M. Jankowski, M. Las-Jankowska, D. Bała, W. Zegarski
Introduction. Preoperative chemoradiotherapy (preCRT) improves local control of rectal cancer and such is particularly merited for treating locoregionally advanced tumors. Nevertheless, the role of postoperative chemotherapy (postCT) in such patients is currently disputed. Materials. Subjects were 75 patients with unresectable cT3–4 and/or N+ tumors who underwent radical surgery following preCRT between January 2003 and December 2012 at the Oncology Centre in Bydgoszcz. PostCT was subsequently used in 32 (43%) of these patients. Results. There were 20 abdominoperineal resections (APR), 50 anterior resections (AR) and 5 Hartmann’s procedures (HART) performed in the patient group, where respectively 30%, 46% and 60%, received systemic treatment. Based on postoperative histopathological assessment, disease staging was assigned as follows: stage III for 32 (43%), patients,stage II for 22 (29%) and stage I for 15 (20%). Pathologic complete pathological response (pCR) was seen in 6 cases (8%). In the postCT+ group, disease stage III was observed in 13 (41%) patients. A three-year survival was observed in 43 patients; 25 (58%) and 18 (56%) of patients respectively undergoing either postCT– or postCT+. A five-year survival was noted in 26 patients; 19 (44%) and 7 (22%) in both groups, respectively. Conclusion. Together with the most recent reports, our study demonstrates that postoperative chemotherapy has no significant effect on the outcomes of oncological treatment in those patients having undergone preoperative chemoradiotherapy for locoregionally advanced rectal cancer.
{"title":"The role of postoperative chemotherapy in patients who undergoing surgery following chemoradiotherapy of initially unresectable rectal cancer","authors":"M. Jankowski, M. Las-Jankowska, D. Bała, W. Zegarski","doi":"10.5603/NJO.2017.0046","DOIUrl":"https://doi.org/10.5603/NJO.2017.0046","url":null,"abstract":"Introduction. Preoperative chemoradiotherapy (preCRT) improves local control of rectal cancer and such is particularly merited for treating locoregionally advanced tumors. Nevertheless, the role of postoperative chemotherapy (postCT) in such patients is currently disputed. Materials. Subjects were 75 patients with unresectable cT3–4 and/or N+ tumors who underwent radical surgery following preCRT between January 2003 and December 2012 at the Oncology Centre in Bydgoszcz. PostCT was subsequently used in 32 (43%) of these patients. Results. There were 20 abdominoperineal resections (APR), 50 anterior resections (AR) and 5 Hartmann’s procedures (HART) performed in the patient group, where respectively 30%, 46% and 60%, received systemic treatment. Based on postoperative histopathological assessment, disease staging was assigned as follows: stage III for 32 (43%), patients,stage II for 22 (29%) and stage I for 15 (20%). Pathologic complete pathological response (pCR) was seen in 6 cases (8%). In the postCT+ group, disease stage III was observed in 13 (41%) patients. A three-year survival was observed in 43 patients; 25 (58%) and 18 (56%) of patients respectively undergoing either postCT– or postCT+. A five-year survival was noted in 26 patients; 19 (44%) and 7 (22%) in both groups, respectively. Conclusion. Together with the most recent reports, our study demonstrates that postoperative chemotherapy has no significant effect on the outcomes of oncological treatment in those patients having undergone preoperative chemoradiotherapy for locoregionally advanced rectal cancer.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"17 1","pages":"281-284"},"PeriodicalIF":0.0,"publicationDate":"2018-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85257636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cancer disease is a growing health problem in today’s world.Malnutrition frequently occurs in cancer patients and is associated with their higher mortality rates.Nutritional interventions are recommended whenever clinically required and at every stage of oncological therapy. This allows prevention or treatment of cancer therapy-related complications thereby improving the effectiveness of such therapy, reducing cost, improving the quality of life, and prolonging the survival of some patients. From an overall perspective, adequate nutrition is necessary to ensure the most favourable outcomes of oncological therapy.
