RESUMEN
Male breast cancer is a rare form of carcinoma with an incidence rate of approximately 0.5-1% compared with cases of breast carcinoma as a whole. Male breast cancer reacts effectively to endocrine therapy because of a high frequency of hormone receptor expression.The aim of the present study was the assessment of correlations between stage, grade, expression of steroid receptors, basal/mesenchymal markers and proliferation index, as well as analysis of the impact of the above-mentioned parameters on overall (OS) and disease-free survival (DFS) in the group of 32 male breast cancer patients, treated at the Centre of Oncology in Cracow.We showed the significant positive correlation between MIB-1 LI and tumor stage, and hormone receptors (ER or PgR) immunonegativity, and expression of EGFR, vimentin (p<0.05) and P-cadherin (the last at statistical border). The presence of any of basal or masenchymal markers correlated with a more advanced tumor stage. Moreover tumors without vimentin expression were characterised by lower MIB-1 LI and were more frequently EGFR immunonegative.We found that hormone receptor negativity, vimentin immunopositivity and high MIB-1 LI are significant independent indicators of poor OS and DFS for male breast cancer patients (p<0.05).
Asunto(s)
Biomarcadores de Tumor/análisis , Neoplasias de la Mama Masculina/terapia , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama Masculina/química , Neoplasias de la Mama Masculina/mortalidad , Neoplasias de la Mama Masculina/patología , Receptores ErbB/análisis , Humanos , Antígeno Ki-67/análisis , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Vimentina/análisisRESUMEN
PURPOSE: The aim of this paper is to present results of analysis of 102 females with laryngeal cancer. MATERIALS AND METHODS: Between 1974 and 1995, 102 female patients with cancer of larynx were treated at Radiotherapy Department of Oncology Centre in Kraków. Twenty-six of them had positive familial oncological history. The treatment method depended on stage of disease. Primary radical irradiation was performed in 66 patients, 29 patients received postoperative radiotherapy after surgery (total or partial laryngectomy), seven patients received induction chemotherapy followed by laryngectomy with postoperative radiotherapy or radical irradiation. The median dose applied with radiotherapy was 60 Gy, and dose per fraction was 2 Gy. RESULTS: The actuarial 5-year rates were as follows: 88.9% for overall survival, 84.2% for disease-free survival, and 85.4% for local control. Only tumour stage and nodal involvement were found to be significant factor for all three endpoints. We found that younger patients had more supraglottic primary localisation, and these patients frequently were non-smoker. CONCLUSIONS: The tumour stage and nodal involvement were found to be significant prognostic factors in analysed group of female treated with laryngeal cancer.
Asunto(s)
Neoplasias Laríngeas/radioterapia , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/tratamiento farmacológico , Carcinoma de Células Escamosas/mortalidad , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/radioterapia , Carcinoma de Células Escamosas/cirugía , Terapia Combinada , Supervivencia sin Enfermedad , Fraccionamiento de la Dosis de Radiación , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Laríngeas/tratamiento farmacológico , Neoplasias Laríngeas/genética , Neoplasias Laríngeas/mortalidad , Neoplasias Laríngeas/patología , Neoplasias Laríngeas/cirugía , Laringectomía , Laringe/patología , Metástasis Linfática , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Cuidados Posoperatorios , Pronóstico , Dosificación Radioterapéutica , Factores Sexuales , Fumar/efectos adversos , Análisis de Supervivencia , Factores de TiempoRESUMEN
A case of an adenoid cystic carcinoma of trachea is presented. A 30-year-old non-smoking woman with strong inspiratory dyspnea at rest was admitted to the Dept. of Pulmonary Diseases. At auscultation a respiratory murmur was more silent at right lung and stridor over trachea was heard. CT scan revealed tumor at the bifurcation of the trachea. Bronchoscopy was made and biopsy established the diagnosis: adenoid cystic carcinoma. The tumor was partially removed with rigid bronchoscope and radiotherapy was started. Clinical improvement occurred; in control CT scan tumor vanished. The trachea cancers are rare. Symptoms often mimic asthma or chronic bronchitis. Thus in every patient with chronic cough and dyspnea bronchoscopy should be made. A treatment of choice is primary resection and postoperative radiotherapy.
