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A Regional Canadian Cancer Centre Experience with Combined Modality Organ Preservation Treatment in Anal Cancers 加拿大地区癌症中心联合器官保存治疗肛门癌的经验
Pub Date : 2009-12-31 DOI: 10.5580/ccf
R. Koul, S. Mahmood, R. Alvi, M. Salim, H. Chalchal, D. Cross, L. McLean
Background and aim: Anal cancer is a malignant phenomenon which is a distinct entity from the other colorectal malignancies. Local control and sphincter preservation are the two challenges of anal canal cancer treatment that physicians face. Methods and Materials: Population based historical cohort with confirmed histological diagnosis of anal canal or anal margin cancer treated with organ preservation approach such as chemo radiation from 19702006 registered with Saskatchewan Cancer Registry was evaluated. Data was collected on 152 patients; only fifty patients were eligible. Primary end points were colostomy free survival, disease free survival and overall survival. The influences of tumor AJCC stage, nodal stage, age, radiation dose on primary end points were also evaluated. Toxicities scored according to RTOG and late by LENT/SOMA scale. Results: Median age was 58 years (range 31-79 years).Thirty patients (60%) were under 60 years of age and 20 (40%) were above the age of 60 years. Mean follow up was 4.2 years (range 8-21 years). Overall 5 year survival was 53%, 5 year disease specific survival was 67% and 5 year colostomy free survival was 83%. AJCC stage grouping was the only risk factor that showed a statistically significant influence on disease free survival and overall survival. Conclusion: Combined radiochemotherapy for anal cancer is a very effective therapy. Advanced stage at presentation has an adverse effect on overall and disease free survival. However new chemotherapeutic drugs and IMRT based radiation should be thoroughly investigated.
背景与目的:肛门癌是一种不同于其他结直肠恶性肿瘤的恶性肿瘤。局部控制和保留括约肌是肛管癌治疗面临的两大挑战。方法和材料:对1970 - 2006年在萨斯喀彻温省癌症登记处登记的经组织学诊断经器官保存方法(如化疗放疗)治疗的肛管或肛缘癌患者进行以人群为基础的历史队列研究。收集了152例患者的数据;只有50名患者符合条件。主要终点为无结肠造口生存期、无疾病生存期和总生存期。评估肿瘤AJCC分期、结期、年龄、放疗剂量对主要终点的影响。毒性按RTOG评分,后期按LENT/SOMA评分。结果:中位年龄58岁(范围31-79岁)。60岁以下30例(60%),60岁以上20例(40%)。平均随访4.2年(8-21年)。总体5年生存率为53%,5年疾病特异性生存率为67%,5年无结肠造口生存率为83%。AJCC分期分组是唯一对无病生存和总生存有统计学显著影响的危险因素。结论:放化疗联合治疗肛门癌是一种有效的治疗方法。出现的晚期对总生存率和无病生存率有不利影响。然而,新的化疗药物和基于IMRT的放疗应该深入研究。
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引用次数: 0
Oncoinformatics for the healthcare professional: oncology databases and blogs 面向医疗保健专业人员的肿瘤信息学:肿瘤学数据库和博客
Pub Date : 2008-12-31 DOI: 10.5580/B6B
K. Yap, Yu Zong Chen, W. Chui, A. Chan
Medical informatics is a basic biomedical science that has a wide variety of application areas which involve improvements in the management of any information relevant to patient care and community health. Oncoinformatics is an application science under this broad field. This area applies informatics, internet, and interactive technologies with the aim of improving the standards of care for the cancer patient. The rapid growth of the World Wide Web as a tool for global connectivity has impacted the way in which health-related information is distributed and accessed over the internet. Many people frequently use the internet for the searching of drug and other health-related information. Oncoinformatics has enabled the collation of a huge amount of information in the area of oncology. Several oncology-specific databases and blogs that are clinically relevant are described in this paper. The impact of informatics technologies and cybermedicine in oncology is also discussed.
