OBJECTIVE: Interestingly, evidence is currently emerging that the activation of angiogenesis leads to immunomodulatory/immunosuppressive effects both at the local and systemic levels. These are very complex and interconnected processes. In this study, our aim was to establish interferon alpha-2b as an anti-angiogenic agent and show the complexity of angiogenesis and immunomodulation through the serum levels of vascular endothelial growth factor (VEGF) and matrix metalloproteinase 8 (MMP-8) in high-risk resected malignant melanoma before and after adjuvant therapy with high-dose interferon alpha-2b (HDI). Clinical outcomes of patients were also evaluated. MATERIAL AND METHODS: We prospectively measured the serum levels of VEGF and MMP-8 by ELISA in 29 patients with high-risk resected malignant melanoma receiving adjuvant HDI. Blood samples were collected before and within one week after the treatment. RESULTS: To see the results clearly, we divided our patients into two groups. The first group of patients whose VEGF serum level decreased after HDI (66%) showed long-term complete remission. The mean VEGF serum level in these patients decreased from 779.4 pg/ml to 446.2 pg/ml. This downward trend in VEGF was statistically significant. The second group of patients who did not show a decrease in VEGF serum level after HDI (34%) had no clinical benefit from the treatment. The mean VEGF serum levels in group 2 patients were 408 pg/ml before the treatment and 500 pg/ml after HDI. Results for MMP-8 were ambivalent. CONCLUSIONS: Non-specific immunotherapy with interferons reduces angiogenesis. Our results are in line with the current view of the interconnection and complexity of angiogenesis and immunomodulation/immunosuppression. Non-specific immunotherapy with interferons disrupts the immunosup-pressive effect of the angiogenesis on the development of immune response against tumours and supports anti-tumour response in both direct and indirect way. The interference of HDI with the activation of angiogenesis and tumour progression could explain good clinical outcomes of patients with a decrease in serum VEGF. The outcomes of MMP-8 are inconclusive, its role remain unclear, and MMP-8 does not seem to function as a tumour suppressor.
Interferons , Matrix Metalloproteinase 8 , Melanoma , Skin Neoplasms , Vascular Endothelial Growth Factor A , Humans , Immunotherapy , Interferons/therapeutic use , Matrix Metalloproteinase 8/blood , Melanoma/blood , Melanoma/physiopathology , Melanoma/therapy , Vascular Endothelial Growth Factor A/blood
The aim of this study was to evaluate preoperative tumour expression of NAD(P)H:quinone oxidoreductase 1 (NQO1) along with other biological markers as potential predictors of pathological complete response (pCR) to neoadjuvant docetaxel, doxorubicin, and cyclophosphamide-containing (TAC) chemotherapy in patients with primary breast cancer. Sixty-one patients who received neoadjuvant chemotherapy (NCT) with TAC regimen were enrolled in this prospective study. The pre- and post- NCT expression of oestrogen receptor (ER), progesterone receptor (PR), epidermal growth factor receptor 1 and 2 (EGFR and HER2), NQO1, Ki-67 proliferation index, multidrug resistance protein 1 (MDR1), p53 and BCL2 were evaluated by immunohistochemistry. The pCR was reached in 14 patients (23 % of the study group). Multivariate analysis demonstrated that patients with ER-, PR-, NQO1- negative, and Ki-67-positive tumours had a significantly higher chance to achieve pCR. Within the biological subtypes, the highest pCR rate (50 %) was seen in triple-negative (i.e. ER-, PR-, HER2-) tumours. Post-operative evaluation showed that in comparison to pre-operative tissue samples, NQO1 expression was significantly increased, while Ki-67 and HER2 decreased, in the residual tissue after NCT. In conclusion, the present data suggests that NQO1 expression may be a novel diagnostic biomarker for the prediction of positive response to NCT in patients with breast cancer.
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/drug therapy , Breast Neoplasms/pathology , NAD(P)H Dehydrogenase (Quinone)/metabolism , Neoadjuvant Therapy , Antigens, Neoplasm/immunology , Breast Neoplasms/enzymology , Breast Neoplasms/immunology , Female , Humans , Immunohistochemistry , Treatment Outcome
The authors report on a case of tamoxifen/norfloxacin interaction leading to QT interval prolongation in an 83-year-old female patient with extracranial meningioma treated with radiation and hormonal therapy (with Tamoxifen). This case report highlights the potential risk of tamoxifen causing depression of electrical impulse in sinoatrial node, leading to symptomatic sinus bradycardia with prolonged QT interval. At the same time it indicates the need to be on the look out for drug interactions (in our case between tamoxifen and norfloxacin), as well as to be aware of other drugs possibly inducing QT interval prolongation (Fig. 2, Ref. 7).