Asunto(s)
Carcinoma Adenoide Quístico/diagnóstico , Carcinoma Adenoide Quístico/cirugía , Neoplasias de la Tráquea/diagnóstico , Neoplasias de la Tráquea/cirugía , Adulto , Biopsia , Broncoscopía , Carcinoma Adenoide Quístico/radioterapia , Femenino , Humanos , Radioterapia Adyuvante , Inducción de Remisión , Tomografía Computarizada por Rayos X , Neoplasias de la Tráquea/radioterapiaRESUMEN
AIM: To present our experience regarding the efficiency and tolerance of half-body irradiation in patients with multiple cancer metastases. PATIENTS AND METHODS: Between January 1986 and December 1997, 102 patients with multiple cancer metastases received half-body irradiation (HBI) at the Center of Oncology--Maria Sklodowska-Curie Memorial Institute in Krakow. Most of the patients (93/102) had bone metastases (Table 1). The HBI was performed with 9 MV photon beam from linear accelerator. In 88 patients only one region (upper, mid or lower) was treated, and 14 patients received upper and lower HBI (13 patients), or upper and mid HBI (one patient) (Table 2). The mean doses were: 6 Gy in upper HBI, 8 Gy in mid HBI, and 9 Gy in lower HBI (Table 3). RESULTS: The positive palliative effect (complete or partial pain relief) was observed in 77 (75.5%) patients (Table 4). Complete pain relief was higher in patients with prostate cancer, and in patients who received mid or lower HBI. During follow-up 47 (46.1%) patients developed pain progression after treatment (Table 5). The probability of survival without pain progression was higher in patients who developed complete pain relief (86.7% at 6 months, 69.3% at 12 and 24 months) than in patients with partial response (52.9% at 6 months, 32.8% at 12 months, and 5.5% at 24 months) (Figure 1). In most of the patients (74/102, 72.5%) the tolerance was good. CONCLUSIONS: HBI is an efficient method for palliation in patients with multiple painful metastases.
Asunto(s)
Metástasis de la Neoplasia/radioterapia , Adulto , Anciano , Neoplasias Óseas/radioterapia , Neoplasias Óseas/secundario , Neoplasias de la Mama , Femenino , Humanos , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia/fisiopatología , Dolor/etiología , Dolor/prevención & control , Cuidados Paliativos , Aceleradores de Partículas , Fotones/uso terapéutico , Probabilidad , Neoplasias de la Próstata , Tolerancia a Radiación , Dosificación Radioterapéutica , Factores de TiempoRESUMEN
The development of five of non-Hodgkin lymphomas during the course of autoimmune diseases was presented. The treatment methods of autoimmune disease included: irradiation steroids, non-steroidal anti-inflammatory drugs or immuno-suppressive drugs. The time interval between diagnosis of autoimmune disease and lymphoma was from 2 to 28 years. High-grade lymphoma was observed in all cases. After treatment (irradiation with or without combination with multidrug chemotherapy) the complete regression was observed and disease-free survival between 16 and 48 months after treatment was obtained.