医学信息学是一门基础生物医学科学,具有广泛的应用领域,涉及改善与患者护理和社区卫生有关的任何信息的管理。肿瘤信息学是这一广阔领域下的一门应用科学。该领域应用信息学、互联网和互动技术,旨在提高癌症患者的护理标准。作为全球连接工具的万维网的迅速发展影响了在互联网上分发和访问与健康有关的信息的方式。许多人经常使用互联网搜索药物和其他与健康有关的信息。肿瘤信息学使肿瘤学领域的大量信息得以整理。几个肿瘤特异性数据库和博客,是临床相关的描述在本文中。讨论了信息学技术和网络医学对肿瘤学的影响。
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引用次数: 5
Metastatic involvement and perforation of the appendix in a patient with parotid gland tumor treated with paclitaxel 经紫杉醇治疗的腮腺肿瘤患者阑尾转移及穿孔
Pub Date : 2008-12-31 DOI: 10.5580/1bd8
T. Grenader, Anthony Goldberg, C. Reinus
Salivary duct carcinoma is an uncommon malignant tumor, characterized by aggressive behavior and poor prognosis. It accounts for approximately 1–3% of all malignant salivary gland tumors (2), and it is found mainly in the parotid gland, followed by the other major salivary glands (2). Histologically, salivary duct carcinoma resembles ductal carcinoma of the breast (3). Immunohistochemically, the tumor cells are positive for keratin and epithelial membrane antigen. Stains for gross cystic disease fluid protein-15 (GCDFP-15) and androgen receptor are frequently positive, but only rare expression of estrogen and progesterone receptors has been described (3). Metastases are a common feature in the evolution of parotid gland cancer. Gastrointestinal metastases, however, and especially appendicular ones, are very rare. The intrinsic nature of malignant metastases in the appendix leads to a late presentation of appendicitis with a high incidence of perforation, associated with an increased mortality and morbidity (1). We describe the case of a patient presenting as an acute abdomen because of metastatic involvement with perforation of the vermiform appendix from a salivary duct carcinoma of the parotid gland treated with paclitaxel.
摘要唾液管癌是一种罕见的恶性肿瘤,具有侵袭性和预后差的特点。约占所有恶性唾液腺肿瘤的1-3%(2),主要发生在腮腺,其次是其他主要唾液腺(2)。组织学上,唾液腺导管癌类似于乳腺导管癌(3)。免疫组织化学上,肿瘤细胞角蛋白和上皮膜抗原阳性。总囊性疾病液蛋白-15 (GCDFP-15)和雄激素受体的染色通常呈阳性,但只有罕见的雌激素和孕激素受体表达(3)。转移是腮腺癌演变的共同特征。然而,胃肠道转移,尤其是阑尾转移,是非常罕见的。阑尾恶性转移的固有性质导致阑尾炎的晚期表现,穿孔发生率高,与死亡率和发病率增加有关(1)。我们描述了一个病例,患者因腮腺涎管癌转移累及蚓状阑尾穿孔而表现为急性腹部。
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引用次数: 0
Efficacy of Gelclair oral gel in the treatment of oral mucositis in patients with head and neck tumours treated with chemotherapy and /or radiotherapy Gelclair口服凝胶治疗经化疗和/或放疗的头颈部肿瘤患者口腔黏膜炎的疗效
Pub Date : 2008-12-31 DOI: 10.5580/667
Nermina Kantardži, Velda Smajlbegovi, N. Kazic, A. Cardzic
