retrospective comparison of concurrent bolus 5-fluorouracil or raltitrexed in preoperative chemoradiation for locally advanced rectal cancer

5-fluorouracil [FU] is commonly used in preoperative chemoradiation in locally advanced rectal cancer, but not all patients cooperate in taking the 5-day continuous infusion regimen. Raltitrexed [RA], a thymidylate synthase inhibitor, is one of the agents used in place of FU in such cases. We retrospectively compared the toxicity, tumor downstaging, pathologic response and relapse rate with bolus FU or RA during concurrent radiotherapy [RT] to assess the role of RA in place of FU. We conducted a retrospective analysis of response rates and toxicity data on 59 patients diagnosed with locally advanced rectal cancer and treated with surgery following preoperative chemoradiation with either concurrent FU or RA between January 1999 and December 2004. Median follow-up was 38 months [range, 1-70]. Ten patients [10%] had grade 3 gastrointestinal [GIS] toxicity during chemoradiation. The pathologic complete response rates were 6% with FU and 7% with RA [P=0.844], while 66.7% of patients treated with FU and 37.1% with RA had downstaging of the T stage after chemoradiation [P=0.026]. The sphincter preservation rates were 45.8% with FU and 51.4% with RA [P=0.912]. The 5-year local control rates were 79.2% for patients treated with RT+FU and 85.76% for patients treated with RT+RA [P=0.510]. Compared with the RT+RA regimen, the incidence of downstaging was greater with RT+FU but RT+FU was associated with a correspondingly greater rate of acute grade 2 GIS toxicity. However, no significant differences were seen in sphincter preservation, pathologic complete response, local control and distant recurrences rates among patients. FU seems to be the best therapeutic choice, while RA seems to be as effective as bolus FU

retrospective study of treatment and outcome in 39 cases of male breast cancer

Optimal management if male breast cancer [MBC] is not clearly established and treatment guidelines are scarce. We evaluated our own results in the treatment of male breast cancer patients with respect to local control [LC], overall survival [OS] and possible prognostic factors for survival. Thirty-nine patients with MBC were retrospectively studied to evaluate the results in this type of tumor; 94.8% had invasive ductal carcinoma [IDC], 2.6% invasive papillary carcinoma [IDC] and 2.6% invasive lobuler carcinoma [ILC]. The distribution according to stage was 12.8%, 46.2%, 30.7% and 10.3% in Stages I, II, III and IV, respectively; 7.7% underwent radiotherapy [RT] +/- hormonotherapy [HT], 22.8% had chemotherapy [CT], 61.8% had chemoradiotherapy [CRT] +/- HT and 7.7% had HT in addition to surgery. The distant metastases rate was 36% and the local recurrence rate was 5%. All the local recurrences and the distant metastases had occurred after the first two years. The 2-year disease free survival [DFS] and OS rates were 87.2% and 89.7%, respectively, and the 5-year DFS and OS rates were 65.8% and 80.1%, respectively. In a univariate analysis for OS, statistical significance was found for lymph node metastases [P=.00001], stage [P=.0098] and age [P=.03], while presence of RT in the treatment modality [P=.6849], and tumor size [P=.4439] demonstrated no significance. The presence of lymph node metastases significantly impaired OS [P=.004] and DPS [P=.014] in the multivariate analysis. Postoperative radiotherapy was important in the management of MBC to improve LC resulting in one local failure, but did not improve OS and DFS. The presence of lymph node metastases significantly impaired OS and DFS