Clinical medicine. Oncology最新文献

{"title":"Bone Marrow Micrometastases in Breast Cancer Patients: A Long-Term Follow-up Study","authors":"A. Molino, M. Giovannini, R. Micciolo, A. Auriemma, E. Fiorio, A. Santo, G. Cetto","doi":"10.1177/117955490800200404","DOIUrl":"https://doi.org/10.1177/117955490800200404","url":null,"abstract":"In 125 early breast cancer patients who underwent multiple bone marrow aspirates, there was no significant difference in terms of disease-free and overall survival after a median follow-up of 163 months between the patients with or without micrometastasis at the time of primary surgery. However, when the time-dependent evolution of the bone marrow aspirates was taken into account, some evidence for a longer disease-free and overall survival was found for the patients with negative bone marrow","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"43 1","pages":"487 - 490"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87353201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HSP70s: From Tumor Transformation to Cancer Therapy.","authors":"Chih-Wen Shu,&nbsp;Chun-Ming Huang","doi":"10.4137/cmo.s475","DOIUrl":"https://doi.org/10.4137/cmo.s475","url":null,"abstract":"<p><p>Heat shock proteins (HSPs) are a defined set of chaperones for maintaining proper functions of proteins. The HSP70 family, one of the most inducible families in response to stress, protects cells from stress-induced cell death. It has been documented that HSP70s are highly expressed in various types of cancer cells and make the cells resistant to adverse microenvironments, such as hypoxia and glucose starvation, which are common features in malignant progression. Over-expression of HSP70s is thus associated with tumor transformation and eventually results in a decrease of chemotherapy efficacy. Notably, the distribution of HSP70s is deregulated in cancer cells. It has been reported that HSP70s localize distinct organelles or are exported to humoral circulation during cancer development. Either surface or exported HSP70s play danger signals and trigger immune response to destroy the tumor cells. In this review, we lay out recent advances in the HSP70s-mediated cancer diagnosis and therapy. This review would be enlightening for clinical cancer medicine.</p>","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"2 ","pages":"335-45"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/cmo.s475","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30119379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between MR Demonstration of Extramural Venous Invasion and Nodal Disease in Rectal Cancer.","authors":"Dow-Mu Koh,&nbsp;Neil J Smith,&nbsp;R Ian Swift,&nbsp;Gina Brown","doi":"10.4137/cmo.s370","DOIUrl":"https://doi.org/10.4137/cmo.s370","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the relationship between extramural venous invasion (EMVI) detected at T2-weighted MRI and nodal disease rectal cancer compared with histopathology.</p><p><strong>Materials and methods: </strong>The MR imaging of 79 consecutive patients with rectal cancer who underwent primary rectal surgery without neoadjuvant treatment were reviewed. MR images were scored by an expert radiologist for the presence and degree of EMVI using a five point scale blinded to pathological findings. Receiver operating characteristic curve analyses were performed to determine the sensitivity and specificity of MRI scoring in predicting EMVI and nodal disease at histopathology.</p><p><strong>Results: </strong>Compared with histology, an MR score of >2 was found to have 100% sensitivity (95% CI: 77%-100%) and 89% specificity (95% CI: 79%-96%) in identifying EMVI involving veins >3 mm in diameter. An EMVI score of >2 was had a sensitivity of 56% (95% CI: 30%-80%) and specificity of 81% (95% CI: 69%-90%) for identifying patients with stage N2 disease.</p><p><strong>Conclusions: </strong>EMVI score of >2 on T2-weighted MR imaging has a high sensitivity and specificity for histopathologically proven extramural venous invasion involving venules ≥3 mm in diameter. However, EMVI scores have only moderate sensitivity in the predicting nodal involvement.</p>","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"2 ","pages":"267-73"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/cmo.s370","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30119989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Darbepoetin versus epoetin alfa for the correction of anemia in cancer patients receiving radiotherapy or chemoradiotherapy treatment.","authors":"Pilar Ma Samper Ots, Concepción López Carrizosa, Aurora Rodríguez Pérez, Juan de Dios Saez Garrido, José Ma Delgado Pérez","doi":"10.4137/cmo.s510","DOIUrl":"10.4137/cmo.s510","url":null,"abstract":"<p><strong>Introduction: </strong>Anemia is the most frequent hematological disturbance in cancer patients, with prevalence between 30% and 90%, depending on the type of tumor, the antitumor treatment, and other factors (infection, malnutrition, bleeding, tumor infiltration of the bone marrow). A number of erythropoietic agents have shown to be effective in increasing the hemoglobin (Hb) levels, reducing the requirements for transfusion, and improving quality of life. The objective of this study is to compare darbepoetin alfa and epoetin alfa when used to correct anemia in cancer patients who are receiving radiotherapy or radiochemotherapy.