Background: During radiotherapy or chemotherapy of head and neck tumours patients commonly suffer from oral mucositis. Symptoms of oral mucositis are pain; discomfort or inability to tolerate food and fluid. Mucositis can be severe and limit the patient’s ability to tolerate chemotherapy or radiotherapy, cause delay and limit the effectiveness of cancer therapy. Aim: To examine effectiveness of gelclair oral gel in the treatment of oral mucisitis in patients with head and neck tumours during radiotherapy or/and chemotherapy. Material and method: This is nonrandomized, prospective study. We included 15 patients treated with radiotherapy and/or chemotherapy and proven head and neck tumours. During their oncology therapy they were treated with gelclear oral gel and checked every day for severity of their symptoms. Results: In the 13 patients significant improvement in the management of pain was observed, and 11 patients had improvement in food and fluid intakes. There were no delays in treatment, caused by severity of oral mucositis. Conclusion: Gelclear oral gel is safe and efficient agent in the treatment of oral mucositis, one of most common complication of radiotherapy and/or chemotherapy in patients with head and neck tumours. This study was supported by Pharma Swiss – department Sarajevo, Bosnia and Herzegovina. INTRODUCTION Malignant head and neck tumours represent about 4% of all malignancies. Squamous cancers of the upper aero digestive tract constitute approximately 6% of new cancer cases in men and 2% in female at all sites, except the salivary glands; there is a significant preponderance of cases in men1. It is most common between 45 to 70 years2. In the time of diagnosis about 70 % of patients are in III or IV stage of disease3. Treatment options include surgery, radiotherapy and chemotherapy, before, during or after radiotherapy. If the patients are treated with radio and/or chemotherapy one of the most common side effects is oral mucositis. It occurs in 20-40% of patients treated with chemotherapy alone and up to 50% of patients receiving combination radiation and chemotherapy, especially those with head and neck tumors. Main symptoms of oral mucositis are: erythema, taste loss, pain, and a sore or dry mouth, swallowing and eating difficulty. Tooth and gum disease further complicate the problem. Reduction of caloric intake can lead to weight loss, loss in muscle mass strength and other complications, including a decrease in immunity. Patients with damaged oral mucosa and reduced immunity are prone to opportunistic mouth infections. The potential impact of morbidity and mortality with oral mucositis should not be underestimated and requires active treatment. The consequences of mucositis can be mild requiring little intervention to severe that may result in fatal complications. If oral mucisitis is not treated it can cause delays in chemotherapy and/or radiotherapy treatment, or even stopping of specific oncology treatments and comprom
