Wilm's tumor with pulmonary metastases at diagnosis: the significance of primary chemotherapy. International Society of Pediatric Oncology Nephroblastoma Trial and Study Committee.

1990 ◽  
Vol 8 (7) ◽  
pp. 1187-1190 ◽  
Author(s):  
J de Kraker ◽  
J Lemerle ◽  
P A Voûte ◽  
J M Zucker ◽  
M F Tournade ◽  
...  
Keyword(s):  
Pulmonary Metastases ◽  
Wilms Tumor ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Local Therapy ◽  
Stage Iv ◽  
Actuarial Survival ◽  
Preoperative Ct ◽  
Lung Irradiation ◽  
Whole Lung Irradiation

Data from patients with pulmonary metastases (PM) from Wilms' tumor at diagnosis (stage IV) were collected from six European centers. All patients were pretreated with a chemotherapy (CT) regimen consisting of vincristine (VCR), dactinomycin (AD), and Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH). After nephrectomy, local therapy for residual pulmonary disease was considered to avoid whole-lung irradiation. Only four of 36 patients still had multiple inoperable metastases after preoperative CT. Thirty patients survived. Four of them were irradiated. Of the six patients who died, four died of PM, one died of abdominal recurrence, and one of therapy-related disease. Disease-free survival and actuarial survival rates are 83% with a mean follow-up of 4 years postnephrectomy.

scholarly journals Whole-Lung Irradiation for Stage IV Wilms Tumor Patients: Thyroid Dosimetry and Outcomes

2016 ◽  
Vol 96 (2) ◽  
pp. E556
Author(s):  
T. Morgan ◽  
H. Danish ◽  
R.H. Nanda ◽  
L. Meacham ◽  
N. Esiashvili
Keyword(s):  
Wilms Tumor ◽  
Stage Iv ◽  
Tumor Patients ◽  
Lung Irradiation ◽  
Whole Lung Irradiation

Whole lung irradiation in stage IV Wilms tumor patients: Thyroid dosimetry and outcomes

2017 ◽  
Vol 65 (2) ◽  
pp. e26843 ◽  
Author(s):  
Tiffany M. Morgan ◽  
Hasan Danish ◽  
Ronica H. Nanda ◽  
Natia Esiashvili ◽  
Lillian R. Meacham
Keyword(s):  
Wilms Tumor ◽  
Stage Iv ◽  
Tumor Patients ◽  
Lung Irradiation ◽  
Whole Lung Irradiation

The treatment of Wilms' tumor patients with pulmonary metastases detected only with computed tomography: a report from the National Wilms' Tumor Study.

1991 ◽  
Vol 9 (10) ◽  
pp. 1776-1781 ◽  
Author(s):  
D M Green ◽  
D J Fernbach ◽  
P Norkool ◽  
G Kollia ◽  
G J D'Angio
Keyword(s):  
Overall Survival ◽  
Ct Scan ◽  
Pulmonary Metastases ◽  
Wilms Tumor ◽  
Favorable Histology ◽  
Tumor Study ◽  
Plain Chest Radiograph ◽  
Number Of Patients ◽  
Lung Irradiation ◽  
Whole Lung Irradiation

To evaluate the prognosis of patients with Wilms' tumor who have pulmonary densities identified on a computed tomographic (CT) scan of the chest, but have a negative plain chest radiograph, we reviewed the treatments and outcome of 32 patients randomized or followed on National Wilms' Tumor Study (NWTS)-3. The 4-year event-free and overall survival percentages of 18 of these patients who had a favorable histology tumor and were treated as stage IV tumors with three or four drugs plus whole-lung irradiation were 88.1% and 94.0%, respectively. The 4-year event-free and overall survival percentages for nine favorable histology patients treated less aggressively based on the extent of locoregional disease with two or three drugs and without whole-lung irradiation were 88.9% and 88.0%, respectively. There were no statistically significant differences in the 4-year event-free or overall survival percentages between the two groups. The current data do not demonstrate improved survival for favorable histology patients treated with whole-lung irradiation for pulmonary metastases identified only on chest CT scan. However, due to the small number of patients included, no statistically valid conclusions regarding the roles of Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH) and/or whole-lung irradiation in the treatment of these patients can be drawn from the present analysis. Additional patients need to be systematically studied to determine if these preliminary observations can be confirmed.

