bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immunomodulation in a Treatment Program Including Pre- and Post-Operative Interleukin-2 and Chemotherapy for Childhood Osteosarcoma
Authors: Luksch Roberto , Perotti Daniela , Cefalo Graziella , Passerini Carlo Gambacorti , Massimino Maura , Spreafico Filippo , Casanova Michela , Ferrari Andrea , Terenziani Monica , Polastri Daniela , Gambirasio Felicita , Podda Marta , Bozzi Fabio , Ravagnani Fabrizio , Parmiani Giorgio , Bellani Franca Fossati 
Published: April 2018

Aims and Background The treatment applied in our Institution to children with localized osteosarcoma between 1991 and 1999 consisted of four interleukin 2 (IL-2) courses (9 x 106 IU/mL/daily x 4), alternated with pre- and post-operative polichemotherapy. The aims of the present study were to quantify the modifications of some immunological parameters induced by IL-2 and to verify whether polychemotherapy could reduce them. An additional aim was to assess whether any correlation between the immune modifications and the clinical outcome could be found. Patients and Methods We evaluated in 18 consecutive patients the following changes, induced in blood by each IL-2 course: number of lymphocyte subpopulations and natural killer (NK) cells, lymphokine activated killer (LAK) and NK activities. Results Chemotherapy did not influence the modifications of the number of NK and CD4+ cells and of the LAK and NK activities, induced by each of the four courses of IL-2. The magnitudo of the NK activity and the peak of the NK absolute counts significantly correlated with the clinical outcome. Conclusions The results show that the use of IL-2 permitted a repeated immune activation despite the intensive chemotherapy. Furthermore, although the limited number of cases precludes any definitive conclusion, the results suggest a possible role of the NK cells in the control of osteosarcoma.
Clinical Presentation of Peritoneal Mesothelioma
Authors: Acherman Yair IZ , Welch Laura S , Bromley Christina M , Sugarbaker Paul H 
Published: April 2018

Aim To describe the clinical presentation of peritoneal mesothelioma and its impact on survival. Methods Data was collected from 51 patients with peritoneal mesothelioma treated at the Washington Cancer Institute. The demographic, clinical and pathologic information were analyzed. Results Pain was the most common symptom (recorded in 33% of patients); increased abdominal girth occurred in 31%, increased abdominal girth and pain in 5%, and a new onset hernia in 12%. In an additional 14% of patients, a variety of other clinical findings led to the diagnosis. There was a statistically significant difference in survival by gender, weight loss and volume of disease. Conclusions Pain was the most common initial presenting symptom, with increased abdominal girth as a second. A more favorable prognosis occurred in women with a small disease volume.
The Nipple-Sparing Mastectomy: Early Results of a Feasibility Study of a New Application of Perioperative Radiotherapy (Eliot) in the Treatment of Breast Cancer When Mastectomy is Indicated
Authors: Petit Jean Yves , Veronesi Umberto , Orecchia Roberto , Rey Piercarlo , Didier Florence , Giraldo Andrea , Luini Alberto , De Lorenzi Francesca , Rietjens Mario , Garusi Cristina , Intra Mattia , Yamaguchi Satoru , Martella Stefano 
Published: April 2018

Background Breast cancer surgery has become less and less mutilating, however a mastectomy is required in the case of multicentric, large tumors or recurrences after conservative treatment. The removal of the nipple areola complex during the mastectomy dramatically increases the feeling of mutilation. To reduce this negative psychological impact, in cancers located outside of the central area of the breast, we propose a new type of nipple-sparing mastectomy associated with intraoperative electron beam radiotherapy (ELIOT) delivered on the region of the areola. The nipple-sparing mastectomy is performed leaving 5 mm of glandular tissue behind the nipple areola complex to preserve its blood supply. The reconstruction is immediately performed with a prosthesis or an autologous flap. Patients and Methods Twenty-five patients were included in the study; two of them had a bilateral nipple-sparing mastectomy. Results Pathological examinations demonstrated the presence of 19 infiltrating carcinomas and 8 ductal carcinoma in situ. Two patients had a superficial skin areolar slough followed by spontaneous healing. One necrosis of the areola occurred due to extensive retroareolar dissection. In the early follow-up, the color of the areola was preserved. All patients except one expressed their satisfaction of having kept their areola. Conclusions These preliminary results are encouraging but they require further studies to evaluate the long-term results, the local recurrence rate and the psychological impact.
Surgical Management of Cerebral Metastases from Non-Small Cell Lung Cancer
Authors: Koutras Angelos K , Marangos Markos , Kourelis Theodoros , Partheni Melpomeni , Dougenis Dimitrios , Iconomou Gregoris , Vagenakis Apostolos G , Kalofonos Haralabos P 
Published: April 2018