背景:头颈部肿瘤患者在放疗或化疗过程中,口腔黏膜炎是常见的并发症。口腔黏膜炎的症状是疼痛;厌食症不适或不能忍受食物和液体粘膜炎可能很严重,并限制患者对化疗或放疗的耐受能力,造成延迟并限制癌症治疗的有效性。目的:探讨gelclair口腔凝胶治疗头颈部肿瘤患者放疗/化疗期间口腔粘膜炎的疗效。材料和方法:这是一项非随机、前瞻性研究。我们纳入了15例接受放疗和/或化疗并证实头颈部肿瘤的患者。在肿瘤治疗期间,他们接受透明口服凝胶治疗,并每天检查症状的严重程度。结果:13例患者疼痛管理有明显改善,11例患者食物和液体摄入量有改善。由于口腔黏膜炎的严重程度,没有延误治疗。结论:明胶口服凝胶是治疗头颈部肿瘤患者放化疗后最常见的并发症之一——口腔黏膜炎安全有效的药物。这项研究得到了波斯尼亚和黑塞哥维那萨拉热窝瑞士药厂的支持。头颈部恶性肿瘤约占所有恶性肿瘤的4%。除唾液腺外,上消化道鳞状癌约占男性新发癌症病例的6%,占女性新发癌症病例的2%;在男性中有明显的优势。最常见于45岁至70岁之间。在诊断时,约70%的患者处于疾病的III或IV期。治疗选择包括手术、放疗和化疗,在放疗之前、期间或之后。如果患者接受放疗和/或化疗,最常见的副作用之一是口腔黏膜炎。20-40%单独接受化疗的患者和高达50%接受放化疗联合治疗的患者,特别是头颈部肿瘤患者,会发生这种情况。口腔黏膜炎的主要症状有:红斑、味觉丧失、疼痛、口痛或口干、吞咽和进食困难。牙齿和牙龈疾病使问题进一步复杂化。减少热量摄入会导致体重减轻、肌肉力量下降和其他并发症,包括免疫力下降。口腔黏膜受损、免疫力下降的患者易发生机会性口腔感染。口腔黏膜炎的发病率和死亡率的潜在影响不应被低估,需要积极治疗。黏膜炎的后果可以是轻微的,几乎不需要干预,严重的可能导致致命的并发症。如果口腔粘膜炎得不到治疗,它可能导致化疗和/或放疗的延迟,甚至停止特定的肿瘤治疗,危及生存。Gelclair口服凝胶治疗经化疗和/或放疗的头颈部肿瘤患者口腔黏膜炎的疗效[6中的2]许多不同的治疗方案可用于预防和治疗口腔黏膜炎。口腔护理方案包括开始治疗前的牙科工作和治疗期间的口腔清洁。漱口产品,防腐,抗菌,抗真菌,抗病毒,和许多其他产品被使用。很明显,临床实践中使用的许多干预措施从未经过严格的评估。放疗和/或化疗期间口腔粘膜炎的治疗尚无标准的循证方案。凝胶透明口服凝胶于2001年被FDA批准用于治疗口腔黏膜炎。该产品仍未列入波斯尼亚和黑塞哥维那患者的积极药物清单。患者与方法2008年1月至7月共纳入15例患者。病理证实有头颈部肿瘤,男13例,女2例。14例患者行手术治疗,14例患者均行辅助放疗,其中9例患者行放化疗。术后仅放化疗1例,辅助放疗5例。14例采用双对野、一前锁骨上野的肿瘤及颈部放疗技术;其中一组在喉部用两个相对的小磁场照射。9例患者放疗前给予顺铂100mg + 5氟尿嘧啶1000mg化疗2 ~ 3个周期,5例患者放疗后第1、21、42天单独给予顺铂。在肿瘤治疗期间,我们用WHO量表评估口腔黏膜炎的等级。在放射治疗的第二周,他们开始使用凝胶透明口服凝胶标准治疗口腔黏膜炎。图1表1WHO口腔黏膜炎分级表 按年龄分患者以60岁及以上患者居多,平均年龄61岁(26-76岁)。患者的诊断以喉癌、口咽癌多见,且病情进展较晚。图4表5。患者受治疗多数患者采用联合治疗。
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引用次数: 0
Gardnerella vaginalis and breast cancer 阴道加德纳菌和乳腺癌
Pub Date : 2008-12-31 DOI: 10.5580/219c
L. Tumanova, V. Mitin, N. Godoroja, N. Botnariuc
G. vaginalis was suggested to be an associated factor in carcenogenesis. We have studied 41 breast disease (31 breast cancer and 10 fibrosing adenomatosis) patients for the presence of G. vaginalis by PCR in tumor, blood and saliva. G. vaginalis was detected in 46% of saliva samples, 44% of blood samples, and 56% of tumor; in 85% cases at least one of patient’s samples was found to be G. vaginalis positive. For the first time, a relationship between G. vaginalis and breast disease was shown
阴道弧菌被认为是致癌的一个相关因素。我们对41例乳腺疾病(乳腺癌31例,纤维化性腺瘤病10例)患者的肿瘤、血液和唾液进行了阴道支原体PCR检测。46%的唾液样本、44%的血液样本和56%的肿瘤样本中检测到阴道支原体;在85%的病例中,至少有一个患者的样本被发现为阴道弧菌阳性。这是第一次发现阴道弧菌与乳腺疾病之间的关系
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引用次数: 1
Adjuvant Therapy with Curative Intent: Is That Really So? 辅助治疗具有治疗目的:真的是这样吗?