Anti-Bacterial Agents/adverse effects , Antineoplastic Agents, Hormonal/adverse effects , Long QT Syndrome/chemically induced , Meningeal Neoplasms/drug therapy , Meningioma/drug therapy , Norfloxacin/adverse effects , Spinal Neoplasms/drug therapy , Tamoxifen/adverse effects , Aged, 80 and over , Drug Interactions , Female , Humans , Urinary Tract Infections/drug therapy
BACKGROUND: Peripheral blood progenitor cell transplantation (PBPCT) is a therapeutic modality used in the anti-tumorous treatment of hemato-oncological diseases and solid tumors. Apart of that, it is also used in therapy of non-malignant and hereditary diseases. AIM: As is the case with other treatments, PBPCT also affects not only the disease process but also the quality of life (QoL). MATERIALS AND METHODS: In the last decade of 20th century, several QoL studies among patients treated with PBPCT were undertaken and an influence on particular dimensions of QoL was observed. One of closely watched aspects was sexuality in patients treated with PBPCT. RESULTS: Sexuality and its expression belong to very important aspects of human behavior. It is also a very sensitive and sensible aspect, so with no doubts it is affected by the diagnosis of neoplasm and cancer treatment. CONCLUSION: Physical and psychosocial factors of PBPCT do affect patient's sexuality and sexual functioning as part of QoL. They remain in focus because of the complex care of patients treated with PBPCT (Fig. 2, Ref. 21).
Peripheral Blood Stem Cell Transplantation , Quality of Life , Sexual Behavior , Female , Humans , Peripheral Blood Stem Cell Transplantation/adverse effects
BACKGROUND: Depression is seen in many cancer patients. It occurs in approximately 25% of palliative care patients. MATERIALS AND METHODS: This study was local, prospective and cross-sectional. It was carried at Department of Clinical Oncology and Radiation Therapy of Charles University Hospital and Faculty of Medicine in Hradec Králové, Czech Republic. RESULTS: The incidence of depression was 83.3% (25 of all 30 survivors). The relevance of depression is characterized: severely depressed was proved in 9 of all 30 survivors, the moderately depressed in 5 of all 30 survivors, the mildly depressed in 11 of all 30 survivors and normal range in 5 of all 30 survivors. The statistical evaluation not presents statistically significant dependence of ZSRDS on smoking abuse, marital status, age, number of associated diseases and type of palliative cancer care. CONCLUSION: The results of the pilot depression study showed that subsist clear association between metastatic ovarian cancer and depression (Fig. 2, Ref. 30). Full Text (Free, PDF) www.bmj.sk.
Depression/diagnosis , Ovarian Neoplasms/psychology , Palliative Care , Adult , Aged , Aged, 80 and over , Female , Humans , Middle Aged , Ovarian Neoplasms/pathology , Ovarian Neoplasms/therapy
Depression is seen in many cancer patients. It occurs in approximately 25% of palliative care patients. The quality of life term contains the information on an individual's physical social and spiritual condition. The study evaluated incidence and relevance of depression symptoms and level of health-related quality of life (HRQoL) among patients with metastatic breast cancer in programme of palliative cancer care. This study was local prospective and cross-sectional. It was carried at Department of Clinical Oncology and Radiation Therapy of Charles University Hospital in Hrader Králové, Czech Republic. Dates were obtained during year 2008 among 41 patients with metastatic breast cancer in programme of palliative cancer care. The mean age for all 41 subjects was 58 years old (aged 41 - 80 years old). The Czech version of Zung self-rating depression scale was performed for evaluation of depression symptoms. The Czech version of genetic EuroQol questionnaire EQ-5D was performed for evaluation of level of HRQoL. The statistical evaluation presents that mean ZSDS (Zung self-rating depression score) certifies the presence of signs of moderately depression symptoms among patients with metastatic breast cancer (ZSDS range was 60-69). The mean ZSDS in all patients was 60,6. The mean ZSDS is group of healthy females was 38,9 (normal range of ZSDS). The incidence of depression was 61% (25 of all 41 subjects). The relevance of depression is characterized: severely depressed was proved in 5 of all 25 subjects, the moderately depressed in 10 subjects of all 25 subjects and mildly depressed in 10 of all 25 subjects. The statistical evaluation not presents statistically significant dependence of ZSDS on age, number of associated diseases and type of palliative cancer care. The HRQoL among patients with metastatic breast cancer is on very low level. The mean EQ-5D score (dimension of quality of life) was 55%. The mean EQ-5D VAS (subjective health condition) was 59,2%. The mean EQ-5D score in group of healthy female was 78,4% and the mean EQ-5D VAS was 85% (both QoL parameters show very good of QoL level). The statistical evaluation not presents statistically significant dependence of EQ-5D score and EQ-5D VAS on age, number of associated diseases and type of palliative cancer care. The results showed that subsist clear association between metastatic breast cancer in programme of palliative cancer care and depression. Also, the results showed that subsist low level of HRQoL of patients with metastatic breast cancer.
