bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gliosarcoma Associated with Neurofibromatosis Type I: A Case Report
Authors: Elmaci Ilhan , Kurtkaya Özlem , Boran Burak , Kiliç Türker , Pamir M. Necmettin 
Published: April 2018

Neurofibromatosis type I (NF I) is the most common hereditary syndrome predisposing to neoplasia. We report the third case in the literature, documenting the combination of gliosarcoma with NF I. The patient's son was known at our center because of a history of pleomorphic xanthoastrocytoma (PXA) with NF I. A 48-year-old man who had a number of café-au-lait spots with neurofibroma since birth presented with severe headache. Neuroradiological studies revealed a cystic tumor of the right temporal lobe of high grade nature. Surgical excision was performed and the tumor was found to be located on the surface of the temporoparietal area with cystic formation and vascular and infiltrative features. Postoperative MRI showed no detectable contrast enhancing tissue. Immunohistochemical examination evidenced the characteristics of typical gliosarcoma. The patient received radiation therapy but five months following surgery recurrence of the tumor was diagnosed. Reoperation was performed and histopathological studies confirmed the diagnosis of gliosarcoma. We believe that the neurofibromatosis was inherited by the son with PXA from the father with gliosarcoma. The rarity of the combined occurrence of gliosarcoma and NF I, in addition to this uncommon family history, makes this case remarkable. Our findings suggest that NF I is a multifac-eted disease associated with benign as well as malignant astrocytic tumors.
Neoadjuvant Chemotherapy with Taxotere-Epirubicin-5-Fluorouracil (TEF) in Local-Regionally Advanced Breast Cancer: A Preliminary Report
Authors: Baltali Eşmen , Altundağ M Kadri , Onat Demir Ali , Abbasoğlu Osman , Özişik Yavuz , Güler Nilüfer , Atahan Lale , Berberoğlu Uğur , Altinok Mehmet , Baran Ismet , Çelik İsmail , Tekuzman Gülten 
Published: April 2018

Aims and background Sixty-three patients with local-regionally advanced breast cancer were treated with neoadjuvant chemotherapy consisting of docetaxel (Taxotere), epirubicin, and 5-fluorouracil (TEF). Methods and study design Preoperatively, patients received four cycles of Taxotere (80 mg/m2), epirubicin (60 mg/m2), and 5-fluorouracil (500 mg/m2), repeated every 21 days. Following completion of four cycles of chemotherapy, appropriate surgery was performed. After the surgery, patients received one cycle of the TEF chemotherapy regimen; following chemotherapy, radiotherapy was applied, and at the end two more cycles of TEF chemotherapy regimen were given. Results Sixty-three patients with locally advanced breast cancer were treated. Three patients were excluded from the study before the evaluation of response. Median age of the patients was 50 years (range, 25–77). Twenty-seven and 33 patients were premenopausal and postmenopausal, respectively. Thirty-nine patients were in stage IIIA and 21 in stage IIIB. Complete and partial responses were observed in 15 (25%) and 42 (70%) of the patients following four cycles of preoperative TEF chemotherapy regimen, respectively. Overall response was 95%, and primary lesion progressed only in 3 (5%) patients. The mean disease-free survival was 15.9 ± 6.8 (range, 3.5–28) months and the mean overall survival was 18.6 ± 7.2 (range, 5–30) months. The most frequent side effects were nausea-vomiting, mucositis, alopecia and leukopenia. Conclusions TEF therapy is a treatment with a high overall response rate and toxicities similar to other taxotere combinations. A longer follow-up of patients is necessary for the determination of disease-free survival and overall survival.
Evaluation of Standard Tangential Irradiation versus Breast Ring Technique Using Three-Dimensional Tools in Cancerous Large Breasts
Authors: Bora Huseyin , Akmansu Muge , Gürel Ozgur 
Published: April 2018

