Current Issue : January - March Volume : 2018 Issue Number : 1 Articles : 5 Articles
Background: The treatment modalities for recurrent locally advanced head and neck cancer failure after radiotherapy\nare limited with poor prognosis. Salvage supra-radical operation seems to be an option. It has not been established\nwhich patients will benefit from salvage total pharyngolaryngoesophagectomy.\nMethods: We retrospectively reviewed 66 patients with previously irradiated recurrent T4 head and neck cancer who\nunderwent salvage total pharyngolaryngoesophagectomy at our institution between January 2001 and June 2014. The\nclinical outcome and toxicities were analyzed.\nResults: Flap loss occurred in 2 patients, and the incidence of fistulas and anastomosis strictures was 15.6% (10/66) and\n13.6% (9/66), respectively. The median survival time of the entire cohort was 12 months. The interval between radiation\nand salvage surgery, and microscopic carotid artery invasion were identified as independent prognostic factors for\noverall survival. The 3-year overall survival rates of patients with (n = 33) and without (n = 33) risk factors were 9.1%\nand 47.2%, respectively (p = 0.007). A time interval between radiation and salvage surgery �6 months and previous\nconcurrent chemotherapy or targeted therapy were risk factors for severe post-operative complications.\nConclusions: Salvage total pharyngolaryngoesophagectomy is beneficial to selected patients with recurrent locally\nadvanced head and neck cancer after radiotherapy....
Background: As there is a growing number of long-term cancer survivors, the incidence of carcinogenesis as a late\neffect of radiotherapy is getting more and more into the focus. The risk for the development of secondary\nmalignant neoplasms might be significantly increased due to exposure of healthy tissue outside of the target field\nto secondary neutrons, in particular in proton therapy. Thus far, the radiobiological effects of these neutrons and a\ncomparison with photons on normal breast cells have not been sufficiently characterised.\nMethods: MCF10A cells were irradiated with doses of up to 2 Gy with neutrons of different energy spectra and\nX-rays for comparison. The biological effects of neutrons with a broad energy distribution ( = 5.8 MeV),\nmonoenergetic neutrons (1.2 MeV, 0.56 MeV) and of the mixed field of gamma�s and secondary neutrons ( =\n70.5 MeV) produced by 190 MeV protons impinging on a water phantom, were analysed. The clonogenic survival\nand the DNA repair capacity were determined and values of relative biological effectiveness were compared.\nFurthermore, the influence of radiation on the sphere formation was observed to examine the radiation response of\nthe potential fraction of stem like cells within the MCF10A cell population.\nResults: X-rays and neutrons caused dose-dependent decreases of survival fractions after irradiations with up to\n2 Gy. Monoenergetic neutrons with an energy of 0.56 MeV had a higher effectiveness on the survival fraction with\nrespect to neutrons with higher energies and to the mixed gamma - secondary neutron field induced by proton\ninteractions in water. Similar effects were observed for the DNA repair capacity after exposure to ionising radiation\n(IR). Both experimental endpoints provided comparable values of the relative biological effectiveness. Significant\nchanges in the sphere formation were notable following the various radiation qualities.\nConclusion: The present study compared the radiation response of MCF10A cells after IR with neutrons and photons.\nFor the first time it was shown that monoenergetic neutrons with energies around 1 MeV have stronger radiobiological\neffects on normal human breast cells with respect to X rays, to neutrons with a broad energy distribution ( = 5.\n8 MeV), and to the mixed gamma - secondary neutron field given by interactions of 190 MeV protons in water. The\nresults of the present study are highly relevant for further investigations of radiation-induced carcinogenesis and are very\nimportant in perspective for a better risk assessment after secondary neutron exposure in the field of conventional and\nproton radiotherapy....
Introduction. Emergency resection represents the traditional treatment for left-sided malignant obstruction. However, the\nplacement of self-expanding metallic stents and delayed surgery has been proposed as an alternative approach. The aim of the\ncurrentmeta-analysis was to review the available evidence, with particular interest for the short-termoutcomes, including a recent\nmulticentre RCT. Methods.We considered randomized controlled trials comparing stenting as a bridge to surgery and emergency\nsurgery for the management of left-sided malignant large bowel obstruction, performing a systematic reviewinMEDLINE, PubMed\ndatabase, and the Cochrane libraries. Results.We initially identified a total of 2543 studies. After the elimination of duplicates and\nthe screening of titles and abstracts, seven studies, for a total of 448 patients, were considered.The current meta-analysis revealed\nno difference in the mortality rate between the stent group and the emergency surgery group; the postoperative complication\nrate (37.84% versus 54.87%, ...
Concomitant radiochemotherapy is the therapeutic standard for locally advanced (Ib2 to IVa stage FIGO) cervical cancer. In the\nabsence of a radiotherapy in many of our Sub-Saharan African countries, surgical resection is the only therapeutic method available\nin hopes of achieving a definite cure. However, criteria for curative surgery are not always met due to preoperative understaging\nof most of our patients. In addition to socioeconomic factors, the causes for understaging are numerous. These include the lack of\npersonnel or underqualified personnel and the absence of complete workup to assess the resectability of the tumor, but above all the\nlack of decision-making throughmultidisciplinary consultation meetings. This studymakes a plea in order to provide our hospitals\nwith qualified personnel and adequate technical platform to allow efficient management of our patients with cervical cancer....
Abstract: Many synthetic peptides have been developed for diagnosis and therapy of human cancers\nbased on their ability to target specific receptors on cancer cell surface or to penetrate the cell\nmembrane. Chemical modifications of amino acid chains have significantly improved the biological\nactivity, the stability and efficacy of peptide analogues currently employed as anticancer drugs or as\nmolecular imaging tracers. The stability of somatostatin, integrins and bombesin analogues in the\nhuman body have been significantly increased by cyclization and/or insertion of non-natural amino\nacids in the peptide sequences. Moreover, the overall pharmacokinetic properties of such analogues\nand others (including cholecystokinin, vasoactive intestinal peptide and neurotensin analogues)\nhave been improved by PEGylation and glycosylation. Furthermore, conjugation of those peptide\nanalogues to new linkers and bifunctional chelators (such as AAZTA, TETA, TRAP, NOPO etc.),\nproduced radiolabeled moieties with increased half life and higher binding affinity to the cognate\nreceptors. This review describes the most important and recent chemical modifications introduced in\nthe amino acid sequences as well as linkers and new bifunctional chelators which have significantly\nimproved the specificity and sensitivity of peptides used in oncologic diagnosis and therapy....
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