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1.
Ann Oncol ; 22(1): 156-164, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20587509

RESUMO

BACKGROUND: this study analyzed prognostic factors and treatment outcomes of primary thyroid lymphoma. PATIENTS AND METHODS: data were retrospectively collected for 87 patients (53 stage I and 34 stage II) with median age 65 years. Fifty-two patients were treated with single modality (31 with chemotherapy alone and 21 with radiotherapy alone) and 35 with combined modality treatment. Median follow-up was 51 months. RESULTS: sixty patients had aggressive lymphoma and 27 had indolent lymphoma. The 5- and 10-year overall survival (OS) rates were 74% and 71%, respectively, and the disease-free survival (DFS) rates were 68% and 64%. Univariate analysis revealed that age, tumor size, stage, lymph node involvement, B symptoms, and treatment modality were prognostic factors for OS, DFS, and local control (LC). Patients with thyroiditis had significantly better LC rates. In multivariate analysis, OS was influenced by age, B symptoms, lymph node involvement, and tumor size, whereas DFS and LC were influenced by B symptoms and tumor size. Compared with single modality treatment, patients treated with combined modality had better 5-year OS, DFS, and LC. CONCLUSIONS: combined modality leads to an excellent prognosis for patients with aggressive lymphoma but does not improve OS and LC in patients with indolent lymphoma.


Assuntos
Linfoma não Hodgkin/terapia , Neoplasias da Glândula Tireoide/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Linfoma não Hodgkin/tratamento farmacológico , Linfoma não Hodgkin/radioterapia , Linfoma não Hodgkin/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taxa de Sobrevida , Neoplasias da Glândula Tireoide/tratamento farmacológico , Neoplasias da Glândula Tireoide/radioterapia , Neoplasias da Glândula Tireoide/cirurgia , Resultado do Tratamento , Adulto Jovem
2.
J BUON ; 15(2): 274-80, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20658721

RESUMO

PURPOSE: To evaluate the efficacy of gamma knife radiosurgery (GKRS) for the treatment of brain metastases from non small cell lung cancer (NSCLC) and find out the prognostic factors for overall survival. METHODS: Between February 1997 and August 2003 100 patients underwent treatment for 184 brain metastases from NSCLC, either for recurrence (n=49) or with a new diagnosis (n=51). Median age was 55 years and 77 patients were male. Seventy-eight of the patients received whole brain radiotherapy (WBRT) prior to or after GKRS and 26 patients had surgical removal of the metastasis. Imaging and clinical status were monitored every 3 months following treatment. Kaplan-Meier survival curves, Cox proportional hazards regression for risk factor analysis were used. RESULTS: The median follow up after the procedure was 8 months and after the diagnosis 11 months. The median overall survival for all patients was 9 months from the date of GKRS and 14 months from the diagnosis of brain metastasis. Local tumor control was achieved in 95% of the lesions. In multivariate analysis, adenocarcinoma histology, Karnofsky performance status (KPS) score > 80, 1-3 metastases and tumor diameter <2 cm were related to longer survival. Addition of WBRT did not have any effect on overall survival. CONCLUSION: Gamma knife surgery appears to be effective in treating patients with brain metastases from NSCLC, either alone or with WBRT in selected groups of patients.


Assuntos
Neoplasias Encefálicas/secundário , Neoplasias Encefálicas/cirurgia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Radiocirurgia , Atividades Cotidianas , Adulto , Idoso de 80 Anos ou mais , Neoplasias Encefálicas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/patologia , Feminino , Humanos , Estimativa de Kaplan-Meier , Avaliação de Estado de Karnofsky , Masculino , Pessoa de Meia-Idade , Prognóstico , Qualidade de Vida , Estudos Retrospectivos , Taxa de Sobrevida , Fatores de Tempo
3.
J BUON ; 14(2): 251-7, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19650175