Aims and background In patients with large breasts, tangential irradiation after lumpectomy is technically difficult. Tangential plans of large breasts comprise a large volume of the lung, axilla and heart, as well as an important volume of the opposite breast and lung. Methods Instead of classical positioning of the breast, we encircled the breast with a plastic polyvinyl ring-shaped tube. All five left-sided breast cancer patients underwent CT scan planning with and without the plastic ring in conventional treatment positioning. Skin treatment portals at the midline and mid axilla were marked with radio-opaque markers. The scan volume encompassed the region from just below the diaphragm to the lung apex. Patients' plans were evaluated with regard to dose-volume coverage of the breast planning target volume, ipsilateral lung, contralateral lung, heart and contralateral breast. End points were maximum dose, minimum dose, and mean dose delivered to the target or critical structure. Results As expected, the average volume of the left lung treated above a tolerance dose of 2000 cGy was less than 10% in the ringed breast, whereas in the other method without the ring the corresponding lung volume was 30%. The cardiac volume receiving a dose over 4000 cGy was 2% in the ringed breast and 18% in the breast without a ring. Conclusions With the use of a simple technique with a fairly low expenditure, acute skin reactions and late cardiac and lung morbidity can be minimized in patients with large breasts.
Experimental Assessment of Chemotherapy-induced Early Intestinal Damage in Colon Cancer the Lactulose-mannitol Permeability Test
Authors: Sukkar Samir Giuseppe , Schenone Emanuela , Foppiani Luca , Nobile Maria Teresa 
Published: April 2018

Aims and Background Although chemotherapy plays an important role in the management and cure of cancer, it has undesiderable side effects mostly affecting the bone marrow and gastrointestinal tract, which greatly limit patient compliance and treatment efficacy. Methods The lactulose-mannitol test was used to assess intestinal mucosa damage 48 hours after the end of the first adjuvant chemotherapy cycle with 5-fluorouracil (5-FU) and levamisole in 12 patients with colon cancer. Fifteen age- and sex-matched subjects were studied as controls. The excreted amount of lactulose and mannitol was expressed as the percentage of the administered doses recovered in the urine as well as their ratio. Results The percent urinary recovery of lactulose was significantly (P <0.001) higher in colon cancer patients (1.1 ± 0.5%) than in the control group (0.3 ± 0.03%), whereas the mannitol recovery was only slightly reduced in the former. As a result, the lactulose/mannitol excretion ratio was significantly (P <0.001) higher in colon cancer patients (0.07 ± 0.03) than in the control group (0.01 ± 0.01). Conclusions As assessed by the lactulose-mannitol test, the combined chemotherapy regimen with 5-FU and levamisole affects mainly the barrier function of the intestinal mucosa rather than its absorption capacity. The toxic effect seems to be attributable to the 5-FU molecule rather than to levamisole. The lactulose-mannitol test is a simple, safe and reliable tool to evaluate chemotherapy-induced early damage to the intestinal epithelium, in particular when new kinds of substances are being administered. Its use in clinical practice seems appropriate to establish the correct timing of drug administration, thereby enhancing treatment efficacy and improving patient compliance.
Narrower Surgical Margins Might be Sufficient in Invasive Horizontal Growth Phase Melanoma
Authors: Bono Aldo , Bartoli Cesare , Baldi Marzia , Moglia Daniele , Santoro Nicola , Tomatis Stefano , Dorji Tshering , Cascinelli Natale , Santinami Mario 
Published: April 2018

Background and Aims The delineation of horizontal and vertical growth phases in primary cutaneous melanoma has contributed to our understanding of melanoma progression. Horizontal growth phase invasive melanomas are now believed to metastasize very rarely. Consequently, some of us have started to treat these lesions with very limited surgical margins, assuming that in terms of biological behavior this type of melanoma is more similar to an in situ than an invasive lesion. Methods Between January 1997 and December 2001 42 lesions of this type in 41 patients (24 women and 17 men) were treated in the outpatient clinic under local anesthesia. The excision margin was half a centimeter and the subcutaneous fat was cleared in most cases to the deep fascia, which was conserved. Loss was made good by direct tissue closure. All patients had undergone an excisional biopsy before definitive surgery. The size of the lesions ranged from 2 mm to 19 mm in maximum linear extent (median 7 mm). Lesion thickness ranged from 0.11 mm to 0.58 mm (median, 0.27 mm). Results The median follow-up was 47 months (range, 26-83). During this period none of the patients had locoregional or distant relapses. Conclusions This preliminary report seems to corroborate the assumption that horizontal growth phase melanoma is not an aggressive lesion and might therefore be cured by non-aggressive surgery. The proper treatment of such lesions might be a surgical excision at half a centimeter distance from the biopsy scar. This approach may produce very good cosmetic results, while keeping the costs and required resources to a minimum.
Preradiation Chemotherapy with VM-26 and CCNU in Patients with Glioblastoma Multiforme
Authors: Mañé Joan M , Fernández Ricardo , Muñoz Alberto , Rubio Itziar , Ferreiro Josefa , López-Argumedo Gonzalo , Barceló Ramón , López-Vivanco Guillermo 
Published: April 2018

