Mesothelioma is a rare neoplasm arising from mesothelial surfaces with the malignant pleural mesothelioma (MPM) as the most common form. Secondline chemotherapy in MPM is still controversial and in ...this study we evaluated whether it is superior to best supportive care.
A total of 51 patients with MPM from Acibadem Kayseri Hospital, Kayseri Training and Research Hospital and Erciyes University were analyzed retrospectively. The patients treated with secondline chemotherapies (SLCT) were compared with those treated with best supportive care (BSC) for overall survival.
The median overall survival (OS) for firstline chemotherapy?SLCT and firstline chemotherapy?BSC groups were 20.3 and 14.7 months respectively (p=0.079). After firstline chemotherapy the median OS for SLCT and BSC were 5.9 and 4.7 months (p=0.355).
Although there was a trend for improvement in overall survival in patients treated with secondline chemotherapy, the difference was not statistically significant. Our results do not support the proposal that secondline chemotherapy could be effective in patients with MPM.
Thyroid sarcoma is a very rare entity, accounting for less than 1% of all malignant thyroid tumours. Rhabdomyosarcoma (RMS) is a sarcoma subtype, which is more common in children and adolescents. In ...this case, a 68-year old man, presented with hoarseness and diagnosed with pleomorphic RMS, was explored. No study of primary thyroid pure RMS has been reported in the literature, with the exception of the case reports of differentiated RMS.
Small bowel adenocarcinoma (SBA) is a rare tumor of the gastrointestinal system with poor prognosis. Since these are rarely encountered tumors, there are limited numbers of studies investigating ...systemic treatment in advanced SBA. The purpose of this study was to evaluate the prognostic factors and systemic treatments in patients with advance SBA.
Seventy-one patients from 18 Centers with advanced SBA were included in the study. Fifty-six patients received one of the four different chemotherapy regimens as first-line therapy and 15 patients were treated with best supportive care (BSC).
Of the 71 patients, 42 (59%) were male and 29 (41%) female with a median age of 56 years. Median follow- up duration was 14.3 months. The median progression free survival (PFS) and overall survival (OS) were 7 and 13 months, respectively (N=71). In patients treated with FOLFOX (N=18), FOLFIRI (N=11), cisplatin-5-fluorouracil/ 5-FU (N=17) and gemcitabine alone (N=10), median PFS was 7, 8, 8 and 5 months, respectively, while median OS was 15, 16, 15 and 11 months, respectively. No significant differences between chemotherapy groups were noticed in terms of PFS and OS. Univariate analysis revealed that chemotherapy administration, de novo metastatic disease, ECOG PS 0 and 1, and overall response to therapy were significantly related to improved outcome. Only overall response to treatment was found to be significantly prognostic in multivariate analysis (p=0.001).
In this study, overall response to chemotherapy emerged as the single significant prognostic factor for advanced SBAs. Platin and irinotecan based regimens achieved similar survival outcomes in advanced SBA patients.
Bone metastases are frequently observed in patients with certain types of cancer and are significant cause of morbidity. Zoledronic acid (ZA) is routinely prescribed for patients with bone metastases ...by affecting osteoclast function. We aimed to assess the effect of ZA over time in patients with bone metastases by analyzing novel bone turnover marker levels including receptor activator of nuclear factor-k B ligand (RANKL) and osteoprotegerin (OPG) in serum and gingival crevicular fluid (GCF). Also, associations between these bone turnover markers with hematological and biochemistry dysregulation were studied. The study enrolled patients with bone metastases including 32 patients diagnosed with solid tumors and 15 patients with multiple myeloma. In these patients, GCF and serum RANKL and OPG levels were measured and compared with measures of hematological and biochemical parameters before and after 3 months of ZA therapy. Mean subject age was 54 years old with a range of 28–80 years. Skeletal-related events were observed in 8.5 % of all patients. After the 3-month treatment of ZA therapy, no significant differences were found in serum and GCF levels of RANKL and OPG when compared with before treatment levels. GCF RANKL levels at baseline and following 3 months of ZA therapy were significantly higher in patients with solid tumors when compared patients diagnosed with multiple myeloma (
p
= 0.001;
p
< 0.001, respectively). GCF OPG levels after the entire course of ZA therapy were greater in patients with 5 or more bone metastases (
p
= 0.04). For patients with multiple myeloma, control GCF OPG was negatively correlated with control platelet and WBC counts (
p
= 0.018 and
p
= 0.027, respectively). A negative correlation was observed between control serum RANKL and control serum OPG levels in myeloma patients (
p
= 0.001). After 3 months of ZA therapy, no significant differences were observed in GCF and serum RANKL and OPG levels when compared with baseline. A negative correlation was observed between serum control RANKL and OPG levels in myeloma patients. OPG levels were greater in patients with 5 or more bone metastases. In patients diagnosed with multiple myeloma, GCF OPG levels were negatively associated with WBC and platelet counts.