RESUMO

PURPOSE: Since the anterior projection alone has several limitations in the conventional preoperative sentinel lymph node (SLN) mapping, multiple projections including anterior oblique (AO) view are preferred. There are many AO acquisition techniques described in the literature but none of them creates an image which fully reflects the surgical perspective. We aimed to compare the AO view in the surgical position with the conventional projections according to quantitative parameters. PATIENTS AND METHODS: Sixty female breast cancer patients entered the study. Two hours after the radiotracer injection, preoperative SLN mapping at anterior, lateral and 35 degrees AO projections in surgical position was performed. For each projection, mapping success rate (MSR), the mean number of SLNs, lymphatic channel visualization rate, image contrast and distance measurements between each SLN and between the SLNs and the injection site were recorded. RESULTS: The best MSR and image contrast for the first and the consecutive axillary SLNs were found at the AO projection. The longest distance between the injection site and the SLNs and between the two SLNs were observed at the AO views. Although the AO view gave the best results for intramammary SLNs the difference was not statistically significant from the anterior view. CONCLUSION: The 35 degrees AO view in the surgical position was superior to the anterior and lateral projections. Therefore, the simple 4-min AO view in the surgical position may entirely reflect the surgeon's perspective and could be used safely alone in the preoperative lymphatic mapping for breast cancer patients.


Assuntos
Neoplasias da Mama/patologia , Linfonodos/diagnóstico por imagem , Biópsia de Linfonodo Sentinela , Cirurgia Assistida por Computador , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/cirurgia , Feminino , Humanos , Metástase Linfática , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Cuidados Pré-Operatórios , Interpretação de Imagem Radiográfica Assistida por Computador , Cintilografia , Compostos Radiofarmacêuticos , Compostos de Tecnécio , Compostos de Estanho
4.
J BUON ; 14(2): 309-11, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19650184

RESUMO

Kikuchi-Fujimoto disease (KFD), a rare clinicopathological entity, is a benign and self-limiting disease. It was first described in 1972 by Kikuchi and Fujimoto in Japan independently. KFD is prevalent in Asia, although it may be seen in wide geographical areas, including Turkey. It mainly affects young women. Cervical lymphadenopathy is the most prominent sign and should be differentiated from lymphoproliferative, autoimmune, and infectious diseases. We report on a 30-year-old female patient who was referred to our medical oncology unit for chemotherapy and/or radiotherapy with diagnosis of Hodgkin's lymphoma. Ultimately her diagnosis was corrected as KFD after second opinion of the pathology specimens. We herein provide a brief review about KFD and the importance of second opinion of the pathology specimens.


Assuntos
Linfadenite Histiocítica Necrosante/diagnóstico , Doença de Hodgkin/diagnóstico , Encaminhamento e Consulta , Adulto , Diagnóstico Diferencial , Feminino , Humanos
5.
J BUON ; 13(1): 43-50, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18404785

RESUMO

PURPOSE: To assess the side effects of cisplatin-based concurrent chemoradiotherapy (CRT) for locally advanced nasopharyngeal carcinoma (NPC). PATIENTS AND METHODS: From 2001 through 2007, 34 (27 males; 7 females) patients received a median of 70 Gy curative radiotherapy (RT) with conventional fractionation. Twenty-one (62%) patients received induction chemotherapy (CT): 8 of them received 2 courses of cisplatin (75 mg/m(2), day 1) and 5-fluorouracil (5-FU) (750 mg/m(2), days 1-5) every 3 weeks and 13 patients received 3 courses of cisplatin (75 mg/m(2), day 1) and docetaxel (75 mg/m(2), day 1) every 3 weeks. Concomitant cisplatin was administered either 40 mg/m(2) weekly (n=8) or 75-80 mg/m(2) every 3 weeks (n=26) during RT. Median Karnofsky performance status (KPS) prior to RT was 80 (range 70-90). Patient, disease and treatment-related factors were analysed in relation to termination of concurrent CT. RESULTS: Concurrent CT was administered to 13 (38.2%) patients without cisplatin termination, whereas 10 (29.4%) patients received 2 cycles of the 3-weekly schedule. Grade 3 oral mucositis (47.1%), grade 2-3 weight loss (44.2%) and grade 2 fatigue (44.1%) were the most frequently dose-limiting side effects during concurrent therapy. The rate of receiving cisplatin cycles as planned was 85% for patients with KPS >80, whilst it was 15% only for patients with KPS < or = 80 (p=0.006). None of the patients suffering of grade 2 fatigue could complete all cycles compared to 68% of patients with < grade 2 fatigue who completed all cycles (p <0.001). The severity of mucositis was significantly related to initial haemoglobin level (p=0.02) and weight loss during RT (p=0.04). Median follow-up was 20 months (range 5-65). Three-year locoregional relapse free (LRRFS), disease free (DFS) and overall survival (OS) rates were 79.3%, 68.8% and 79.2%, respectively. CONCLUSION: Concurrent administration of CT during RT reveals better outcome but requires careful consideration for toxicity. Initial performance status prior to CRT might be a predictor for unplanned CT stopping due to side effects.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Cisplatino/efeitos adversos , Neoplasias Nasofaríngeas/terapia , Adolescente , Adulto , Idoso , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mucosite/induzido quimicamente , Neoplasias Nasofaríngeas/mortalidade
6.
J BUON ; 12(2): 203-8, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17600873