{"title":"Nutritional treatment improves the effectiveness of anti-cancer therapy","authors":"M. Jankowski","doi":"10.5603/NJO.2017.0052","DOIUrl":"https://doi.org/10.5603/NJO.2017.0052","url":null,"abstract":"Cancer disease is a growing health problem in today’s world.Malnutrition frequently occurs in cancer patients and is associated with their higher mortality rates.Nutritional interventions are recommended whenever clinically required and at every stage of oncological therapy. This allows prevention or treatment of cancer therapy-related complications thereby improving the effectiveness of such therapy, reducing cost, improving the quality of life, and prolonging the survival of some patients. From an overall perspective, adequate nutrition is necessary to ensure the most favourable outcomes of oncological therapy.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"25 1","pages":"313-315"},"PeriodicalIF":0.0,"publicationDate":"2018-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81797823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sydney Rowland’s brief life (1872–1917) is described with emphasis on his contribution to radiology in the first two years following the discovery of X-rays. Not only was he the first editor of the Archives of Clinical Skiagraphy but was also appointed Special Commissioner to the British Medical Journal with a remit to write a report on the application of X-rays in medicine and surgery. He was to cease his studies with X-rays in 1897 to become a microbiologist. Working in the Royal Army Medical Corps in World War I, he died of cerebrospinal fever age only 45 years, in France in 1917.
{"title":"Sydney Rowland (1872–1917) World’s first editor of an X-ray journal, 1896","authors":"R. Mould","doi":"10.5603/NJO.2017.0053","DOIUrl":"https://doi.org/10.5603/NJO.2017.0053","url":null,"abstract":"Sydney Rowland’s brief life (1872–1917) is described with emphasis on his contribution to radiology in the first two years following the discovery of X-rays. Not only was he the first editor of the Archives of Clinical Skiagraphy but was also appointed Special Commissioner to the British Medical Journal with a remit to write a report on the application of X-rays in medicine and surgery. He was to cease his studies with X-rays in 1897 to become a microbiologist. Working in the Royal Army Medical Corps in World War I, he died of cerebrospinal fever age only 45 years, in France in 1917.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"17 1","pages":"316-320"},"PeriodicalIF":0.0,"publicationDate":"2018-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73470999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A beneficial effect of nutrition treatment on multiple aspects of oncological therapy is chiefly demonstrated by preventing and in treating the wasting syndrome and cancer cachexia accompanying the cancer disease. The presence of the wasting syndrome prior to commencing treatment is associated with shorter time for developing complications along with a shorter overall survival (OS), worse response to oncological treatment, deteriorating quality of life, poorer general status; moreover, cachexia strongly affects treatment tolerance. Clinical nutrition is one of the most significant pillars supporting oncological treatment, nonetheless, one has to be mindful of certain cases where nutritional intervention, especially parenteral nutrition, does not bring benefits, and may even be harmful to the patient. Such cases include: PN (parenteral nutrition) for patients with normal body mass and a correctly functioning gastrointestinal tract; PN due to hypoalbuminemia, in patients where feeding via the gastrointestinal tract is possible (orally or enterally); lack of refeeding syndrome prevention for cachectic patients starting PN or EN; use of feeding mixtures containing only soya oil as the sole fatty nutrient; incomplete nutrition (macronutrients or micronutrients only); inclusion of PN in patients in the terminal phase of cancer undergoing persistent nutrition therapy.
{"title":"Nutrition treatment does not improve the efficacy of oncological treatment","authors":"A. Kapała","doi":"10.5603/NJO.2017.0051","DOIUrl":"https://doi.org/10.5603/NJO.2017.0051","url":null,"abstract":"A beneficial effect of nutrition treatment on multiple aspects of oncological therapy is chiefly demonstrated by preventing and in treating the wasting syndrome and cancer cachexia accompanying the cancer disease. The presence of the wasting syndrome prior to commencing treatment is associated with shorter time for developing complications along with a shorter overall survival (OS), worse response to oncological treatment, deteriorating quality of life, poorer general status; moreover, cachexia strongly affects treatment tolerance. Clinical nutrition is one of the most significant pillars supporting oncological treatment, nonetheless, one has to be mindful of certain cases where nutritional intervention, especially parenteral nutrition, does not bring benefits, and may even be harmful to the patient. Such cases include: PN (parenteral nutrition) for patients with normal body mass and a correctly functioning gastrointestinal tract; PN due to hypoalbuminemia, in patients where feeding via the gastrointestinal tract is possible (orally or enterally); lack of refeeding syndrome prevention for cachectic patients starting PN or EN; use of feeding mixtures containing only soya oil as the sole fatty nutrient; incomplete nutrition (macronutrients or micronutrients only); inclusion of PN in patients in the terminal phase of cancer undergoing persistent nutrition therapy.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"4 1","pages":"308-312"},"PeriodicalIF":0.0,"publicationDate":"2018-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87585004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The prognosis of patients with multiple myeloma has improved markedly over the last two decades. Despite that, allogeneic hematopoietic stem cell transplantation remains the only treatment option with curative potential. Therefore it should be considered for younger patients, especially those with high-risk disease as defined based on revised international scoring system. A decision to use transplantation, as well as the choice of conditioning regimen should be personalized, taking into account a particular center’s experience.
