bluuebunny/crossref_metadata_2025_split huggingface dataset:
Doses of capecitabine and oral vinorelbine are not relevant for efficacy in breast cancer patients: An analysis of dose intensity
Authors: Battelli Nicola , Bittoni Alessandro , Pagliacci Alessandra , Zepponi Laura , Scartozzi Mario , Mariotti Carlo , Cascinu Stefano 
Published: February 2018

Background The combination of capecitabine and vinorelbine is a valuable regimen in metastatic breast cancer treatment, even in pretreated patients. Patients and methods Forty-one pretreated consecutive patients were treated with capecitabine, 1000 mg/m2, twice daily, for two of three weeks, and vinorelbine, given orally at a dose of 60 mg/m2, days 1 and 8 in three-week cycles. Results A total of 301 courses was given, with a median of 8 courses (range, 3–13). Median dose intensity of capecitabine was 75% of the planned dose and for vinorelbine it was 72%. We observed 18 partial response (43.9%), 15 stable disease (36.6%), and 8 progressive disease (19.5%). Median progression-free survival was 9 months (range, 1–22) and median overall survival was 27.2 months (range, 4–40). Overall response rate (complete + partial response) was not statistically different between patients who received more or less than the median dose intensity of capecitabine and vinorelbine, and there was no difference in overall survival or progression-free survival. Conclusions Capecitabine and oral vinorelbine is an effective and well-tolerated “all-oral” regimen for advanced breast cancer patients. The use of lower doses than those currently recommended should be not detrimental in terms of efficacy.
TomoDirect: An efficient means to deliver radiation at static angles with tomotherapy
Authors: Franco Pierfrancesco , Catuzzo Paola , Cante Domenico , La Porta Maria Rosa , Sciacero Piera , Girelli Giuseppe , Borca Valeria Casanova , Pasquino Massimo , Numico Gianmauro , Tofani Santi , Meloni Teodoro , Ricardi Umberto , Ozzello Franca 
Published: February 2018

Aims and background The TomoTherapy Hi-Art II system is able to deliver dynamic intensity-modulated radiation therapy within a helical geometry providing robust conformality and modulation, abrupt dose falloff, and reliable accuracy. A new upgrade named TomoDirect was introduced recently, allowing delivery of radiation at discrete angles with a fixed gantry. We present our preliminary clinical experience with TomoDirect. Methods Three specific clinical contexts were chosen for the implementation of TomoDirect, namely palliation of bone metastasis pain (BP), whole brain radiation therapy for intracranial secondary lesions (WBRT), and adjuvant whole breast radiation therapy after conservative surgery for early stage breast cancer (AWBRT). After appropriate positioning, planning CT, contouring, and plan generation, all patients were treated with the TomoDirect upgrade of the TomoTherapy Hi-Art II system with different doses and fractionation according to clinical decision-making. Results Between May and December 2010, 41 patients were treated with TomoDirect. Eighteen patients were treated for BP (mainly vertebral metastases) with a predominant posterior field arrangement. Seven patients were treated for WBRT (multiple brain lesions) with a parallel-opposed latero-lateral approach and 16 patients were treated for conventionally fractionated AWBRT mainly with a 2-field tangential approach. Radiation treatments were generally well tolerated and the acute toxicity was mild. Conclusions While helical tomotherapy allows the delivery of very sophisticated treatment plans, in certain anatomical sites and clinical contexts where the number of beam directions is constrained and supposed not to affect plan quality, TomoDirect might be an efficient means to deliver radiation at static angles with consistent dosimetric and clinical results.
Mesenchymal chondrosarcoma of the spleen: Report of a case
Authors: Rossetto Anna , Saccomano Enrico , Zompicchiatti Aron , Avellini Claudio , Toffoli Silvia , Miolo GianMaria , Frustaci Sergio , Uzzau Alessandro 
Published: February 2018