RESUMO

PURPOSE: We report the feasibility and toxicity profile, and the impact on local control, disease-free survival and overall survival rates of our study which consisted of postoperative concurrent chemoradiotherapy, followed by adjuvant chemotherapy using uracil-tegafur (UFT)/leukovorin (LV) in locally advanced rectal cancer patients. PATIENTS AND METHODS: Thirty-one patients operated for rectal adenocarcinoma (pT3/4 or N+) were enrolled onto the study. Twenty-three patients were males and 8 females with median age 62 years (range 21-85). Radiotherapy (RT) to the pelvis with conformal technique and individual blocks was delivered within 8 weeks following surgery. Total RT dose was 50.4 Gy and was given in a conventional single fraction of 1.8 Gy per day. Chemotherapy was administered concomitantly and consisted of UFT (300 mg/m(2)/day) and LV (30 mg/day) during RT-days. Following chemoradiotherapy, chemotherapy alone was administered for 4 cycles in the same dose for 28 days every 35 days. RESULTS: No lethal toxicity occurred. All patients completed the scheduled RT. Concurrent chemotherapy continued in 22 (70.9%) patients until the end of RT. Seventeen (54.8%) patients completed the whole concurrent chemoradiotherapy and adjuvant chemotherapy as planned. No grade 3-4 stomatitis/mucositis or haematological toxicities were observed during the whole treatment period. During concomitant therapy grade 1-2 toxicities were: nausea/vomiting 60%, dyspepsia/gastric pain 39%, diarrhea 39% and dysuria 10%, whereas grade 3 nausea and diarrhea occurred in 6% and 19%, respectively. Median follow-up was 22 months. Two-year local control, disease-free survival and overall survival rates were 96.3%, 72.3% and 83.2%, respectively. CONCLUSION: The acute toxicity profile of UFT/LV, local control, disease-free survival and overall survival in the concurrent chemoradiotherapy setting for operated, locally advanced rectal cancer seem comparable with the standard 5-fluorouracil (5-FU)-based therapies.


Assuntos
Adenocarcinoma/terapia , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Leucovorina/administração & dosagem , Neoplasias Retais/terapia , Tegafur/administração & dosagem , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/radioterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Intervalo Livre de Doença , Feminino , Humanos , Leucovorina/efeitos adversos , Leucovorina/uso terapêutico , Masculino , Pessoa de Meia-Idade , Radioterapia Adjuvante , Neoplasias Retais/tratamento farmacológico , Neoplasias Retais/radioterapia , Taxa de Sobrevida , Tegafur/efeitos adversos , Tegafur/uso terapêutico
7.
J Endocrinol ; 189(2): 257-69, 2006 May.
Artigo em Inglês | MEDLINE | ID: mdl-16648293

RESUMO

The objective of this study was to examine the potential radioprotective properties of propylthiouracil (PTU)-induced hypothyroidism against oxidative organ damage induced by irradiation. Sprague-Dawley rats were pre-treated with saline or PTU (10 mg/kg i.p.) for 15 days, and were then exposed to whole-body irradiation (800 cGy). A group of rats were decapitated at 6 h after exposure to irradiation, while another group was followed for 72 h after irradiation, during which saline or PTU injections were repeated once daily. Lung, liver, kidney and ileum samples were obtained for the determination of malondialdehyde (MDA; an index of lipid peroxidation) and glutathione (GSH, an antioxidant) levels, myeloperoxidase activity (MPO; an index of tissue neutrophil accumulation) and collagen contents, while oxidant-induced DNA fragmentation was evaluated in the ileal tissues. All tissues were also examined microscopically and assayed for the production of reactive oxidants using chemiluminescence (CL). Lactate dehydrogenase (LDH), an indicator of tissue damage, and tumour necrosis factor-alpha (TNFalpha) were assayed in serum samples. Irradiation caused a significant decrease in GSH level, which was accompanied by significant increases in MDA levels, MPO activity, CL levels and collagen content of the tissues studied (P<0.05-0.001). Similarly, serum TNFalpha and LDH were elevated in the irradiated rats as compared with the control group. On the other hand, PTU treatment reversed all these biochemical indices, as well as histopathological alterations induced by irradiation. Our results suggested that PTU-induced hypothyroidism reduces oxidative damage in the lung, hepatic, renal and ileal tissues probably due to hypometabolism, which is associated with decreased production of reactive oxygen metabolites and enhancement of antioxidant mechanisms.