{"title":"Should young patients with high-risk multiple myeloma be offered allogeneic transplants? A vote in favour","authors":"S. Giebel","doi":"10.5603/NJO.2018.0032","DOIUrl":"https://doi.org/10.5603/NJO.2018.0032","url":null,"abstract":"The prognosis of patients with multiple myeloma has improved markedly over the last two decades. Despite that, allogeneic hematopoietic stem cell transplantation remains the only treatment option with curative potential. Therefore it should be considered for younger patients, especially those with high-risk disease as defined based on revised international scoring system. A decision to use transplantation, as well as the choice of conditioning regimen should be personalized, taking into account a particular center’s experience.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"24 1","pages":"202-204"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89262486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Sas-Korczyńska, E. Łuczyńska, Adrianna Chudyba, T. Skóra, A. Sokołowski
Introduction. The standard treatment for patients with LD SCLC (limited stage small-cell lung cancer) is combined modality therapy that includes chemotherapy (ChT) with platinum-based regimens and thoracic radiotherapy (RT), followed by prophylactic cranial irradiation (PCI) in patients with a response in the thorax. Objectives. The evaluation of PCI in patients with LD SCLC and the analysis of the effects of certain therapeutic factors on the frequency and occurrence of brain metastases. Materials and methods. Between 2002 and 2015, a total of 271 patients with LD SCLC received chemo-radiotherapy (concurrently in 122 pts — 45% and sequential in 149 pts — 55%). PCI was administered in 167 pts (61.6%) with total dose of 30 Gy given to the whole brain; 86 pts (51.1%) received PCI after completed chemo-radiotherapy and in 81 pts (48.9%) PCI was administered immediately after the end of thoracic irradiation. The following statistical methods were used: Kaplan-Meier method (evaluation of survival rates: overall survival — OS, and brain metastases-free survival — BMFS), log-rank test (for comparison of survival rates), Cox’ proportional hazard model (for multivariate analysis), Pearson chi2 test for independence (for categorized variables comparison) and variance analysis (for continuous variables comparison). All the calculations were performed using Statistica v. 13.3 software (TIBCO Software Inc.) and the significance level for all the statistical methods was p < 0.05. Results. Complete response in thorax was observed in 172 pts (63.5%) and remaining 99 pts (36.5%) developed partial response. During follow-up, 120 pts (44.3%) developed distant metastases from which brain metastases were most frequent (61 cases — 60.8%). The cumulative 5-year incidence of brain metastases amounted to 18.9% (when PCI was administered) and 45.9% (when PCI was omitted) and these differences were significant (p < 0.0001). PCI was an independent prognostic factor for BMFS and for OS. Omitted PCI is related with HR amounted: 6.25 for BMFS and 1.81 for OS. Conclusions. PCI significantly reduces the incidence of brain metastases and delays the development of brain metastases in patients treated for LD SCLC. PCI is a significant independent prognostic factor for brain metastases-free survival and overall survival. The development of brain metastases is the most common type of failure in patients with LD SCLC and 90% of such relapses occurred during the 24 months following the completion of chemo-radiotherapy.