</p><p><strong>Material and methods: </strong>A prospective study of 125 consecutive patients with anemia (Hb <13 g/dL in males or <12 g/dL in females) who were undergoing treatment with radiotherapy (RT) or radiochemotherapy (RCT) in our department were enrolled between March 2003 and March 2005. The treatment for the anemia was either darbepoetin alfa 150 mcg/week (62 patients, group 1) or epoetin alfa 40,000 IU/week (63 patients, group 2). Patients received iron supplements in both groups. Treatment was administered in a consecutive manner depending on tumor type. If the increase in Hb was <1 g/dL after 4 weeks of treatment, the dose was increased to 300 mcg/week in group 1 or to 60,000 IU/week in group 2. The treatment was terminated when a Hb value of ≥15 g/dL was reached during RT treatment, a Hb value of ≥14 g/dL was reached if the RT had been completed, or after 16 weeks of treatment whatever the Hb value. The mean age of patients was 63.36 ± 11.27 years, 67% were male. No significant differences were observed between the 2 groups in tumor type or stage, previous treatments, or intent to treat with RT or RCT.</p><p><strong>Results: </strong>Comparing group 1 and group 2 by intent to treat, the mean Hb at the start of treatment with the study drug was 12.1 g/dL vs 11.8 g/dL, the proportion of patients whose dose was increased was 19.7% vs 24.6%, the need for transfusion was 3.2% in each group, the duration of erythropoietic treatment was 6.5 weeks in both groups, and 2 patients in group 2 restarted treatment with epoetin alfa. The percentage of patients who responded (defined as an increase in the Hb ≥ 2 g/dL in the absence of transfusions) was of 72.6% and 66.7%, respectively. Four vascular adverse events were observed, 2 in each group. No significant differences were observed with respect to the baseline, week 4, and week 12 levels of endogenous erythropoietin, serum iron,% saturation, and ferritin. The increase in Hb 1 month after the final administration of the study drug was 2.21 g/dL in group 1 and 2.46 g/dL in group 2 (p = ns).</p><p><strong>Conclusions: </strong>The results of our study demonstrate that both treatments are equally effective in correcting anemia in cancer patients undergoing RT or RCT.</p>","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"2 ","pages":"393-9"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3161674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30120481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malignant struma ovarii: good response after thyroidectomy and I ablation therapy.","authors":"Erica W M Janszen,&nbsp;Helena C van Doorn,&nbsp;Patricia C Ewing,&nbsp;Ronald R de Krijger,&nbsp;Johannes H W de Wilt,&nbsp;Boen L R Kam,&nbsp;Wouter W de Herder","doi":"10.4137/cmo.s410","DOIUrl":"https://doi.org/10.4137/cmo.s410","url":null,"abstract":"<p><strong>Background: </strong>Malignant struma ovarii is a rare malignant germ cell tumor of the ovary. Due to the rarity of this disease, treatment has not been uniform throughout the published literature.</p><p><strong>Cases: </strong>We present three cases of malignant struma ovarii. Following primary surgery, all were subsequently treated with thyroidectomy and (131)I ablation therapy, two patients as first line management, one following the occurrence of metastatic disease.</p><p><strong>Conclusion: </strong>Histological diagnosis of malignant struma ovarii is similar to that of well differentiated thyroid carcinoma (WDTC). In line with the latest advice on treatment of WDTC, we believe that the best option for patients with malignant struma ovarii is surgical removal of the ovarian lesion followed by total thyroidectomy which allows the exclusion of primary thyroid carcinoma, and in addition, allows radioiodine ((131)I) ablation therapy for (micro) metastasis. After thyroidectomy, thyroglobulin can be used as a tumor marker for follow-up. Moreover, nuclear medicine imaging using radioiodine ((123)I) can be performed to demonstrate metastatic carcinoma. A multidisciplinary approach is essential.</p>","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"2 ","pages":"147-52"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/cmo.s410","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30121209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Hybrid Lesion of Lung Cancer and Aspergillosis","authors":"H. Takeoka, T. Koga, H. Yano, Jiro Ikeda, Munetsugu Nishimura, T. Kamimura, H. Aizawa","doi":"10.1177/117955490800200303","DOIUrl":"https://doi.org/10.1177/117955490800200303","url":null,"abstract":"A 74-year-old man presented with gradual wall thickening of a cystic lung lesion. Serologic tests indicated Aspergillus infection, but neither fungal organisms nor evidence of malignant disease were recovered from repeated sputum collections, a bronchoscopic lung biopsy specimen, or bronchial washings. Treatment with antifungal agents did not result in clinical improvement. Surgical resection of the lesion demonstrated both squamous cell carcinoma and aspergillosis. These distinct disorders share common radiologic manifestations that can present a diagnostic challenge, as in the present case.","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"64 1","pages":"113 - 116"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74063077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression Levels of Thymidylate Synthase, Thymidylate Phosphorylase and Dihydropyrimidine Dehydrogenase in Head and Neck Squamous Cell Carcinoma: Preliminary Study","authors":"K. Aubry, K. Aubry, J. Labourey, J. Bessède, N. Tubiana-Mathieu, M. Rigaud, E. N. T. Department","doi":"10.1177/117955490800200101","DOIUrl":"https://doi.org/10.1177/117955490800200101","url":null,"abstract":"Introduction Pharyngo-laryngeal tumors classified as T3-4, N0-3, M0, are conventionally treated by mutilating surgery (total (pharyngo)-laryngectomy). Neo-adjuvant chemotherapy with 5-FU/platinum salt can be proposed in an attempt to preserve the larynx. The level of the response to chemotherapy ranges from 36 to 54% of cases. Thus, a