomas (< 0.75 mm) are Similarly and Commonly Recognizable
Authors: Bono Aldo , Bartoli Cesare , Tessandri Laura , Del Prato Ivan , Tragni Gabrina , Bucci Alessandra , Moglia Daniele , Cascinelli Natale 
Published: April 2018

Aims and Background Recent data have suggested that cutaneous melanoma in situ can be clinically recognized in most cases by its features, which resemble those of early invasive melanoma. The aim of the study was to verify whether the diagnostic sensitivity of melanoma in situ is actually equivalent to that of early invasive melanoma. Methods We retrospectively reviewed the clinical diagnosis of 274 consecutive cutaneous melanoma <0.75 mm thick. The series consisted of 84 in situ and 190 invasive lesions. Results The clinical diagnosis of melanoma was performed in 62% (52/84) of cases of in situ melanoma and in 68% (130/190) of the cases of invasive melanoma. The differences were not statistically significant. Conclusions Our results show that cutaneous melanoma can be clinically diagnosed at a very early stage. In situ and very thin melanomas (< 0.75 mm) are similarly recognizable.
Steroid Hormone Receptors Related to Parameters Characterizing the Biology of Human Breast Cancer
Authors: Görlich Max , Jandrig Burkhard 
Published: April 2018

Steroid hormone receptors are important parameters to characterize breast tumors. Thus, it is important to evaluate their relationships with factors such as histological type and size of the tumor, axillary lymph node invasion and distant spread, age and menopausal status of the patients, and parameters of tumor differentiation. The receptor levels observed vary within wide ranges. Therefore, statistically significant differences between different groups of parameters are seldom found. A significant dependence on receptor levels has been observed only for patient age and menopausal status. The parameters clinical stage, tumor size, tumor histology, metastatic involvement and histopathologic grading showed no statistically significant relation with receptor levels. Nevertheless, a relationship exists between all parameters mentioned and the frequency of a positive receptor status. Consequently, receptor status can contribute to define the biological behavior of the disease in specific groups of patients. In individual cases other parameters than the biochemical evidence of steroid receptor binding seem to be more important. We found that data derived from DNA flow cytometric measurements allowed a better recognition of tumor aggressiveness than ER status. In axillary lymph node metastases we usually observed higher receptor levels than in primary tumors, but we did not find an age dependency of ER levels in these metastases.
Preliminary Experience with High-Dose Cisplatin, Reduced Glutathione and Natural Interferon-α in Dacarbazine-Resistant Malignant Melanoma
Authors: Bajetta Emilio , Rimassa Lorenza , Carnaghi Carlo , Del Vecchio Michele , Celio Luigi , Cassata Antonio 
Published: April 2018

Aims and background The incidence of malignant melanoma is rapidly increasing in many countries, and when this disease has reached advanced stages, standard therapies have little impact. Dacarbazine (DTIC) is the most effective chemotherapeutic agent with an overall response rate of 20-25%, but durable responses are uncommon. Interesting results with the use of cisplatin (CDDP) have been reported in DTIC-resistant melanoma. Moreover, malignant melanoma is an immunogenic tumor and a potential target for biological response modifier (BRM) therapies. The aim of the present study was to evaluate the efficacy and tolerability of a chemo-immunotherapeutic regimen including high-dose CDDP combined with glutathione (GSH) to limit platinum-related toxicity, and natural interferon-α (IFN-α) in patients with DTIC-resistant metastatic melanoma. Methods The treatment schedule included GSH 1,500 mg/m2 i.v. and CDDP 40 mg/m2 i.v. for 4 consecutive days every 3 weeks, with a maximum of 6 courses, and IFN-α 3 MIU i.m. 3 times a week, continuative for a maximum of 12 months. Results Twelve patients were enrolled in this phase II trial. Accrual was stopped due to treatment-related toxicity. Ten patients were evaluable for response; there were 2 partial responses, lasting 5+ and 9+ months, respectively, and 2 cases of stable disease, lasting 3+ and 8+ months. None of these patients completed the therapeutic program due to treatment-related side effects. Conclusions This regimen seems to be only partially active in DTIC-resistant metastatic melanoma. Hematologic and non-hema-tologic (nausea and vomiting, peripheral neurotoxicity, and asthenia) side effects are significant and GSH is not effective in limiting CDDP-related neurotoxicity in pretreated patients. Therefore, there is no indication to employ this regimen as second-line treatment in metastatic melanoma and these disappointing results highlight the urgent need for new therapeutic approaches.
Biological and Clinical Implications for Multimodality Treatment in Patients Affected by Squamous Cell Carcinoma of the Head and Neck
Authors: Corvò Renzo , Sanguineti Giuseppe , Benasso Marco 
Published: April 2018

