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Biomedical subjects

E Wiatr

Publications and source records attributed to E Wiatr.

At least 37 records · Page 2Linked to original sources
PubMed1995

The role of human chorionic gonadotropin beta subunit elevation in small-cell lung cancer patients.

Human chorionic gonadotropin (HCG)-like immunoreactivity has been found in many non-trophoblastic tumours, but the biological behaviour of HCG-producing cells has not been clarified yet. The aim of the study was to estimate the frequency of serum HCG beta subunit (s beta HCG) elevation in patients with small-cell lung cancer (SCLC) and to assess its possible prognostic role in this type of tumour. An attempt was also made to reclassify the histology in selected cases to see whether the elevated (s beta HCG) level is connected with any special subtype of small-cell lung cancer. A total of 156 SCLC patients entered the study: 93 men, 63 women, median age 58 years. s beta HCG activity was measured by immunoenzyme assay (Abbott EIA beta HCG 15-15) before treatment. s beta HCG elevation (above 5 mIU/ml) was found in 21 of 156 patients (14%). Response to treatment after chemotherapy (complete and partial response) was obtained in only 48% of those patients in whom elevated s beta HCG was found, in comparison to the 73% response rate observed in the remaining patients. Only 5% of patients with elevated s beta HCG survived 2 years, in comparison to 21% surviving for 2 years among the remaining patients. The prognostic significance of elevated s beta HCG and extent of disease were independent of each other (Cox's proportional-hazard model). Thus s beta HCG elevation in SCLC seems to be a marker of more resistant tumours and of poor prognosis. We have not found any connection between the subtype of small-cell lung cancer and elevated s beta HCG. Elevated s beta HCG was found in 2 out of 11 patients with oat-cell carcinoma, in 3 out of 10 patients with an intermediate cell type and in 5 out of 13 patients with small-cell lung cancer in which the assessment of the subtype was not possible.

Adult↗
PubMed1995

Survival of patients with limited small cell lung cancer in whom complete remission was obtained (a non-randomised retrospective study of 124 consecutive patients.

The aim of this study was to assess whether thoracic radiotherapy (TRT) is necessary for those patients (pts) with limited small cell lung cancer (SCLC) who obtained CR after induction chemotherapy (ChT). The analysis include retrospective material of 124 consecutive pts with limited SCLC. All pts had induction ChT (3-5 courses): 78 with CAVE (cyclophosphamide, doxorubicine, etoposide) and 46--with other regimens without etoposide. After induction ChT 55 pts were irradiated on tumor and mediastinum and in 69 the same ChT was continued for 6-8 courses or till progression. After induction ChT CR was obtained in 31 pts, PR in 67 and NR in 26. TRT significantly increased the number of CR among those pts who did not achieve satisfactory tumor response after induction ChT. The median survival was 24 months for those patients who obtained CR, 12 months for those who obtained PR and 9 months for those who did not respond. In the group of patients who obtain CR, survival was the same for those treated with ChT alone and for those treated with ChT and TRT. We conclude that in the treatment of individual patient with limited SCLC TRT is indicated for those who did not obtain CR after ChT. Whether patients in whom CR after chemotherapy was obtained can further gain by application of TRT is worth further randomised studies.

Aged↗
PubMed1995

[The role of radiotherapy in combined treatment of limited small cell lung cancer in relation to results of induction chemotherapy].

The comparison between results of chemotherapy (ChT) and ChT plus radiotherapy (RT) was performed in the group of 124 patients with limited SCLC. After induction ChT 25% pts obtained CR, 54%-PR and 21% did not respond. In 69 pts ChT was continued and in 55 others RT was added to ChT. The number of patients in whom tumor response was observed increased significantly after addition of RT to ChT. The degree of complete response had important impact on survival time. The pts who obtained CR had significantly longer survival time than those who achieved only PR or NR. Median survival time was very similar in both groups (13 months after ChT alone and 15 months after ChT plus RT). This was also true for the groups of patients who obtained CR after completion of treatment. Achievement of complete response is the most important factor for good prognosis. RT is indicated in those patients who achieved only PR after induction ChT.

Adult↗
PubMed1995

[Ultrasonographic examination of the heart as a basis for determining the cause of inflammatory infiltration changes in the lungs].

Diagnostic difficulties found in a 41 year old female presenting with fever, chills, fainting spells, tachycardia, hypotension, interstitial consolidation in both lungs and enlargement of the cardiac silhouette on a chest radiogram are discussed. Unsuccessful antibacterial and antituberculous therapy led to a supposition of a collagen disease. The diagnosis of a bacterial endocarditis with bacterial pulmonary emboli was made basing on determination of bacterial vegetation on cusps of the tricuspid valve.

Adult↗
PubMed1995

[Comparison of the degree of regression of small cell lung neoplasm in clinical-radiologic evaluation with levels of neuron specific enolase (NSE) in serum].