large number of patients receive chemotherapy that is ineffective and not free from adverse effects. Three main enzymes are involved in the metabolism of 5-FU: thymidylate synthase (TS), thymidylate phosphorylase (TP) and dihydropyrimidine dehydrogenase (DPD). Several studies suggest that a high level of expression of these three genes correlates with a poor clinical response to 5-FU. The main purpose of our study was to look for a correlation between the levels of expression of the genes for sensitivity to 5-FU (TS, TP, DPD) within the tumor and the clinical response observed after three courses of chemotherapy combining 5-FU/platinum salt in patients presenting with advanced cancer of the pharyngolarynx. Methods This was a prospective genetic study that had required approval from the Ethics Committee. The main assessment criterion was based on the assessment of the clinical response by an ENT panendoscopy and a cervical CT scan, after three courses of chemotherapy. The expression of the genes was determined by quantitative RT-PCR, using total RNA extracted from tumor biopsies taken during the initial panendoscopy. Results The means calculated, in our study, for the three genes of interest (TS, TP, DPD) were lower in the responder group than those in the non-responder group. Discussion Our preliminary findings reveal trends that confirm the hypothesis that the lower the level of expression of the sensitivity genes, the better the clinical response to chemotherapy. They now form part of a larger study that is currently in progress.","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"2 1","pages":"27 - 35"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81542771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Observational study of topical imiquimod immunotherapy in the treatment of difficult lentigo maligna.","authors":"E E Craythorne, C M Lawrence","doi":"10.4137/cmo.s690","DOIUrl":"10.4137/cmo.s690","url":null,"abstract":"","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"2 ","pages":"551-4"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3161671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30120342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiotherapy Plus Concomitant and Adjuvant Temozolomide for Glioblastoma—A Critical Review","authors":"R. Komotar, M. Otten, Gaetan Moise, E. Connolly","doi":"10.1093/NEUROSURGERY/57.1.N7A","DOIUrl":"https://doi.org/10.1093/NEUROSURGERY/57.1.N7A","url":null,"abstract":"Glioblastoma Multiforme (GBM), the most common primary brain tumor in adults, has a median survival rate of 12 months, even with aggressive resection and radiation therapy (Fig. 1A). Regrettably, outcomes for this disease have not substantially improved since the Brain Tumor Study Group published their results over 25 years ago. The current standard of care for GBM consists of surgery followed by adjuvant radiotherapy. Although numerous phase III trials have attempted to demonstrate the benefit of employing chemotherapy in these patients, either concomitantly with radiotherapy or as isolated adjuvant treatment, a significant prolongation of survival has never been documented. \u0000 \u0000 \u0000 \u0000Figure 1 \u0000 \u0000 \u0000 \u0000Stupp and colleagues investigated the use of temozolomide (Fig. 1B) as an adjuvant to radiotherapy in patients with GBM and recently published their findings in The New England Journal of Medicine (1). In this multi-institutional randomized clinical trial, 573 patients with newly diagnosed, histologically confirmed GBM received either radiotherapy alone or radiotherapy plus concomitant temozolomide. Results demonstrated a median overall survival of 14.6 months (95% CI 13.2–16.8) for patients treated with radiotherapy and chemotherapy, compared to 12.1 months (95% CI 11.2–13.0) for those treated with radiotherapy alone. More importantly, the two-year survival rate was 26.5 percent (95% CI 21.2–31.7) for patients treated with radiotherapy and chemotherapy, compared to only 10.4 percent (95% CI 6.8–14.1) for those treated with radiotherapy alone. The calculated hazard ratio for death in the radiotherapy-plus-temozolomide group was 0.63 (p < 0.001). Of note, only 7 percent of patients receiving concomitant chemotherapy experienced grade III/IV hematologic toxic effects. Based on these findings, the authors concluded that the addition of temozolomide to radiotherapy for GBM leads to survival benefits that are both clinically and statistically significant with minimal additional toxicity. It is important to note, however, that patients with poor preoperative neurological status undergoing biopsy only are unlikely to benefit. Moreover, it remains unclear whether the addition of chemotherapy increases the risk of radiation induced cognitive deficits. \u0000 \u0000In the same issue of The New England Journal of Medicine, Hegi and colleagues investigated the relationship between promoter methylation of the MGMT DNA-repair gene and responsiveness to temozolomide (2). The authors demonstrated that the survival benefit of temozolomide is limited to those patients with tumor containing methylated MGMT promoters. Among these patients, the median survival with radiotherapy and temozolomide was 21.7 months (95% CI 17.4–30.4), compared to 15.3 months with radiotherapy alone (95% CI 13.0–20.9; p = 0.007). An insignificant survival difference was demonstrated between treatment groups in patients with unmethylated MGMT promoters. This finding points to a genetic basis for the effica","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"24 1","pages":"421 - 422"},"PeriodicalIF":0.0,"publicationDate":"2005-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89317025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}