RESUMEN
AIMS: To determine the prognostic value of proliferative potential and DNA ploidy in 72 brain tumours (36 grade III and 36 grade IV astrocytomas) using bromodeoxyuridine (BrdUrd) incorporation and flow cytometry. MATERIAL AND METHODS: All 72 patients underwent excision, mostly incomplete of the tumour. After surgery, eight patients received conventionally fractionated radiotherapy, 11 patients received accelerated radiotherapy, and 53 patients received hypofractionated radiotherapy. Tumour samples taken during surgery from each patient were incubated in vitro for 1 h at 37 degrees C with BrdUrd using the high pressure oxygen method. The percentage of BrdUrd-labelled cells (BrdUrd labelling index [BrdUrd LI]), and the total DNA content were evaluated: RESULTS: The tumours showed variability in the BrdUrd LI values, which ranged from 0.3 to 19.1%. No difference was observed in mean BrdUrd LI between grade III and grade IV sub-groups. A significantly higher percentage of DNA aneuploidy was observed in grade III gliomas (69.4%) than in grade IV gliomas (52.8%). Univariate analysis showed that younger patients (< or = 51 years) (P = 0.021) with grade III gliomas (P = 0.030) and low tumour proliferation rate (BrdUrd LI < or = 2.7%, P = 0.028) had significantly higher 5-year survival rates. Tumour ploidy had no influence on patients' survival (P = 0.591). However, Cox multi-variate analysis showed that only age over 51 years, and high tumour proliferation rate (BrdUrd LI > 2.7%), were significant unfavourable prognostic factors in patient survival. CONCLUSION: In this study, independent prognostic factors for patients with high-grade gliomas treated with surgery and post-operative radiotherapy are age and tumour proliferation rate assessed according to the BrdUrd LI.
Asunto(s)
Neoplasias Encefálicas/radioterapia , Neoplasias Encefálicas/cirugía , Bromodesoxiuridina , Glioma/radioterapia , Glioma/cirugía , Adulto , Factores de Edad , Anciano , Neoplasias Encefálicas/diagnóstico , Proliferación Celular/efectos de los fármacos , Terapia Combinada , ADN de Neoplasias/análisis , ADN de Neoplasias/efectos de los fármacos , Progresión de la Enfermedad , Femenino , Citometría de Flujo , Estudios de Seguimiento , Glioma/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Estadificación de Neoplasias , Oxígeno/farmacología , Ploidias , Pronóstico , Sensibilidad y Especificidad , Coloración y Etiquetado , Tasa de Supervivencia , Resultado del Tratamiento , Células Tumorales CultivadasRESUMEN
The diagnostic sensitivity and specificity of tumor markers in head and neck cancers is not satisfactory. It is a stimulus for search of other biochemical indicators, among others determinations of acute phase proteins, helpful in head and neck cancers diagnostics and prognosis. In a group of 33 patients with squamous cell carcinoma of the pharynx and larynx (T1-4 N0-3 M0) CYFRA 21-1, SCC-Ag and acute phase proteins such as prealbumin, albumin, alpha-1 acid glycoprotein, alpha-1 antytrypsin, transferrin, ceruloplasmin and C-reactive protein (CRP) determinations were performed before radiotherapy. Significantly greater area under ROC curve for CYFRA 21-1 than for SCC-Ag was found. In T3-4 group, significantly lower albumin and higher AAG and CRP concentrations in comparison with T1-2 patients were observed. Multivariate analysis revealed that apart from tumor stage, elevated concentrations of SCC-Ag and/or CRP are independent unfavorable prognostic factors.
