scholarly journals Palliative Surgery or Metallic Stent Positioning for Advanced Gastric Cancer: Differences in QOL

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 428
Author(s):  
Enrico Fiori ◽  
Daniele Crocetti ◽  
Paolo Sapienza ◽  
Roberto Cirocchi ◽  
Antonio V. Sterpetti ◽  
...  
Keyword(s):  
Stomach Cancer ◽  
Outlet Obstruction ◽  
Stage Iv ◽  
Palliative Surgery ◽  
Karnofsky Performance Scale ◽  
Metallic Stent ◽  
Significant Deterioration ◽  
Group 2 ◽  
Endoscopic Placement ◽  
Group 1

Background and Objectives: Twenty percent of the patients affected with stage IV antropyloric stomach cancer are hospitalized with a gastric outlet obstruction syndrome (GOOS) requiring its resolution to improve the quality of life (QoL). We present our preliminary short- and mid-term results regarding the influence of endoscopic placement of self-expandable metal stent (SEMS) or open stomach-partitioning gastrojejunostomy in QoL. Materials and Methods: In this prospective randomized longitudinal cohort trial, we randomly assigned 27 patients affected with stage IV antropyloric stomach cancer into two groups: Group 1 (13 patients) who underwent SEMS positioning and Group 2 (14 patients) in whom open stomach-partitioning gastrojejunostomy was performed. The Karnofsky performance scale and QoL assessment using the EQ-5D-5L™ questionnaire was administered before treatment and thereafter at 1, 3, and 6 months. Results: At 1-month, index values showed a statistically significant deterioration of the QoL in patients of Group 2 when compared to those of Group 1 (p = 0.004; CI: 0.04 to 0.21). No differences among the groups were recorded at 3-month; whereas, at 6-month, the index values showed a statistically significant deterioration of the QoL in patients of Group 1 (p = 0.009; CI: −0.25 to −0.043). Conclusions: Early QoL of patients affected with stage IV antropyloric cancer and symptoms of GOOS is significantly better in patients treated with SEMS positioning but at 6-month the QoL significantly decrease in this group of patients. We explained the reasons of this fluctuation with the higher risk of re-hospital admission in the SEMS group.

Extending the multistage surgical strategy for recurrent initially low-grade gliomas: functional and oncological outcomes in 31 consecutive patients who underwent a third resection under awake mapping

2021 ◽  
pp. 1-10 ◽  
Author(s):  
Noor Hamdan ◽  
Hugues Duffau
Keyword(s):  
High Rate ◽  
Karnofsky Performance Scale ◽  
Consecutive Series ◽  
Low Grade ◽  
Oncological Treatment ◽  
The Third ◽  
Oncological Outcomes ◽  
Group 2 ◽  
Group 1

OBJECTIVE Maximal safe resection is the first treatment in diffuse low-grade glioma (DLGG). Due to frequent tumor recurrence, a second surgery has already been reported, with favorable results. This study assesses the feasibility and functional and oncological outcomes of a third surgery in recurrent DLGG. METHODS Patients with DLGG who underwent a third functional-based resection using awake mapping were consecutively selected. They were classified into group 1 in cases of slow tumor regrowth or group 2 if a radiological enhancement occurred during follow-up. All data regarding clinicoradiological features, histomolecular results, oncological treatment, and survival were collected. RESULTS Thirty-one patients were included, with a median age of 32 years. There were 20 astrocytomas and 11 oligodendrogliomas in these patients. Twenty-one patients had medical oncological treatment before the third surgery, consisting of chemotherapy in 19 cases and radiotherapy in 8 cases. No neurological deficit persisted after the third resection except mild missing words in 1 patient, with 84.6% of the patients returning to work. The median follow-up duration was 13.1 ± 3.4 years since diagnosis, and 3.1 ± 2.9 years since the third surgery. The survival rates at 7 and 10 years were 100% and 89.7%, respectively, with an estimated median overall survival of 17.8 years since diagnosis. A comparison between the groups showed that the Karnofsky Performance Scale score dropped below 80 earlier in group 2 (14.3 vs 17.1 years, p = 0.01). Median residual tumor volume at the third surgery was smaller (2.8 vs 14.4 cm3, p = 0.003) with a greater extent of resection (89% vs 70%, p = 0.003) in group 1. CONCLUSIONS This is the first consecutive series showing evidence that, in select patients with progressive DLGG, a third functional-based surgery can be achieved using awake mapping with low neurological risk and a high rate of total resection, especially when reoperation is performed before malignant transformation.