{"title":"The retrospective evaluation of prophylactic cranial irradiation in patients treated for limited stage small-cell lung cancer — a single centre study","authors":"B. Sas-Korczyńska, E. Łuczyńska, Adrianna Chudyba, T. Skóra, A. Sokołowski","doi":"10.5603/2018.0037","DOIUrl":"https://doi.org/10.5603/2018.0037","url":null,"abstract":"Introduction. The standard treatment for patients with LD SCLC (limited stage small-cell lung cancer) is combined modality therapy that includes chemotherapy (ChT) with platinum-based regimens and thoracic radiotherapy (RT), followed by prophylactic cranial irradiation (PCI) in patients with a response in the thorax. Objectives. The evaluation of PCI in patients with LD SCLC and the analysis of the effects of certain therapeutic factors on the frequency and occurrence of brain metastases. Materials and methods. Between 2002 and 2015, a total of 271 patients with LD SCLC received chemo-radiotherapy (concurrently in 122 pts — 45% and sequential in 149 pts — 55%). PCI was administered in 167 pts (61.6%) with total dose of 30 Gy given to the whole brain; 86 pts (51.1%) received PCI after completed chemo-radiotherapy and in 81 pts (48.9%) PCI was administered immediately after the end of thoracic irradiation. The following statistical methods were used: Kaplan-Meier method (evaluation of survival rates: overall survival — OS, and brain metastases-free survival — BMFS), log-rank test (for comparison of survival rates), Cox’ proportional hazard model (for multivariate analysis), Pearson chi2 test for independence (for categorized variables comparison) and variance analysis (for continuous variables comparison). All the calculations were performed using Statistica v. 13.3 software (TIBCO Software Inc.) and the significance level for all the statistical methods was p < 0.05. Results. Complete response in thorax was observed in 172 pts (63.5%) and remaining 99 pts (36.5%) developed partial response. During follow-up, 120 pts (44.3%) developed distant metastases from which brain metastases were most frequent (61 cases — 60.8%). The cumulative 5-year incidence of brain metastases amounted to 18.9% (when PCI was administered) and 45.9% (when PCI was omitted) and these differences were significant (p < 0.0001). PCI was an independent prognostic factor for BMFS and for OS. Omitted PCI is related with HR amounted: 6.25 for BMFS and 1.81 for OS. Conclusions. PCI significantly reduces the incidence of brain metastases and delays the development of brain metastases in patients treated for LD SCLC. PCI is a significant independent prognostic factor for brain metastases-free survival and overall survival. The development of brain metastases is the most common type of failure in patients with LD SCLC and 90% of such relapses occurred during the 24 months following the completion of chemo-radiotherapy.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"25 1","pages":"232-239"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73037762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
At the moment, there is no clear scientific data on the use of preoperative chemotherapy in patients with colorectal, synchronous, resectable liver metastases. Below arguments are presented against the use of preoperative chemotherapy in the above clinical situation, based on an analysis of three issues: the toxicity of preoperative chemotherapy and associated perioperative complications, the efficacy of pre- and postoperative chemotherapy, doubts related to the use of preoperative chemotherapy. To summarise, most scientific data is against preoperative chemotherapy as it causes significant adverse effects (hepatotoxicity and consequent postoperative complications) without a significant improvement in survival rates. Therefore, postoperative chemotherapy in this group of patients seems to be the more optimal treatment.
{"title":"Pre- or postoperative chemotherapy in patients with colorectal cancer with synchronous, resectable liver metastases?","authors":"R. Stec","doi":"10.5603/2018.0044","DOIUrl":"https://doi.org/10.5603/2018.0044","url":null,"abstract":"At the moment, there is no clear scientific data on the use of preoperative chemotherapy in patients with colorectal, synchronous, resectable liver metastases. Below arguments are presented against the use of preoperative chemotherapy in the above clinical situation, based on an analysis of three issues: the toxicity of preoperative chemotherapy and associated perioperative complications, the efficacy of pre- and postoperative chemotherapy, doubts related to the use of preoperative chemotherapy. To summarise, most scientific data is against preoperative chemotherapy as it causes significant adverse effects (hepatotoxicity and consequent postoperative complications) without a significant improvement in survival rates. Therefore, postoperative chemotherapy in this group of patients seems to be the more optimal treatment.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"39 1","pages":"277-281"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73586296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives. Retrospective analysis of 22 patients with high risk prostate cancer and clinical regional lymph node involvement treated with radical radiotherapy and ADT. Material and methods. The mean pre-treatment PSA level was 69 ng/ml. Median age — 65 years. Lymph nodes involvement was determined by radiological imaging. Duration of ADT was 2–3 years. All patients underwent conventional radiotherapy. Dose to the prostate ranged from 75.6 to 78 Gy, to elective lymph nodes — 44 to 50 Gy, boost dose to involved lymph nodes — 60 to 75,6 Gy. Median follow-up was 40 months. Results. The 3-year and prognosed 5-year bCR in studied group was 78% and 65%. The 3-years and 5-years prognosed OS was 88% and 73%. We observed 5 failures. No relapse in a nodal boost region was observed. No dose-effect relationship was observed for bCR nor OS. Only T stage proved prognostic for bCR. Conclusions. The results showed good outcome for node positive prostate cancer patients treated with radical intent. No dose-effect relationship suggest that metastatic pelvic lymph nodes may not require such dose escalation as primary tumor.
