ABSTRACT
Purpose. To evaluate the risk factors associated with lung cancer (LC) and other second neoplasms (SN) in Hodgkin lymphoma (HL) survivors. Methods. We retrospectively analyzed the clinical characteristics and outcomes of 604 patients treated in our institution between 1968 and 2012. Results. 90 out of 604 patients developed SN: 27 LC and 63 other SN. The median time elapsed until LC and other SN was 16.5 and 11.8 years, respectively (p = 0.003). In the LC group, 85.5 % of patients were male and 84.6 % smokers (HR 7, 95 % CI 2.4-20.7, p < 0.001). Radiotherapy (RT) doses applied were higher in the SN group with an increased risk of LC (HR: 4.0 95 % CI 1.1-11.6, p = 0.010) and other SN (HR: 3.3 95 % CI 1.6-6.7 p = 0.001) with doses higher than 42 Gy. No association was found between alkylating agents and development of SN. In LC, the most frequent histology was adenocarcinoma with an elapsed time after HL of 13.2 years in early stages and 21.3 in advanced (p = 0.02). Median OS after a diagnosis of LC was 12.6 months ranging from 5.9 (in cases presenting due to symptoms) to 49.1 (incidentally diagnosed cases) (p = 0.005). Conclusions. RT treatment, especially with doses higher than 42 Gy, and smoking increase the risk of SN after HL. In this series, LC patients with early stages had a shorter elapsed time from HL diagnosis and longer OS, therefore the role of LC screening in HL survivors should be prospectively evaluated and smoking cessation counseling ought to be a key aspect during follow-up (AU)
No disponible
Subject(s)
Humans , Male , Female , Lung Neoplasms/metabolism , Lung Neoplasms/pathology , Therapeutics/methods , Hodgkin Disease/diagnosis , Hodgkin Disease/metabolism , Smoking/genetics , Adenocarcinoma/diagnosis , Adenocarcinoma/metabolism , Lung Neoplasms/drug therapy , Lung Neoplasms/therapy , Therapeutics/instrumentation , Hodgkin Disease/complications , Hodgkin Disease/pathology , Smoking/metabolism , Adenocarcinoma/complications , Adenocarcinoma/pathology , Retrospective StudiesABSTRACT
PURPOSE: To evaluate the risk factors associated with lung cancer (LC) and other second neoplasms (SN) in Hodgkin lymphoma (HL) survivors. METHODS: We retrospectively analyzed the clinical characteristics and outcomes of 604 patients treated in our institution between 1968 and 2012. RESULTS: 90 out of 604 patients developed SN: 27 LC and 63 other SN. The median time elapsed until LC and other SN was 16.5 and 11.8 years, respectively (p = 0.003). In the LC group, 85.5 % of patients were male and 84.6 % smokers (HR 7, 95 % CI 2.4-20.7, p < 0.001). Radiotherapy (RT) doses applied were higher in the SN group with an increased risk of LC (HR: 4.0 95 % CI 1.1-11.6, p = 0.010) and other SN (HR: 3.3 95 % CI 1.6-6.7 p = 0.001) with doses higher than 42 Gy. No association was found between alkylating agents and development of SN. In LC, the most frequent histology was adenocarcinoma with an elapsed time after HL of 13.2 years in early stages and 21.3 in advanced (p = 0.02). Median OS after a diagnosis of LC was 12.6 months ranging from 5.9 (in cases presenting due to symptoms) to 49.1 (incidentally diagnosed cases) (p = 0.005). CONCLUSIONS: RT treatment, especially with doses higher than 42 Gy, and smoking increase the risk of SN after HL. In this series, LC patients with early stages had a shorter elapsed time from HL diagnosis and longer OS, therefore the role of LC screening in HL survivors should be prospectively evaluated and smoking cessation counseling ought to be a key aspect during follow-up.