Asunto(s)
Proteínas de Fase Aguda/biosíntesis , Antígenos de Neoplasias/biosíntesis , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/radioterapia , Neoplasias Laríngeas/metabolismo , Neoplasias Laríngeas/radioterapia , Neoplasias Faríngeas/metabolismo , Neoplasias Faríngeas/radioterapia , Serpinas/biosíntesis , Biomarcadores de Tumor/metabolismo , Carcinoma de Células Escamosas/mortalidad , Humanos , Queratina-19 , Queratinas , Neoplasias Laríngeas/mortalidad , Análisis Multivariante , Neoplasias Faríngeas/mortalidad , Pronóstico , Curva ROC , Sensibilidad y Especificidad , Factores de Tiempo , Resultado del TratamientoRESUMEN
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
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
DNA ploidy and the proliferative potential in 75 gliomas were investigated using bromodeoxyuridine labelling index (BrdUrd LI), S-phase fraction (SPF) and argyrophilic nucleolar organizer regions (AgNOR) technique. There were 53 highly malignant (AIII-AIV), and 22 low-grade (AI-AII) gliomas. One fragment of the tumour was fixed in Carnoy's solution for AgNOR test, while the other fragments were used for flow cytometric determination of the labelling index, SPF and DNA ploidy. For the BrdUrdLI, tumour samples from each patient were incubated in vitro for one hour at 37 degrees C with BrdUrd using the high pressure oxygen method. The tumours showed variability in the BrdUrdLI values, SPF and AgNOR counts/cell nucleus. The same percentage of DNA aneuploidy (55%) was found in high-grade as well as in low-grade gliomas. Univariate analysis showed that patients with grade I & II gliomas had significantly higher 3-year survival rate (p = 0.0193) than those with grade III and grade IV gliomas. Also patients with lower proliferation rate of tumours (BrdUrdLI < or =2.3% and AgNOR counts < or =2.6%/cell) had higher 3-year survival rate (p<0.03), which can be helpful in prognosis. Tumour ploidy or SPF had no influence on patients' survival (p = 0.7908). Cox multivariate analysis showed that only patients' age > 45 years and high tumour grade (III and IV) were significant unfavourable prognostic factors in terms of patients' survival.
Asunto(s)
Astrocitoma/patología , Neoplasias Encefálicas/patología , División Celular , Ploidias , Adulto , Aneuploidia , Astrocitoma/genética , Astrocitoma/mortalidad , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/mortalidad , Bromodesoxiuridina/metabolismo , ADN de Neoplasias/análisis , Femenino , Citometría de Flujo , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Región Organizadora del Nucléolo/ultraestructura , Pronóstico , Fase S , Tinción con Nitrato de Plata , Tasa de SupervivenciaRESUMEN
In non-Hodgkin's lymphoma (NHL) patients, prognostic significance of S-phase fraction (SPF) is well known, however the significance of DNA ploidy status and antigen expressions is still unclear. The purpose of the present study is to evaluate the prognostic and predictive impact of SPF, immunophenotype and DNA ploidy in prospectively analysed NHL patients. The study was performed on lymph node biopsies of 117 nodal NHL patients. The median follow-up of patients was 25 months (range 1-64 months). All histologically verified lesions were considered according to the Working Formulation and Kiel classification. SPF, immunophenotype and ploidy were determined by flow cytometry. The rate of 2-year overall survival was 56%. SPF and DNA ploidy status were found to be independent prognostic factors in low and high grade lymphomas, respectively. Patients with near-tetraploid lymphomas were characterised by unfavourable clinical outcome, whereas hypertetraploidy was a favourable prognostic indicator. Among B-cell lymphomas CD5 expression seems to be of prognostic significance.
Asunto(s)
ADN de Neoplasias/análisis , Linfoma no Hodgkin/genética , Fase S/fisiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Evaluación como Asunto , Humanos , Inmunofenotipificación , Linfoma no Hodgkin/inmunología , Linfoma no Hodgkin/patología , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Estudios ProspectivosRESUMEN
PURPOSE: To report the results of a prospective randomized study concerning the role of radiotherapy in the treatment of stage III, unresectable, asymptomatic non-small cell lung cancer. MATERIAL AND METHODS: Between 1992 and 1996, 240 patients with stage III, unresectable, asymptomatic non-small cell lung cancer were enrolled in this study, and sequentially randomized to one of the three treatment arms: conventional irradiation, hypofractionated irradiation and control group. In the conventional irradiation arm (79 patients), a dose of 50 Gy in 25 fractions in five weeks was delivered to the primary tumor and the mediastinum. In the hypofractionated irradiation arm (81 patients), there were two courses of irradiation separated by an interval of four weeks. In each series, patients received 20 Gy in five fractions in five days, in the same treatment volume as the conventional irradiation group. In the control group arm, 80 patients initially did not receive radiotherapy and were only observed. Delayed palliative hypofractionated irradiation (20-25 Gy in four to five fractions in four to five days) was given to the primary tumor when major symptoms developed. RESULTS: The two-year actuarial survival rates for patients in the conventional irradiation, hypofractionated irradiation and control group arms were 18%, 6% and 0%, with a median survival time of 12 months, nine months and six months respectively. The differences between survival rates were statistically significant at the 0.05 level. CONCLUSION: Although irradiation provides good palliation, the results are disappointing. The comparison of conventional and hypofractionated irradiation shows an advantage for conventional schedules.