Aims and Background The objective of the study was to assess the efficacy of surgical resection of solitary brain metastasis in patients with non-small-cell lung cancer. Methods and Study Design We report a retrospective analysis of 32 patients with single brain metastasis surgically excised at our hospital. All but one patient underwent postoperative whole brain radiation therapy. Results The median survival of patients was 12.5 months postoperatively (mean, 17 months), and the overall 1-year survival was 53%. Thirteen patients had recurrence of brain metastasis: 6 of 13 underwent reoperation for the recurrent lesion, and 1 of the 6 patients had a third craniotomy. Baseline characteristics, which significantly influenced survival, included age less than 60 years, tumor histology (ie, adenocarcinoma), and treatment of the primary lung cancer. The analysis did not yield any significant differences between treatment modalities. Conclusions Our findings correspond well with those reported in the literature and suggest that surgical resection of single brain metastasis in patients with non-small cell lung cancer can improve survival over conservative management. Furthermore, surgical treatment of the primary tumor and the single brain metastasis, combined or not with radiotherapy and chemotherapy, represents an approach that merits further investigation with more patients and a prospective longitudinal design.
Feasibility of Intensity-Modulated Radiation Therapy in the Treatment of Advanced Cervical Chordoma
Authors: Gabriele Pietro , Macias Victor , Stasi Michele , Chauvie Stéphane , Munoz Fernando , Delmastro Elena , Scielzo Giuseppe 
Published: April 2018

Aims and Background Postoperative radiation is often given in cases of cervical chordoma because of the high incidence of local recurrence. The tumor mass usually surrounds the spinal cord and infiltrates vertebral bone. A combined technique using protons or electrons to boost the initial photon fields is generally applied. We evaluated the use of dynamic intensity-modulated radiation therapy as an alternative technique for treating advanced cervical chordoma. Methods and Study Design A female patient with incomplete resection of a vertebral chordoma surrounding C2-C3 was irradiated with a total dose of 58 Gy (ICRU point) in 2 Gy daily fractions for 29 days between December 2001 and January 2002. Beam arrangement consisted of seven 6 MV non-opposed coplanar fields. Pretreatment quality assurance included checking of the absolute dose at reference points and 2D dose map analysis. Treatment was delivered with a 120-leaf collimator in sliding window mode. To verify the daily setup, portal images at 0° and 90° were compared with the simulation images before treatment delivery (manual matching) and after treatment delivery (automatic anatomy matching). Results and Conclusions The mean dose to the planning target volume (PTV) was 57.6 ± 2.1 Gy covering 95% of the PTV per 95% isodose. The minimum dose to the PTV (D99) was 53.6 Gy in the overlapping area between the PTV and the spinal cord planning organ at risk volume (PRV). The maximum dose to the spinal cord was 42.2 Gy and to the spinal cord PRV (8 mm margin) 53.7 Gy. The mean dose to the parotid glands was 37.4 Gy (homolateral gland) and 19.5 Gy (contralateral gland). Average deviation in setup was -1.1 ± 2.5 mm (anterior-posterior), 2.4 ±1.3 mm (latero-lateral), 0.7 ± 0.9 mm (craniocaudal) and -0.43 ± 1° (rotation). Conclusions In the treatment of chordomas surrounding the spinal cord, intensity-modulated radiotherapy can provide high dose homogeneity and PTV coverage. Frequent digital portal image-based setup control is able to reduce random positioning errors for head and neck cancer patients immobilized with conventional thermoplastic masks.
Small Cell Carcinoma of the Urinary Bladder. A Clinicopathologic Study of Five Cases
Authors: Kanat Ozkan , Evrensel Turkkan , Adim Saduman Balaban , Yavascaoglu Ismet , Kurt Ender , Demiray Mutlu , Gonullu Guzin , Manavoglu Osman 
Published: April 2018