Subject(s)
Hodgkin Disease/epidemiology , Hodgkin Disease/therapy , Lung Neoplasms/epidemiology , Neoplasms, Radiation-Induced/epidemiology , Neoplasms, Second Primary/epidemiology , Adolescent , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Bleomycin/adverse effects , Dacarbazine/adverse effects , Doxorubicin/adverse effects , Hodgkin Disease/radiotherapy , Humans , Lung Neoplasms/etiology , Lung Neoplasms/pathology , Male , Mechlorethamine/adverse effects , Middle Aged , Neoplasms, Radiation-Induced/pathology , Neoplasms, Second Primary/pathology , Prednisone/adverse effects , Procarbazine/adverse effects , Radiotherapy Dosage , Retrospective Studies , Risk Factors , Vinblastine/adverse effects , Vincristine/adverse effects , Young AdultABSTRACT
We aimed to describe the incidence of neutropenia in breast cancer and lymphoma patients and granulocyte colony-stimulating factors (G-CSF) use in clinical practice. We conducted a multicentre, prospective, observational study including breast cancer and lymphoma patients initiating chemotherapy (≥ 10% febrile neutropenia risk). We included 734 patients with breast cancer and 291 with lymphoma. Over the first four chemotherapy cycles, patients had an incidence of 11.0% grade 3-4 neutropenia (absolute neutrophil count <1.0 × 10(9) /L) and 4.3% febrile neutropenia (absolute neutrophil count <0.5 × 10(9) /L and fever ≥ 38 °C) in the breast cancer cohort, and 40.5% and 14.8% in the lymphoma cohort. Full dose on schedule (>85% of planned chemotherapy dose and ≤ 3 days delay) was achieved by 85.6% of breast cancer and 68.9% of lymphoma patients. Hospitalisation due to febrile neutropenia was required in 2.0% and 12.0% of breast cancer and lymphoma patients respectively. G-CSF was administered to 70.0% of breast cancer and 83.8% of lymphoma patients, and initiated from the first chemotherapy cycle (primary prophylaxis) in 60.6% and 64.2% of cases. Severe neutropenia affects approximately one in 10 breast cancer patients and one in two lymphoma patients receiving chemotherapy with moderate or greater risk of febrile neutropenia. Most patients received treatment with G-CSF in Spanish clinical practice.
Subject(s)
Antineoplastic Agents/adverse effects , Breast Neoplasms/drug therapy , Granulocyte Colony-Stimulating Factor/administration & dosage , Lymphoma/drug therapy , Neutropenia/epidemiology , Adult , Aged , Aged, 80 and over , Breast Neoplasms/complications , Female , Hospitalization/statistics & numerical data , Humans , Incidence , Lymphoma/complications , Male , Middle Aged , Neutropenia/chemically induced , Neutropenia/prevention & control , Prospective Studies , Spain/epidemiology , Young AdultABSTRACT
Lung cancer is the most common cancer in the world. 15 % of all patients with lung cancer are diagnosed at an early stage, and surgery is the treatment of choice for them. 40 % of all patients survive more than 5 years after surgery, and most of them die as a result of systemic disease. Half of all recurrences are diagnosed within the first 24 months after curative treatment, and 90 % in the first 5 years. Despite this, it is not standardized who should do the monitoring, what additional tests are needed and how often should they be performed. We present here a review on the various recommendations in clinical guidelines (AU)
Subject(s)
Humans , Male , Female , Lung Neoplasms/metabolism , Lung Neoplasms/mortality , Lung Neoplasms/diagnosis , Lung Neoplasms/surgeryABSTRACT
Lung cancer is the most common cancer in the world. 15 % of all patients with lung cancer are diagnosed at an early stage, and surgery is the treatment of choice for them. 40 % of all patients survive more than 5 years after surgery, and most of them die as a result of systemic disease. Half of all recurrences are diagnosed within the first 24 months after curative treatment, and 90 % in the first 5 years. Despite this, it is not standardized who should do the monitoring, what additional tests are needed and how often should they be performed. We present here a review on the various recommendations in clinical guidelines.
