bluuebunny/crossref_metadata_2025_split huggingface dataset:
Results of Whole Brain Radiation Therapy in Patients with Brain Metastases from Colorectal Carcinoma
Authors: Amichetti Maurizio , Lay Giancarlo , Dessì Marina , Orrù Silvia , Farigu Roberta , Orrù Paola , Farci Daniele , Melis Sandro ,   Cagliari Neuro-Oncology Group, Battolu M , Bruder F , Cherchi C , Desogus A , Miragliotta G , Murtas S , Porcu G , Pusceddu C , Rais M , Sulas P 
Published: July 2019

Aims and background Carcinoma of the colon-rectum is an infrequent cause of brain metastases, constituting 1-5% of all metastatic lesions to the brain. We reviewed our experience in the treatment of brain metastases from colorectal cancer to define the efficacy of whole brain radiation therapy as a palliative measure in this setting of patients. Methods Twenty-three consecutive cases of brain metastasis from colorectal cancer treated between 1999 and 2004 were identified in the files of the Division of Radiotherapy of the A Businco Regional Oncological Hospital, Cagliari. Their records were reviewed for patient and tumor characteristics and categorized according to the RTOG RPA classes. Results Fifteen patients (65%) had multiple metastases. Twenty-one patients (91%) showed extracranial metastases. Fourteen patients were classified as RTOG RPA class II and 9 class III. The median radiation dose delivered was 2000 cGy in 5 fractions in one week (range, 20-36 Gy). In 14 of 20 assessable patients (70%), symptomatic improvement was observed. The median follow-up and survival time for all the patients, 12 females and 11 males, was 3 months. In 3 patients only the cause of death was the brain metastasis. Conclusions Despite the disappointing survival time, external radiation therapy to the whole brain proved to be an efficacious palliative treatment for patients with multiple or inoperable brain metastasis from colorectal cancer.
Human Papillomavirus Detection by Hybrid Capture II and Residual or Recurrent High-Grade Squamous Cervical Intraepithelial Neoplasia after Large Loop Excision of the Transformation Zone (LLETZ)
Authors: Sarian Luís Otávio , Derchain Sophie Françoise Mauricette , da Rocha Pitta Denise , Andrade Liliana Aparecida Angelo , Moráis Sirlei Siani , Figueiredo Priscila Garcia 
Published: July 2019

Aims and background The purpose of this study was to assess the association between highly-oncogenic types HPV DNA detection by Hybrid Capture II (HCII) and residual or recurrent high-grade cervical intraepithelial neoplasia (CIN 2 or 3) during the follow-up of women submitted to large loop excision of the transformation zone (LLETZ). Study design In this cohort study, 94 women submitted to LLETZ because of CIN 2 or 3 between March 2001 and September 2002 were followed up twice yearly until September 2003. Follow-up visits consisted of an interview regarding clinical, social and demographic characteristics complemented with gynecological examination with specimen collection for Pap test and HCII and colposcopy. Eighty-one patients attended the first visit (mean 4.8 months, range 3-6) and 75 the second visit (mean 10.9 months, range 7-17 months). McNemar's test to assess the variation of HPV DNA detection following LLETZ, odds ratios (OR) to evaluate the correlation between HPV DNA positivity and residual/recurrent CIN during follow-up, and logistic regression to assess the risk of residual/recurrent CIN were used. Results There was a strong and significant reduction in HPV detection after LLETZ ( P <0.001). HPV DNA detection was correlated with residual/recurrent CIN at the first (OR = 103.4; 95% CI 5.5 to 1961.2) and second (OR = 12.7; 95% CI 1.1 to 345.5) follow-up visits. Multivariate analysis showed HPV persistence as a stand-alone risk factor for residual/recurrent CIN (OR = 50.3; 95% CI 3.8 to 663.1). Conclusions High risk HPV DNA detection decreased substantially after CIN treatment with LLETZ, but HPV persistence was strongly correlated with residual/recurrent CIN.
A Short Impact of Epidemiological Features of Colorectal Cancer in Iran
Authors: Pahlavan Payam Samareh , Jensen Katrin 
Published: July 2019