{"title":"The efficacy of radical radiotherapy for patients with primarily diagnosed prostate cancer with metastases to regional lymph nodes","authors":"T. Krzysztofiak, W. Majewski","doi":"10.5603/2018.0040","DOIUrl":"https://doi.org/10.5603/2018.0040","url":null,"abstract":"Objectives. Retrospective analysis of 22 patients with high risk prostate cancer and clinical regional lymph node involvement treated with radical radiotherapy and ADT. Material and methods. The mean pre-treatment PSA level was 69 ng/ml. Median age — 65 years. Lymph nodes involvement was determined by radiological imaging. Duration of ADT was 2–3 years. All patients underwent conventional radiotherapy. Dose to the prostate ranged from 75.6 to 78 Gy, to elective lymph nodes — 44 to 50 Gy, boost dose to involved lymph nodes — 60 to 75,6 Gy. Median follow-up was 40 months. Results. The 3-year and prognosed 5-year bCR in studied group was 78% and 65%. The 3-years and 5-years prognosed OS was 88% and 73%. We observed 5 failures. No relapse in a nodal boost region was observed. No dose-effect relationship was observed for bCR nor OS. Only T stage proved prognostic for bCR. Conclusions. The results showed good outcome for node positive prostate cancer patients treated with radical intent. No dose-effect relationship suggest that metastatic pelvic lymph nodes may not require such dose escalation as primary tumor.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"1 1","pages":"253-258"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90850325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Autologous stem cell transplantation (ASCT) is considered the standard of care in younger patients diagnosed with multiple myeloma (MM). However, despite an increase in the number of sustained responses, MM remains an incurable disease. Allogeneic stem cell transplantation (alloSCT) may have a curative potential resulting from induction of graft-versus-myeloma effect, but several factors limit its implementation in routine clinical practice. Myeloablative conditioning is associated with high (> 30%) treatment-related mortality (TRM), primarily due to graft-versus-host disease and infections, while the use of reduced-intensity conditioning increases the risk of relapse and disease progression, and also results in an unacceptably high TRM (21–23%). Auto/allotransplantation is not superior to tandem ASCT in terms of progression-free survival and overall survival, even in high-risk MM patients. The majority of younger patients may achieve sustained remissions after novel agents and ASCT, and nowadays alloSCT should be considered mainly in the context of clinical trials.