Whole lung irradiation for completely responding pulmonary metastases in pediatric Ewing sarcoma

2020 ◽  
Vol 16 (15) ◽  
pp. 1043-1051
Author(s):  
Hagar Elghazawy ◽  
Azza Nasr ◽  
Iman Zaky ◽  
Manal Zamzam ◽  
Ahmed Elgammal ◽  
...  
Keyword(s):  
Pulmonary Metastases ◽  
Pediatric Population ◽  
Event Free Survival ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Real Value ◽  
Lung Irradiation ◽  
Whole Lung Irradiation ◽  
The Impact

Aim: Scarce data assessing the real value of whole lung irradiation (WLI) in Ewing’s sarcoma (ES) with lung-only metastasis, with published conflicting results. We studied the impact of WLI in a homogenous pediatric population. Materials & methods: Retrospective study evaluating the survival outcomes of WLI in these patients. Results: Out of 163 metastatic ES; 41 patients were eligible for WLI. 30 patients (73.1%) received WLI (+ve) while 11 patients (26.8%) did not receive WLI (-ve). Five-year event-free survival was statistically significant in WLI (+ve). Five-year pulmonary relapse-free survival showed trend for improvement with WLI (+ve), while 5-year overall survival was not statistically significant between the two arms. Conclusion: WLI added significantly to the long term clinical outcome of metastatic ES patients, with no irreversible toxicity.

A phase II study of gemcitabine, ifosfamide, and oxaliplatin (GIFOX) as upfront treatment for high-risk, non-anaplastic large cell, peripheral T-cell lymphomas.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 8564-8564
Author(s):  
Gaetano Corazzelli ◽  
Gianpaolo Marcacci ◽  
Ferdinando Frigeri ◽  
Gaetana Capobianco ◽  
Francesco Volzone ◽  
...  
Keyword(s):  
T Cell ◽  
High Risk ◽  
Nk Cell ◽  
Autologous Transplantation ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Stage Iv ◽  
Early Death ◽  
Free Survival ◽  
Safe Delivery

8564 Background: Patients (pts) with peripheral T/NK cell lymphomas (PTCL) and intermediate-high/high IPI risk have a 5-yr overall survival < 20%. Current chemotherapy is unsatisfactory while benefit of upfront autologous transplantation (ASCT) is limited by high pre-transplant progression rates and pts advanced age. We evaluated efficacy and stem cells (SCs)-mobilizing activity of a biweekly regimen of gemcitabine (G), ifosfamide (Ifo) and oxaliplatin (Ox) (GIFOX), as an upfront strategy ensuring fast cytoreduction and early ASCT access or an effective alternative to CHOP-like programs in transplant-inelegible pts. Methods: Six biweekly courses of GIFOX [G 1000 mg/m2 D1, Ox 130 mg/m2 D2, Ifo 5 g/m2 D2 as 24h infusion (fractionated over days 2-4 in pts>65 yrs), G-CSF DD 7-11] were planned for all pts, with SCs mobilization at course 3 in ASCT-eligible pts. Simon's minimax two-stage design was adopted with the primary and secondary endpoints of response rate (RR) and progression-free survival (PFS), respectively. Results: Thirty-four pts (median age 63 yrs, r 42-80) [PTCL, nos (n=16), AITL (n=7), extranodal NK/T-cell (n=5), SS (n=6)], with IPI score intermediate-high (62%) or high (38%) were accrued [stage IV: 71%; BM involvement: 38%; E-site >1: 47%; hi LDH: 71%; ECOG>1: 38%; B-symptoms: 44%]. A total of 172 courses was delivered (median 6, r 2-6). Only 5 pts received <4 courses, due to progression (n=4) or early death (n=1). Overall RR was 82% [95% CI, 66-92; 22 complete (CR) and 6 partial (PR) responses]. Twelve pts mobilized SCs (median CD34+ cells harvest: 4.36x106/kg) and 8 (7CRs,1PR) underwent ASCT, 6 to 13 weeks after the 6th course. Estimated 5-yr PFS was 48% (95%CI: 28-65); median PFS for non-transplanted pts was 15 mo.s. Estimated 4-yr disease-free survival was 58%. Relevant toxicities were G4 thrombocytopenia (13%), G4 anemia (23%), G3/G4 infection (29%/6%), G3 encephalopathy (6%). Conclusions: Response and survival rates of GIFOX in high-risk PTCL compared more than favorably to CHOP-based regimens. Effective cytoreduction and prompt access to ASCT were ensured, together with safe delivery of a full induction program to transplant-ineligible pts.