Breast Neoplasms/psychology , Depressive Disorder/psychology , Quality of Life/psychology , Adult , Aged , Aged, 80 and over , Breast Neoplasms/pathology , Breast Neoplasms/therapy , Cross-Sectional Studies , Czech Republic , Female , Humans , Middle Aged , Neoplasm Metastasis , Outcome Assessment, Health Care , Palliative Care , Prospective Studies , Surveys and Questionnaires
BACKGROUND: Obesity is a multifactorial, chronic disorder that has reached epidemic proportions in most industrialised countries and is threatening to become a global epidemic. AIMS: The pilot study evaluates the effect of sibutramine therapy on health-related quality of life and occurence of depression symptoms among adult obese non-diabetic patients. PATIENTS AND METHODS: This study was prospective and longitudinal. It was conducted at the Department of Hygiene of Faculty of Military Health Sciences in Hradec Králove, Czech Republic. Dates were obtained during year 2007. Twenty two adult obese non-diabetic patients (6 males and 16 females) were treated with sibutramine in dose of 10 mg daily. All of these 22 patients were over 18 years old. The European Quality of Life Questionnaire--EQ-5D Version was used for evaluation of health-related quality of life. The self-assessement Zung-SDS was applied for evaluation of occurrence of depression. RESULTS: The statistical evaluation demonstrated that health-related quality of life (EQ-5D score and EQ-5D visual analogue scale) presents highly significant statistical dependence on sibutramine therapy (p < 0.05). The statistical evaluation demonstrated that index of depression (SDS index) presents highly significant statistical dependence on sibutramine therapy (p < 0.05). CONCLUSION: The results show that sibutramine therapy has a highly positive effect on health-related quality of life among adult obese non-diabetic patients. Also, the results show that sibutramine therapy has a highly positive effect on occurence of depresion symptoms among adult obese non-diabetic patients (Fig. 2, Ref. 10).
Cyclobutanes/therapeutic use , Depressive Disorder/drug therapy , Obesity/complications , Quality of Life , Adult , Aged , Depressive Disorder/complications , Depressive Disorder/psychology , Female , Humans , Male , Middle Aged , Obesity/drug therapy , Surveys and Questionnaires , Young Adult
Cancer diagnosis and treatment often produce psychologic stresses resulting from the actual symptoms of the disease, as well as from perceptions of the disease and its stigma. Depression is seen in many cancer patients. Depression occurs in approximately 25% of palliative care patients. It is widely recognised by clinicians that depression is a difficult symptom to identify amongst patients with advanced illness. The study is aimed for screening of depression among palliative care female patients. This study was local, prospective and cross-sectional. It was carried at Department of Clinical Oncology and Radiation Therapy of Charles University Hospital in Hradec Kralove, Czech Republic. Dates were obtained during year 2007 - 2008 in 64 palliative care female patients. The mean age for all 64 subjects was 60,5 years old (aged 29 - 88 years old). The Czech version of Zung self-rating depression scale was performed. The statistical evaluation presents that mean SDS (self-rating depression score) certifies the presence of signs of mildly depression among palliative care female patients (SDS range was 50-59). The mean SDS in all subjects was 56. The mean SDS in group of healthy females was 38,9 (normal range). The incidence of depression is 71,8% (46 of all 64 subjects). The relevance of depression is characterized: severely depressed was proved in 8 of all 46 subjects, the moderately depressed in 21 subjects of all 46 subjects and mildly depressed in 17 of all 46 subjects. The statistical evaluation not presents statistically significant dependence of SDS on smoking abuse, marital status, age, number of associated diseases and type of palliative care. The statistical evaluation presents that patients with cancer of lung, with cancer of endometrium, with cancer of gallbladder and with melanomas are moderately depressed (SDS 60-69), patients with cancer of ovary, with cancer of breast, with primary brain tumour, with cancer of ventricle, with cancer of pancreas head and with cancer of bucall cavity are mildly depressed (SDS 50-59). The results show that subsists clear association between oncological disease in palliative care and depression.
Depression/epidemiology , Neoplasms/psychology , Adult , Aged , Aged, 80 and over , Cross-Sectional Studies , Depression/diagnosis , Female , Humans , Incidence , Middle Aged , Palliative Care , Prospective Studies