Aims and Background The objective of the study was to evaluate the efficacy of combined chemoradiation in patients with newly diagnosed glioblastoma multiforme. The main end points were time to progression and overall survival. Methods Thirty-one patients with glioblastoma multiforme underwent surgery whenever possible and then received intravenous VM26 (120 mg/m2) and oral CCNU (120 mg/m2) for three cycles followed by radiotherapy (60 Gy). Results Surgery consisted of a complete resection in 39% of patients, partial resection in 35% and a biopsy in 26%. Sixteen patients had clinical or radiological evidence of progression during or after chemotherapy. Hematologic toxicity was mild. Forty-five percent of patients received the scheduled dose of radiation. The outcome was disappointing, with a median time to progression of 18 weeks and median survival of 37.17 weeks. Conclusions The survival of patients with glioblastoma multiforme remains disappointing. Multimodal therapy does not seem to modify the evolution of the tumor. Stratification according to prognostic factors might detect a potential benefit of other therapeutic approaches.
Androgen Ablation Therapy Does not Increase the Risk of Late Morbidity following 3D-conformal Radiotherapy of Organ-confined Prostate Cancer: The Experience of the European Institute of Oncology
Authors: Greco Carlo , Castiglioni Simona , Fodor Andrei , Mazzetta Chiara , De Cobelli Ottavio , Orecchia Roberto 
Published: April 2018

Aims and Background Androgen ablation therapy in conjunction with radiotherapy-neoadjuvant and adjuvant – has consistently been shown to be associated with improved biochemical and local control, whereas controversy still remains as regards its benefit in terms of overall survival. The objective of this study is to determine the impact of androgen ablation in combination to 3D-conformal radiotherapy on late treatment-related toxicity. Methods 236 patients were treated with 3D-conformal radiotherapy to a total dose ranging from 70 and 78.6 Gy. Fifty-six patients did not receive any form of androgen ablation whereas 176 were given at least 3 months of neoadjuvant androgen ablation. Of these, 64 stayed on androgen ablation for a median time of 6 months post-radiotherapy. Acute toxicity was evaluated weekly during the course of treatment. Late toxicity was assessed at 3-months intervals during the follow-up. Toxicity was scored according to the RTOG criteria. Results The median follow-up was 24.6 months (range, 12-62). The incidence of late genitourinary toxicity was: 3% G2, 3.5% G3, 0.5% G4. The incidence of late gastrointestinal toxicity was: 12% G2, 2% G3, 1% G4. No association was observed between the use of androgen ablation and late treatment-related toxicity. High-risk patients who continued on androgen ablation long-term were not found to have an increased risk of developing late toxicity with respect to those who never had any form of androgen ablation or those only treated neoadjuvantly. Conclusions In our experience, the use of androgen ablation does not impact on late toxicity following high dose 3D-conformal radiotherapy for prostate cancer.
Measures of Late Effects in Conservative Treatment of Breast Cancer with Standard or Hypofractionated Radiotherapy
Authors: Marcenaro Michela , Sacco Simona , Pentimalli Sara , Berretta Laura , Andretta Valeria , Grasso Rachele , Parodi Roberto Carlo , Guarrera Marcella , Scarpati Daniele 
Published: April 2018

Aims and Background To confirm the equivalence in terms of late effects between two fractionation schedules of radiotherapy in conservative treatment of breast cancer. Methods Fifty-eight patients treated at our institution from 1999 to 2002, with a median follow-up of 15 months (range, 7-46 months), were evaluated retrospectively. Twenty-nine patients (group A) were treated with standard fractionation: 5000 cGy/25fx/5 weeks, and 29 patients (group B) were treated with a hypofractionated schedule: 4500 cGy/15fx/5 weeks, three fractions per week. Late effects were evaluated using the LENT-SOMA scoring scale. The cosmetic results were assessed on a five-point scale. Skin elasticity was measured using a dedicated device (Cutometer SEM 575). Results There were no differences in breast volume, age at diagnosis and follow-up between groups. The LENT-SOMA toxicity observed in groups A and B, respectively, was as follows: grade 2-3 pain in five patients in each group; grade 2 breast edema in two and three patients; grade 2-3 and grade 2 fibrosis in six and eight patients; grade 2 and grade 2-3 telangiectasia in two and three patients; grade ≥2 and 2 arm edema in two and one patients; no ulceration or atrophy were observed. Two patients in group A and one patient in group B needed treatment for breast and arm edema and arm edema, respectively. Very good, good-acceptable, and poor cosmetic results were observed in seven and two, fifteen and nineteen, and six and eight patients, respectively. Median skin elasticity loss due to treatment was −4.19% in group A and −6.29% in group B. These results are not statistically different. Conclusions LENT-SOMA toxicities were minimal and no differences were observed between groups. Few patients in the hypofractionated group had very good cosmetic results, but it is debatable if radiotherapy was the only cause. Skin elasticity was not different between groups. Our results seem to suggest that it is possible to treat patients with both schedules, with similar late toxicity.
Two Cases of Secondary Sotf Tissue Sarcomas after Radiotherapy and Radiochemotherapy
Authors: Saggia Chiara , Forti Giorgio , Biaggi Gabriele , Lattuada Sara , Santagostino Alberto , Angeli Giovanni , Pollo Maria Cristina , Negru Maria Emanuela , Alabiso Oscar 
Published: April 2018