Cisplatin-based chemotherapy regimen (DECAV) for uterine sarcomas

2002 ◽  
Vol 12 (6) ◽  
pp. 749-754 ◽  
Author(s):  
P. Pautier ◽  
C. Genestie ◽  
K. Fizazi ◽  
P. Morice ◽  
C. Mottet ◽  
...  
Keyword(s):  
Chemotherapy Regimen ◽  
Rare Event ◽  
Local Therapy ◽  
Stage Iv ◽  
Complete Response ◽  
Disease Stage ◽  
Uterine Sarcomas ◽  
Hospital Stays ◽  
Group 2 ◽  
Group 1

Uterine sarcomas are an extremely rare event. There is no standard therapy for cases of relapse, although chemotherapy is commonly used. We studied the use of a cisplatin-based chemotherapy regimen for uterine sarcomas with an unusually long follow-up. Thirty-nine women with a median age of 50 years (32–71) entered the study. Histologically, leiomyosarcomas (26), carcinosarcomas (8), and stromal sarcomas (5) were represented. Group 1 consisted of patients undergoing adjuvant therapy (for initial disease, eight patients; for pelvic recurrence, two patients); Group 2 consisted of patients with advanced disease (locoregional after initial local therapy, five patients; local recurrence, six patients) or metastatic disease (stage IV, four patients; recurrence, 14 patients). DECAV therapy consisted of doxorubicin 50 mg/m2 d1, dacarbazine (DTIC) 200 mg/m2/d d1–3, vindesine 2 mg/day d1–2, cisplatin 100 mg/m2 d3, and either cyclophosphamide (CPM) 200 mg/m2/d d1–3 (n = 21), or ifosfamide (IFM) 2 g/m2/d d1–3 with mesna every 4 weeksToxicity included 18 hospital stays for cytopenia (nine patients), including 13 cases of febrile neutropenia. Twenty blood transfusions in 10 patients and 12 platelet transfusions in seven patients were required. One toxicity-related death (hemorrhage) occurred. The overall response rate was 54% (3 complete response, 11 partial response) with a median duration of 13 months (4–36). Median overall survival was 14 month overall, 45 months for Group 1 and 13 months for Group 2. We conclude that the DECAV regimen is clearly active in uterine sarcomas but is too toxic to be recommended routinely.

Patient-reported outcomes for determining prognostic groups in veterans with stage IV solid tumors starting systemic therapy.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 48-48
Author(s):  
Victor Tsu-Shih Chang ◽  
Charles B. Scott ◽  
Melanie L. Gonzalez ◽  
Jan Einhorn ◽  
Houling Yan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Solid Tumors ◽  
Systemic Therapy ◽  
Stage Iv ◽  
Group 4 ◽  
Prognostic Groups ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

48 Background: A Recursive Partitioning Analysis (RPA) prognostic algorithm based on quality of life and symptoms predicted 4 groups with distinct median survivals in patients with metastatic solid tumors receiving chemotherapy (ASCO 2013, Abst 9567). We update our findings. Methods: The RPA algorithm is based upon Karnofsky performance status (KPS), Functional Assessment of Cancer Therapy (FACT) physical well-being (PWB) subscale, and Memorial Symptom Assessment Scale Short Form (MSAS-SF) physical symptom distress (PHYS) subscale. Starting in 2007, a convenience sample of Veterans who were prescribed systemic treatment for their cancer was enrolled in an IRB approved protocol, and completed quality of life (FACT- G) and symptom (MSAS SF) questionnaires at the first cycle of treatment. We analyzed records of patients with stage IV metastatic solid tumors enrolled through June 2013, and determined survival as of June 15, 2014. Analyses were performed with STATA 11.0. Results: There were 97 patients(pts). The median age was 64 yrs, range 27-88. Males comprised 95 (98%) pts. First line chemotherapy was given to 78 (80%) pts. The most common primary sites were lung cancer 33 (35%), prostate 17 (17%) and colon 11 (11%) pts. Median KPS was 90% range 40-100%, PWB median 23 (range 6-28), and MSAS SF median PHYS 0.76 (range 0-3.2). Overall median survival was 285 days (range 6-2,358) and 80 pts (82%) had died. There was 1 pt in group 1, 58 in group 2, 12 in group 3, and 23 in group 4. The patient in group 1 had uterine sarcoma. Median survival (days) by RPA group was 155 for group 1, 177 for group 2, 292 for group 3, and 674 for group 4 (p=.011). Conclusions: These preliminary findings suggest that this algorithm is capable of dividing patients with metastatic solid tumor who are starting systemic therapy into prognostic groups. Further development is indicated.