NSE was estimated using Pharmacia test and radioimmunologic method in the serum of 41 SCLC patients before treatment, at the time of maximal tumor response and in some patients also during progression. The level of 12,5 ng/l was regarded as the upper limit of normal. Elevated NSE levels before treatment were found in 12 out of 20 patients with limited disease and in 19 out of 21 patients with extensive disease. Complete remission (CR) was observed only in patients with limited disease and in those in whom NSE serum level was below 50 ng/l. Elevated NSE serum levels decreased in all those in whom partial remission (PR) or CR of tumor was obtained. Decrease of elevated NSE levels was however also observed in some patients with no significant regression of tumor. The decrease of serum NSE level seemed to be a good prognostic factor even in this last group. NSE serum level increased in 7 out 10 patients where progressive disease after PR was found. In 3 patients however NSE level persisted in normal values despite progression. The significance of this fact was discussed.

Adult↗
PubMed1995

[Evaluation of the value of determining levels of cytokeratin-19 fragments for diagnosis of lung cancer].

Cytokeratins, the intermediate filaments, are expressed by many epithelial cells. Immunohistochemistry revealed the presence of cytokeratin-19 both in bronchial epithelium and in lung cancer cells. The aim of our study was to establish the value of serum cytokeratin-19 estimation by immunoenzymatic assay (Enzymun Cyfra 21-1, Boehringer Mannheim) in the patients (pts) with lung cancer (Ic). 153 pts (104 men, 49 women, median age 50 years) entered this study. The group consisted of 37 pts with benign lung diseases (control group), 56 pts with squamous cell Ic, 37 pts with small cell Ic and 23 with adenocarcinoma. Cut off value was determined at 4 ng/ml, with 96% of specificity. Elevated cytokeratin-19 values were found in 41% of pts with lung cancer (45% of squamous cell Ic, 39% of adenocarcinoma and 35% of small cell Ic). Median cytokeratin-19 values were 2.2 ng/ml in the control group, 3.4 ng/ml in squamous cell Ic, 3.3 ng/ml adenocarcinoma and 2.9 in small cell Ic. Cytokeratin-19 elevation was observed more often in non small cell Ic pts with advanced disease, stage III--46%, stage IV--50% than in early stages (I + II)--34%. In small cell Ic pts the frequency of cytokeratin-19 elevation was 20% in limited disease versus 45% in extensive disease. We conclude that cytokeratin estimation is not valuable in the recognition of histologic type of lung cancer, although elevated levels are seen more often in squamous cell Ic. Cytokeratin-19 estimation may be also helpful in lung cancer staging.

Adenocarcinoma↗
PubMed1995

[Incidence of beta HCG elevation in serum of patients with small cell lung neoplasms and their prognosis].

HCG-like immunoreactivity has been found in many nontrophoblastic tumors, but the biological behaviour of HCG--producing cells has not been clarified yet. The aim of the study was to estimate the frequency of serum bHCG (sbHCG) elevation in SCLC patients and to assess its possible prognostic role in this type of tumor. 156 SCLC patients entered the study: 93 men, 63 women, median age 58 years. SbHCG activity was measured with immunoenzymassay (Abbott EIA bHCG 15-15) before treatment. ScHCG elevation (5 mIU/ml) was found in 21 of 156 patients (14%). Response to treatment after chemotherapy (CR + PR) was obtained in only 48% of those patients in whom elevated sbHCG was found, in comparison to 73% of response rate observed in the remaining patients. Only 5% of patients with elevated sbHCG survived 2 years, in comparison to 21% of 2-years survivors in the remaining patients. Thus sbHCG elevation in SCLC seems to be a marker of more resistant tumors and of poor prognosis.

Adult↗
PubMed1994

Combination chemotherapy with cyclophosphamide, epirubicin and etoposide in small cell lung cancer.

From March 1987 to February 1991, 136 patients with untreated small cell lung cancer (64 patients with limited disease and 72 with extensive disease), were treated as part of a prospective multi-center study, with a combination of cyclophosphamide 1000 mg/m2 i.v. on day 1, epirubicin 70 mg/m2 i.v. on day 1 and etoposide 100 mg/m2 i.v. on days 1, 3 and 5. Courses were repeated every 3 weeks. One-hundred thirty-four patients were evaluable. There were 42 (31%) complete responses and 66 (49%) partial responses for an overall response rate of 80% (95% confidence interval 71-87%). A complete response was seen in 24 patients (38%) with limited disease and in 18 patients (26%) with extensive disease, while a partial response was observed for 31 (48%) and in 35 (50%) patients, respectively. The median duration of response for all patients was 8.9 months (range, 1-60+ months). The median duration of survival for the entire group was 11.4 months (12.5 months for limited disease and 9.8 months for extensive disease). The 2-year survival rate for the whole group was 13%. The main side-effects were myelosuppression, alopecia, nausea and vomiting. Grade 4 toxicity was seen in 8.5% of patients. In conclusion, the studied regimen was found to be active and well tolerated and may be considered as an alternative to standard chemotherapy combinations in SCLC.

Adult↗
PubMed1994

[Neoplastic metastasis in lungs simulating primary tumor of the respiratory system].