Aims and background Several strategies combining radiotherapy and chemotherapy have been developed for the cure of squamous cell carcinoma of the head and neck (SCC-HN) in an attempt to improve loco-regional control and survival. This overview aims to summarize clinical results of reported randomized trials and to discuss the biological mechanisms underlying the interactive and non-interactive processes promoted when chemotherapy is added to radiotherapy. Methods The clinical goals of combined modality therapy and exploitable associations of chemotherapy and radiotherapy that may lead to a therapeutic gain in comparison with radiotherapy alone are reported and reviewed. Clinical applications of the four main ways of combining chemotherapy with radiotherapy (neoadjuvant, concomitant, alternating and adjuvant) are briefly re-analyzed and discussed. Results and Conclusions Published evidence suggests that induction chemotherapy (neo-adjuvant) should not be routinely recommended; however, induction chemotherapy increases the likelihood of larynx preservation in patients with laryngeal and hypopharyngeal cancer and should be offered as a treatment option as an alternative to surgery. Positive results of several randomized studies and a recent meta-analysis show that concomitant use of chemotherapy and radiotherapy in unresectable SCCHN is beneficial and should be considered as a potential standard treatment. A complementary biological staging of SCCHN, by evaluating new predictive factors of tumor response, is presently under investigation to better interpretate clinical randomized trials exploring chemo-radiotherapy.
Promoting Participation in a Population Screening Program for Breast and Cervical Cancer: A Randomized Trial of Different Invitation Strategies
Authors: Segnan Nereo , Seriore Carlo , Giordano Livia , Ponti Antonio , Ronco Guglielmo 
Published: April 2018

Aims and background Attendance level has been identified as a major determinant of cost-effectiveness of organized screening programs. We tested the effectiveness of 4 different invitation systems in the context of an organized population screening program for cervical and breast cancer. Methods Women eligible for invitation - 8385 for cervical and 8069 for breast cancer screening - listed in the rosters of 43 and 105 general practitioners (GP), respectively, who had accepted to collaborate in the program, were randomized to 4 invitation groups: Group A - letter signed by the GP, with a prefixed appointment; Group B - open-ended invitation, signed by the GP, prompting women to contact the screening center to arrange an appointment; Group C - letter (same as for group A), signed by the program coordinator, with a prefixed appointment; Group D - extended letter (highlighting the benefits of early cancer detection) signed by the GP, with a prefixed appointment. Assignment to the interventions was based on a randomized block design (block=GP). Results Assuming Group A as the reference, the overall compliance with cervical cancer screening was reduced by 39% in Group B (RR=0.61; 95% CI, 0.56-0.68) and by 14% in Group C (RR=0.86; 95% CI, 0.78-0.93); no difference was observed for Group D (RR=1.03; 95% CI, 0.95-1.1). The response pattern was similar for breast screening (Group B: RR=0.71; 95% CI, 0.65-0.76; Group C: RR=0.87; 95% CI, 0.81-0.94; Group D: RR=1.01; 95% CI, 0.94-1.08). Conclusions Personal invitation letters signed by the woman's GP, with preallocated appointments, induce a significant increase in compliance with screening. Efficiency can be ensured through the adoption of overbooking, provided that attendance levels are regularly monitored.
La Ricerca Sugli Antiemetici: Un Modello Italiano Di Successo
Authors: Roila Fausto 
Published: April 2018