Aims and background The incidence of colorectal cancer varies from one country to another although the variation is not much different in neighboring countries. Even in one country there is no relevant variation in incidence from one province to another. A study of different provinces in a vast developing country, Iran, was performed to determine the incidence of colorectal cancer. Methods Information from cancer registries of four provinces in the north, north-west and central-south of Iran regarding colorectal cancer was gathered for analysis. A total of 1628 cases with colorectal cancer in a total population of 6,435,549 was identified. Results and conclusions In all provinces, there were more male than female patients with colorectal cancer. The study also showed that the incidence of the disease in young patients was higher than expected. Except for Israel because of genetic factors, these provinces showed one of the highest ASR among Asian countries. This finding probably indicates more westernization in the Iranian diet with a genetic influence. Some social habits including dietary and tobacco smoking may also influence the incidence of colorectal cancer in the Iranian population. Community-related risk factors need further investigation, especially in the high-risk Northern part of the country.
Vacuum-Assisted Core Biopsy (Mammotome) for the Diagnosis of Non-Palpable Breast Lesions: Four-Year Experience in an Italian Center
Authors: Costantini Raffaele , Sardellone Augusto , Marino Cristiana , Giamberardino Maria Adele , Innocenti Paolo , Napolitano Antonio Maria 
Published: July 2019

Aims and background Microinvasive biopsy techniques are increasingly employed in the diagnostic assessment of non-palpable breast lesions (NPBLs). This study reports the four-year experience of an Italian surgical center in the evaluation of the diagnostic effectiveness versus adverse effects of vacuum-assisted core biopsy (Mammotome). Methods 314 NPBLs with a dubious ultrasound and/or radiographic appearance were subjected to mammography-guided (86) or ultrasound-guided (228) Mammotome biopsy. Results The procedure could be completed and was diagnostic in 305 cases (P <0.0001). Adverse events were transient lightheadedness. in two cases and moderate bleeding in three cases. Histological processing of the biopsies showed 227 cases of benign disease (74.42%), 68 cases of carcinoma (20 carcinomas in situ and 48 infiltrating carcinomas) (22.29%), nine cases of atypical ductal hyperplasia (2.95%) and one atypical lobular hyperplasia (0.33%). Only 12 patients reported mild discomfort relative to the procedure. The difference between the number of patients reporting discomfort and that of patients reporting no discomfort at all was highly significant (P <0.0001). Conclusions The results confirm that Mammotome biopsy is a highly effective procedure for the diagnosis of NPBLs, with minimal negative effects.
Raltitrexed and Radiotherapy as Adjuvant Treatment for Stage II-III Rectal Cancer: A Feasibility Study
Authors: Lupattelli Marco , Maranzano Ernesto , Bellavita Rita , Natalini Giovanni , Corgna Enrichetta , Rossetti Riccardo , Trippa Fabio , Mascioni Francesca , Sidoni Angelo , Anselmo Paola , Buzzi Franco , Brugia Mauro , Latini Paolo 
Published: July 2019

Aims and Background Adjuvant 5-FU chemotherapy plus radiotherapy represents the standard treatment for radically resected rectal cancer at high risk of relapse according to the NIH Consensus Conference. The therapeutic gain was obtained with a high rate of severe treatment-related toxicity and a sub-optimal patient compliance with this regimen. Raltitrexed is a specific thymidylate synthase inhibitor with a convenient administration schedule, acceptable toxicity and radiosensitizing properties, as the published phase I trials in combination with radiotherapy have shown. The aim of this prospective multicenter phase II study was to evaluate the feasibility, gastrointestinal and hematological acute toxicity of raltitrexed in combination with radiotherapy in rectal cancer patients. Methods From September 2000 to June 2004, 50 patients with radically resected stage II-III rectal adenocarcinoma were treated. All patients were evaluable for compliance and acute toxicity. Within 45-60 days of surgery, each patient underwent concomitant adjuvant radiochemotherapy. Radiotherapy was administered to the pelvis (plus perineum after abdominoperineal resection) with photon beam energy exceeding 5 MV, 3-4 fields, 45 Gy/25 fractions/5 weeks plus a boost delivered to the site of resected disease with 3-4 fields, 9 Gy/5 fractions/1 week to a total dose of 54 Gy. The boost dose was administered after complete exclusion of the small bowel from the treatment volumes; if this was not possible a total dose of 50.4 Gy was given. Raltitrexed was administered intravenously at a dose of 3 mg/m2 as a bolus injection on days 1 and 22 of radiotherapy one hour before treatment, for a total of two cycles. Each patient underwent weekly clinical evaluation and laboratory tests. Toxicity was assessed by the WHO scale. Results Forty-five (90%) patients completed the established treatment. Acute severe toxicity included grade III proctitis in 4/50 (8%), grade III-IV diarrhea in 4/50 (8%), grade III perineal dermatitis in 4/50 (8%) and grade III leukopenia in 2/50 (4%) patients; five patients (10%) experienced a transient grade III increase in their liver biochemistry values. Conclusions Our data related to acute toxicity and patient compliance proved the feasibility of this adjuvant radiochemotherapy treatment. A longer follow-up is necessary to evaluate the effectiveness of this new regimen in terms of disease-free and overall survival.
Bag-1 Expression in Hyperplastic and Neoplastic Prostate Tissue: Is There Any Relationship with BCL-Related Proteins and Androgen Receptor Status?
Authors: Bozdoğan Önder , Atasoy Pınar , Bozdoğan Nazan , Erekul Selim , Batislam Ertan , Yilmaz Erdal , Başar M. Murad 
Published: July 2019