Subject(s)
Carcinoma, Non-Small-Cell Lung/surgery , Lung Neoplasms/surgery , Monitoring, Physiologic/methods , Carcinoma, Non-Small-Cell Lung/diagnosis , Diagnostic Techniques and Procedures/statistics & numerical data , Humans , Lung Neoplasms/diagnosis , Medical Oncology/methods , Practice Guidelines as TopicABSTRACT
Positron emission tomography with 2-((18)F)-fluoro- 2-deoxy-D-glucose (FDG-PET) is a metabolic imaging technique. FDG-PET is more accurate than CT for the evaluation of mediastinal involvement in patients with nonsmall- cell lung cancer, offering a high negative predictive value. It can detect occult metastases in 11% of patients, although the etiology of the extrathoracic isolated uptakes needs confirmation. Theoretically, FDG-PET can influence the planning volume for radiotherapy, primarily in patients with atelectasis. Quantification of metabolic activity using FDG-PET is influenced by the size of the lesion, glucose levels and the time elapsed since the isotope injection. More clinical trials are required to standardize the methods for performing PET, assess its use as a prognostic factor and for the evaluation of treatment response (AU)
Subject(s)
Humans , Male , Female , Carcinoma, Non-Small-Cell Lung/pathology , Clinical Trials as Topic/methods , Fluorodeoxyglucose F18 , Lung Neoplasms/pathology , Tomography, X-Ray Computed/methods , Positron-Emission Tomography/methods , Radiopharmaceuticals , Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Lymphatic Metastasis , Neoplasm Staging/methods , Neoplasm StagingABSTRACT
Central nervous system involvement in Hodgkin's lymphoma is extremely rare. We report three cases who had a relapse from the disease involving CNS. The most frequent causes are skull contiguity, meningeal invasion and via the hematogenous route. It is frequent that the association between Epstein-Barr Virus and Hodgkin's lymphoma, and a biopsy for confirmation, is always required. Diagnostic imaging tests like CT and MRI are useful. The standard treatment remains holocraneal radiotherapy combined with chemotherapy.
Subject(s)
Central Nervous System Neoplasms/complications , Central Nervous System Neoplasms/diagnosis , Hodgkin Disease/complications , Hodgkin Disease/diagnosis , Adult , Aged , Female , Humans , Male , Young AdultABSTRACT
Nodular lymphocyte-predominant Hodgkin's lymphoma (NLPHL) accounts for approximately 5% of Hodgkin's lymphoma, presents with early-stage disease and has an indolent course. Treatment is not well established. We present a patient diagnosed with NLPHL and treated with Rituximab second-line therapy after chemotherapy (AU)
Subject(s)
Humans , Female , Aged , Antibodies, Monoclonal/therapeutic use , Hodgkin Disease/drug therapy , Hodgkin Disease/immunology , Lymphocyte Activation , Lymphocyte Activation/immunology , Antibodies, Monoclonal, Murine-Derived , Antineoplastic Agents/therapeutic use , Chemotherapy, Adjuvant/methods , Chemotherapy, Adjuvant , Hodgkin Disease/classification , RecurrenceABSTRACT
The results of the recently performed randomised trials support the conclusion that adjuvant chemotherapy confers survival advantage in early stage in non-small cell lung cancer, and now has become the standard of care for patients with resected stage II and IIIA. The role of adjuvant chemotherapy for stage I disease remains controversial. Only some patients benefit from systemic adjuvant therapy and we need to identify factors of patients most likely to respond to chemotherapy. The purpose of this article is to provide a general overview of adjuvant chemotherapy for early stage in non-small cell lung cancer.
Subject(s)
Carcinoma, Non-Small-Cell Lung/drug therapy , Carcinoma, Non-Small-Cell Lung/surgery , Lung Neoplasms/drug therapy , Lung Neoplasms/surgery , Carcinoma, Non-Small-Cell Lung/pathology , Chemotherapy, Adjuvant , Humans , Lung Neoplasms/pathology , Neoplasm StagingABSTRACT
Hodgkin's disease (HD) is an example of a curable disease. In addition, it can serve as a lesson about other pathologies because of the delayed side effects it produces and the appearance of associated processes that may simulate disease progression. Here we provide a case report of a patient who encapsulates a compendium of situations that may occur in HD.
