Facial Basal Cell Carcinomas in Elderly Frail Patients Treated with Low Total-dose Radiotherapy.

AIM: A retrospective analysis was performed in our two Institutions in order to evaluate the feasibility and reliability of a hypofractionated-radiotherapy regimen in the treatment of frail elderly patients with facial basal cell carcinomas (BCCs). PATIENTS AND METHODS: The records of elderly patients (age >75 years) with histologically-confirmed BCC, T1-2, treated to a total radiation dose of 25-30 Gy over 5-6 weeks, were retrospectively analyzed. RESULTS: From February 2007-December 2010, 134 ambulatory patients with 159 BCCs were treated. Their median age was 82.5 years (range=75-103). Grade 1-2 skin acute toxicities were observed in 30.6% of patients (41/134). Complete responses were observed in 157 tumors in 132 patients. At the last follow-up, June 2014, no late toxicities had been noted; three patients had local recurrent disease. CONCLUSION: Our results seem to demonstrate both the feasibility and efficacy of curative hypofractionated radiation therapy in elderly patients with BCCs unfit for daily irradiation.

MGMT promoter methylation and glioblastoma: a comparison of analytical methods and of tumor specimens.

It is already well known that hypermethylation of the O6-methylguanine DNA methyltransferase (MGMT) gene promoter is a predictive biomarker of response to temozolomide treatment and of favorable outcomes in terms of overall survival (OS) and progression-free survival (PFS) in glioblastoma (GBM) patients. Nevertheless, MGMT methylation status has not currently been introduced into routine clinical practice, as the choice of the ideal technique and tissue sample specimen is still controversial. The aim of this study was to compare 2 analytical methods, methylation-specific polymerase chain reaction (MSP) and pyrosequencing (PSQ), and their use on 2 different tissue type samples, snap-frozen and formalin-fixed paraffin-embedded (FFPE), obtained from a single-center and uniformly treated cohort of 46 GBM patients. We obtained methylation data from all frozen tissues, while no results were obtained for 5 FFPE samples. The highest concordance for methylation was found on frozen tissues (88.5%, 23/26 samples), using PSQ (76.7%, 23/30 samples). Moreover, we confirmed that OS and PFS for patients carrying methylation of the MGMT promoter were longer than for patients with an unmethylated promoter. In conclusion, we considered MSP a limited technique for FFPE tissues due to the high risk of false-positive results; in contrast, our data indicated PSQ as the most powerful method to stratify methylated/unmethylated patients as it allows reaching quantitative results with high sensitivity and specificity. Furthermore, frozen tumor tissues were shown to be the best specimens for MGMT methylation analysis, due to the low DNA degradation and homogeneity in methylation throughout the tumor.