Assuntos
Antitireóideos/farmacologia , Hipotireoidismo/metabolismo , Propiltiouracila/farmacologia , Radiação Ionizante , Animais , Antioxidantes/análise , Colágeno/análise , Fragmentação do DNA/efeitos dos fármacos , Fragmentação do DNA/efeitos da radiação , Glutationa/análise , Íleo/efeitos dos fármacos , Íleo/efeitos da radiação , Mucosa Intestinal/fisiologia , Rim/efeitos dos fármacos , Rim/efeitos da radiação , L-Lactato Desidrogenase/sangue , Peroxidação de Lipídeos/efeitos dos fármacos , Peroxidação de Lipídeos/efeitos da radiação , Fígado/efeitos dos fármacos , Fígado/efeitos da radiação , Pulmão/efeitos dos fármacos , Pulmão/efeitos da radiação , Masculino , Malondialdeído/análise , Estresse Oxidativo/fisiologia , Estresse Oxidativo/efeitos da radiação , Peroxidase/metabolismo , Proteção Radiológica , Ratos , Ratos Sprague-Dawley , Fator de Necrose Tumoral alfa/análise , Irradiação Corporal Total/métodos
8.
J BUON ; 11(4): 529-31, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17309189

RESUMO

Nasopharyngeal presentation of Hodgkin's disease (HD) is an uncommon event with relatively favorable prognosis. It is predominantly seen in males and most papers are case reports. Here, we report an unusual case in a female patient with stage IA(E)HD treated by radiotherapy (RT), and achieving complete disease remission, lasting 26(+) months.


Assuntos
Doença de Hodgkin/diagnóstico , Neoplasias Nasofaríngeas/diagnóstico , Intervalo Livre de Doença , Feminino , Doença de Hodgkin/radioterapia , Humanos , Pessoa de Meia-Idade , Neoplasias Nasofaríngeas/radioterapia
9.
Clin Transl Oncol ; 16(1): 91-5, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23615982

RESUMO

PURPOSE: We aimed to determine the efficacy and the toxicity of low dose weekly gemcitabine with radiation therapy in medically unfit muscle-invasive bladder cancer patients. METHODS: Twenty-six patients were included into the retrospective analysis. Weekly gemcitabine was administered 75 mg/m(2) with a median dose of 63 Gy radiation therapy. Clinical target volume was defined as the urinary bladder only in conformal treatment planning. RESULTS: Median follow-up was 51 months (range 14-118 months). Complete response rate was 62.5 %. The 5-year local progression-free survival, disease-specific survival and overall survival rates were 40.6, 59.5 and 58.5 %, respectively. Concurrent chemotherapy was continued in 80.7 % of patients without any interruption. Gemcitabine was stopped due to grade 3 thrombocytopenia (n = 1), cardiac angina (n = 1), chronic obstructive pulmonary disease exacerbation (n = 1) or patients' reluctance (n = 2). CONCLUSIONS: Low dose weekly gemcitabine with concurrent radiotherapy is a tolerable regimen and have comparable outcomes with platinum-based combined treatments in muscle-invasive bladder cancer. Prospective randomized trials can help in understanding the safety and efficacy of this treatment specially in medically unfit patients.


Assuntos
Antimetabólitos Antineoplásicos/administração & dosagem , Carcinoma de Células de Transição/terapia , Quimiorradioterapia/métodos , Desoxicitidina/análogos & derivados , Neoplasias da Bexiga Urinária/terapia , Idoso , Idoso de 80 Anos ou mais , Desoxicitidina/administração & dosagem , Intervalo Livre de Doença , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Neoplasias da Bexiga Urinária/mortalidade , Gencitabina
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