Asunto(s)
Carcinoma de Células Pequeñas/radioterapia , Neoplasias Pulmonares/radioterapia , Adulto , Anciano , Carcinoma de Células Pequeñas/patología , Fraccionamiento de la Dosis de Radiación , Femenino , Humanos , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Cuidados Paliativos , Estudios Prospectivos , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
DNA content according to six various ploidy classes was analysed by flow cytometry on fresh tumor tissue in 701 unselected, consecutive breast cancers. Age, menopausal status, tumor size, histology and in particular nodal status were also taken into consideration. Diploid and nondiploid mammary carcinomas differed significantly in values of proliferative indicators. In node positive patients nondiploid tumors were more frequent. In node negative and node positive breast cancer patients tumor grade strongly influenced disease free survival and in the last group hypertriploidy (1.6 < DI < or = 1.8) was also an independent prognostic factor. The combination of tumor grade and hypertriploidy permitted differentiation of three groups of node positive patients, differing in the risk of relapses.
Asunto(s)
Adenocarcinoma/genética , Neoplasias de la Mama/genética , ADN de Neoplasias/análisis , Recurrencia Local de Neoplasia/genética , Adenocarcinoma/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/patología , División Celular , Femenino , Citometría de Flujo , Fase G2 , Humanos , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Estudios Prospectivos , Fase S , Análisis de SupervivenciaRESUMEN
The proliferative potential and DNA ploidy in 203 brain tumours (27 astrocytomas grade I, 37 grade II, 80 grade III, and 59 grade IV) were investigated using bromodeoxyuridine (BrdUrd) incorporation and flow cytometry. One to three tumour samples from each patient were incubated in vitro for one hour at 37 degrees C with bromodeoxyuridine (BrdUrd) using the high preasure oxygen method. After incubation, fixation and staining, the cell preparations were analysed by flow cytometry. The percentage of BrdUrd-labelled cells (BrdUrd Labelling Index, BrdUrdLI), the predicted potential doubling time (predTpot) and the total DNA content were evaluated. The percentage of unlabelled S-phase cells (SPF) and proliferative index (PI, the percentage of cells in S + G2 phases) were also estimated. DNA aneuploidy was found in 61.1% of high-grade (III-IV) and 50.0% of low-grade (I-II) astrocytomas. The tumours showed variability in the BrdUrdLI values which ranged from 0.2 to 15.8%. Significantly higher mean value for BrdUrdLI was shown in grade III-IV astrocytomas (3.4%), than in grade I-II astrocytomas (1.5%), p = 0.0068. Also significantly shorter mean predTpot was shown in high grade III-IV astrocytomas (28 days) than in low grade I-II tumours (51 days), p = 0.0096. However, no relationship was shown between other cell proliferation parameters and histological grade. The mean intratumoral variability calculated on the basis of BrdUrdLI values on 2-3 samples from each tumour amounted to 31.2% +/- SD 15.9%.
Asunto(s)
Neoplasias Encefálicas/genética , Neoplasias Encefálicas/patología , ADN/genética , Ploidias , División Celular , Citometría de Flujo , Humanos , Técnicas In Vitro , PronósticoRESUMEN
A group of 350 unselected breast cancer patients, treated at the Center of Oncology in Cracow, Poland, between January 1992 and December 1994, was analyzed. The following reciprocally interrelated histologic characteristics were evaluated: 1) histologic tumor type (considered in 3 categories of aggressivity), 2) tumor grade (according to Scarf-Bloom-Richardson), 3) constituent of in-situ carcinoma in invasive cancers and characterization of breast lobuli, 4) tumor growth pattern (microfocal, macrofocal or mixed), 5) invasion of nerves, 6) vascular invasion by cancer cells in tumor surroundings, 7) extensiveness of tumor necrosis, 8) involvement of the breast distant from the tumor mass by cancer cells, 9) status of axillary lymph nodes, 10) invasion of metastatic lymph node surroundings. Metastases in axillary lymph nodes were independently influenced by vascular invasion in tumor surroundings and tumor diameter. The disease-free survival was independently influenced by tumor diameter, necrosis and stage of the disease (pTNM), whereas total survival related to tumor diameter, nodal status, microfocal pattern of tumor growth, vascular invasion and involvement of breast by cancer distant from the tumor mass was independently influenced only by tumor stage (pTNM).