{"title":"“No” for the allogeneic stem cell transplantation in young patients diagnosed with multiple myeloma","authors":"A. Jurczyszyn, A. Suska","doi":"10.5603/NJO.2018.0033","DOIUrl":"https://doi.org/10.5603/NJO.2018.0033","url":null,"abstract":"Autologous stem cell transplantation (ASCT) is considered the standard of care in younger patients diagnosed with multiple myeloma (MM). However, despite an increase in the number of sustained responses, MM remains an incurable disease. Allogeneic stem cell transplantation (alloSCT) may have a curative potential resulting from induction of graft-versus-myeloma effect, but several factors limit its implementation in routine clinical practice. Myeloablative conditioning is associated with high (> 30%) treatment-related mortality (TRM), primarily due to graft-versus-host disease and infections, while the use of reduced-intensity conditioning increases the risk of relapse and disease progression, and also results in an unacceptably high TRM (21–23%). Auto/allotransplantation is not superior to tandem ASCT in terms of progression-free survival and overall survival, even in high-risk MM patients. The majority of younger patients may achieve sustained remissions after novel agents and ASCT, and nowadays alloSCT should be considered mainly in the context of clinical trials.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"46 1","pages":"205-211"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81632244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Sas-Korczyńska, Wojciech Kamzol, M. Kołodziej-Rzepa, J. Mituś, W. Wysocki
Introduction. Bilateral breast cancer (BBC) consists of 2–12% all cases of breast carcinoma. In relation to time between the first and second cancer diagnosis, the synchronous (s-BBC) or metachronous (m-BBC) bilateral breast cancer is defined. Material and methods. The clinicopathologic characteristics of 303 patients treated between 1963 and 2014 for bilateral breast cancer was presented. Synchronous BBC was diagnosed in 70 patients (23.1%) and remaining 233 patients (76.9%) developed metachronous BBC. Patients with m-BBC in comparison to s-BBC were younger (mean age: 51.4 vs 60.6 years), the positive family cancer history was rare (36.7% vs 48.5%), and more frequently these patients were before menopause (65.7% vs 44.3%). While the lobular type of breast cancer which consisted of 6.6% cases in first breast and 8.9% cases of second carcinomas, more frequently was presented in s-BBC (8.6%) in comparison to m-BBC (6%). Results. The mean time of follow up was 174 months. The 5- and 10-year overall survival rates were 89.3% and 76.1%, respectively. The presence of s-BBC connected with worse prognosis; the 5- and 10-year overall survival were 93.1% and 82% for m-BBC and 76.4% and 52.1% for s-BBC (p = 0.00244, log-rank test).
介绍。双侧乳腺癌(BBC)占所有乳腺癌病例的2-12%。根据第一次和第二次癌症诊断之间的时间，定义了同步(s-BBC)或异时(m-BBC)双侧乳腺癌。材料和方法。报告1963 - 2014年间303例双侧乳腺癌患者的临床病理特点。同步BBC 70例(23.1%)，异时BBC 233例(76.9%)。与s-BBC相比，m-BBC患者更年轻(平均年龄:51.4岁vs 60.6岁)，阳性家族史罕见(36.7% vs 48.5%)，绝经前患者更常见(65.7% vs 44.3%)。小叶型乳腺癌在第一乳房中占6.6%，在第二乳房中占8.9%，但s型bbc(8.6%)比m型bbc(6%)更常见。结果。平均随访时间为174个月。5年和10年总生存率分别为89.3%和76.1%。s-BBC的存在与预后较差有关;m-BBC的5年和10年总生存率分别为93.1%和82%，s-BBC的5年和10年总生存率分别为76.4%和52.1% (p = 0.00244, log-rank检验)。
{"title":"The characteristics of bilateral breast cancer patients","authors":"B. Sas-Korczyńska, Wojciech Kamzol, M. Kołodziej-Rzepa, J. Mituś, W. Wysocki","doi":"10.5603/2018.0035","DOIUrl":"https://doi.org/10.5603/2018.0035","url":null,"abstract":"Introduction. Bilateral breast cancer (BBC) consists of 2–12% all cases of breast carcinoma. In relation to time between the first and second cancer diagnosis, the synchronous (s-BBC) or metachronous (m-BBC) bilateral breast cancer is defined. Material and methods. The clinicopathologic characteristics of 303 patients treated between 1963 and 2014 for bilateral breast cancer was presented. Synchronous BBC was diagnosed in 70 patients (23.1%) and remaining 233 patients (76.9%) developed metachronous BBC. Patients with m-BBC in comparison to s-BBC were younger (mean age: 51.4 vs 60.6 years), the positive family cancer history was rare (36.7% vs 48.5%), and more frequently these patients were before menopause (65.7% vs 44.3%). While the lobular type of breast cancer which consisted of 6.6% cases in first breast and 8.9% cases of second carcinomas, more frequently was presented in s-BBC (8.6%) in comparison to m-BBC (6%). Results. The mean time of follow up was 174 months. The 5- and 10-year overall survival rates were 89.3% and 76.1%, respectively. The presence of s-BBC connected with worse prognosis; the 5- and 10-year overall survival were 93.1% and 82% for m-BBC and 76.4% and 52.1% for s-BBC (p = 0.00244, log-rank test).","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"1 1","pages":"221-226"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73205687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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