Pub Date : 2008-12-31 DOI: 10.5580/12da
A. Mangalik
It is a mantra, a dogma, a belief system. It has merit. It has saved many lives. It is almost 50 years now since Bernie Fisher first noted the high relapse rate in patients with breast cancer who had been “cured” by surgery. He realized more needed to be done. He set up systemic studies, went step by step and established a new approach to the understanding and “early” breast cancer. Seventy years before that, Halstead had developed what was thought to be the best approach for the treatment of breast cancer. Based on the best thinking and understanding at that time, he developed a surgical method that helped many but also reduced the quality of life of many others without giving them any benefit – that is what we found out later.
它是一种咒语,一种教条,一种信仰体系。它有它的优点。它挽救了许多生命。伯尼·费舍尔(Bernie Fisher)首次注意到通过手术“治愈”的乳腺癌患者的高复发率,距今已近50年。他意识到需要做的还有很多。他建立了系统的研究,一步一步地建立了一种新的方法来理解和“早期”乳腺癌。在那之前70年,霍尔斯特德发明了一种被认为是治疗乳腺癌的最佳方法。基于当时最好的思考和理解,他开发了一种手术方法,这种方法帮助了许多人,但也降低了许多人的生活质量,没有给他们带来任何好处——这就是我们后来发现的。
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引用次数: 0
Radiation Induced Sarcoma of Pelvis 放射引起的骨盆肉瘤
Pub Date : 2008-12-31 DOI: 10.5580/2299
G. Karunanithi, P. Sethi, K. S. Reddy, S. Vivekanandam
Radiation-induced sarcomas are uncommon potential late sequelae of radiation therapy. These tumors are aggressive, occurring in bones or soft tissues in an irradiated area after a latent period of five or more years following radiotherapy. We report a case of radiation-induced osteosarcoma involving the pelvic girdle with latency period of 11 years following whole pelvis radiation treatment for carcinoma cervix.
放射引起的肉瘤是罕见的放射治疗的潜在晚期后遗症。这些肿瘤具有侵袭性,在放射治疗后潜伏5年或更长时间后发生在受照射区域的骨骼或软组织中。我们报告一例放射诱发骨肉瘤累及骨盆带,潜伏期11年后全骨盆放射治疗宫颈癌。
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引用次数: 1
Colonic metastasis from primary squamous cell carcinoma of the cervix 原发性宫颈鳞状细胞癌的结肠转移
Pub Date : 2008-12-31 DOI: 10.5580/739
R. Seshadri, Ritesh Tapkire, U. Majhi, Selvaluxmy Ganesharajah
Abstract Metastasis from carcinoma of the uterine cervix to the gastrointestinal tract is uncommonand is usually associated with a poor prognosis. We report a case of a 50-year-old lady treated byconcurrent chemoradiation for stage III B carcinoma of the uterine cervix. One and a half yearslater, she developed a metastatic growth in the transverse colon which was resected. She isdisease free ten months after surgery. The colon is an unusual site of metastasis from carcinomacervix, and colonic metastasis from carcinoma cervix has to be differentiated from a primarysquamous cell carcinoma of the colon. Palliative resection of colonic metastasis may preventfuture intestinal obstruction.