Background Chondrosarcoma is a malignant tumor of chondrogenic origin and the mesenchymal type is a very rare finding. Mesenchymal chondrosarcoma tends to develop mostly in the skeleton but may also occur as a primary tumor in periosteal nervous and muscular tissues, the anterior cerebral falx, meninges, brain, maxillary sinus, eyelid, thyroid, pleura and mediastinum, while in the abdomen the most frequent locations are the kidney, retroperitoneum and even the perineum and the anogenital area. Apparently, the only splenic mesenchymal chondrosarcoma in the literature occurred in a dog. Methods and study design Our paper reports the case of a patient who had a diagnosis of mesenchymal chondrosarcoma of the spleen. Results We adopted surgery as the main therapeutic procedure without achieving complete recovery but preserving a good quality of life for our patient, minimizing the repercussions of the disease on her working and relational life. Conclusions The absence of important or invalidating symptoms and the persistence of good general conditions before and after each surgical operation encouraged us to adopt the surgical option as the most rational.
Synchronous primary lung cancers: A multidisciplinary approach in diagnosis
Authors: Kontic Milica , Stevic Ruza , Stojsic Jelena , Jekic Biljana , Bunjevacki Vera 
Published: February 2018

Background For patients with two or more primary cancers a correct diagnosis is critically important because prognosis and treatment vary considerably between multiple primary cancers and metastatic disease. Case report Two bilateral synchronous primary lung malignancies of different histological types were diagnosed and immunohistochemically confirmed in a 60-year-old woman. In biopsy specimens of the right lung pure squamous cell carcinoma was detected (stage IIIa). The tumor expressed AE1/AE3, cytokeratin 5 and 34βE12. In biopsy specimens of the left lung small cell carcinoma was detected (stage IIIa). The small cells expressed synaptophysin, chromogranin A and CD56. DNA was extracted from paraffin-embedded tissue of both tumors. Exons 5–9 of the TP53 gene were examined for genetic mutations by polymerase chain reaction and DNA sequencing analysis. Direct sequencing of DNA isolated from the small cell carcinoma revealed a TGC to TTC mutation at codon 404 of TP53 exon 5. In DNA isolated from the squamous cell carcinoma no TP53 mutation was found. The tumors' different response to chemotherapy also suggested that they belonged to different histological types. The patient lived 24 months after the diagnosis, which is more typical for stage III than for stage IV lung carcinoma. Conclusion Discrimination of synchronous primary lung cancers from intrapulmonary metastases based only on clinical findings can be very difficult. Multidisciplinary diagnostic evaluation is therefore very helpful in cases like this, because a correct diagnosis will determine the best treatment for the patient and consequently a better prognosis.
Neuroendocrine tumors of unknown primary site: Gold dust or misdiagnosed neoplasms?
Authors: Catena Laura , Bichisao Ettore , Milione Massimo , Valente Monica , Platania Marco , Pusceddu Sara , Ducceschi Monika , Zilembo Nicoletta , Formisano Barbara , Bajetta Emilio 
Published: February 2018

Aims and background Neuroendocrine tumors of an unknown primary site are rarer than other neuroendocrine tumors (0.6–2% of all neuroendocrine tumors) and have a poor prognosis. The aim of the study was to review the cases of unknown primary site neuroendocrine tumors encountered at the Istituto Nazionale Tumori of Milan between 1984 and 2008 in order to verify their incidence and evaluate their characteristics and prognosis. Methods and study design During the study period, 750 neuroendocrine tumor patients attended our Institute, 82 of whom (10.9%) were diagnosed as having neuroendocrine tumors of an unknown primary site. The data from their medical records were analyzed descriptively, and survival probabilities were calculated using the Kaplan-Meier method and the logrank test, considering patient, tumor and treatment-related characteristics. Results The 82 patients with neuroendocrine tumors of an unknown primary site (34 males) had a median age of 60 years; 57 (69.5%) had histologically well-differentiated tumors, 3 (3.7%) poorly differentiated tumors, and 22 (26.8%) had tumors that could not be classified. Of the 52 patients (62.2%) who underwent Octreoscan(®) (Bykgulden Italia SpA), 40 (78.4%) showed a pathological uptake and 11 (21.6%) were negative. Thirty-one patients (37.8%) underwent metastatic site surgery, which was radical in 11 cases (35.4%). Forty-eight patients (58.5%) received somatostatin analogues, and 41 (50.0%) underwent chemotherapy. At the end of the study period, 59 patients (72.0%) had died, 31 (53.0%) because of disease progression, and 23 (28.0%) were still alive. Conclusions Neuroendocrine tumors of an unknown primary site are difficult to identify but their incidence is higher than previously reported, and the prognosis remains unfavorable.
Multi-field-of-view SPECT is superior to whole-body scanning for assessing metastatic bone disease in patients with prostate cancer
Authors: Giovanella Luca , Castellani Massimo , Suriano Sergio , Ruberto Teresa , Ceriani Luca , Tagliabue Luca , Lucignani Giovanni 
Published: February 2018