Aims and Background To evaluate the function and distribution of BAG-1 protein in hyperplastic and neoplastic prostate tissue and establish the relationship between this protein and BCL-related proteins (BCL-2 and BAX), androgen receptor (AR) expression and chromogranin A. Methods Twenty-eight prostatic adenocarcinomas and 16 prostate hyperplasias were included in this retrospective study. BAG-1, BCL-2, BAX, androgen receptor and chromogranin A immunostaining was performed by means of standard avidin-biotin peroxidase methods. The M30 antibody was used to identify preapoptotic and apoptotic cells. The immunohistochemical histological score (HSCORE) semi-quantative system was used to evaluate immunohistochemical staining. Results Statistical analysis showed a significant difference in HSCOREs of BAX, M30 and AR between the carcinoma and hyperplasia groups. Carcinomas expressed higher HSCOREs of these markers than hyperplasias. There were significant differences in nuclear and cytoplasmic BAG-1 positivity between high and low-grade carcinomas. BAG-1 expression was higher in low-grade carcinomas. In the carcinoma group there was a positive correlation (Pearson) between BCL-2 and cytoplasmic/nuclear BAG-1. In the hyperplasia group there was a negative correlation between BAX and BCL-2, and between AR and M30. We also detected a positive correlation between AR and nuclear/cytoplasmic BAG-1 and between nuclear and cytoplasmic BAG-1 in hyperplasias. BAG-1 showed the same specific basal cell localization as BCL-2 in hyperplastic and normal glands. Conclusions The BAG-1 protein showed a distinct distribution pattern in hyperplastic and neoplastic prostate. BAG-1 in association with BCL-2 inhibits apoptosis and may prolong the life of neoplastic cells and give them a chance to gain new oncogenic features in early carcinogenesis.
Phase II Study of Induction Chemotherapy with Gemcitabine plus 5-Fluorouracil Followed by Gemcitabine-Based Concurrent Chemoradiotherapy for Unresectable Locally Advanced Pancreatic Cancer
Authors: Kurt Ender , Kurt Meral , Kanat Ozkan , Cetintas Sibel Kahraman , Aygun Sevilcan , Palazoglu Tulay , Ozkan Lutfi , Evrensel Turkkan , Kaya Ekrem , Manavoglu Osman 
Published: July 2019

Aims and background To evaluate the efficacy and tolerability of a new treatment approach including induction chemotherapy (CT) and concurrent chemoradiotherapy (CRT) in unresectable, locally advanced pancreatic cancer (LAPC). Patients and methods Twenty-four patients with LAPC were enrolled in the study. They first received induction CT consisting of 5-fluorouracil (5FU) (500 mg/m2) and gemcitabine (1000 mg/m2), which were given weekly for 3 weeks of every 4. Patients showing a response or disease stabilization after 2 cycles of induction CT received CRT consisting of external beam radiotherapy (50.4-54 Gy in fractions of 1.8 Gy/day) and gemcitabine (350 mg/m2, weekly for 6 weeks). Patients without disease progression received 2 additional cycles of CT consisting of 5FU plus gemcitabine with the same doses and schedule as given in the induction CT. Results After the end of the study, 2 (8%) and 5 (21%) patients showed complete and partial responses, respectively. Five patients (21%) had disease stabilization. The grade 3 and 4 toxicities associated with CT were neutropenia (21%) and thrombocytopenia (4%). The grade 3 and 4 toxicities occurring in patients who received CRT were neutropenia (24%), thrombocytopenia (24%), diarrhea (18%), and nausea (12%). The median progression-free survival for all patients was 6 months (95% CI, 3.6-8.4), and the median overall survival was 11 months (95% CI, 8.16-13.84). Conclusions The CRT approach of this study is moderately active and has an acceptable toxicity profile. However, the incor-poration of combination CT into CRT at the present schedule could not produce any additional benefit over CRT alone. Newer agents with more systemic activity are clearly warranted.
Analysis of Metastatic Ovarian Tumors from Extragenital Primary Sites
Authors: Turan Taner , Aykan Burcu , Koc Sevgi , Boran Nurettin , Tulunay Gokhan , Karacay Ozlem , Erdogan Zuhal , Kose Faruk 
Published: July 2019