Rituximab Plus Dose Intense Rapid-Cycling Chemotherapy with Intrathecal CNS Prophylaxis in Patients with Burkitt Lymphoma (BL) and Intermediate Unclassifiable Diffuse Large B-Cell Lymphoma/BL: Single Institution Experience

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 1631-1631
Author(s):  
Chiara Frairia ◽  
Chiara Ciochetto ◽  
Ernesta Audisio ◽  
Giulia Benevolo ◽  
Barbara Botto ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Bone Marrow Involvement ◽  
Stage Iv ◽  
B Cell Lymphoma ◽  
High Dose ◽  
Rapid Cycling ◽  
High Dose Cytarabine ◽  
Group 2 ◽  
Group 1

Abstract Abstract 1631 Introduction. Burkitt Lymphoma (BL) and the novel category of B-cell lymphoma, unclassifiable, with features intermediate between BL and diffuse large B-cell lymphoma (intermediate DLBCL/BL) listed in the 2008 WHO classification, are mature B-cell non-Hodgkin lymphomas. They were characterized by a high degree of proliferation with an aggressive clinical course. With the introduction of dose intense, rapid-cycling chemotherapy (Magrath 1996), mainly when supplemented with Rituximab, the prognosis of BL was improved. Conversely, the issue of intermediate DLBCL/BL treatment is still a matter of debate. On this basis, we conducted a retrospective analysis to investigate the outcome of adult patients with BL and intermediate DLBCL/BL treated in a single hematological center. Methods. We retrospectively analyzed 23 adult patients divided in two groups according to histological diagnosis treated with Rituximab plus dose intense rapid-cycling chemotherapy with intrathecal CNS prophylaxis. Group 1: 18 adult BL patients, including three with a diagnosis of L3 acute lymphoblastic leukemia, treated according to CODOX-M/IVAC regimen including Cyclophosphamide, Doxorubicin, Vincristine, Methotrexate, Ifosfamide, Etoposide and high dose Cytarabine in association with Rituximab and intrathecal liposomal Cytarabine (R-CODOX-M/IVAC). Group 2: five intermediate DLBCL/BL, treated with Rituximab intensified CHOP with intrathecal Methotrexate followed by high dose Cytarabine and Mitoxantrone and high dose chemotherapy with autologous stem cell transplantation (R-HDC plus ASCT) or with R-CODOX-M/IVAC. Results. Group 1 included 18 patients with a median age of 45 years (range 29–74), stage IV in 14 cases (78%), performance status (PS) 2 in 14 (78%), LDH upper normal value in 13 (72%), bone marrow involvement in eight (44%), B symptoms in eight (44%) and liquor positivity at citoflussimetry in one (5%). Between 2006 and 2011 all 18 patients were treated according to R-CODOX-M/IVAC. Group 2 included five patients with median age of 47 years (range 32–58), stage IV in four patients (80%), PS 2 in all patients, LDH upper normal value in four (80%) bone marrow involvement in three (60%), B symptoms in three (60%) and liquor positivity at citoflussimetry in two (50%). Between 2008 and 2011 two patients were treated with R-HDC plus ASCT while the other three patients were treated with R-CODOX-M/IVAC regimen. All 18 BL patients of group 1 were evaluable for response: 15 patients were in persistent complete remission (CR) and three died of progressive disease. With a median follow-up of 70.3 months, progression free survival and overall survival were 76.5% and 80.3%, respectively. Therapy was well tolerated, with no significant acute and late treatment related toxicities and no toxic deaths. In group 2 the two patients treated with R-HDC plus ASCT died of progressive disease; of the three patients treated with R-CODOX-M/IVAC regimen, one died of early relapse disease occurred three months after achieving CR and two are still on therapy. Conclusions. Our data suggest that in BL R-CODOX-M/IVAC is a safe and highly effective therapeutic regimen providing a high rate of persistent CR. Within the limits of a small sample size, in our experience, patients with intermediate DLBCL/BL have a clinical aggressive disease with a poor prognosis regardless of the type of treatment. Additional and larger studies are warranted to clarify the behavior of this new histological entity and develop novel and efficacy therapeutic approaches. Disclosures: Vitolo: Roche Italy: Speakers Bureau; Celgene: Speakers Bureau; Jannsen-Cilag: Speakers Bureau.

