Biomedical subjects
J Jassem
Publications and source records attributed to J Jassem.
[New imaging methods in diagnosis of lung cancer].
The paper reviews new imaging methods allowing more precise diagnosing and staging of lung cancer. From among the methods currently used in clinical practice computed tomography and nuclear magnetic resonance were reviewed. Advantages and limitations of these techniques were presented. As for isotopic tests we reviewed single photon emission computed tomography and positron-emission tomography as well as novel endoscopic methods--lung imaging fluorescence bronchoscopy and video assisted thoracoscopy.
Sarcoma of the uterus. A clinical study of 42 patients.
Records of 42 patients with a diagnosis of uterine sarcoma treated between 1974 and 1995 at the Department of Oncology and Radiotherapy, Medical University of Gdańsk have been reviewed. There were 15 cases of leiomyosarcoma, 14 cases of carcinosarcoma (malignant mixed mesodermal tumor) and 13 cases of endometrial stromal sarcoma. There were 24 FIGO stage I patients, 3 stage II patients, 7 stage III patients and 8 stage IV patients. Thirty seven patients had previously been operated on, of whom 33 had undergone total abdominal hysterectomy and bilateral salpingoophorectomy. Adjuvant postoperative treatment was administered in 19 patients and included radiotherapy in 16 patients, chemotherapy in two and chemotherapy and irradiation in one. Out of 31 radically operated patients, 19 (61%) had recurrences, within 2-42 months of primary treatment (median 10 months); nine patients had distant metasases, six patients had local recurrence and four had both local and distant failure. Treatment failure occurred in seven out of 14 patients who received adjuvant radiotherapy and in 12 out of 17 treated without irradiation. Median survival time in both groups was 26 months. The survival for the whole series ranged from 2 months to 19+ years (median 26 months) and was not related to tumor type. Two and five year actuarial survival rates were 54% and 30%, respectively.
Klinefelter syndrome and neoplasia presentation of three new cases.
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Post-operative radiotherapy in non-small-cell lung cancer: more questions than answers.
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Biological treatment of NSCLC. The need for conclusive studies.
Despite extensive investigation, biological treatments for non-small cell lung cancer (NSCLC) remain largely undeveloped. The lack of satisfactory models has frequently led to inadequate phase II studies and to small and inconclusive phase III trials. Nonuniformity of trials has prevented clearer conclusions from being reached by meta-analysis. In general, immunotherapy has failed to fulfill expectations for clinical usefulness. The benefit with this approach, if any, seems to be marginal, but it is not clear whether this is a result of lack of activity or faulty clinical testing. The future of biological agents in cancer treatment lies in ongoing advances in molecular biology, for example in making tumors more immunogenic. Another avenue of further clinical research includes novel forms of therapy with monoclonal antibodies. Adequate models for testing and appropriate clinical trial settings could clarify the role of biological agents in NSCLC.
Primary cancer of the fallopian tube. Report of 26 patients.
BACKGROUND: Due to rarity of fallopian tube cancer most series on this tumor are small and many problems have remained unsolved. The aim of this report is to review our experience with this neoplasm and to compare it with previously published data. METHODS: Retrospective study of 26 patients with fallopian tube cancer treated in one institution between 1974 and 1994. All patients underwent primary surgical treatment and 18 received adjuvant therapy including pelvic irradiation in 14 cases and chemotherapy in four. RESULTS: Relapse occurred in 18 out of 25 followed up patients. Upper abdominal component of relapse was encountered in 12 patients (67%), pelvic component - in eight (44%) and extraperitoneal component - six (33%). Pelvic relapse occurred in two out of 13 followed up patients treated with postoperative irradiation and in six out of 12 who did not receive postoperative radiotherapy. Survival ranged from 6 to 218+ months (median 23 months). Five-year actual survival was 33%. There were no 2-year survivors in patients presenting with stage II-IV disease. No correlation was found between tumor grade and survival. CONCLUSIONS: Fallopian tube cancer is a treatable disease but cure can be only achieved in patients with early tumor. Postoperative radiotherapy may result in better local control but does not preclude extrapelvic dissemination, therefore adjuvant chemotherapy should be considered in high risk patients. Registration of all new cases as well as prospective multicenter studies are warranted to establish optimal management.
[Mutation of gene p53 in lung cancer].
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Autopsy findings in small cell lung cancer.