Issue Title: Including PIH Articles on Basic and Clinical Updates in Multiple Myeloma Stenotrophomonas maltophilia infection is of concern in patients with cancer. Antibiotics active against S. ...maltophilia are rarely used in the treatment of febrile neutropenia, making it important to identify the factors influencing mortality in cancer patients with S. maltophilia infection. The objective of this study was to analyze the clinical characteristics and outcomes of cancer and hemopathic patients with S. maltophilia infection and assess the factors influencing the mortality. The microbiology laboratory records of Erciyes University, Faculty of Medicine Hospital were reviewed to retrospectively identify patients with S. maltophilia infection between January 2007 and June 2011. A total of 38 patients (25 male, 13 female) were eligible for the study. The median age of the patients was 53Â years. The underlying disease was hematological malignancy and disorders in 76.3Â % (29 cases), solid tumors in 15.8Â % (six cases), aplastic anemia in 7.9Â % (three cases), while 18.4Â % (seven cases) were hematopoietic stem cell transplantation (HSCT) recipients. An indwelling central venous catheter was used in 32 cases (84.2Â %). Twenty-seven patients (71.1Â %) were neutropenic at the onset of infection. Nine patients (23.7Â %) were receiving corticosteroid therapy. The overall 14-day mortality rate was 50Â %. Three of the patients received empirical antibacterial treatment, and three HSCT recipients received trimethoprimâeuro"sulfamethoxazole prophylaxis, which is active against S. maltophilia. Severe sepsis (OR 13.24, 95Â % confidence interval (CI) 1.62âeuro"108.57) and the duration of the treatment (OR 0.73, 95Â % CI 0.60âeuro"0.90) were related to death based on logistic regression analysis findings. In immunocompromised hematologyâeuro"oncology patients with severe sepsis, S. maltophilia should be considered as a possible cause of infection, and should be given effective empirical antibiotic treatment immediately; the antimicrobial spectrum may be narrowed according to results of antibiotic susceptibility test.PUBLICATION ABSTRACT
Bevacizumab, which is a humanized monoclonal antibody against vascular endothelial growth factor, is used to treat metastatic cancers of the colon. Adverse effects common with bevacizumab treatment ...are hypertension, arterial-venous thrombosis, bleeding, gastrointestinal perforation, and proteinuria. To date, there have been no reports of refractory seizure following treatment with bevacizumab. We describe a patient who presented with refractory generalized tonic-clonic seizures after receiving last dose of bevacizumab for treatment of metastatic colorectal cancer with FOLFIRI and bevacizumab regimen.
Surgery is the only curative treatment for operable non-small lung cancer (NSCLC) and the importance of adjuvant chemotherapy for stage IB patients is unclear. Herein, we evaluated prognostic factors ...for survival and factors related with adjuvant treatment decisions for stage I and IIA NSCLC patients without lymph node metastasis.
We retrospectively analyzed 302 patients who had undergone curative surgery for prognostic factors regarding survival and clinicopathological factors related to adjuvant chemotherapy.
Nearly 90% of the patients underwent lobectomy or pneumonectomy with mediastinal lymph node resection. For the others, wedge resection were performed. The patients were diagnosed as stage IA in 35%, IB in 49% and IIA in 17%. Histopathological type (p=0.02), tumor diameter (p=0.01) and stage (p<0.001) were found to be related to adjuvant chemotherapy decisions, while operation type, lypmhovascular invasion (LVI), grade and the presence of recurrence were important factors in predicting overall survival (OS), and operation type, tumor size greater than 4 cm, T stage, LVI, and visceral pleural invasion were related with disease free survival (DFS). Multivariate analysis showed operation type (p<0.001, hazard ratio (HR):1.91) and the presence of recurrence (p<0.001, HR:0.007) were independent prognostic factors for OS, as well visceral pleural invasion (p=0.01, HR:0.57) and LVI (p=0.004, HR:0.57) for DFS.
Although adjuvant chemotherapy is standard for early stage lymph node positive NSCLC, it has less clear importance in stage I and IIA patients without lymph node metastasis.
Association of excision repair cross-complementing gene 1 (ERCC1) expression and treatment response and survival was evaluated in advanced stages of gastric cancer patients who were given different ...platinum-based chemotherapy.
Forty-one patients with advanced gastric cancer were enrolled into the study from January 2000 to December 2009. ERCC1 expression was evaluated by immunohistochemistry (IHC).
Thirteen of the 41 patients (31%) were shown to have ERCC1 positive lesions. Although the clinical benefit from platin based chemotherapy was the same for ERCC1 positive and negative patients, survival times were statistically significantly better in ERCC1 negative gastric cancer patients.
We suggest that IHC studies for ERCC1 may be useful in prediction of the clinical outcome of advanced gastric cancer patients treated with platin-based chemotherapy.
Purpose Bevacizumab-based chemotherapy has become the standard of care in metastatic colorectal cancer (MCRC). We aimed to measure the levels of serum soluble FAS, FASL, tumor necrosis factor-related ...apoptosis-inducing ligand (TRAIL), and its death receptors DR4 and DR5 in MCRC patients and to define prognostic significance of these parameters in response to bevacizumab in these patients. Patients and methods The levels of these parameters in serum samples were quantified by a commercially available ELISA kit in 31 MCRC patients before and after 2 cycles of therapy and 25 healthy controls. Results Pretreatment sFAS levels in MCRC patients was significantly lower than the levels of controls (p = 0.043). There was no significant difference in sFAS and sFASL levels in MCRC patients before and after bevacizumab-based treatment. There was no significant difference in sFAS/sFASL ratio in MCRC patients before and after treatment and controls. Soluble DR5 levels were significantly higher in pretreatment serum samples compared with controls (p = 0.008). However, pretreatment sTRAIL and sDR4 levels were similar to the levels of controls. There was no significant difference in sTRAIL, sDR4, and sDR5 levels in MCRC patients before and after treatment. When patients were grouped according to treatment response (responders vs. non-responders), post-treatment sFAS/sFASL ratio was significantly lower in responding patients compared with non-responders (p = 0.029). Significant correlations were observed between post-treatment sFASL and sDR4, sFAS and sTRAIL, sTRAIL and sFAS/sFASL ratio, and sFASL and sDR5. Conclusion Non-significant changes in apoptotic markers with bevacizumab-based chemotherapy showed that they have no prognostic significance in MCRC patients. Significant change in sFAS/sFASL ratio according to treatment response could be an indicator of chemosensitivity.
PDF
