Our objective was to determine whether oral etoposide and cisplatin combination (EoP) is superior to paclitaxel in the treatment of advanced breast cancer (ABC) patients pretreated with anthracyclines. From December 1997 to August 2003, 201 patients were randomised, 100 to EoP and 101 to paclitaxel arms. Four patients in each arm were ineligible. The doses of etoposide and cisplatin were 50 mg p.o. twice a day for 7 days and 70 mg m−2 intravenously (i.v.) on day 1, respectively, and it was 175 mg m−2 on day 1 for paclitaxel. Both treatments were repeated every 3 weeks. A median of four cycles of study treatment was given in both arms. The response rate obtained in the EoP arm was significantly higher (36.3 vs 22.2%; P=0.038). Median response duration was longer for the EoP arm (7 vs 4 months) (P=0.132). Also, time to progression was significantly in favour of the EoP arm (5.5 vs 3.9 months; P=0.003). Median overall survival was again significantly longer in the EoP arm (14 vs 9.5 months; P=0.039). Toxicity profile of both groups was similar. Two patients in each arm were lost due to febrile neutropenia. The observed activity and acceptable toxicity of EoP endorses the employment of this combination in the treatment of ABC following anthracyclines.
Bu calismada DSO 1999 siniflamasina gore yeniden siniflanan 29 timoma olgusu ( 21 erkek, 8 kadin; yas 22-77) ve 10 adet hiperplastik ve normal timusdan olusan kontrol grubu uzerinde VEGF, CD34 ve Ki67 ile immunhistokimyasal olarak anjiogenez ve proliferasyon indeksi arastirilmistir. CD 34 goruntu analiz sisteminde birim alandaki damar sayisi (FLDC), birim alandaki damar alani (FLDA), damar alaninin toplam alana orani (FLDAP) olmak uzere uc parametre ile degerlendirilmistir. Ki 67 sadece epitel hucrelerindeki proliferasyonu saptayabilmek icin keratin ile cift immunhistokimyasal boyama yoluyla degerlendirilmistir.Buna gore olgularin tiplere gore dagilimi soyledir: Tip A: 3 (%10.3), Tip B1: 7 (%24.1), Tip B2: 10 (%34.5), Tip B3: 1 (%3.4), Tip AB: 8 (%27.6). Olgularin 5'i (%17.2) kapsullu, 19'u (%65.5) minimal invaziv, 5'i (%17.2) yaygin invazivdir. Proliferasyon indeksi tip A, B1, B2, B3 ve AB'de sirasiyla %4.3, %9.5, %10.7, %3.6, %9.5 olarak bulunmustur. Timomalarin 18'inde (%62) VEGF ekspresyonu izlenmezken, 5'inde (%17.3) (+), 6'sinda (%20.7) (++) bulunmustur. Ki67 ekspresyonu ile FLDA, FLDAP arasinda negatif korelasyon saptanmistir. VEGF ekspresyonu ile FLDA, FLDAP, FLDC arasinda anlamli bir iliski tespit edilmemistir. FLDA, FLDAP, FLDC ve Ki67 indeksi kontrol grubunda tumor grubuna gore daha yuksek bulunmustur.Bu calismadaki sonuclar timomalarda anjiogenezin VEGF'den farkli mekanizmalarla duzenlendigini ve yuksek mikrodamar yogunlugunun sadece neoplastik durumlar ile sinirli olmadigini gostermistir.
The orbit is an uncommon primary site for non-Hodgkin's lymphomas (NHL), and it accounts for less than 1% of all sites of primary presentations. We report the experience of the Department of Radiation Oncology at Ankara University Faculty of Medicine with radiation therapy in treatment of patients with stage I primary orbital NHL.From February 1978 through August 1993, 14 patients with stage I primary orbital NHL were treated with radiation therapy. According to the Working Formulation classification, 8 patients had low-grade and 6 had intermediate-grade lymphomas. The most commonly used radiation therapy technique was a single anterior field with a Cobalt-60 unit, delivering 40 Gy in 2 Gy daily fractions. Two patients with intermediate-grade lymphomas received the CHOP regimen following radiation therapy.Follow-up ranged from 0.8 to 18.3 years (median, 10.3 years). Local control was achieved in all patients. Two patients with low-grade lymphomas relapsed locally and were successfully salvaged with radiation therapy. Three patients with intermediate-grade lymphomas failed systemically. Salvage therapy consisted of combination chemotherapy for 2 of them but was unsuccessful. Overall survival probabilities at 2, 5 and 10 years were 78.6%, 61.1% and 52.4%, respectively, for the entire group of 14 patients. Overall, cause-specific and disease-free survival probabilities were higher for patients with low-grade lymphomas than for those with intermediate-grade lymphomas (P = 0.03, P = 0.03 and P = 0.06, respectively). Cataracts were observed in 9 and lacrimal disorders in 4 patients.The study suggests that among stage I primary orbital NHL, low-grade lymphomas could be treated with radiation therapy alone, whereas combination chemotherapy could accompany radiation therapy for intermediate-grade lymphomas.
AbstractBackground:Patients with non-small cell lung cancer (NSCLC) wihtout lymph node (LN) metastases (pN0) have different survival rates even when the T status is similar. This may be because excised mediastinal and bronchial LNs are currently examined using a 2D method. Because, despite the rules of 2D pathological examination, unfortunately, not all of the removed LN can be sampled, and there may be metastatic foci in these remaining and unsampled LN tissues. Whereas, evaluation with micro-computed tomography (micro-CT) provides detailed information on internal structures of all these LNs as a whole and and without damaging the sample. We used quantitative micro-CT parameters to evaluate the metastasis status of LNs embedded in paraffin blocks.MethodsTwelve paraffin blocks and the corresponding whole slide images from eight NSCLC patients with pathological mediastinal LN metastases were used. The formalin-fixed paraffin-embedded (FFPE) LN blocks were subjected to micro-CT. Forty-seven regions of interest (ROIs) (17 metastatic foci, 11 normal lymphoid tissues, 10 adipose tissues, and 9 anthracofibrotic areas) were marked. Quantitative structural variables obtained via micro-CT analysis from tumoral and non-tumoral ROIs were analyzed.ResultsLinear density, connectivity, connectivity density, and closed porosity all differed significantly between tumoral and non-tumoral ROIs (kappa coefficients: 1, 0.90, 1, and 1, respectively). Receiver operating characteristic analysis showed that tumoral and non-tumoral ROIs differed in terms of thickness, linear density, connectivity, connectivity density, and percentage of closed porosity.ConclusionsQuantitative micro-CT parameters can distinguish between tumoral and non-tumoral areas in FFPE blocks of mediastinal LNs. These quantitative micro-CT parameters may facilitate the development of an artificial intelligence algorithm that can detect metastatic foci in the LN in FFPE LN blocks .
Liposarcoma is the second most common soft tissue sarcoma after malignant fibrous histiocytoma in adults. It is frequently found in the extremities and retroperitoneum; rarely it can be seen in the chest wall. We report a rare case of giant liposarcoma originating from the chest wall representing a transformation of a relapsing lipoma in the same region. We performed chest wall resection, reconstruction with latissimus dorsi muscle transposition via posterolateral thoracotomy. The patient received 4 series of adjuvant chemotherapy after the postoperative diagnosis of dedifferentiated liposarcoma. The patient had no postoperative complication and has remained disease-free for 30 months.