Aims and Background Small cell carcinoma of the bladder (SCCB) is a rare entity characterized clinically by an aggressive behavior with a high incidence of systemic metastases. We report the clinicopathologic findings of five cases. Methods We reviewed five consecutive patients with SCCB treated at our institute. In each case the following clinical data were recorded: age, sex, presenting symptoms, endoscopically determined location of the tumor, clinical staging, node involvement (if any), site of metastases (if any), treatment, follow-up and outcome. Results There were four male and one female patients, age range 42 to 68 years, mean 57.6 years. The clinical presentation was not different from conventional transitional cell carcinoma, with hematuria being the most frequent complaint (four cases). Microscopic examination revealed oat cells in three cases and an intermediate variant in one. At the time of diagnosis the tumors were staged as T3bN2M0, T2N2M0, T4N0M0, T3aN0M0, and T2N0M0. Primary therapy consisted of radical cystectomy alone (one case), transurethral resection (TUR) alone (one case), TUR with chemotherapy (two cases), or TUR with chemotherapy and radiotherapy (one case). Four patients died of progressive disease, with survival from the time of diagnosis ranging from 7 to 16 months (mean, 12.2 months). One patient died of myocardial infarction (unrelated to the primary disease) one month after diagnosis. Conclusion Our study indicates that primary small cell carcinoma of the urinary bladder is as aggressive as its pulmonary counterpart and the overall prognosis of this tumor is very poor.
Cancer Incidence in Suriname from 1980 through 2000 a Descriptive Study
Authors: Mans Dennis Ricardo August , Mohamedradja Rabia Natasha , Hoeblal Aartie Reena Debie , Rampadarath Roshnidevi , Joe Susan Soei-Len Tjin A , Wong Jennifer , Ramautar Prakash , Mahabier Roël , Vrede Martinus Albertus 
Published: April 2018

Background and aims Current data on the epidemiology of cancer in the Republic of Suriname are scant and incomplete. In this study, incidence rates of the histopathologically confirmed malignancies in the country from 1980 through 2000 were inventoried. Patients and methods Numbers of diagnoses, as well as patient information, were acquired from the Pathology Laboratory. The General Bureau of Statistics of Suriname provided relevant demographic information. For each year, crude incidence and sex-specific rates were calculated for: cancer overall; the most frequent cancer sites; age strata 0-19, 20-49, and 50+ years; as well as for the presumably largest, second largest, and third largest ethnic group, viz. the Hindustani, Creole, and Javanese. From these data, average rates were calculated, which were expressed as mean ± SD per 100,000 population per year, or per 100,000 males or females per year. Results Average yearly crude and sex-specific incidence rates for cancer overall were 70 ± 12: 59 ± 9 for men and 83 ± 12 for women. The leading cancer sites were cervix uteri (sex-specific rate of 22.1 ± 5.1) as well as gastrointestinal tract, breast, hematological system, prostate, head and neck, lung, and liver (sex-specific rates ranging from 2 to 17). The relatively high rate of cervical cancer was for an important part responsible for the 1.4-fold female over male overall cancer excess. Incidence rates of most cancers increased from age group 20-49 years on, being highest after age 50+ years, but hematological malignancies occurred in all age groups with rates of 1-3 new cases per 100,000 males or females per year. Cancer was in general 2-6 times more common in Creole than in Hindustani and Javanese. However, cervical cancer was seen as often in Hindustani as in Creole. Most cases of primary liver cancer involved, besides Creole of both genders, Javanese males. Thyroid cancer occurred more frequently in Hindustani women. Conclusions The data from the study suggest that the incidence profile of cancer in Suriname may resemble that of most developing countries. It was relatively low for cancer overall as well as for most individual sites, but relatively high for cervical cancer, thus producing the characteristic female over male excess. More detailed studies on the peculiarities in the ethnic distribution of cancer may help to shed more light on the etiology of certain malignancies.
A Phase I Study of Gemcitabine Combined with Vinblastine in Patients with Solid Tumors
Authors: Capuchino Izabel , Suarez Eloah Rabello , del Giglio Auro 
Published: April 2018