Asunto(s)
Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/patología , Carcinoma/diagnóstico , Carcinoma/patología , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/mortalidad , Carcinoma/mortalidad , Supervivencia sin Enfermedad , Femenino , Humanos , Metástasis Linfática/patología , Persona de Mediana Edad , Invasividad Neoplásica/patología , Pronóstico , Estudios Prospectivos , Tasa de SupervivenciaRESUMEN
Results of altered therapy schedules obtained in postoperative treatment of 294 patients with malignant gliomas over last 20 years are presented. During this period 135 patients received Conventional Irradiation and Chemotherapy (CICH), 61 patients received Conventional Irradiation (CI), 59 patients received Split Course High Fractional Dose Irradiation (SCHFDI), and 39 patients received Twice a Day Accelerated Irradiation (TDAI). Actuarial survival rates at 2, 3 and 5 years were 19%, 7%, 0% respectively for patients treated with CICH, and they were 21%, 10%, 0% for CI group, 24%, 12%, 0% for SCHFDI option and 15%, 8%, 0% for TDAI schedule. According to the Cox proportional hazard model, only age was significant factor in prognosis.
Asunto(s)
Terapia Combinada , Glioma/cirugía , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Irradiación Craneana/efectos adversos , Femenino , Glioma/tratamiento farmacológico , Glioma/radioterapia , Humanos , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Pronóstico , Estudios Prospectivos , Distribución AleatoriaRESUMEN
BACKGROUND AND OBJECTIVES: The 1990s have established the contribution of multimodality therapy in the management of IIIb noninflammatory breast cancer (IIIb NIBC), by reducing the odds of recurrence and death. METHODS: A total of 300 women with IIIb NIBC received a multimodality therapy. The treatment consisted of neoadjuvant chemotherapy [FAC (5-fluorouracil, Adriamycin, cyclophosphamide) regimen], radical (Halsted) mastectomy or modified (Patey mastectomy), postoperative radiotherapy, and adjuvant chemohormone therapy [FAC regimen + cyclophosphamide, 5-fluorouracil and methotrexate (CMF) regimen or Tamoxifen]. RESULTS: Complete or partial clinical response (CR or PR) after neoadjuvant chemotherapy was obtained in 83% patients. Ninety-nine patients (33%) survived 5 years without evidence of disease (NED). The uni- and multivariate analyses factors that had significant influence on the treatment results were: clinical response to neoadjuvant chemotherapy, pathological tumor size, and microscopical status of the axillary lymph nodes. CONCLUSIONS: We conclude that neoadjuvant FAC regimen chemotherapy is very effective in producing objective tumor regression and offers the benefit of radical mastectomy to patients with previously unresectable IIIb NIBC.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/terapia , Mastectomía Radical , Adulto , Anciano , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/radioterapia , Neoplasias de la Mama/cirugía , Quimioterapia Adyuvante , Terapia Combinada , Ciclofosfamida/administración & dosificación , Supervivencia sin Enfermedad , Doxorrubicina/administración & dosificación , Femenino , Fluorouracilo/administración & dosificación , Humanos , Escisión del Ganglio Linfático , Mastectomía Radical Modificada , Metotrexato/administración & dosificación , Persona de Mediana Edad , Análisis de Supervivencia , Tamoxifeno/administración & dosificaciónRESUMEN
Eighty-five patients with stage II glottic laryngeal cancer were treated with radiotherapy in Center of Oncology in Kraków between 1973 and 1989. Fifty-five patients were irradiated with 60Co unit, 30 with mixed photon--electron beam. The 5-year survival rates without evidence of disease after the radiotherapy only were 65.9%, after the radiotherapy and surgery for recurrences--76.5%. The sex, age, local extension of primay tumour and vocal cord mobility were evaluated in a uni- and multivariate analysis of prognostic factors. For the end-point of 5-year survival without evidence of disease no statistically significant relationship was found between results and analysis variables, especially between survival and impaired cord mobility.
Asunto(s)
Glotis/patología , Neoplasias Laríngeas/patología , Neoplasias Laríngeas/radioterapia , Pliegues Vocales/fisiopatología , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Humanos , Neoplasias Laríngeas/complicaciones , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Estadificación de Neoplasias , PronósticoRESUMEN
Three hundred patients with early stage supraglottic cancer were treated with radiotherapy in Center of Oncology in Kraków between 1973 and 1989. The 5-year NED survival rates after the radiotherapy only were 82.9% in stage I, and 70%in stage II cancer, after the radiotherapy and surgery for recurrences--90% and 75% respectively. The stage and tumor site were an important prognostic factors in the treated group of patients.