摘要子宫颈癌转移至胃肠道并不常见,且预后较差。我们报告一例50岁的妇女同时化疗治疗III期B宫颈癌。一年半后,她的横结肠出现了转移性生长,并被切除。手术后10个月,她的病痊愈了。结肠是一种罕见的宫颈癌转移部位,宫颈癌的结肠转移必须与结肠癌的原发性鳞状细胞癌区分开来。姑息性结肠转移切除可预防未来肠梗阻。
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引用次数: 2
Appendiceal Adenocarcinoma Arising after Bone Marrow Transplantation for Non-Hodgkin Lymphoma: An Unusual Treatment Dilemma 非霍奇金淋巴瘤骨髓移植后产生的阑尾腺癌:一个不寻常的治疗困境
Pub Date : 2008-12-31 DOI: 10.5580/48a
J. Schwartz, B. Woods, L. Emerson, R. Andtbacka
Appendiceal tumors are rare neoplasms occurring in approximately 0.1% of appendectomy specimens1. The majority present as acute appendicitis and are treated by simple appendectomy. Although controversial, in the setting of peritoneal carcinomatosis discovered at the time of appendectomy, cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC) may represent potential therapeutic options. However, debate exists with regard to patient selection, quality of life and procedureassociated morbidity, what constitutes effective cytoreduction, and whether cytoreduction alone offers a survival benefit in the absence of intraperitoneal chemotherapy. This report describes a rare case of a perforated appendiceal adenocarcinoma arising after bone marrow transplantation for non-Hodgkin lymphoma. The occurrence of peritoneal carcinomatosis in this setting has not previously been reported, but exemplifies the importance of an individualized approach to therapy based on a patient’s presentation.
阑尾肿瘤是一种罕见的肿瘤,约占阑尾切除标本的0.1%。多数表现为急性阑尾炎,采用单纯阑尾切除术治疗。虽然存在争议,但在阑尾切除术时发现腹膜癌的情况下,细胞减少和腹腔内高温化疗(HIPEC)可能是潜在的治疗选择。然而,关于患者的选择、生活质量和手术相关的发病率、有效的细胞减少是什么,以及在没有腹腔化疗的情况下,单独的细胞减少是否能提供生存益处,存在争议。本文报告一例罕见的非霍奇金淋巴瘤骨髓移植后发生的阑尾穿孔腺癌。腹膜癌在这种情况下的发生以前没有报道,但例证了基于患者表现的个体化治疗方法的重要性。
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引用次数: 0
Pharmacokinetics Of Adriamycin After Intravenous Administration In Rat. 大鼠静脉给药后阿霉素的药动学。
Pub Date : 2008-12-31 DOI: 10.5580/1dc4
R. Nwankwoala, O. Georgewill, U. Georgewill
Pharmacokinetics of adriamycin in the rat testis, heart and plasma was Investigated using male Wister rats. The control group received 0. 9%saline Given I.V. One group of adriamycin treated rats received 20mg/kg adriamycin administered intravenously. The Second group received1mg/kg adriamycin also given I.V. Thereafter, the animals weresacrificed 1,3,12 and 24 hours and the testes, and hearts were removed.The plasma was recovered from the blood. Using fluorimetric method, the amount of adriamycin in the tissues and plasma was quantitated. The Half life of the drug in the tissues and plasma was calculated from the Graph of log adriamycin concentration (ug/g) vs. time. The pattern of distribution in the heart and plasma at the two doses used in the pharmacokinetic studies revealed an exponential fall in drug concentration with time. In the testis on the other hand, after the initial drop on the level of the drug in this organ, the level of the drug was elevated with time. This ability of the testis to accumulate adriamycin renders it highly susceptible to the lethal effects of adriamycin And thus accounts for the observed drug induced testicular toxicity.
用雄性Wister大鼠研究了阿霉素在睾丸、心脏和血浆中的药动学。对照组接受0。阿霉素治疗组大鼠静脉滴注阿霉素20mg/kg。第二组给予阿霉素1mg/kg,同时静脉注射。分别于1、3、12、24小时处死,取睾丸、心脏。血浆是从血液中提取出来的。采用荧光法定量测定组织和血浆中阿霉素的含量。药物在组织和血浆中的半衰期由阿霉素浓度(ug/g)与时间的对数曲线图计算。药代动力学研究中使用的两种剂量在心脏和血浆中的分布模式显示药物浓度随时间呈指数下降。另一方面,在睾丸中,在该器官中药物水平最初下降后,药物水平随着时间的推移而升高。睾丸积累阿霉素的这种能力使其极易受到阿霉素的致命影响,从而解释了观察到的药物引起的睾丸毒性。
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引用次数: 6
期刊
The Internet Journal of Oncology
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