Retrospective long-term follow-up analysis in 21 patients with chordomas of various sites treated at a single institution

1991 ◽  
Vol 75 (3) ◽  
pp. 374-377 ◽  
Author(s):  
Martin E. Keisch ◽  
Delia M. Garcia ◽  
Robert B. Shibuya
Keyword(s):  
Survival Rates ◽  
Disease Free Survival ◽  
Subtotal Resection ◽  
Survival Times ◽  
Actuarial Survival ◽  
Free Survival ◽  
Content Type ◽  
Long Term Follow Up ◽  
Radiotherapy Alone ◽  
Disease Free

✓ Twenty-one patients with chordoma were treated at the Radiation Oncology Center, Mallinckrodt Institute of Radiology, between 1949 and 1986. Thirteen patients had sacrococcygeal tumors, five had clival tumors, two had nasopharyngeal tumors, and one had a lumbar spine tumor. Nine patients were treated with surgery alone, eight patients with subtotal resection and postoperative irradiation, and four patients with radiotherapy alone after biopsy. The 5- and 10-year actuarial survival rates were 74% and 46%, respectively. The 10-year actuarial survival rate was significantly better in patients treated with surgery alone or surgery and irradiation than in those treated with radiotherapy alone (52%, 32%, and 0%, respectively, p = 0.02). Although all patients ultimately suffered a recurrence, those with lumbosacral tumors treated with surgery and irradiation had a longer mean disease-free survival period (6.6 years) than those treated with surgery alone (4.1 years) (p = 0.08). Disease-free survival times of patients with base of the skull tumors was not significantly different between the treatment groups. Irradiation after resection of chordomas appears to increase the time to first relapse in lumbosacral tumors and should be considered after subtotal resection.

scholarly journals Role of preoperative CA-125 levels in predicting the DFS and OS in epithelial ovarian cancer

2017 ◽  
Vol 7 (1) ◽  
pp. 69
Author(s):  
Shashidhar V. Karpurmathrmath ◽  
Velukuru Sai Vivek ◽  
Manjunath I. Nandennavar ◽  
Veerandra Angadi ◽  
Annalakshmi Sekar
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Stage Iv ◽  
Significant Rise ◽  
Stage I ◽  
Ca 125 ◽  
Screening Methods

Background: Ovarian cancer has the highest mortality rate among all the other gynaecologic malignancies. Stage I cancer treated with surgery and adjuvant chemotherapy report a 5-year overall survival of 95% while this value significantly drops to 25% in stage IIIC and IV patients. Unfortunately, effective screening methods to detect the early cancer are yet to be identified.Methods: All the patients diagnosed to have epithelial ovarian carcinoma from January 2012 to December 2014 at our center with pre-treatment CA-125 levels were included in this retrospective study. Disease free survival and overall survival were tabulated either by telephonic conversation or on a regular follow up visit to the hospital.Results: Among the 69 patients enrolled 38% of the patients were in the age group of 50-60 years. 58% of patients had stage 3 disease up front. mean CA-125 levels were lowest in patients with stage I disease and the highest in stage IV disease with a statistically significant rise in CA-125 levels with the stage of disease. Only 52% of the patients completed the treatment as per protocol. There was a significant negative co relation between the CA-125 levels and survival rates in both the sub groups of patients who received complete and incomplete treatment respectively.Conclusions: In the present study we would like to conclude that pre-operative CA-125, which has already been included in the screening algorithms like ROCA, has a greater potential to become a prognostic marker. Present study is limited by the small number of patient’s and thus larger multi centric studies with better randomization could establish the role of CA-125 as a prognostication marker.

scholarly journals Activity of Vincristine and Irinotecan in Diffuse Anaplastic Wilms Tumor and Therapy Outcomes of Stage II to IV Disease: Results of the Children’s Oncology Group AREN0321 Study

2020 ◽  
Vol 38 (14) ◽  
pp. 1558-1568 ◽  
Author(s):  
Najat C. Daw ◽  
Yueh-Yun Chi ◽  
John A. Kalapurakal ◽  
Yeonil Kim ◽  
Fredric A. Hoffer ◽  
...  
Keyword(s):  
Wilms Tumor ◽  
Survival Rates ◽  
Stage Iv ◽  
High Response Rate ◽  
Stage Ii ◽  
Therapy Outcomes ◽  
Free Survival ◽  
Nonhematologic Toxicity ◽  
Measurable Disease ◽  
To Receive