Subject(s)
Hodgkin Disease/complications , Hodgkin Disease/physiopathology , Neoplasm Recurrence, Local/physiopathology , Opportunistic Infections/complications , Adult , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Cryptococcosis/complications , Cryptococcus neoformans , Diagnosis, Differential , Hodgkin Disease/therapy , Humans , Male , Neoplasm Recurrence, Local/therapy , Opportunistic Infections/physiopathology , Pneumococcal Infections/complications , Primary Myelofibrosis/chemically induced , Streptococcus pneumoniaeABSTRACT
Hodgkin's disease (HD) is an example of a curable disease. In addition, it can serve as a lesson about other pathologies because of the delayed side effects it produces and the appearance of associated processes that may simulate disease progression. Here we provide a case report of a patient who encapsulates a compendium of situations that may occur in HD (AU)
No disponible
Subject(s)
Humans , Male , Adult , Hodgkin Disease/complications , Hodgkin Disease/diagnosis , Hodgkin Disease/physiopathology , Neoplasm Recurrence, Local/physiopathology , Neoplasm Recurrence, Local/therapy , Opportunistic Infections/complications , Opportunistic Infections/physiopathology , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Cryptococcosis/complications , Cryptococcosis/diagnosis , Cryptococcus neoformans/isolation & purification , Diagnosis, Differential , Hodgkin Disease/therapy , Streptococcus pneumoniae/isolation & purification , Pneumococcal Infections/complications , Pneumococcal Infections/diagnosis , Primary Myelofibrosis/chemically inducedABSTRACT
Los resultados de los recientes estudios demuestran el beneficio de la quimioterapia adyuvante en la supervivencia de los pacientes con estadios iniciales de cáncer de pulmón no microcítico, por lo que en la actualidad se considera como tratamiento estándar en los estadios II y IIIA. El papel de la quimioterapia adyuvante en el estadio I es controvertido. Sólo algunos pacientes se benefician del tratamiento con quimioterapia adyuvante, por lo que es preciso la identificación de factores que nos indiquen la probabilidad de respuesta. El objetivo de este artículo es proporcionar una visión general del papel de la quimioterapia adyuvante en los estadios iniciales del cáncer de pulmón no microcítico
The results of the recently performed randomised trials support the conclusion that adjuvant chemotherapy confers survival advantage in early stage in non-small cell lung cancer, and now has become the standard of care for patients with resected stage II and IIIA. The role of adjuvant chemotherapy for stage I disease remains controversial. Only some patients benefit from systemic adjuvant therapy and we need to identify factors of patients most likely to respond to chemotherapy. The purpose of this article is to provide a general overview of adjuvant chemotherapy for early stage in non-small cell lung cancer (AU)
Subject(s)
Humans , Carcinoma, Non-Small-Cell Lung/drug therapy , Lung Neoplasms/drug therapy , Chemotherapy, Adjuvant/standards , Carcinoma, Non-Small-Cell Lung/pathology , Lung Neoplasms/pathology , Neoplasm Staging , Patient SelectionABSTRACT
BACKGROUND AND PURPOSE: Ototoxicity is a known adverse effect of cisplatin (CDDP). Since apoptosis is involved in the development of some pathological conditions associated with the administration of anticancer drugs, we examined, using immunohistochemical and electrophysiological techniques, the apoptotic changes in the cochlea of Sprague-Dawley (SD) rats after an injection of CDDP (5 mgkg(-1) body weight). EXPERIMENTAL APPROACH: Luciferase assays were used to determine the different caspase activities and ATP levels in protein extracts of whole cochleae. The expression of several apoptotic-related proteins was measured by means of Western blotting. These analyses were performed 2, 7 and 30 days after the CDDP injection. The auditory brain stem response was obtained before and at the different times after the injection of CDDP, before the animals were killed. KEY RESULTS: CDDP significantly increased the levels of caspase-3/7 activity and active caspase-3 protein expression and caspase-3 immunofluorescence staining, caspase-9 activity, and Bax protein expression but decreased Bcl-2 protein expression within the rat cochleae. Threshold shifts were significantly elevated 2 days after CDDP treatment. CONCLUSIONS AND IMPLICATIONS: These findings support the hypothesis that cisplatin-related apoptosis evokes an intrinsic pathway of pro-apoptotic signalling within the rat cochleae. Thus, selective inhibition of the sequence of events involved in the intrinsic apoptotic pathway could provide a strategy to minimize cisplatin-induced ototoxicity.