Effect of introduction of paclitaxel on survival among women with stage III and IV ovarian cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5536-5536
Author(s):  
S. S. Dawood ◽  
C. Albaracin ◽  
A. Gonzalez-Angulo ◽  
M. Markman ◽  
B. Hennessy
Keyword(s):  
Ovarian Cancer ◽  
Stage Iv ◽  
Stage Iii ◽  
First Line ◽  
Fda Approval ◽  
Significant Difference ◽  
Stage Iv Disease ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

5536 Background: The objective of this study was to evaluate survival over time in relation to FDA approval of paclitaxel (P) for second- and first-line treatment in a population-based cohort of women with stage III and de novo stage IV ovarian cancer. Methods: The Surveillance, Epidemiology, and End Results (SEER) program was searched to identify 8,267 and 10,746 women with stage III and stage IV epithelial ovarian cancer diagnosed between 1988–2004. Women were divided according to their year of diagnosis and year of FDA approval of P for second- (1992) and first-line(1998) treatment of ovarian cancer: Group1 (1988–1991; before P approval); Group2 (1992–1997; P approved for second-line); Group3 (1998–2003; P approved for first-line). Overall (OS) and ovarian-cancer-specific survival (OCS) were estimated using Kaplan-Meier product method and compared across groups with log rank statistic. Cox-proportional hazards models were fitted to determine the association of group year of diagnosis and survival after adjusting for patient/tumor characteristics. Results: Median age was 66 years. Median OCS was 44 and 18 months among women with stages III and IV disease, respectively. With stage III disease, 2-year OCS was 64%, 68%, and 70% for groups 1, 2, and 3, respectively (p < 0.0001). With stage IV disease, 2-year OCS was 39%, 41%, and 42% for groups 1, 2, and 3, respectively (p = 0.19). In the multivariable model for stage III disease, women in group 1 (HR = 1.4, 95% CI 1.2–1.5, p < 0.0001) and group 2 (HR = 1.2, 95% CI 1.1–1.3, p = 0.0003) had an increased hazard of ovarian-cancer-specific death vs. group 3. For stage IV disease, women in group 1 (HR = 1.2, 95% CI 1.12–1.3, p < 0.0001) had a significantly increased hazard of ovarian cancer-specific death, but no significant difference in group 2 (HR = 1.0, 95% CI 0.9–1.1, p = 0.88) vs. group 3. Similar trends were observed for OS. Conclusions: The survival of women with stages III and IV ovarian cancer has significantly improved with the introduction of P over the last two decades. However, the incremental improvement in survival with stage IV disease is clinically minimal and indeed not significant in the univariable analysis in the SEER patient cohort analyzed, suggesting a desperate need for new and more active drugs in these patients. No significant financial relationships to disclose.