Asunto(s)
Enfermedades Autoinmunes/complicaciones , Linfoma no Hodgkin/etiología , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Artritis Reumatoide/complicaciones , Quimioterapia Adyuvante , Terapia Combinada , Supervivencia sin Enfermedad , Femenino , Enfermedad de Graves/complicaciones , Humanos , Cirrosis Hepática/complicaciones , Lupus Eritematoso Sistémico/complicaciones , Linfoma no Hodgkin/terapia , Masculino , Persona de Mediana Edad , RadioterapiaRESUMEN
The prognostic importance of various pretherapeutic and therapeutic factors was analysed in a group of 413 cervical cancer patients with stage IIB (183 pts) and IIIB (230 pts) treated with radical radiotherapy, which consisted of external irradiation and intracavitary brachytherapy. Univariate analysis of pretherapeutic factors revealed the prognostic significance of patient age, history of abortion, stage, haemoglobin and hematocrit levels. Five-year overall survival rate in stage IIB patients was 51%, in stage IIIB 40% and the respective rates for local control at each stage were 61%, and 46%. Univariate analysis of therapeutic factors showed that survival and local control rates increased with the dose, but a significant difference was found only in the case of a paracentral (point A) dose. In a multivariate analysis only patient age, abortions, and clinical stage appeared to have a significant and independent impact on survival. Linear regression analysis results indicated that prolongation of treatment time between 33 and 108 days caused a loss of local control of 0.36% per day.
Asunto(s)
Neoplasias del Cuello Uterino/radioterapia , Adulto , Anciano , Relación Dosis-Respuesta en la Radiación , Femenino , Humanos , Modelos Lineales , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Estudios Retrospectivos , Tasa de Supervivencia , Neoplasias del Cuello Uterino/mortalidad , Neoplasias del Cuello Uterino/patologíaRESUMEN
BACKGROUND/PURPOSE: The results of conventional radiotherapy in patients with inoperable recurrence of laryngeal cancer after total laryngectomy are bad. Therefore experimental methods including neutron therapy and combination of chemo- and radiotherapy have been used. This presentation evaluates results of different treatment modalities in patients with inoperable recurrences of laryngeal cancer after total laryngectomy. PATIENTS AND METHODS: Forty-two patients with inoperable recurrences of laryngeal cancer after total laryngectomy were treated. Thirty patients received radiotherapy alone, and 12 patients received multidrug chemotherapy and radiotherapy. Patients were irradiated with cobalt-60 beam, neutron beam and with mixed cobalt-60 and neutron beam. The tumor dose in cobalt-60 therapy was 60 Gy in 20 to 30 fractions. In 8 patients additional dose of 10 to 20 Gy in 5 to 10 fractions was given to the reduced field. The doses used in neutron irradiation varied from 10 to 13 Gy in 5 to 20 fractions. RESULTS: In 20 patients (47.6%) complete regression after therapy was observed, but only 9 (21.4%) patients survived without evidence of disease at 2 years after radiotherapy. In patients treated with radiotherapy alone the 2-year disease-free survival was observed in 16.7% and in patients who received induction chemotherapy with Cisplatin followed by radical irradiation the 2-year disease-free survival was observed in 40%. CONCLUSION: The results of therapy of inoperable recurrence of laryngeal cancer after total laryngectomy remain bad. Radiotherapy combined with multidrug chemotherapy including cisplatin may contribute to some improvement of the patients survival.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma de Células Escamosas/tratamiento farmacológico , Carcinoma de Células Escamosas/radioterapia , Neoplasias Laríngeas/tratamiento farmacológico , Neoplasias Laríngeas/radioterapia , Laringectomía , Recurrencia Local de Neoplasia/tratamiento farmacológico , Recurrencia Local de Neoplasia/radioterapia , Adulto , Anciano , Bleomicina/uso terapéutico , Carcinoma de Células Escamosas/mortalidad , Cisplatino/uso terapéutico , Radioisótopos de Cobalto/uso terapéutico , Terapia Combinada , Supervivencia sin Enfermedad , Humanos , Neoplasias Laríngeas/mortalidad , Leucovorina/uso terapéutico , Masculino , Metotrexato/uso terapéutico , Persona de Mediana Edad , Recurrencia Local de Neoplasia/mortalidad , Neutrones/uso terapéutico , Dosificación Radioterapéutica , Factores de Tiempo , Vincristina/uso terapéuticoRESUMEN
