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Biomedical subjects

Branislav Jeremic

Publications and source records attributed to Branislav Jeremic.

59 records · Page 4Linked to original sources
PubMed2002

Second single 4 Gy reirradiation for painful bone metastasis.

To investigate the efficacy of the second 4 Gy given as a single fraction radiotherapy (RT) for patients with painful bone metastasis who had already twice received single fraction RT (4, 6, or 8 Gy plus 4 Gy), a total of 25 patients were assessed before and after re-irradiation. The patients included 19 responders and 6 nonresponders to two prior single fraction RT, the latter one being 4 Gy. The overall response rate was 80%, with both complete response (CR) and partial response (PR) being 40%. No difference was found between the previous responders and previous nonresponders regarding both CR (P = 0.70) and overall response rate (P = 0.35). Response duration was longer in the previous responders (P = 0.0041), but the time to pain relief was similar between the two treatment groups. No acute or late high-grade toxicity was observed during this study and no pathological fractures or spinal cord compressions were seen. In this small and highly selected series of patients, the third single fraction RT of 4 Gy was effective and not toxic in the treatment of painful bone metastasis.

Adult↗
PubMedDate not supplied

Radiotherapy-induced lung toxicity: risk factors and prevention strategies.

Radiotherapy-induced lung toxicity might compromise the success of current efforts regarding lung cancer treatment intensification. Compounds which prevent lung toxicity without affecting the radiosensitivity of the tumor can contribute to improvement of cure rates. Basic research on radiotherapy-induced lung reactions significantly improved our understanding of the molecular and cellular mechanisms underlying acute radiation pneumonitis and the tissue remodelling leading to lung fibrosis. Identification of mediators such as various adhesion molecules, cytokines and growth factors in this process allows for innovative intervention studies. This review summarizes translational research data as well as clinical strategies for response modification and prediction.

Animals↗
PubMedDate not supplied

Comparison of serum growth factors and tumor markers as prognostic factors for survival in non-small cell lung cancer.

Tumor markers have been shown to correlate with stage of disease and histologic type of non-small cell lung cancer (NSCLC). Probably their most important role is monitoring of treatment response and prediction of relapse. More recently, measurement of growth factors became possible. The purpose of this review was to compare the usefulness of serum tumor markers and growth factors as prognostic factors in NSCLC. The endpoint was the hazard ratio in multivariate analysis. Studies published between January 1995 and December 2002 were identified by a comprehensive MEDLINE search and systematically selected. Overall, 25 articles were found and analysed. We evaluated data from up to 1600 patients per marker. The exact type of assay and the cut-off values varied widely. This analysis failed to demonstrate a clear prognostic role for many commonly used markers, especially for squamous cell carcinoma antigen. Conflicting results were found for carcinoembryonic antigen, neuron-specific enolase and tissue polypeptide specific antigen. The most convincing data were those for Cyfra 21-1, where the vast majority of studies was positive. With regard to growth factors, the vascular endothelial growth factor studies uniformly came out negative, whereas basic fibroblast growth factor appears more promising. So far, growth factors do not appear superior to Cyfra 21-1. Overall, established prognostic factors such as performance status and stage continue to remain more important than biological markers. In virtually all large studies with multivariate analysis, their influence was higher than that of emerging factors.

Antigens, Neoplasm↗
PubMedDate not supplied

Dose escalation of concurrent hypofractionated radiotherapy and continuous infusion 5-FU-chemotherapy in advanced adenocarcinoma of the pancreas.

BACKGROUND/AIMS: To investigate the advantages and palliative effectiveness of concurrent hypofractionated radiotherapy (RT) and chemotherapy (5-FU) in patients with locally advanced and metastatic adenocarcinoma of the pancreas. METHODOLOGY: A total of 26 patients were enrolled in this study. Twenty patients had locally advanced (M0) and 6 patients had metastatic (M1) disease. They were treated with hypofractionated radiation therapy (RT) (4x3 Gy per week) and concurrent continuous infusion (300mg/sqm/24h) of 5-fluorouracil. The RT doses were escalated in 6-Gy increments starting from 24 Gy in 8 fractions in 2 weeks to 30 Gy in 10 fractions in 2.5 weeks and finally to 36 Gy in 12 fractions in 3 weeks. RESULTS: Only 1 (4%) patient experienced grade 3 mucositis, while 12 (46%) patients experienced grade 2 nausea and 1 (4%) patient experienced grade 2 weakness. No patient experienced treatment interruption or dose reduction. Late high-grade (>3) toxicity was not observed, but few patients experienced prolonged hematological toxicity, due to administration of chemotherapy after radiochemotherapy. Pain improved in 70% of the patients. The median survival time for all 26 patients is 8 months, 9 months for locally advanced cancer patients and 5 months for metastatic cancer patients. CONCLUSIONS: Dose escalation to 36 Gy in a hypofractionated manner proved to be feasible with low toxicity in patients with locally advanced and metastatic adenocarcinoma of the pancreas and warrants further investigation aiming at optimal tailoring in these two subgroups of patients.

Adenocarcinoma↗