Concomitant chemoradiotherapy with docetaxel and cisplatin followed by consolidation chemotherapy in locally advanced unresectable non-small cell lung cancer

To evaluate treatment results and toxicities in patients who received concomitant chemoradiotherapy [CRT] followed by consolidation with docetaxel and cisplatin in locally advanced unresectable non-small cell lung cancer [NSCLC]. Ninety three patients were included in this retrospective study. The patients received 66 Gy radiotherapy and weekly 20 mg/m[2] docetaxel and 20 mg/m[2] cisplatin chemotherapy concomitantly. One month later than the end of CRT, consolidation chemotherapy with four cycles of docetaxel 75 mg/m[2] and cisplatin 75 mg/m[2] were administered at each 21 days. Median age of the patients was 57 [range, 30-74]. Following concomitant CRT, 14 patients [15%] showed complete and 50 patients [54%] showed partial response [total response rate was 69%]. The median follow-up was 13 months [range: 2-51 months]. The median overall survival was 18 months [95% confidential interval [Cl]: 13.8-22.1 months]; local control was 15 months [95% Cl: 9.3-20.6 months]; progression-free survival was 9 months [95% Cl: 6.5-11.4 months]. Esophagitis in eight [9%] patients, neutropenia in seven [8%] patients and pneumonitis in eight [9%] patients developed as grade III-IV toxicity due to concomitant CRT. Concomitant CRT with docetaxel and cisplatin followed by docetaxel and cisplatin consolidation chemotherapy might be considered as a feasible, and well tolerated treatment modality with high response rates despite the fact that it has not a survival advantage in patients with locally advanced unresectable NSCLC

Serum Chitotriosidase Activity in Pulmonary Tuberculosis: Response to Treatment and Correlations with Clinical Parameters

BACKGROUND: Chitotriosidase is an accepted marker of macrophage activation. In this study, we investigated serum chitotriosidase levels in pulmonary tuberculosis (PTB). METHODS: Forth-two patients with PTB and 30 healthy subjects were enrolled in the study. The radiological extent of PTB, radiological sequela after treatment, and the degree of smear positivity were assessed. Chitotriosidase levels were measured by a fluorometric method. RESULTS: The serum chitotriosidase levels of the PTB patients were significantly higher than those of the control subjects (39.73+/-24.97 vs. 9.63+/-4.55 nmol/mL/h, P<0.001). After completion of the standard 6-month antituberculous treatment, chitotriosidase levels in PTB patients significantly decreased (10.47+/-4.54 nmol/mL/h, P<0.001). Chitotriosidase levels correlated significantly with the radiological extent of PTB, degree of smear positivity, and post-treatment radiological sequela score (r=0.439, r=0.449, and r=0.337, respectively). CONCLUSIONS: This study demonstrated that serum chitotriosidase levels increase in PTB; therefore, chitotriosidase can be used as a marker of disease activity, severity, and response to treatment.

Clinicopathologic Characteristics and Therapeutic Outcomes of Primary Gastrointestinal Non-Hodgkin's Lymphomas in Central Anatolia, in Turkey

Primary gastrointestinal lymphoma is a common presentation of non-Hodgkin's lymphoma. The main controversy arises when many aspects of its classification and management are under discussion, particularly regarding roles for surgical resection. The aim of this study was to evaluate clinicopathologic characteristics and the therapeutic outcome of primary gastrointestinal non-Hodgkin's lymphoma. We carried out a retrospective analysis of 74 patients who were presented to our center with histopathological diagnosis of primary gastro-intestinal non-Hodgkin's lymphoma between 1990 and 2001. All patients have been staged according to Lugano Staging System. For histopathological classification, International Working Formulation was applied. The treatment choice concerning the surgical or non-surgical management was decided by the initially acting physician. Treatment modalities were compared using the parameters of age, sex, histopathological results, stage, and the site of disease. Of the 74 patients, 31 were female and 43 were male, with a median age of 49 years (range 15-80). The stomach was the most common primary site and was seen in 51 of 74 patients (68.9%). The intermediate and high grade lymphomas constituted 91.9% of the all cases. In a median follow-up of 29 months (range 2-128), 20 out of 74 patients died. There was a three year overall survival rate in 65.4% of all patients. The three year overall survival rate was better in stage I and II1 patients who were treated with surgery plus chemotherapy (+/-RT) than those treated with chemotherapy alone (93.7% vs. 55.6%, p<0.05). The stage and presence of B symptoms affected the disease free survival and overall survival significantly, but the histopathologic grade only affected the overall survival. On the basis of these results, we suggest that surgical resection is necessary before chemotherapy in early stage (stage I and II1) patients with gastrointestinal non-Hodgkin's lymphomas because of the significant survival advantage it would bring to the patient.