Aim The aim of this study was to compare the diagnostic performance of whole-body bone scintigraphy (WBS) and multi-field-of-view single photon emission tomography (multi-FOV SPECT) with 99mTc-oxidronate (99mTc-HDP) in patients with prostate cancer (PCa). Methods In a prospective study, WBS and SPECT acquisitions were performed in194 patients with histologically confirmed PCa and serum prostate-specific antigen (PSA) levels above 10 ng/mL. Scans obtained using the two modalities were interpreted separately. Clinical and biochemical follow-up, radiological studies and biopsies served as benchmarks for the assessments. The impact of PSA level on WBS and SPECT results was also evaluated. Results The patient-based sensitivity, specificity, accuracy, PPV and NPV values of SPECT examinations were higher than those of WBS, especially in patients with serum PSA levels ≶40 ng/mL. Conclusion Multi-FOV SPECT proved to be more sensitive and specific than WBS in detecting bone metastases in PCa patients.
Influence of Tumor Cell Culture Supernatants on Macrophage Functional Polarization: In Vitro Models of Macrophage-tumor Environment Interaction
Authors: Caras Iuliana , Tucureanu Catalin , Lerescu Lucian , Pitica Ramona , Melinceanu Laura , Neagu Stefan , Salageanu Aurora 
Published: February 2018

Aims and background Macrophages are heterogeneous cells with extensive functional plasticity; they can change their functional profiles repeatedly in response to environmental changes anywhere between their extreme phenotypical programs (labeled as M1 and M2 polarization, respectively). In terms of antitumoral immune response, M1 macrophages are considered to be beneficial, while M2 macrophages supposedly promote tumor progression. Tumor-associated macrophages (TAMs) represent a major leukocyte population present in many tumors. Although many studies indicate that TAMs elicit several M2-associated protumoral functions, including promotion of angiogenesis, matrix remodeling and suppression of adaptive immunity, their role regarding tumor progression is still controversial. The aim of the present study was to develop an appropriate in vitro model to study the effect of tumor-secreted soluble factors on the functional phenotype of macrophages. Methods and study design THP-1 human monocytic line cells and peripheral blood mononuclear cells from healthy volunteers were used for macrophage differentiation; primary tumor cell culture supernatants or tumor cell line supernatants were employed along with various cytokines, growth factors and other stimuli to design different model variants and to better mimic the in vivo tumor microenvironment. Results The cytokine secretion patterns of these macrophages suggest that primary tumor cell culture supernatants are able to switch the macrophage phenotype or to induce functional polarization of macrophages toward a mixed M1/M2 phenotype. Conclusions These data support the hypothesis that TAM behavior is modulated by the tumor microenvironment itself.
A Phase II Trial of 5-Fluorouracil, Leucovorin and Mitomycin C in Patients with Advanced Gastric Cancer
Authors: Kim Sung Rok , Yuh Young Jin , Sohn Byeong Seok , Yang Sung Hyun 
Published: February 2018

Aims and Background Low-dose leucovorin is a well known potentiator of 5-fluorouracil activity in colorectal cancer but not in gastric cancer. To assess their efficacy on response rate and survival, 5-fluorouracil and low-dose leucovorin were combined with mitomycin C. Methods Fifty patients with gastric cancer and metastatic disease, unresectable or relapsed disease were treated with the following regimen every 28 days: mitomycin C, 7 mg/m2 IV bolus on day 1, and leucovorin, 20 mg/m2 IV, followed immediately by 5-fluorouracil, 375 mg/m2 on days 1–5. All had measurable disease and were assessable for toxicity. Prognostic factors were analyzed to examine any association with response rate or overall survival. Results Nineteen of the 48 assessable patients (39.6%; 95% confidence interval [CI], 25.8–53.4) responded, including 4 complete responses (8.3%). The median progression-free survival was 108 days (range, 18+ - 146), and the median duration of survival was 338 days (11.3 months; range, 18+ - 903 days). Response rate and overall survival were not significantly associated with CEA level, performance status, age, or primary and metastatic tumor sites. Toxicity associated with the chemotherapy was tolerable, and all patients were treated at the outpatient clinic. Leukopenia and thrombocytopenia WHO grade ≥3 occurred in 5% and 1% of the patients, respectively. Nausea and vomiting were the most frequent adverse effects (29%), all grade 1 or 2. Conclusions Combination chemotherapy of 5-fluorouracil plus leucovorin with mitomycin C is effective for the treatment of advanced gastric cancer and is well tolerated.
Overexpression of Tyrosine Kinase Receptor B Promotes Metastasis of Ovarian Serous Adenocarcinoma by Lymphangiogenesis
Authors: Zheng Weiping , Dai Qunyun , Tao Pingping , Sun Aijing , Wang Yungen , Bao Lei , Zhang Guorong 
Published: February 2018