BACKGROUND: Late menarche, early menopause, high parity, and early first birth decrease the risk of development of breast cancer. The influence of these factors on the survival of breast cancer patients has not been explained. METHODS: A group of 1885 patients with operable breast cancer was studied retrospectively. A univariate analysis was used to calculate 10-year overall survival (OS) and disease free survival (DFS) in relation to age, menopausal status, age at menarche and menopause, and number of pregnancies and deliveries. A multivariate analysis (Cox model) was performed in which classic prognostic factors (tumor size and grade, lymph node involvement) were included in addition to reproductive factors. RESULTS: Univariate analysis demonstrated better prognosis in patients who had never been pregnant compared with those who had (OS, 62% vs. 54%, respectively; P = 0.01; DFS, 53% vs. 44%, respectively; P = 0.005) and in nulliparous compared with parous patients (OS, 62% vs. 53%, respectively; P = 0.006; DFS, 52% vs. 44%, respectively; P = 0.004). Survival rates decreased with the number of pregnancies and deliveries. Patients with late menarche had worse survival then those whose first menstruation occurred before the age of 16 years (DFS, 47% vs. 41%, respectively; P = 0.04). By multivariate analysis, parity remained an independent prognostic indicator in addition to classic highly significant prognostic factors (nodal involvement, tumor grade and size). CONCLUSIONS: Results suggest that reproductive factors known to decrease the risk of breast cancer development have an adverse effect on prognosis.
Asunto(s)
Neoplasias de la Mama/cirugía , Historia Reproductiva , Aborto Espontáneo , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/patología , Terapia Combinada , Femenino , Humanos , Metástasis Linfática , Mastectomía Radical , Menarquia , Menopausia , Persona de Mediana Edad , Análisis Multivariante , Paridad , Embarazo , Premenopausia , Pronóstico , Estudios Retrospectivos , Tasa de SupervivenciaRESUMEN
A retrospective analysis of clinical and pathological prognostic factors was performed in 1,068 breast cancer patients treated with radical mastectomy alone in 1952-1980. Three endpoints were considered: 10-year survival, 10-year disease-free survival and 10-year loco-regional relapse-free survival. Both univariate and multivariate analyses confirmed the prognostic significance of tumour size, histological type and grade (Bloom classification) and involvement of axillary nodes for all three endpoints. Additionally, young age appeared to be a significant risk factor for loco-regional disease-free survival. Prognostic subgroups were defined by the use of 3 main indicators. In node negative patients with T1 tumours the prognosis seemed to be good regardless of histological grade (80-90% 10-year disease-free survival), in T2 tumours the survival was significantly dependent on histological type and grade. In node positive patients increasing number of involved nodes and higher histological grade had an independent adverse effect on all three endpoints. The study demonstrates that classical, commonly available prognostic factors clearly distinguish subgroups with different prognosis, which may be helpful when deciding on the use of adjuvant local and/or systemic therapies.
Asunto(s)
Neoplasias de la Mama/cirugía , Mastectomía Radical/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/mortalidad , Neoplasias de la Mama/patología , Femenino , Humanos , Persona de Mediana Edad , Análisis Multivariante , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Pronóstico , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Análisis de SupervivenciaRESUMEN
Since 1975 to 1989 in the Department of Radiotherapy of Centre of Oncology in Krakow 49 patients with inoperable recurrences of the larynx carcinoma after total laryngectomy were treated. The palliative therapy (chemotherapy and/or palliative radiotherapy) was used in 18 patients. This study presents the group of 31 patients which were treated with radical intent. Radical radiotherapy was used in 20 patients. Combined multidrug chemotherapy and radiotherapy was used in 11 patients: in 2 patients chemotherapy VBM was used in combination with radiotherapy and 9 patients received the induction chemotherapy (treatment schedules containing Cisplatin) followed by radical radiotherapy. Observations show that the effectiveness of the induction chemotherapy combined with radiotherapy. Two year symptom-free 3 patients (15). Better results were observed after combined treatment with the use the induction chemotherapy combined with radiotherapy. Two year symptom-free survival was achieved in 4 patients (44%). These findings require confirmation in the greater group of patients.