Asunto(s)
Neoplasias Laríngeas/mortalidad , Neoplasias Laríngeas/radioterapia , Adulto , Distribución por Edad , Femenino , Humanos , Neoplasias Laríngeas/patología , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Distribución por Sexo , Tasa de Supervivencia , Factores de TiempoRESUMEN
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
Two-hundred and fifty patients presenting with a stage I-II cancer of the supraglottic larynx were definitively treated with irradiation. The 5-year disease-free survival rate is 76%. Multivariate analysis reveals that the only statistically significant prognostic parameters are clinical stage (I versus II), and tumour site (epilarynx versus supraglottis).
Asunto(s)
Carcinoma de Células Escamosas/radioterapia , Neoplasias Laríngeas/radioterapia , Adulto , Anciano , Carcinoma de Células Escamosas/mortalidad , Carcinoma de Células Escamosas/patología , Causas de Muerte , Femenino , Humanos , Neoplasias Laríngeas/mortalidad , Neoplasias Laríngeas/patología , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Radioterapia/efectos adversos , Dosificación Radioterapéutica , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
Two hundred and forty-five patients with stage I glottic laryngeal cancer were treated with radiotherapy in Center of Oncology in Kraków between 1973 and 1988. One hundred and fifty-five patients were irradiated with Co-60 unit, 90 patients with mixed photon-electron beam. The 5-year NED survival rates after the radiotherapy only were 85.3%, after the radiotherapy and surgery for recurrences--95.1%. The sex, age, local extension of primary tumor (T1a vs. T1b), location of the tumor on true vocal cord and involvement of anterior commissure were evaluated in a uni- and multivariate analysis of prognostic factors. For the end-point of 5-year NED survival no statistically significant relationship was found between results and analysis variables.
Asunto(s)
Carcinoma de Células Escamosas/radioterapia , Glotis/efectos de la radiación , Neoplasias Laríngeas/radioterapia , Adulto , Anciano , Carcinoma de Células Escamosas/patología , Femenino , Glotis/patología , Humanos , Neoplasias Laríngeas/patología , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Estudios Prospectivos , Dosis de Radiación , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
There is increasing evidence that rapidly proliferating tumours, i.e. those with a high bromodeoxyuridine labelling index (BrdUrdLI), could benefit from an accelerated course of radiotherapy. Also, DNA ploidy may be a prognostic factor in term of patients survival. Thus, measurements of cell kinetics and DNA ploidy might become part of routine characterization of tumours before treatment. It is supposed, that a simple and cheap argyrophilic nucleolar organizer regions (AgNOR) test reflects the proliferative status of the tumour and correlates with BrdUrdLI. The BrdUrdLI, AgNOR test and DNA ploidy were assessed in 49 squamous cell carcinoma (SCC) of the cervix (stage II B-III B) and 5 normal epithelium. The number of NORs per cell nucleus, the mean AgNOR particle area and the total AgNOR area per cell were evaluated. Significant differences in the proliferative rate were found within the examined groups of tumours assessed by the BrdUrdLI and AgNOR test. The mean BrdUrdLI values were significantly lower in normal than in carcinomatous cells, while for AgNOR values this was true for stage III B only. The mean number of AgNORs and total AgNOR area per cell were not significantly higher at stage III B than at stage II B, respectively. A high DNA aneuploidy was found in the examined tumours: 78% in stage II B and 77% in stage III B of disease. The results of proliferative markers were not significantly different in diploid than in aneuploid tumours. A significant correlation (p < 0.0001) was found between the mean AgNOR values and BrdUrdLI, however the correlation coefficient was poor (r = 0.50). This was due to different fragments of the same tumours used in these tests. Therefore these techniques might be used as independent methods reflecting the proliferative rate of the tumour.
Asunto(s)
Aneuploidia , Bromodesoxiuridina/metabolismo , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/patología , ADN de Neoplasias/genética , Región Organizadora del Nucléolo/química , Neoplasias del Cuello Uterino/genética , Neoplasias del Cuello Uterino/patología , Adulto , Anciano , Carcinoma de Células Escamosas/ultraestructura , División Celular/fisiología , Femenino , Humanos , Persona de Mediana Edad , Pronóstico , Tinción con Nitrato de Plata/métodos , Neoplasias del Cuello Uterino/ultraestructuraRESUMEN
In a period from 1.01.1979 to 31.12.1984 in the Oncology Centre, Department in Cracow, 202 female patients with locally advanced stage of mammary cancer (T3-4 a-d, N 2-3) were treated with inductive chemotherapy with following local treatment completed with maintenance treatment. The aim of this study is to try to show distant results of the treatment based on current experiences and to analyse failure reasons. Kaplan-Mayer method was used to estimate probability of 3 and 5 year lasting surviving.