Aims and Background The aim of this study was to detect the expression features of tyrosine kinase receptor B (TrkB) and analyze the possible correlation between TrkB expression and lymph vessel density (LVD) in metastasis of ovarian serous adenocarcinoma. Methods An immunohistochemical method was used to evaluate TrkB expression in 139 ovarian tumor sections (103 primary ovarian serous adenocarcinomas and 36 serous adenomas) and investigate the correlation between TrkB expression and LVD, which was estimated by means of VEGFR-3 assessment. Results TrkB was significantly upregulated in serous adenocarcinomas and absent in serous adenomas. There was no association between TrkB expression and the histological grade of cancer cells. The expression of TrkB was correlated with surgico-pathological stage and metastasis in serous adenocarcinomas. The level of TrkB was higher in advanced-stage than in early-stage disease. TrkB was overexpressed in metastatic lesions compared with the corresponding primary lesions. Furthermore, a positive correlation between TrkB expression and LVD in serous adenocarcinomas was observed. Conclusions TrkB was overexpressed in ovarian serous adenocarcinomas and might be involved in cancer metastasis by associated lymphangiogenesis.
Limited-Stage Small-Cell Lung Cancer Treated with Early Chemo-Radiotherapy: The Impact of Effective Chemotherapy
Authors: Scotti Vieri , Meattini Icro , Saieva Calogero , Rampini Andrea , De Luca Cardillo Carla , Bastiani Paolo , Mangoni Monica , Agresti Benedetta , Santomaggio Carmine , Di Cataldo Vanessa , Franzese Ciro , Livi Lorenzo , Magrini Stefano Maria , Biti Giampaolo 
Published: February 2018

Aims and Background Small cell lung cancer is characterized by an aggressive clinical course and a high sensitivity to both chemotherapy and radiotherapy. We present the Florence University experience in concurrent early radio-chemotherapy in patients affected by limited-stage small cell lung cancer, with particular emphasis on treatment safety, disease outcome and prognostic factors. Methods and Study Design Fifty-seven patients were treated between June 2000 and February 2005. All patients underwent platinum-based chemotherapy, administered intravenously following two different regimens, for at least three cycles. Eighteen patients (31.6%) received epirubicin and ifosfamide in 3-week cycles alternating with etoposide and cisplatin, administered on day 1 to 3; 39 patients (68.4%) received etoposide and cisplatin. A total of 6 cycles were planned. Radiotherapy was administered concurrently to the first cycle of etoposide and cisplatin. Results Clinical stage (P = 0.036) and number of chemotherapy courses (P = 0.009) emerged as the only significant death predictors at univariate analysis. Number of chemotherapy courses persisted as a significant death predictor also at multivariate regression analysis, with a reduced death risk for 5–6 chemotherapy cycles in comparison to 3–4 cycles (hazard ratio, 0.44). At a mean follow up of 38.5 months (standard deviation, 3.24 years; range, 6–164 months), considering the best overall tumor response achieved at any time during the whole treatment period, we obtained 32 complete responses (56.1%), 23 partial responses (40.3%) and 2 stable diseases. Conclusions Our analysis showed that concurrent early radio-chemotherapy in limited-stage small cell lung cancer treatment represents a safe and effective approach in patients. We confirmed the relevant impact on overall survival of effective chemotherapy delivery.
Pulmonary Resections: Cytostructural Effects of Different-Wavelength Lasers versus Electrocautery
Authors: Scanagatta Paolo , Pelosi Giuseppe , Leo Francesco , Furia Simone , Duranti Leonardo , Fabbri Alessandra , Manfrini Aldo , Villa Antonello , Vergani Barbara , Pastorino Ugo 
Published: February 2018