Patient-reported outcomes for determining prognostic groups in veterans with stage IV solid tumors starting systemic therapy.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9567-9567
Author(s):  
Victor T Chang ◽  
Charles B. Scott ◽  
Jan Einhorn ◽  
Houling Yan ◽  
Melanie L. Gonzalez ◽  
...  
Keyword(s):  
Solid Tumors ◽  
Median Survival ◽  
Systemic Therapy ◽  
Stage Iv ◽  
Group 4 ◽  
Patient Reported ◽  
Prognostic Groups ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

9567 Background: A Recursive Partitioning Analysis (RPA) algorithm predicted four groups with distinct median survivals in patients with advanced cancer entering palliative care (ASCO 2010, Abst 9040). We investigated whether this algorithm could apply to cancer patients starting systemic therapy. Methods: The RPA algorithm is based upon Karnofsky performance status (KPS), Functional Assessment of Cancer Therapy (FACT) physical well-being (PWB) subscale, and Memorial Symptom Assessment Scale Short Form (MSAS-SF) physical symptom distress (PHYS) subscale. Starting in 2007, a convenience sample of Veterans who were prescribed systemic treatment for their cancer was enrolled in an IRB approved protocol, and completed quality of life (FACT- G) and symptom (MSAS SF) questionnaires prior to starting the first cycle of treatment. We analyzed records of patients with stage IV metastatic solid tumors enrolled through August 2011, and determined survival as of December 1, 2012. Analyses were performed with STATA 11.0. Results: There were 72 patients (pts). The median age was 63 yrs, (range 46-86). Men comprised 71 (98%) pts. First line systemic therapy was given to 59 (82%) pts. The most common primary sites were lung cancer (25 pts, 35%), prostate 9 pts(12%) and colon 7 pts (10%). Median KPS was 90% (range 40-100%), PWB median 23 (range 6-28), and MSAS SF median PHYS 0.73 (range 0-2.93). Overall median survival was 269 days (range 6-1762) and 57 pts (79%) had died. There was 1 pt in group 1, 45 pts in group 2, 8 pts in group 3, and 18 pts in group 4. Median survival (days) by RPA group was 155 for group 1, 177 for group 2, 292 for group 3, and 610 for group 4 (p=.011). Conclusions: These preliminary findings suggest that this algorithm is capable of dividing patients with metastatic solid tumor who are starting chemotherapy into prognostic groups. It may have applications in clinical trials. Further development is indicated. [Table: see text]

scholarly journals CTA Evaluation of Bioresorbable Scaffolds versus Metallic Coronary Stents – a Feasibility Study

2018 ◽  
Vol 3 (3) ◽  
pp. 152-159
Author(s):  
Ioan Ferenț ◽  
András Mester ◽  
Monica Chițu ◽  
Annabella Benedek ◽  
Mihaela Rațiu ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Bare Metal Stents ◽  
Coronary Stents ◽  
Metal Stents ◽  
Imaging Method ◽  
Metallic Stent ◽  
Bioresorbable Scaffolds ◽  
Group 2 ◽  
Diagnostic Ct ◽  
Group 1

Abstract Background: Computed tomography angiography (CTA) presents important limits in in-stent restenosis (ISR) evaluation in case of metallic coronary stents, due to the artifacts determined by stent struts, which alter in-stent plaque analysis. In case of bioresorbable scaffolds, stent strut resorption allows accurate evaluation of the vessel wall. Aim of the study: This study aims to compare the feasibility of CTA as a follow-up imaging method for ISR diagnosis following elective PTCA procedures, between bioresorbable scaffolds and metallic coronary stents. Material and methods: We conducted a prospective, observational study on 73 patients with elective PTCA procedures in their medical history, in whom 113 stents were assessed via CTA in order to diagnose ISR. Based on stent type, the patients were divided into two groups: Group 1 – patients with bioresorbable vascular scaffolds (BVS) (n = 30); and Group 2 – patients with bare metal stents (BMS) (n = 43). Plaque analysis was possible only in the BVS group with a post-processing research-dedicated software, Syngo.via Frontier, which identified plaque morphology and virtual histology composition. Results: After CTA evaluation, the BVS group presented a significantly higher incidence of severe coronary artery disease (CAD) (Group 1 – 73% vs. Group 2 – 30%, p <0.0001). The proximal part of the right coronary artery (RCA) presented a significantly higher percentage of metallic stents (14% BMS vs. 2% BVS, p = 0.0029). The comparative analysis of CTA sensibility for the visual evaluation of ISR identified a significantly higher percentage of diagnostic CT evaluations in the BVS group (Group 1 – 94% vs. Group 2 – 76.19%, p = 0.0006). CTA evaluation provided the most accurate results for the 3.0 and 3.5 mm devices. Regarding CTA sensibility for ISR diagnosis, the BVS group presented the smallest incidence of non-diagnostic CT evaluations. Conclusions: CTA evaluation of bioresorbable scaffolds is superior to metallic stent assessment, the latter being influenced by numerous sources of error dependent mainly on the presence of the metal structure.