Background The development of secondary soft tissue sarcomas after chemo-radiotherapy is a rare and little known event, but its frequency is increasing. Patients and Methods We report two cases of secondary soft tissue sarcomas. The first is the case of a 51-year-old woman treated for Hodgkin's disease with chemotherapy and radiotherapy 15 years before she developed a high-grade malignant pleural sarcoma. The patient had no history of asbestos exposure. The second is the case of a 64-year-old woman with a giant cell malignant histiocytoma secondary to colorectal cancer treated with surgery and radiotherapy nine years before. The patients were not eligible for surgery or radiotherapy. Both were treated with chemotherapy (ifosfamide and epirubicin) without any relevant secondary effects; however, the response to therapy was poor. Conclusions The causes of secondary malignancies are multifactorial, but radiation therapy and chemotherapy are certainly implicated in the development of post-therapy neoplasms that are difficult to treat.
A Long-term Follow-up Analysis in Adult Acute Myeloid Leukemia Patients after Hematopoietic Stem Cell Transplantation
Authors: Annaloro Claudio , Zilioli Vittorio Ruggero , Fracchiolla Nicola Stefano , Verier Claudia , Soligo Davide , Volpe Aldo Della , Deliliers Giorgio Lambertenghi 
Published: April 2018

Aims and Background Over the last 17 years, 119 adult acute myeloid leukemia patients have undergone hematopoietic stem cell transplantation at our Center. Study Design Seventy patients in first complete remission received hematopoietic stem cell transplantation (28 allogeneic and 42 autologous HSCT) as late intensification after conventional chemotherapy; 38 patients received allogeneic hematopoietic stem cell transplantation in a more advanced phase. A reference group was built up by collecting 40 acute myeloid leukemia patients who received high-dose cytosine arabinoside as late intensification and whose complete remission lasted more than 10 months. Results Results of the study led to conclude that an earlier timing of allogeneic hematopoietic stem cell transplantation can be recommended in order to treat patients who would otherwise suffer an early relapse. Conclusions The outcome of autologous hematopoietic stem cell transplantation in patients not in first complete remission supports the possibility of achieving good quality second complete remissions and suggests that autografting may be a life-saving strategy in selected acute myeloid leukemia patients with advanced disease.
Chemotherapy with Mitomycin C and Capecitabine in Patients with Advanced Colorectal Cancer Pretreated with Irinotecan and Oxaliplatin
Authors: Rimassa Lorenza , Gullo Giuseppe , Carnaghi Carlo , Abbadessa Giovanni , Zuradelli Monica , Tronconi Maria Chiara , Pressiani Tiziana , Santoro Armando 
Published: April 2018

Aims and background To assess the activity and tolerability of the combination of mitomycin C and capecitabine in patients with metastatic colorectal cancer after failure of irinotecan- and oxaliplatin-containing regimens. Methods We retrospectively reviewed 28 patients with pretreated advanced colorectal cancer who had been treated with mitomycin C, 6 mg/m2 on day 1, and capecitabine, 1,900 mg/m2 on days 1–14, every 3 weeks. Tumor assessment was performed every 3 cycles, toxicity assessed at each cycle. Results Main patient characteristics were median age, 61 years (range, 35–73); male/female ratio, 16/12; single metastatic site involvement, 5/28 (18%); ≥3 metastatic sites, 10/28 (36%). Ninety-six courses of therapy were given (median number, 3; range, 1–9). Twenty-six patients were assessable for response, and all were assessable for toxicity. There was 1 partial response (4%) and 12 had stable disease (43%). Median time to progression was 2 months (range, 1–9) and median overall survival was 6 months (range, 1–29+), with a 1-year overall survival rate of 25%. The regimen was very well tolerated without significant hematological toxicity. Conclusions Our results are disappointing. Despite the good safety profile, they do not support further investigation or the routine use of this regimen in this setting.
The Correlation between TTF-1 Immunoreactivity and the Occurrence of Lymph Node Metastases in Patients with Lung Cancer
Authors: Altaner Semsi , Yoruk Yener , Tokatli Fusun , Koçak Zafer , Tosun Birsen , Guresci Servet , Kutlu Kemal 
Published: April 2018