Asunto(s)
Carcinoma de Células Escamosas/terapia , Neoplasias de Cabeza y Cuello/terapia , Neoplasias Laríngeas/terapia , Laringectomía , Recurrencia Local de Neoplasia/terapia , Cuidados Paliativos , Adulto , Anciano , Antineoplásicos/uso terapéutico , Carcinoma de Células Escamosas/tratamiento farmacológico , Carcinoma de Células Escamosas/radioterapia , Terapia Combinada , Neoplasias de Cabeza y Cuello/tratamiento farmacológico , Neoplasias de Cabeza y Cuello/radioterapia , Humanos , Neoplasias Laríngeas/tratamiento farmacológico , Neoplasias Laríngeas/radioterapia , Irradiación Linfática , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/tratamiento farmacológico , Recurrencia Local de Neoplasia/radioterapia , Resultado del TratamientoRESUMEN
Between 1970 and 1985, 130 patients were irradiated with curative intent at the Center of Oncology in Kraków. The histological diagnosis was squamous-cell carcinoma in 60.8% of patients, adenocarcinoma in 25.4% of patients and other non-small cell cancer in 13.8% of patients. Out of 130 irradiated patients 21.5% refused surgery, 26.2% were inoperable for medical reasons, and 52.3% had unresectable tumors. According to the UICC TNM 1987 classification, 62 (47.7%) patients had early (stages I and II) disease. The remaining 68 (52.3%) patients had stage III A cancer. Additional criteria for patients selection to radiotherapy with curative intent were: Karnofsky performance status > or = 50, and no respiratory insufficiency. All patients were treated with megavoltage radiation. Patients with stage I were treated by three isocentric beams. Tumor dose was 6000 cGy in 24 fractions over five weeks. In patients with stage II and III A disease the radiotherapy was started with two parallel opposed beams encompassing primary lesion and mediastinum. The dose of 4000 cGy was given in 20 fractions over four weeks, followed by a "boost" dose of 2000 cGy in the fractions over two weeks, delivered with three isocentric beams. 54% of patients were disease-free at the twelfth month, 24.6% at the 36th month, and 18.5% of patients survived five years without evidence of cancer. A significantly better survival has been observed in patients with stages I and II, with Karnofsky performance status > or = 70, and with complete radiological regression eight weeks after radiation therapy. The main cause of failure of the treatment were distant metastases.
Asunto(s)
Adenocarcinoma/radioterapia , Carcinoma de Pulmón de Células no Pequeñas/radioterapia , Carcinoma de Células Escamosas/radioterapia , Neoplasias Pulmonares/radioterapia , Adenocarcinoma/mortalidad , Adenocarcinoma/patología , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Carcinoma de Pulmón de Células no Pequeñas/patología , Carcinoma de Células Escamosas/mortalidad , Carcinoma de Células Escamosas/patología , Humanos , Neoplasias Pulmonares/mortalidad , Neoplasias Pulmonares/patología , Análisis Multivariante , Estadificación de Neoplasias , Polonia/epidemiología , Traumatismos por Radiación/epidemiología , Traumatismos por Radiación/etiología , Radioterapia/efectos adversos , Radioterapia/estadística & datos numéricos , Dosificación Radioterapéutica , Análisis de SupervivenciaRESUMEN
Between 1958 and 1986, twenty-four patients with chemodectoma of the temporal bone received radiation therapy at the Center of Oncology in Cracow. In 22 patients incomplete excision of the tumor had been performed at other hospitals before admission for radiotherapy. Two patients had biopsy only. Three patients had early stage tumors without bone destruction or cranial nerve palsy and 21 patients had advanced tumors at presentation. Three patients treated between 1958 and 1967 received orthovoltage 250 V irradiation, 20 patients received 60Co teletherapy, and one patient received a combination of photon and electron therapy. Tumor doses ranged from 30 Gy to 60 Gy, given in 2-2.5 Gy fractions, 5 times weekly. There were no serious acute or late complications. Long-term local control was achieved in 23 patients with follow-up ranging from 16 months to 21.5 years (median 87 months). Only one patient had locally uncontrolled tumor along with lung and cervical node metastases. Irradiation appeared to be an effective and well tolerated method of treatment in chemodectoma of the temporal bone.