Treatment of diffuse histiocytic lymphoma (DHL) with COMLA (cyclophosphamide, oncovin, methotrexate, leucovorin, cytosine arabinoside): a 10-year experience in a single institution.

1985 ◽  
Vol 3 (12) ◽  
pp. 1596-1604 ◽  
Author(s):  
E R Gaynor ◽  
J E Ultmann ◽  
H M Golomb ◽  
D L Sweet
Keyword(s):  
Cytosine Arabinoside ◽  
Disease Free Survival ◽  
Stage Iv ◽  
Aggressive Treatment ◽  
Free Survival ◽  
Histiocytic Lymphoma ◽  
Group 2 ◽  
Diffuse Histiocytic Lymphoma ◽  
Disease Free ◽  
Group 1

Between March 1974 and December 1983, 83 patients with diffuse histiocytic lymphoma (DHL) were treated with COMLA (cyclophosphamide 1.5 g/m2 day 1; Oncovin (Lilly, Indianapolis) 1.4 mg/m2 days 1, 8, and 15; and cytosine arabinoside 300 mg/m2 and methotrexate 120 mg/m2 days 22, 29, 36, 43, 50, 57, 64, and 71; and leucovorin 25 mg/m2 every six hours X 4, beginning 24 hours after methotrexate). For the purpose of analysis, patients were divided into two groups. Group 1 (n = 54) included patients age 65 or under who had received no prior curative radiotherapy or chemotherapy. Group 2 (n = 29) included all patients over age 65 and patients who had received prior curative radiation therapy or prior minimal chemotherapy. The median time of follow-up for all patients was 28 months. Group 1 included 11 stage II, ten stage III, and 33 stage IV patients. Of 48 evaluable patients in this group, 21 (44%) achieved a complete remission (CR), eight (17%) achieved a partial remission (PR), and 19 (40%) showed no response (NR). Median survival of CR patients was 114+ months, PR patients, 42 months, and NR patients, 13 months. Six CR patients relapsed. The median disease-free survival of CR patients was 108+ months. Group 2 included nine stage II, seven stage III, and 13 stage IV patients. Of 24 patients evaluable for response, eight (33%) achieved a CR, six (25%) achieved a PR, and ten (42%) showed no response. The median survival of CR patients was 114+ months, that of PR patients was 17 months, and that of NR patients, 9 months. Two CR patients relapsed. The median disease-free survival of CR patients had not been reached at 102 months. The regimen was well tolerated in most patients and toxicity was acceptable. We conclude that COMLA is a well tolerated outpatient chemotherapy regimen capable of inducing durable CRs in some patients with DHL. Results achieved with COMLA, however, are inferior to those of more aggressive treatment programs; thus, the use of COMLA as first-line therapy in DHL should be limited to those patients unable to tolerate a more aggressive treatment program.

A prospective evaluation of 5-fluorouracil plus cisplatin in advanced squamous-cell cancer of the head and neck.

1985 ◽  
Vol 3 (11) ◽  
pp. 1486-1489 ◽  
Author(s):  
K S Dasmahapatra ◽  
P Citrin ◽  
G J Hill ◽  
R Yee ◽  
M A Mohit-Tabatabai ◽  
...  
Keyword(s):  
Head And Neck ◽  
Squamous Cell ◽  
Response Rate ◽  
Squamous Cell Cancer ◽  
Cell Cancer ◽  
Stage Iv ◽  
Previously Treated Patients ◽  
Previously Treated ◽  
Group 2 ◽  
Group 1