Aims and background The aim of this study was to evaluate patients with metastatic ovarian tumors from extragenital primary sites. Methods The medical records of 75 patients were reviewed retrospectively for age at diagnosis, presenting symptoms, preoperative tumor marker levels, preoperative diagnostic workup, operative technique, intraoperative evaluation, frozen-section and pathology results, laterality of metastasis, and primary tumor site. The specific impact of metastasis from colorectal and gastric primary sites on laterality, gross features and dimensions of ovarian mass, volume of ascites and tumor marker levels was investigated. Results Primary sites were stomach (37.3%), colorectal region (28%), lymphoma (12%), breast (6.7%), biliary system (2.7%), appendix (1.3%) and small intestine (1.3%). It was not possible to identify the primary tumor site in 8 (10.7%) patients. Bilateral metastasis was found in 86.4% patients; 42.7% of the metastatic ovarian tumors were Krukenberg tumors; 50.7% of the ovarian masses were solid. Frozen section was confirmed by postoperative pathological results in 98% of the patients. The mean preoperative serum levels of tumor markers were 298.7 U/mL, 178 U/mL and 113.3 U/mL for CA 125, CA 19-9 and CA 15-3, respectively. CA 125 levels were above 35 U/mL in 81.3% of the patients. The presence of ascites was more frequent in ovarian tumors originating from colorectal and gastric primaries. Conclusions Surgery is essential for the diagnosis of the primary tumor and necessary for relief of symptoms. The identification of the primary site is required to plan adequate treatment.
Target Coverage in Head and Neck Cancer Treated with Intensity-Modulated Radiotherapy: A Comparison between Conventional and Conformal Techniques
Authors: Palazzi Mauro , Orlandi Ester , Pignoli Emanuele , Lualdi Manuela , Zonca Giancarlo , Sangalli Claudia , Stucchi Claudio , Olmi Patrizia 
Published: July 2019

Aims and background We designed a comparative planning study aimed at quantifying the advantages of intensity-modu-lated radiotherapy (IMRT) over the conventional 3-field technique (3FT) and a 5-field conformal technique (5FCT) for head and neck (HN) cancer. Methods We selected 9 patients treated at our institution with curative radiotherapy for a HN cancer. For all cases 4 plans were generated: 2 plans using the “standard” techniques (3FT and 5FCT), a third plan using IMRT, and a fourth “mixed” plan using IMRT followed by a conventional boost. Results Our study confirmed literature data on the ability of IMRT to significantly decrease the dose received by organs at risk, compared with previous techniques. Target coverage was systematically better with 5FCT and IMRT than with 3FT. However, the increase in coverage of both PTV2 and PTV1 was only about 3-5% and this was achieved at the price of a similar increase in maximum dose (D1%). Volumetric parameters (V100%, V95%) were much more sensitive in detecting the improvement with IMRT. Conclusions The improvement of target coverage attained by IMRT, as compared with conventional and conformal techniques, might be overestimated by data currently available in the medical literature. If treatment with conventional techniques is planned using all tools provided by currently available fully 3-D planning systems, excellent target coverage can be obtained.
MRI in the Early Detection of Breast Cancer in Women with High Genetic Risk
Authors: Trecate Giovanna , Vergnaghi Daniele , Manoukian Siranuosh , Bergonzi Silvana , Scaperrotta Gianfranco , Marchesini Monica , Ferranti Claudio , Peissel Bernard , Spatti Gianbattista , Bohm Silvia , Conti Alberto , Costa Claudia , Sporeni Manila , Podo Franca , Musumeci Renato 
Published: July 2019