Asunto(s)
Paraganglioma Extraadrenal/radioterapia , Neoplasias Craneales/radioterapia , Hueso Temporal , Adulto , Anciano , Conducto Auditivo Externo/efectos de la radiación , Femenino , Estudios de Seguimiento , Humanos , Inflamación/etiología , Masculino , Persona de Mediana Edad , Piel/efectos de la radiaciónRESUMEN
Results of combined treatment with the use of induction chemotherapy with cisplatinum and 5-fluorouracil in 28 patients with advanced squamous cell head and neck cancer are presented. Treatment schedule included cisplatinum 100 mg/m2 i.v. in day 1 and 5-fluorouracil 100 mg/m2/24 hour in days 1-5. Complete or partial regression was observed in 15 patients (53%) Radical radiotherapy was subsequently used in 18 patients and 6 were irradiated palliatively++. One year symptom-free survival was achieved in 10 patients (36%).
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma de Células Escamosas/tratamiento farmacológico , Cisplatino/administración & dosificación , Fluorouracilo/administración & dosificación , Neoplasias de Cabeza y Cuello/tratamiento farmacológico , Adulto , Carcinoma de Células Escamosas/patología , Femenino , Neoplasias de Cabeza y Cuello/patología , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Inducción de RemisiónRESUMEN
15 patients with cancer of the trachea have been irradiated in 1959-1986 period. 7 patients received radical, 8 palliative radiotherapy. Analysis of results indicates that chance of survival of long duration exists for patients with not advanced adenocystic carcinoma treated with high doses of irradiation (67-70 Gy). In more advanced cases radiotherapy provided good palliative effect in majority of patients.
Asunto(s)
Radioisótopos de Cobalto/administración & dosificación , Radioterapia de Alta Energía/métodos , Neoplasias de la Tráquea/radioterapia , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dosificación Radioterapéutica , Tasa de Supervivencia , Tecnología Radiológica/métodos , Neoplasias de la Tráquea/mortalidadRESUMEN
Between 1971-1986 29 patients with cancer of the middle ear were treated with radiotherapy. Eighteen patients were treated with curative intent, 17 after incomplete surgery and 1 after biopsy only. Eleven patients were irradiated palliatively. In curative radiotherapy wedge pair technique or mixed photon-electron beam was used with a tumor dose of 60 Gy in 24-30 fractions. The probability of 5-year disease-free survival (DFS) is 53% for patients treated with curative intent. There is a correlation between extent of disease and survival. Excessive early reaction was observed in two patients, and late bone necrosis in one. Mean survival in the palliatively irradiated group was 3.6 months.
Asunto(s)
Carcinoma de Células Escamosas/radioterapia , Neoplasias del Oído/radioterapia , Oído Medio , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/mortalidad , Neoplasias del Oído/mortalidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tasa de SupervivenciaRESUMEN
8 patients with the nasofibromata were treated by radiotherapy in Oncologic Center in Kraków. In most part of these patients tumors exceeded the nasopharynx or gave the massive postoperational recurrencies. Complete regression was obtained in 6 out of 8 cases. The radiation changes are described. The radiotherapy is effective in more advanced and recurrent stages of the juvenile nasofibroma.