PURPOSE AREN0321 evaluated the activity of vincristine and irinotecan (VI) in patients with newly diagnosed diffuse anaplastic Wilms tumor (DAWT) and whether a regimen containing carboplatin (regimen UH1) in addition to regimen I agents used in the National Wilms Tumor Study 5 (NWTS-5; vincristine, doxorubicin, cyclophosphamide, and etoposide plus radiotherapy) would improve patient outcomes. PATIENTS AND METHODS Patients with stage II to IV DAWT without measurable disease received regimen UH1. Patients with stage IV measurable disease were eligible to receive VI (vincristine, 1.5 mg/m2 per day intravenously on days 1 and 8; irinotecan, 20 mg/m2 per day intravenously on days 1-5 and 8-12 of a 21-day cycle) in an upfront window; those with complete (CR) or partial response (PR) had VI incorporated into regimen UH1 (regimen UH2). The study was designed to detect improvement in outcomes of patients with stage II to IV DAWT compared with historical controls treated with regimen I. RESULTS Sixty-six eligible patients were enrolled. Of 14 patients with stage IV measurable disease who received VI, 11 (79%) achieved CR (n = 1) or PR (n = 10) after 2 cycles. Doses of doxorubicin, cyclophosphamide, and etoposide were reduced midstudy because of nonhematologic toxicity. Four patients (6%) died as a result of toxicity. Four-year event-free survival, relapse-free survival, and overall survival rates were 67.7% (95% CI, 55.9% to 79.4%), 72.9% (95% CI, 61.5% to 84.4%), and 73.7% (95% CI, 62.7% to 84.8%), respectively, compared with 57.5% (95% CI, 47.6% to 67.4%; P = .26), 57.5% (95% CI, 47.6% to 67.4%; P = .048), and 59.2% (95% CI, 49.4% to 69.0%; P = .08), respectively, in NWTS-5. CONCLUSION VI produced a high response rate in patients with metastatic DAWT. AREN0321 treatment seemed to improve outcomes for patients with stage II to IV DAWT compared with NWTS-5, but with increased toxicity. The UH2 regimen warrants further investigation with modifications to reduce toxicity.

scholarly journals Comparison of oncologic outcome of abdominoperineal resection versus sphincter saving resection for low lying rectal cancer

2021 ◽  
Vol 17 (2) ◽  
pp. 73-81
Author(s):  
Won Il Jo ◽  
Dae Ro Lim ◽  
Jung Cheol Kuk ◽  
Eung Jin Shin
Keyword(s):  
Rectal Cancer ◽  
Lymph Nodes ◽  
Recurrence Rate ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Stage Iv ◽  
Positive Lymph Node ◽  
Oncological Outcomes ◽  
Sphincter Saving Resection ◽  
Sphincter Saving

Purpose: The present study compares the peri/postoperative and oncological outcomes of abdominoperineal resections (APR) and sphincter saving resection (SSR) for low lying rectal cancer.Methods: Between January 2001 and December 2014, 176 patients who underwent SSR (n = 67) and APR (n = 109) for low rectal cancer, without stage IV, were retrieved from a retrospective database.Results: With a median follow-up of 66.5 months. The mean total number of harvested lymph nodes was 16.7 (SSR) versus 17.1 (APR) (P = 0.801). The advanced T stage was higher in the APR group (82.6%) versus the SSR group (55.2%) (P = 0.006). The positive rate of lymph nodes after surgery was significantly higher in the APR group (45.9%) versus SSR group (25.4%) (P < 0.05). The 5-year overall survival rates for SSR and APR were 87.3% and 67.6%, respectively (P < 0.005). The 5-year disease-free survival rate (DFS) was 83.6% (SSR) versus 65.5% (APR) (P = 0.002). The recurrence rate was higher in the APR group (34.9%) versus the SSR group (14.9%) (P = 0.004). Local recurrence rate was not different between the two groups. However, distant recurrence rate was significantly higher in the APR group (26.6% vs. 11.9%, P = 0.023). In multivariate analysis, node positive (N0 vs. N1-2) was an independent prognostic factor for DFS (P < 0.005).Conclusion: Based on the present data, SSR achieved better 5-year oncological outcome than APR. The positive lymph node ratio in the N stage after surgery was higher in the APR group and this seems to have an effect on the oncological outcomes of the APR group.

Sign in / Sign up

Export Citation Format

Share Document