Aims and background Women with BRCA1 or BRCA2 germline mutations have an elevated risk of developing breast and/or ovarian cancer. Because of the early onset of the disease, screening of this group of women should start at an earlier age than in the general population. The association of breast magnetic resonance imaging (BMRI) and ultrasonography (US) with mammography (MX) and clinical breast examination (CBE) in the regular surveillance of these individuals has been proposed and seems to improve the early detection of breast cancer. Methods Within a multicenter study started by the Istituto Superiore di Sanita (Rome), at the Istituto Nazionale Tumori of Milan (INT) we enrolled 116 women at high genetic risk for breast cancer; they were either BRCA1 or BRCA2 mutation carriers or had a strong family history of breast cancer. They underwent CBE, MX, US and BMRI once a year. Results Between June 2000 and April 2005, at INT 12 cancers were detected among the 116 screened individuals (10%). In this subgroup, 1 patient refused BMRI and in 2 cases US was not performed. With BMRI we found 11 cancers and 6 of them were detectable only by this technique. In these 6 cases, the size of the disease was less than 1 cm and MX was false negative due to irregularly nodular parenchyma in 4 cases and scar tissue or prosthesis in the other 2. US was not performed in 2 cases and was false negative in 4 cases. Three false positive results were found with BMRI: 1 case was considered suspect but related to hormonal influences; 1 case with the same pattern was sent for second-look US, which gave a negative result and BMRI review after 6 months showed normalization of the parenchyma; in the third case histology revealed the presence of adenosis. No false positive results were registered for MX. Conclusions The aim of secondary prevention is the detection of cancer at its earliest stage. BMRI screening in women with BRCA1 or BRCA2 mutations or at high familiar risk appears to be highly sensitive and may detect mammographically occult disease. The accuracy of MR imaging is higher than that of conventional imaging but the technique is flawed by a lower specificity. In order to avoid unnecessary biopsies we believe that the combination of BMRI and conventional imaging can be very useful in screening women with a high genetic risk of breast cancer, especially with second-look evaluation by means of US when BMRI yields the only positive diagnostic result. Second-look US has been demonstrated to be of critical importance both in recognizing false positive BMRI results and in guiding biopsies, when necessary.
Predicting chemotherapy-induced thrombocytopenia in cancer patients with solid tumors or lymphoma
Authors: Razzaghdoust Abolfazl , Mofid Bahram , Zangeneh Masoumeh 
Published: July 2019

Purpose Chemotherapy-induced thrombocytopenia is a serious complication in chemotherapy-treated patients. Identification of patients at risk for chemotherapy-induced thrombocytopenia could have clinical value in personalized management of patients and optimized administration of prophylactic thrombopoietic agents. The aim of this study was to develop a predictive model for chemotherapy-induced thrombocytopenia (platelet count < 100,000/µl) in cancer patients undergoing chemotherapy. Methods A total of 14 covariates were prospectively assessed as explanatory variables in a cohort of consecutive patients with solid tumors or lymphoma. A multivariable logistic regression model was developed after univariable analysis. A bootstrapping technique was applied for internal validation. Results Data from 305 patients during 1732 chemotherapy cycles were considered for analysis. Forty-eight patients (15.73%) developed chemotherapy-induced thrombocytopenia during their treatment course. The multivariable model exhibited three final predictors for chemotherapy-induced thrombocytopenia, including high ferritin (odds ratio, 4.41; bootstrap P = 0.001), estimated glomerular filtration rate <60 ml/min/1.73 m2 (odds ratio, 3.08; bootstrap P = 0.005), and body mass index <23 kg/m2 (odds ratio, 2.23; bootstrap P = 0.044). The main characteristics of the model include sensitivity 75%, specificity 65.4%, positive likelihood ratio 2.16, and negative likelihood ratio 0.382. Moreover, the model was well calibrated (Hosmer–Lemeshow P = 0.713) and the area under the receiver operating characteristic curve was 0.735 (95% confidence interval, 0.654–0.816; P < 0.001). Conclusions We developed a predictive model for chemotherapy-induced thrombocytopenia based on readily available and easily assessable clinical and laboratory factors. This study may provide a valuable insight to guide optimized treatment of cancer patients. Further studies with larger sample size are warranted.