Aims and background Gemcitabine and vinblastine are chemotherapeutic drugs with a wide spectrum of antitumor activity. We conducted a phase I trial to define the maximal tolerated dose of this combination. Methods Twenty-nine patients with a variety of solid tumors with measurable disease were included. Twenty-seven of these patients had been previously treated with chemotherapy. The use of hematological growth factors was not allowed. The maximal tolerated dose was defined as the level in which WHO grades 3 or 4 non-hematological toxicity would occur in at least a third of the patients. Results The maximal tolerated dose was reached at level 5, which consisted of gemcitabine (1000 mg/m2) with vinblastine (3 mg/m2) given intravenously on days 1, 8 and 15 every 28 days. At this level, one patient had WHO grade 3 cerebellar toxicity and another WHO grade 4 anorexia. Furthermore, patients were able to receive all 3 weekly doses of chemotherapy in only 2 out of 10 cycles of treatment given at this level. We also observed 5 episodes of WHO grades 1 and 2 neuropathy, most of which (4/5) occurred in patients previously exposed to neurotoxic chemotherapy. We recorded 2 partial responses (one at level 3 and the other at level 4) and 8 instances of stable disease after 3 scheduled cycles of the combination. Conclusions We therefore recommend gemcitabine (1100 mg/m2) plus vinblastine (5.5 mg/m2) given on days 1 and 8 every 21 days (level 4) for previously treated patients with solid tumors, with special caution in patients previously exposed to neurotoxic chemotherapy.
Case-Control Study of Anaplastic Thyroid Cancer
Authors: Zivaljevic Vladan , Vlajinac Hristina , Jankovic Radovan , Marinkovic Jelena , Diklic Aleksandar , Paunovic Ivan 
Published: April 2018

Aims and background The aim of the present study was to test some hypothetical risk factors for anaplastic thyroid cancer. Study design A case-control study comprised 110 patients with histologically or cytologically verified anaplastic thyroid cancer and 110 hospital controls individually matched with cases by sex, age, place of residence and time of hospitalization. Univariate and multivariate logistic regressions were used for data analysis. Results According to the conditional logistic regression analysis, the following factors were significantly and independently related to anaplastic thyroid cancer: history of goiter or thyroid nodules (odds ratio, OR, 37.55; 95% confidence interval, CI, 4.86–290.11), history of residence in endemic goiter area (OR, 2.56; 95% CI, 1.05–6.22), history of previous malignant non-thyroid tumor (OR, 5.51; 95% CI, 1.04–29.25), diabetes mellitus (OR, 4.06; 95% CI, 1.29–12.81) and low educational level (OR, 2.44; 95% CI, 1.17–5.06). Conclusions The results are in line with the current knowledge on factors related to thyroid cancer, except for the association between thyroid cancer and diabetes mellitus, which as far as we know has not yet been reported.
Contralateral Parotid-Sparing Radiotherapy in Patients with Unilateral Squamous Cell Carcinoma of the Head and Neck: Technical Methodology and Preliminary Results
Authors: Corvò Renzo , Foppiano Franca , Bacigalupo Almalina , Berretta Laura , Benasso Marco , Vitale Vito 
Published: April 2018

Aims and background Radiation-induced permanent xerostomia occurs frequently in patients affected by squamous cell carcinoma of the head and neck treated by parallel opposed lateral fields. An ipsilateral technique by using co-planar multiple-field arrangement was designed to restrict treatment to the primary tumor and neck on the same side for patients with selected lateralized squamous cell carcinoma of the head and neck. Methods From November 2001 till December 2002, 30 patients affected by squamous cell carcinoma of tonsillar fossa, retro-molar trigone, alveolar ridge and oropharyngeal lateral wall were included in this investigational trial and treated with an ipsilateral multiple field technique: in detail, oblique opposed two upper half fields were planned ipsilaterally to the squamous cell carcinoma site to cover PTV1 and PTV2, whereas an anterior-lower half field was planned to encompass the lower neck node area above clavicles. On CT scans, the contralateral parotid gland was outlined as organ at risk and the contralateral upper lymph node area was contoured as volume of interest. In selected cases, convergent oblique two wedge-pair half fields were added to opposed oblique two-field technique in order to cover only PTV2: generally, in these patients, PTV1 received 1.8 Gy per fraction and PTV2 2.2 Gy per fraction up to total doses of 54 Gy and 66 Gy, respectively. Results Ten patients received radical radiotherapy, 9 patients radical alternating chemo-radiotherapy, and 11 patients adjuvant radiotherapy. At the end of treatment, unilateral confluent mucositis was recorded in 13 (43%) patients and unilateral moist skin epidermolysis in 14 (46%) patients. Six months after the end of radiotherapy, grade 0 xerostomia was recorded in 20 (67%) patients. No patient experienced grade 2+ xerostomia. At a median follow-up of 12 months, 26 (86%) patients were alive and well; 2 patients (6%) developed contralateral neck node failure, both 4 months after the end of ipsilateral radiotherapy. Conclusions These results, although preliminary, suggest that by using an ipsilateral radiotherapy technique, symptomatic xerostomia may be avoided in selected patients with lateralized squamous cell carcinoma of the head and neck without an increased short-term risk of contralateral nodal failure.
Comparative Evaluation of Two Hypofractionated Radiotherapy Regimens for Painful Bone Metastases
Authors: Amichetti Maurizio , Orrù Paola , Madeddu Angela , Murtas Rita , Carau Barbara , Farigu Roberta , Carta Serena , Orrù Silvia , Nagliati Michele , Lay Giancarlo , Dessì Marina 
Published: April 2018