16 patients with clinical and radiological symptoms suggesting lung disease were described. Metastatic character of process was documented in 7 of them during life and in 9 after death. The pulmonary symptoms without any signs of primary tumor lasted from few months to 3 years. Two patients revealed primary tumor in ovary, 1-in uterus, 4-in thyroid gland, 2-in prostata, 2-in breast, 2-in pancreas, 1-in bone, one in testicle, and 2-in kidney.

Adult↗
PubMed1993

The prognostic significance of bone marrow metastases in small cell lung cancer patients.

One-hundred forty-six SCLC patients were classified as localised (56) or extensive (90) using chest X-ray, bronchoscopy, brain CT, bone scintigraphy, ultrasonography of the abdomen and bilateral bone marrow trephine biopsy. Bone marrow metastases were found in 28 cases. Patients with bone marrow metastases had significantly shorter time to progression (median 20 weeks) and significantly shorter survival time (median 31 weeks) than other patients with extensive disease (medians 30 and 46 weeks). Patients with bone marrow involvement had significantly more often metastases in three or more organs than others with extensive disease. The negative prognostic significance of bone marrow involvement was however independent of the negative prognostic significance of the number of organs with metastases.

Adult↗
PubMed1993

[Significance of bronchoscopy in the early phase of chemotherapy in patients with small cell lung carcinoma for assessment of tumor regression and prognosis].

70 SCLC patients (pts): 25 women and 45 men aged 34 to 76 with limited disease were treated with chemotherapy in Institute of Tuberculosis in the period 1.01.1987-31.12.1992. After 3-5 courses of chemotherapy restaging was done using chest X-ray examination, bronchoscopy with cytological examination of bronchial material, abdomen ultrasound examination and other methods according to clinical indications. Complete regression (CR) of the tumor in chest X-ray examination was found in 17 cases, partial regression (PR) in 37 cases and no response (NR)-in 16 pts. The degree of tumor regression on chest X-ray had significant prognostic value. The median survival time in this group was 20 months while median was 13.5 months in PR patients group and 11.5 in NR patients. Bronchoscopy revealed macroscopic or microscopic signs of cancer in 5 of 17 pts with CR on chest X-ray examination, in 23 of 37 cases with PR on X-ray and in 12 of 16 with NR on X-ray. The persistence of tumor signs in bronchoscopic examination seemed to worsen the prognosis in pts with CR on chest X-ray. Complete regression of tumor revealed during bronchoscopy did not have any prognostic significance if CR on the chest X-ray was not obtained. It was concluded that bronchoscopic examinations in early phase of chemotherapy is useful to further treatment planning only in these pts in whom CR of tumor on chest X-ray examination was confirmed.

Adult↗
PubMed1993

[Correlation between chest examination with radiography, bronchoscopy and cytology of bronchial alveolar lavage in patients treated for small cell lung cancer].

In 129 SCLC patients (pts) 250 control fibrobronchoscopic (FOB) procedures were performed during chemotherapy. 71 pts had extensive disease and 58 limited disease. The evident correlation between radiologic and bronchoscopic assessment of tumor regression was confirmed in 60% of examinations. Tumor was visible during 16 bronchoscopic examinations in spite of complete regression on X-ray picture and on 53 chest X-ray examinations despite complete regression in the bronchi. Cancer cells found in 74 out of 250 bronchial washings samples were present significantly more often in these situations in which no regression of tumor in the bronchi was confirmed. Nevertheless tumor cells were also found in 3 out 57 cases in which complete regression on X-ray and in the bronchi was found. It was concluded that complete tumor regression on X-ray picture ought to be confirmed by bronchoscopy with cytologic examination of bronchial washing.

Adult↗
PubMed1993

[Value of bone marrow trephine biopsy in evaluating the extent of small cell lung cancer].

Bone marrow metastases using Jamshidi needle were found before treatment in 28 of 146 small cell lung cancer patients (19.2%). Bone marrow was a sole site of distant metastases in 3.4% of all cases and in 8.2% of those with no metastases in other organs. Patients with bone marrow involvement had more often metastases in 3 or more organs and had significantly more often liver metastases as well. Bone marrow infiltration was more often observed in patients with poor performance status and with disseminated disease, but was also found in 4 of 47 patients with good performance status and without metastases in other organs. Bone marrow trephine biopsy should be included in staging procedure in small cell lung cancer patients with good performance status, without metastases in other organs and with abnormalities in peripheral blood picture.

Adult↗
PubMed1992

Epirubicin in previously untreated patients with small cell lung cancer: a phase II study by the EORTC Lung Cancer Cooperative Group.

Epirubicin 110 mg/m2 was administered intravenously every 3 weeks to 41 elderly and/or unfit, previously untreated patients with small cell lung cancer (SCLC). There were three complete responses, 16 partial responses and 14 treatment failures, with a response rate of 57% in 33 evaluable patients. The main toxicity was haematological, characterised by leukopenia and, less frequently, thrombocytopenia and anaemia. There were three toxic deaths due to infection occurring during leukopenia. Non-haematological side effects were alopecia, nausea, stomatitis and diarrhoea. WHO grade 2 cardiac toxicity was seen in 3 patients after a cumulative dose of more than 740 mg/m2. In conclusion epirubicin is an active agent in untreated SCLC.

Aged↗