Aims and Background There are few papers on the cytostructural effects of surgical instruments used during pulmonary resections. The aim of the present study was to evaluate the parenchymal damage caused by different surgical instruments: a new generation electrosurgical scalpel and two different-wavelength lasers. Methods Six surgical procedures of pulmonary resection for nodules were performed using a new generation electrosurgical scalpel, a 1318 nm neodymium (Nd:YAG) laser or a 2010 nm thulium laser (two procedures for each instrument). Specimens were analyzed using optical microscopy and scansion electronic microscopy. Results Severe cytostructural damage was found to be present in an average of 1.25 mm in depth from the cutting surface in the patients treated using electrosurgical cautery. The depth of this zone dropped to less than 1 mm in patients treated by laser, being as small as 0.2 mm using the laser with a 2010 nm-wavelength and 0.6 mm with the 1318 nm-wavelength laser. Discussion These preliminary findings support the use of laser to perform conservative pulmonary resections (i.e., metastasectomies), since it is more likely to avoid damage to surrounding structures. Controlled randomized trials are needed to support the clinical usefulness and feasibility of new types of lasers for pulmonary resections.
Expression of the Hepatocyte Growth Factor and C-Met in Colon Cancer: Correlation with Clinicopathological Features and Overall Survival
Authors: Liu Yao , Li Qiaoyan , Zhu Liwei 
Published: February 2018

Aim and Background The hepatocyte growth factor (HGF)/c-Met signaling system has been implicated in the development and progression of colon cancer, but the relationship between the expression of HGF or c-MET and clinicopathologic features remains controversial. In the study, we analyzed the expression of HGF and c-Met in colon cancer and assessed the influence of the expression of this growth factor and its receptor on clinical and histological parameters and patient survival. Methods and Study Design We investigated the mRNA expression of HGF and c-Met with real-time PCR in 90 unselected colon carcinomas and the corresponding normal mucosa. Furthermore, HGF and c-Met protein expression was investigated with immunohistochemistry in all the samples. Results The mRNA and protein expression levels of HGF and c-Met were significantly higher in colon cancer than in matched normal mucosa. The protein level in most of the cases investigated was correlated with the mRNA level. Overexpression of HGF and c-Met, at both protein and mRNA levels, was correlated with depth of invasion, lymph node metastases and overall AJCC stage. According to univariate analysis, the mean survival time was shorter in the HGF-positive and c-Met-positive groups. Multivariate Cox analysis showed that high M stage and the expression of c-Met independently had a negative impact on overall survival. Conclusions The HGF/c-Met signaling pathway may be involved in the pathogenesis and progression of colon cancer. C-Met overexpression can be used as a useful parameter to evaluate the prognosis of colon cancer.
Expression of A1 and A3 Adenosine Receptors in Human Breast Tumors
Authors: Panjehpour Mojtaba , Hemati Simin , Forghani Mohammad Ali 
Published: February 2018

Background Adenosine receptors (A1, A2A, A2B, A3) play an important role in the regulation of growth, proliferation and death of cancer and normal cells. We recently showed the expression profile of A2A and A2B receptors in normal and tumor breast tissues. In the present study, we used semiquantitative RT-PCR to measure the A1 and A3 gene expression levels in normal and tumor breast tissues. Methods Breast tumors (n = 18) and non-neoplastic mammary tissues (n = 10) were collected and histologically confirmed to be neoplastic or non-neoplastic, respectively. Total RNA was extracted and reverse transcribed into cDNA, and PCR was performed under optimized condition for each receptor subtype. Amplification of beta-actin mRNA served as control for RT-PCR. The PCR products were separated on 1.7% agarose gels. The intensity of the bands was quantitated with ImageJ software after normalization against beta-actin expression. Results All breast tumor and normal tissue specimens expressed A1 and A3 adenosine receptor transcripts. However, we observed that the expression level of the A3 receptor in tumor tissues was 1.27-fold that of normal tissues, whereas there was no significant difference between the expression levels of A1 in normal and tumor tissues. Conclusions Interestingly, the results of the present study indicate that breast tumors exhibit a higher level of A3 transcripts (than normal tissues) and support the possible key role of A3 adenosine receptor in tumor development. However, further studies based on real-time quantitative RT-PCR are needed to identify the exact gene expression levels.