The objective of this study was to assess the pattern of autopsy findings in 174 small cell lung cancer patients treated between 1971 and 1991 at seven Polish medical centres. Eighty nine autopsied patients were previously treated with different chemotherapy regimens including 32 patients who also received chest irradiation, 74 received only supportive care and for 11 patients the data on treatment were not available. The age range at diagnosis was 28-81 years (median 57); there were 39 females (22%) and 135 males (78%). Seventy two patients had limited disease at the time of diagnosis, 86-extensive disease and in 16 the disease extent was not determined. The primary tumor and/or metastases in regional lymph nodes were present in 157 autopsies (90%). There was a significant difference in the rate of locoregional disease found at autopsy in patients given chemotherapy and in those who received only supportive care (85% and 100%, respectively; p = 0.01). Chest radiation therapy given in limited disease as an adjunct to chemotherapy did not decrease the rate of persistent locoregional disease (primary tumor in the chest was found in 92% of irradiated and in 96% of nonirradiated patients). Locoregional tumor deposit only was found in 28 (16%). Distant metastases were distributed in 143 patients (82%) and were found in 25 different locations, most frequently in liver (49%), suprarenal glands (25%), peripheral lymph nodes (21%), kidneys (18%), brain (17%) and pancreas (12%). In 3 patients no tumor foci were found. The number of organs involved varied between 0 and 10 (median 3). The number of involved organs was not dependent on the disease extent at the time of diagnosis and on the type of treatment.
Chemotherapy in locally advanced head and neck cancer: a critical reappraisal.
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[The role of serum markers in diagnosis and treatment monitoring in patients with lung cancer].
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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.
Concomitant and alternating radiation therapy (RT) and chemotherapy (CT) for inoperable, M0, non-small cell lung cancers (NSCLC): a consensus report.
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[Paraneoplastic syndromes in lung cancer].
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[Analysis of prognostic factors for long term survival in patients with small cell lung cancer].
Prognostic factors for long term survival were analyzed in a group of 719 patients with small cell lung carcinoma treated within 4 consecutive prospective multicenter trials between 1981 and 1990. 74 patients (10.3%) survived more than 2 years; 30 of them (4.2%) with no evidence of disease. The most significant determinator of prolonged survival was extent of disease: 13.9% (59/424) of patients with limited disease vs. 5.1% (15/295) with extensive disease survived more than 2 years (p < 0.001). Of 138 female patients 24 (17.4%) were long term survivors, compared to 8.6% (50/581) of males (p < 0.01). Initial good performance status and no weight loss were also found to be correlated with long term survival. Of the group of 2-year survivors 51 patients subsequently died (median survival duration 31 months), 10 are alive with cancer or are lost to follow up and 13 are in complete remission with median follow up of 64 months. 20 patients (3.8%) survived more than 5 years. This study confirms the possibility of cure in SCLC, especially in patients with favorable prognostic factors.
[Prevention of emesis accompanying antitumor chemotherapy].
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Combination of daily 4-h infusion of 5-fluorouracil and cisplatin in the treatment of advanced head and neck squamous-cell carcinoma: a South-East European Oncology Group study.
Between April 1986 and May 1989 a multicentre study was conducted to evaluate the efficacy of a 4-h intravenous infusion of 1000 mg/m2 5-fluorouracil (5-FU) followed by a 1-h infusion of 25 mg/m2 cisplatin (CDDP) given for 4 consecutive days every 4 weeks to patients with advanced squamous-cell carcinoma of the head and neck. A total of 189 consecutive patients entered the study, including 106 who had previously undergone chemotherapy and 83 who were chemotherapy-naive. Of the 165 evaluable patients, 96 (58%) responded to treatment, including 22 (13%) who achieved a complete remission (CR). In the group of previously untreated patients an objective response (CR+PR) was seen in 78% (CR, 14%) whereas in pretreated patients the response rate (CR+PR) was 40% (CR, 13%). The median survival period was 10 months. No significant difference in the duration of survival or of remission was found between the two groups in relation to previous therapy, tumour localisation, disease stage or performance status. Almost half of the patients (49%) experienced leucopenia but it was severe in only 11% of cases. Anemia (mainly WHO grades 1-2) occurred in 38% of the patients. Nausea and vomiting were common (84%). Nephrotoxicity (23%) was mild and of short duration. Moderate hair loss was seen in 42% of the patients, and phlebitis occurred in 8%. A few cases of cardiotoxicity and neurotoxicity were observed. This regimen is well tolerated and can be given even on an outpatient basis. The resultant response rate and side effects appear to be similar to those previously reported for combination chemotherapy with CDDP and continuous 5-FU infusion.