Recent studies have shown improved efficacy of chemotherapy in patients with advanced squamous-cell cancer of the head and neck. Our purpose was to evaluate prospectively the activity of cisplatin plus 5-fluorouracil (5FU) in 37 patients with advanced stage IV squamous-cell cancer of the head and neck. There were two groups. Group 1 consisted of 19 previously untreated patients with either T4 or N3 disease. They received 100 mg/m2 cisplatin (days 1 and 28) and 120-hour infusion of 1,000 mg/m2/24 hours 5FU (days 1 to 5 and 28 to 32). They subsequently were offered preoperative radiotherapy (RT) and surgery. Group 2 consisted of 18 previously treated patients. They received 5FU and cisplatin in the same dosage every 28 days for either recurrent or metastatic disease. It was found that in group 1 there was an 84% response rate (five complete responses (CR) and 11 partial responses (PR) ). Three of those with PR achieved a CR after RT. Seven patients have had RT plus surgery and are disease free at 8 to 27 month follow-up. Six patients (one CR, five PR) refused surgery and progressed within 4 months. In group 2 there was an 11% response rate after two cycles (two PR), three patients had a minimal response (MR, less than 50% response) and received a mean of four cycles of treatment. Three patients with stable disease received a mean of four cycles of chemotherapy until progression. Two of 11 patients who had received previous chemotherapy plus RT showed an MR; nine of these patients had shown a response to their previous chemotherapy. Only one of 14 patients who had RT plus chemotherapy had a PR, and three had MR. Of five patients who had previous surgery, only one had a PR. All five had received chemotherapy as well. It was concluded that 5FU plus cisplatin is an effective combination in previously untreated patients. In previously treated patients with recurrent disease, there is a substantially lower response rate.

scholarly journals Protective/restorative role of the adipose tissue-derived mesenchymal stem cells on the radioiodine-induced salivary gland damage in rats

2017 ◽  
Vol 51 (3) ◽  
pp. 307-316 ◽  
Author(s):  
Güleser Saylam ◽  
Ömer Bayır ◽  
Salih Sinan Gültekin ◽  
Ferda Alparslan Pınarlı ◽  
Ünsal Han ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Adipose Tissue ◽  
Salivary Gland ◽  
Study Groups ◽  
Significant Deterioration ◽  
Group 6 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

AbstractBackgroundTo analyze protective/regenerative effects of adipose tissue-derived mesenchymal stem cells (ADMSC) on131I-Radioiodine (RAI)-induced salivary gland damage in rats.Materials and MethodsStudy population consisted of controls (n:6) and study groups (n:54): RAI (Group 1), ADMSC (Group 2), amifostine (Group 3), RAI+amifostine (Group 4), concomitant RAI+ADMSC (Group 5) and RAI+ADMSC after 48 h (Group 6). We used light microscopy (LM), transmission electron microscopy (TEM), and salivary gland scintigraphy (SGS), and analyzed data statistically.ResultsWe observed the homing of ADMSC in salivary glands at 1stmonth on LM. RAI exposure affected necrosis, periductal fibrosis, periductal sclerosis, vascular sclerosis and the total sum score were in a statistically significant manner (P< 0.05). Intragroup comparisons with LM at 1stand 6thmonths revealed statistically significant improvements in Group 6 (P< 0.05) but not in Groups 4 and 5. Intergroup comparisons of the total score showed that Groups 4 and 5 in 1stmonth and Group 6 in 6thmonth had the lowest values. TEM showed vacuolization, edema, and fibrosis at 1stmonth, and an improvement in damage in 6thmonth in Groups 5 and 6. SGSs revealed significant differences for the maximum secretion ratio (Smax) (P= 0.01) and the gland-to-background ratio at a maximum count (G/BGmax) (P= 0. 01) at 1stmonth, for G/BGmax (P= 0.01), Smax (P= 0.01) and the time to reach the maximum count ratio over the time to reach the minimum count (Tmax/Tmin) (P= 0.03) at 6thmonth. 1stand 6thmonth scans showed differences for Smax and G/BGmax (P= 0.04), but not for Tmax/Tmin (p> 0.05). We observed a significant deterioration in gland function in group 1, whereas, mild to moderate deteriorations were seen in protective treatment groups.ConclusionsOur results indicated that ADMSC might play a promising role as a protective/regenerative agent against RAI-induced salivary gland dysfunction.

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