At the beginning of the 80's the Italian Group for Clinical Research (G.O.I.R.C.) identified chemotherapy-induced nausea and vomiting as one of the most distressing adverse events, and decided to plan and execute clinical trials on antiemetics in order to reduce this negative impact on patients. Therefore, some consecutive double-blind randomized trials were conducted on cisplatin-treated patients. The first was a dose-finding study on four different high-doses of domperidone, followed by a study comparing two different high-doses of metoclopramide, and a study comparing the addition of a corticosteroid to high-dose metoclopramide with respect to metoclopramide alone. Finally, a study demonstrating that a combination of a higher dose of metoclopramide (3 mg/kg x2) plus dexamethasone and diphenhydramine was significantly superior with respect to a lower dose of metoclopramide (1 mg/kg x 4) combined with methylprednisolone was carried out. With the introduction of the 5-HT3 receptor antagonists the interest for antiemetic therapy increased and other Italian gynecological and medical oncology centres became involved in the antiemetic research. The Italian Group for Antiemetic Research was formed in 90's and its first study demonstrated the superiority of a combination of a 5-HT3 receptor antagonist plus dexamethasone with respect to the standard three drug combination of high doses of metoclopramide in the prevention of cisplatin-induced acute emesis. In the following years, the Group contributed to the identification of the best antiemetic prophylaxis for acute emesis induced by moderately emetogenic chemotherapy, and for delayed emesis induced by cisplatin. Also a drug utilization review on antiemetics in clinical practice has recently been carried out. Today, the interest of the Group is concentrated in studying the optimal antiemetic prophylaxis for delayed emesis induced by moderately emetogenic chemotherapy. The rules always followed by the Italian Group for Antiemetic Research are: - complete independence of judgement on the efficacy and the tolerability of antiemetic drugs from the pharmaceutical companies; - priority of ethical problems in designing clinical trials; - strict adherence to the methodological problems of antiemetic research and - complete autonomy concerning the study planned, the data computerization and the data elaboration. In the last twelve years approximately 70 Italian centres have enrolled their patients into the studies of the Italian Group for Antiemetic Research.
Fatty Acid Synthase (Fas) Predictive Strength in Poorly Differentiated Early Breast Carcinomas
Authors: Alò Piero L. , Visca Paolo , Trombetta Giorgio , Mangoni Antonella , Lenti Luisa , Monaco Simona , Botti Claudio , Serpieri Daniele Eleuteri , Di Tondo Ugo 
Published: April 2018

Aims and background Many normal and human cancer tissues express fatty acid synthase (FAS), the major enzyme required for endogenous fatty acid biosynthesis. Strong expression of FAS seems to be associated with a poor prognosis. This study examines the strength of FAS and other common markers of relapse in poorly differentiated breast carcinoma. Materials and methods Fifty-one patients with poorly differentiated ductal infiltrating breast carcinomas were followed up for more than 10 years. Immunohistochemical detection of FAS was associated with morphological features of the tumors, with immunohistochemical expression of c-erbB-2, cathepsin D, estrogen and progesterone receptor status and with DNA ploidy in order to detect a statistical correlation. Results The chi-square test revealed a correlation between FAS and peritumoral lymphatic vessel invasion (PLVI) (P = 0.001). Univariate analysis showed that FAS was correlated with disease-free survival (DFS) (P = 0.0001). Other prognosticators associated with DFS were PLVI (P = 0.002), estrogen (P = 0.008) and progesterone receptor status (P = 0.007). Bivariate analysis showed that FAS was a further prognostic discriminant of DFS within the ER, PgR and PLVI subsets. Discussion FAS is a reliable prognosticator of recurrence in poorly differentiated early breast carcinomas. Association of FAS with PLVI may be useful to plan a correct follow-up in patients with breast neoplasms.
The Role of the Academia in Foreign Policymaking: International Practices and Perspectives as Lessons for Namibia
Authors: Mushelenga Peya 
Published: April 2018

Academics for international relations (IR) studies as an academic discipline have over the years contributed to the process of foreign policymaking. Their contribution has been made through research and publications and providing advisory services to policymakers. Other platforms existing for academics are platforms for debates on foreign policy and providing training to foreign policymakers. The article discusses international experiences and perspectives, from all geographic regions, covering large states of the UN Security Council, Brazil, Russia, India, China and South Africa (BRICS) and at least one small state from each geographic region. The lecture analyses the gaps existing between academics and foreign policymakers and explores methods that can be adopted to close the gaps and create a working relationship between the two stakeholders, with a view to make positive contributions to the making of foreign policy. It highlights the challenges facing academics in making an impact on foreign policy and the approach of foreign policymakers to the contribution by academics. The article propounds that, generally, academics are more influential in large states’ foreign policy-making process, compared to small states where the process of foreign policymaking includes a few stakeholders. Further, the appointment of policymakers from the academia background impacts on inclination to the role of the academia in foreign policymaking. There are no many platforms where debates on Namibia’s foreign policy are held and a limited number of Namibian academics play a role on foreign policymaking. The article provides a framework of best practices as lessons for Namibian academics and foreign policymakers.
Memoirs of Three Eminent South Asians: Central Contributions
Authors: Dubey Muchkund 
Published: April 2018

Rehman Sobhan, Untranquil Recollections—The Years of Fulfilment. New Delhi: SAGE, 2016, pp. 486, ₹1250. ISBN: 9789351509868. Khurshid Mahmud Kasuri, Neither a Hawk nor a Dove: An Insider’s Account of Pakistan’s Foreign Policy. Penguin Books, 2015, pp. 888, ₹999. ISBN: 9780670088010. M. K. Rasgotra, A Life in Diplomacy. Gurgaon: Penguin, 2016, pp. 400, ₹699. ISBN: 9780670088843.