Aims and background In 75% of the patients with bone metastases (BM) pain is the dominant symptom. Radiotherapy (XRT) plays a major role in the palliation of pain in patients with BM. Several schedules of short and long fractionation XRT are used in clinical practice, with hypofractionated treatments being even more attractive for practical reasons. A considerable body of evidence supports the clinical use of short schedules and single-dose XRT. We retrospectively evaluated the efficacy of two short fractionated schedules of 8 Gy as a single dose and 20 Gy in 5 fractions in relieving pain in patients with multiple uncomplicated BM. Method From January to December 2001, 130 patients with 146 painful BM were treated with palliative localized XRT. There were 42 males and 88 females with a median age of 58 years (range 28–84). The commonest sites of treatment were the spine (59.6%) and pelvis (14.4%). The primary endpoint was clinically significant pain relief in the first six months of follow-up evaluated with the IAEA (International Atomic Energy Agency) pain measurement score measuring pain severity and pain frequency. Analgesic use was also recorded before and after treatment as drug frequency and drug severity. Patients with painful BM from any primary tumor site were irradiated. Treatment schedules consisted of a course of XRT with 4 Gy/fraction/day (total dose: 20 Gy/5 fractions) (group A, 59 lesions) or with a single dose of 8 Gy (group B, 87 lesions). Results There was no significant difference in complete response (CR) rates between treatment schedules: complete pain relief was achieved in 17/59 lesions (29%) in the fractionated group and in 29/87 lesions (33%) in the single-dose group. Also the overall response (complete + partial) was similar: 35/59 lesions (60%) in group A and 60/87 (69%) in group B. The minimum, maximum and median follow-up was 3, 23, and 9 months, respectively, for group A and 3, 20, and 11 months for group B. The actuarial median duration of pain relief was similar: 4.5 months in group A and 4 months in group B. No particular side effects were recorded in either group. Conclusions There were no differences between the two fractionation schedules used in our study with regard to pain relief and use of analgesics. Palliation of pain was obtained in approximately two thirds of patients with both schedules, providing further evidence of the similar efficacy between single and multiple fractions. With regard to pain response these data justify a recommendation for the use of a more simple and convenient 8 Gy single fraction for the palliation of uncomplicated BM.
Persistent Human Papilloma Virus Infection as an Indicator of Risk of Recurrence of High-Grade Cervical Intraepithelial Neoplasia Treated by the Loop Electrosurgical Excision Procedure
Authors: Cecchini Silvia , Carozzi Francesca , Confortini Massimo , Zappa Marco , Ciatto Stefano 
Published: April 2018

Objective To evaluate the recurrence rate of high-grade cervical intraepithelial neoplasia (CIN) treated by the loop electrosurgical excision procedure (LEEP) according to the persistence of human papilloma virus (HPV) infection. Design Prospective observational study. Setting The Florence District screening program for cervical cancer. Sample Eighty-four cases of CIN2/3 consecutively treated by LEEP and actively followed up. Method Cases underwent HPV testing (polymerase chain reaction) prior to LEEP and after 6 months, and then cyto-colposcopic followup every 6 months. Main outcomes measures Recurrence was defined as histological evidence of high-grade CIN. The association of recurrence to age and CIN grade at treatment and to cytologic and HPV test findings at recurrence was determined. Results The average recurrence rate was 11.9% (10/84 cases; 95% CI, 5.9-20.8%). Recurrence probability was not significantly associated to age (χ2 = 0.25, df = 2, P = 0.88) or CIN grade (CIN 3 = 8/57, CIN2 = 2/27, χ2 = 0.26, df = 1, P = 0.6), whereas a significant association was evident for the cytology report (<LSIL = 6/76, HSIL ≥4/8, χ2 = 8.55, df = 1, P = 0.003) and HPV testing (absent = 1/48, present = 9/36, χ2 = 8.23, df = 1, P = 0.004). Conclusions Most CIN2> recurrences after LEEP occur in subjects with persistent HPV infection. Subjects with negative findings at cytology, colposcopy and HPV testing are at negligible risk of recurrence and might return safely to standard screening protocol.