Aims and background Thyroid transcription factor (TTF-1) is a tissue-specific transcription factor expressed in the epithelial cells of thyroid and lung. The aim of this study was to evaluate the relationship between the expression of TTF-1 and clinicopathological parameters in pulmonary adenocarcinoma and adenosquamous carcinoma. Methods Resection material of pneumonectomies and lobectomies of 39 patients was retrospectively examined. Twenty-eight patients were diagnosed with adenocarcinoma and 11 with adenosquamous carcinoma. Tumors were classified into 3 groups: a strongly positive group (++) with ‡50% tumor cells positive for TTF-1; a weakly positive group (+) with 1–49% positive tumor cells; and a negative group (-) with less than 1% or no positive tumor cells. Analysis was performed with Kaplan-Meier estimates and log-rank tests. Results Staining for TTF-1 was negative in 10 cases. There was focal staining in 9 cases, while there was diffuse staining in 20 (51%) cases out of 39, and 15 (75%) of these were adenocarcinomas. There was a statistically significant association between TTF-1 and lymph node metastases (P = 0.029). No relationship was found between TTF-1 positivity and disease-free and overall survival. Conclusions TTF-1 expression may be a predictor of lymph node metastases. Additional work in a larger group of patients is needed to better assess the utility of this marker.
Combining Independent Studies of Diagnostic Fluorodeoxyglucose Positron-Emission Tomography and Computed Tomography in Mediastinal Lymph Node Staging for Non-Small Cell Lung Cancer
Authors: Alongi Filippo , Ragusa Pietro , Montemaggi Paolo , Bona Cristina Maria 
Published: April 2018

Aims and background A meta-analysis of diagnostic test performance was conducted to compare the results of relevant studies reporting diagnostic accuracy values for mediastinal staging in patients with non-small cell lung cancer (NSCLC). This paper deals with the two most accurate imaging techniques currently in use: positron emission tomography (PET) with FDG and computed tomography (CT). A statistical pooling method was used to perform a quantitative meta-analysis aimed at demonstrating the potential advantage of one of these two methods. Methods Studies in all languages published between 1998 and 2005 that examined the use of FDG-PET and CT for mediastinal staging in NSCLC patients, enrolled at least 18 participants, and provided enough data to allow calculation of sensitivity and specificity rates were considered eligible for the quantitative meta-analysis. Statistical methods to pool the overall estimates of sensitivity and specificity and to compare the discriminant power of PET and CT were discussed and used. Results Of the 13 studies included in the analysis, 12 reported greater accuracy of FDG-PET than CT in detecting mediastinal lymph node metastases. The sensitivity of FDG-PET ranged from 50% to 100%. The estimate of the overall sensitivity was 0.83% with 95% CI (0.749–0.913). Specificity ranged from 79% to 100%, with an overall estimated specificity of 0.87% with 95% CI (0.80–0.95). For CT, the sensitivity and specificity ranged from 50% to 97% and 58% to 94%, respectively; the overall estimate was 0.68% with 95% CI (0.582–0.788) and 0.76% with 95% CI (0.668–0.859). The summary receiver operating characteristic (SROC) approach was used to assess the superior diagnostic accuracy of one of the two methods. The areas under the two SROC curves were AUCPET = 0.909 vs AUCCT = 0.794. Conclusions Numerical and visual results of the meta-analysis of recent relevant reports agreed that FDG-PET is more accurate than CT in identifying mediastinal lymph node metastases in non-small cell lung cancer.
TRATTAMENTO DELLE METASTASI LINFOGHIANDOLARI PERIFERICHE NEI TUMORI A SEDE PRIMITIVA IGNOTA
Authors: Catania V. C. 
Published: April 2018

The relative frequency of peripheric lymphoglandular metastases from unknown primary malignant lesion is outlined. The survival date for untreated, radiologically and surgically treated patients are comparatively examined. In these patients the clinical course of the disease is characterized more by the increasing of metastases than by the evolution of the primary tumor. A radical surgery of the involved lymphatic ganglion is advised and supported by the exposition of a report of cases with late results.