Subject(s)
Antineoplastic Agents/toxicity , Apoptosis/drug effects , Cisplatin/toxicity , Cochlea/drug effects , Animals , Antineoplastic Agents/administration & dosage , Apoptosis/immunology , Caspase 3/biosynthesis , Caspase 3/drug effects , Caspase 3/immunology , Cisplatin/administration & dosage , Cochlea/immunology , Cochlea/pathology , Electrophysiology , Enzyme Activation/drug effects , Evoked Potentials, Auditory, Brain Stem/drug effects , Female , Immunohistochemistry , Injections, Intraperitoneal , Rats , Rats, Sprague-Dawley , Superoxide Dismutase/drug effects , Superoxide Dismutase/immunologyABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Hemoperitoneum/etiology , Stromal Cells/pathology , Intestine, Small/pathology , Intestinal Neoplasms/complications , Intestinal Neoplasms/surgery , Intestinal Neoplasms/drug therapy , Fatal OutcomeABSTRACT
TAp73 variants largely mimic p53 suppressor activities, while DeltaTAp73 forms act as oncogenes through the inactivation of p53 and TAp73. The present study analysed how TAp73 and DeltaTAp73 levels might be affected by the presence of a 73 bp deletion in a regulatory region of p73. The clinical relevance of this deletion was also examined. ZEB1 can bind to the region repressing p73 transcription in vitro. The relationship between ZEB1 and p73 variant expression levels was studied in the context of this deletion and the levels of the ZEB1 cofactors p300 and CtBP. Tumour and normal tissue from 81 colorectal cancer patients was analysed to evaluate firstly the levels of TAp73, DeltaTAp73 (DeltaEx2p73, DeltaEx2/3p73, and DeltaNp73), ZEB1, p300, and CtBP by quantitative real-time RT-PCR, and secondly the presence of the 73 bp deletion. Tumour characteristics were examined in each patient. Suppressor and oncogenic isoforms of p73 were co-up-regulated in tumour tissues. Overexpression of p73 variants was associated with adverse tumour features. The 73 bp deletion was present in 40% of the patients and was associated with adverse pathological parameters of the tumours and also with TAp73 down-regulation. In those cases harbouring the deletion, the levels of ZEB1 and those of DeltaEx2p73, DeltaEx2/3p73, and DeltaNp73 correlated directly. Variations in the concentration of p300 affected the observed correlations between ZEB1 and the different p73 variants. In conclusion, in colorectal cancer, the 73 bp deletion in the first intron of the p73 gene and different expression levels of ZEB1 and p300 may act in concert to affect the ratio of TAp73/DeltaTAp73 forms, favouring p73 oncogenic variants. In addition, up-regulation of p73 oncogenic isoforms predicts a poor prognosis based on its relationship with advanced tumour stage.
Subject(s)
Colorectal Neoplasms/genetics , DNA-Binding Proteins/genetics , Gene Deletion , Homeodomain Proteins/genetics , Nuclear Proteins/genetics , Transcription Factors/genetics , Tumor Suppressor Proteins/genetics , Zebrafish Proteins/genetics , Aged , Alcohol Oxidoreductases/genetics , Colorectal Neoplasms/pathology , E1A-Associated p300 Protein/genetics , Female , Gene Expression Regulation, Neoplastic/genetics , Humans , Inteins/genetics , Male , Neoplasm Proteins/genetics , Protein Isoforms/genetics , RNA, Messenger/analysis , RNA, Neoplasm/analysis , Tumor Protein p73 , Zinc Finger E-box-Binding Homeobox 1ABSTRACT
BACKGROUND: Cancer antigen (CA) 125 tumor-associated antigen is a high molecular glycoprotein used for follow-up of epithelial ovarian cancer. The test is often requested as a differential diagnosis in patients with pleural or peritoneal fluid. This study analyzes the prevalence of CA-125 increases in a population of patients attending a general hospital and discusses the possible clinical implications of increased levels. METHODS: On 4 different days, 380 CA-125 assays were performed in randomly selected patients attending our hospital. Serum CA-125 was measured with a commercial enzyme immunoassay, and clinical records were reviewed for assessment of clinical parameters. RESULTS: Sixty-one patients (16%) had increased CA-125. The pathologies of these patients were heart failure in 9 (14.7%), lung disease 11 (18%), hepatic cirrhosis in 7 (11.4%), malignant tumors in 9 (14.7%), intra-abdominal nonhepatic disease in 6 (10%), previous surgery in 17 (27.8%), and miscellaneous in 2 (3%). Effusions were seen in 34 patients (55.7%). CONCLUSIONS: Our data confirm the variety of benign and malignant pathologies coursing with increased CA-125. Cardiovascular and chronic liver disease were the most frequent diagnoses in patients with increased CA-125; this supports the opinion that CA-125 lacks utility as a marker for malignancy. CA-125 could have a role in the follow-up of cardiovascular, hepatic, and tumoral diseases with serosal involvement.
