Efficacy and safety of local lysozyme treatment in patients with oral mucositis after chemotherapy and radiotherapy.

This observational clinical study was composed of two substudies: a non-comparative one (n = 166), testing only lysozyme-based compounds (LBCs), and a comparative substudy (n = 275), testing both LBCs and bicarbonate-based local compounds (BBCs) on the healing of oral mucositis during radio- or chemotherapy. The density of ulcerations has decreased significantly after the treatment with lysozyme in both substudies. The density of ulcerations in the radiotherapy group was lower in patients treated with LBCs compared to patients treated with BBCs (p < 0.001). In the chemotherapy group, reduction of ulceration density was similar with both LBCs and BBCs. The LBCs reduced pain intensity during the intake of solid food and speech more than BBCs in both patient cohorts (p < 0.05). In the radiotherapy cohort, pain intensity when consuming liquid foods was reduced more with LBCs than with BBCs (p < 0.05). No adverse events were recorded. This study demonstrates the advantages of treating oral mucositis during radiotherapy or chemo-therapy with LBCs.

MAGNETIC RESONANCE IMAGING TO EVALUATE NEOADJUVANT THERAPY EFFECTS ON RECTAL CARCINOMA.

Although total mesorectal excision reduces the local recurrence rate in comparison to other surgical approaches, the occurrence of local relapse is still common, especially in cases when there is malignant infiltration of the circumferential resection margin. Mesorectal fascia is an important prognostic and diagnostic factor and it may be argued that mesorectal fascia represents the circumferential resection margin if total mesorectal excision is used as a surgical approach. Tumor infiltration of mesorectal fascia warrants preoperative neoadjuvant therapy in order to reduce the risk of tumor relapse. The aim of this study was to show the importance of high-resolution phased-array magnetic resonance imaging (MRI) as a modality of choice in preoperative evaluation of the effects of neoadjuvant therapy on locally advanced rectal carcinoma. This prospective comparative study included 51 patients with locally advanced rectal carcinoma that infiltrated mesorectal fascia. All study patients underwent MRI scanning twice, i.e. before and after neoadjuvant chemoradiotherapy. MRI results before and after neoadjuvant chemoradiotherapy were compared to evaluate regression of tumor length and regression of tumor infiltration of mesorectal fascia. Gender distribution of 51 patients with rectal carcinoma subjected to neoadjuvant therapy was equal, and their average age was 51 (32-81) years. MRI results showed tumor regression from mesorectal fascia following chemoradiotherapy in 36 (70.5%) cases, and Wilcoxon test showed significant differences between pretherapeutic and post-treatment MRI findings (Z=-3.162, p=0.002) in the sense of regression of tumor infiltration of mesorectal fascia. In 41 (80.3%) cases there was a reduction of tumor length, where Wilcoxon test showed differences between pretherapeutic and post-treatment MRI findings (Z=-2.754, p=0.006) in the sense of tumor length reduction. The mean pretherapeutic tumor length was 5.4 (2.3-15) cm. The mean reduction of tumor length following chemoradiotherapy was 3.56 (0.3-4.1) cm. In all 36 patients that had tumor-free mesorectal fascia following surgical treatment, the post-treatment MRI results were confirmed by histopathology. In conclusion, MRI is important for evaluation of tumor infiltration of mesorectal fascia, and is useful on patient selection for appropriate treatment for rectal carcinoma. MRI reliably evaluates the effects of neoadjuvant therapy, which contributes to better outcome of treatment for this disease.

Extracapular extension predictors of prostate carcinoma for 2-10 ngr/ml PSA values.

UNLABELLED: Purpose of the research is to establish which clinical and biopsy parameters could predict extra-capsular spread of prostate carcinoma for 2-10 ng/ml PSA values, in patients submitted to radical retropubic prostatectomy. METHODOLOGY: In the period of 30 months, 80 patients were treated with radical retro-pubic prostatectomy with bilateral pelvic lymphadenectomy, for whom clinical, biopsy, radiological and biochemical analysis were positive to organ limited tumor. Serum PSA, fpsa/tpsa, PSAD,values are evaluated, and other parameters as number of positive biopsies, percentage of positive biopsies, localization of positive biopsies, and perineural invasion and biopsy Gleason score. RESULTS: from total number of 80 patients with 2-10 ng/ml PSA, 7 (9%) patients had extra-capsular spread of prostate carcinoma. Upon using multivariate regression analysis, following parameters were proved as significant predictors of extra-capsular spread: biopsy Gleason score, number of positive biopsy samples and invasion, while serum PSA, FPSA/TPSA ratio, PSAD, prostate age and volume have not shown as significant predictors for extra-capsular extension. CONCLUSION: Biopsy GS, perineural invasion and number of biopsy samples are statistically significant predictors of extra-capsular spread of prostate carcinoma for 2-10 ml PSA. Percentage of positive biopsies, tumor length in a sample and the localization of positive biopsies are on the borderline of statistical significance and as such should be taken into consideration.