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1.
Eur J Surg Oncol ; 40(12): 1641-7, 2014 Dec.
Article in English | MEDLINE | ID: mdl-25282099

ABSTRACT

BACKGROUND: The primary treatment of soft tissue sarcomas (STS) is a radical resection of the tumor with adjuvant radiotherapy. Conventional fractionation of preoperative radiotherapy is 50 Gy in fraction of 2 Gy a day. The purpose of the conducted study was to assess the efficacy and safety of hypofractionated radiotherapy in preoperative setting in STS patients. METHODS: 272 patients participated in this prospective study conducted from 2006 till 2011. Tumors were localized on the extremities or trunk wall. Median tumor size was 8.5 cm, 42% of the patients had tumor larger than 10 cm, whereas 170 patients (64.6%) had high grade (G3) tumors. 167 patients (61.4%) had primary tumors. Patients were treated with preoperative radiotherapy for five consecutive days in 5 Gy per fraction, with an immediate surgery. Median follow up is 35 months. RESULTS: 79 patients died at the time of the analysis, the 3-year overall survival was 72%. Local recurrences were observed in 19.1 % of the patients. Factors that had a significant adverse impact on local recurrence were tumor size of 10 cm or more and G3 grade. 114 patients (42%) had any kind of treatment toxicity, vast majority with tumors located on lower limbs. 7% (21) of the patients required surgery for treatment of the complications. CONCLUSION: In this non-selected group of locally advanced STS use of hypofractionated preoperative radiotherapy was associated with similar local control (81%) when compared to previously published studies. The early toxicity is tolerable, with small rate of late complications. Presented results warrant further evaluation.


Subject(s)
Neoadjuvant Therapy/methods , Sarcoma/radiotherapy , Sarcoma/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Disease-Free Survival , Dose Fractionation, Radiation , Female , Humans , Kaplan-Meier Estimate , Limb Salvage , Male , Middle Aged , Neoplasm Grading , Poland , Prospective Studies , Radiotherapy, Adjuvant , Sarcoma/mortality , Sarcoma/pathology , Treatment Outcome , Young Adult
3.
Otolaryngol Pol ; 54 Suppl 31: 21-3, 2000.
Article in Polish | MEDLINE | ID: mdl-10974834

ABSTRACT

In the Head and Neck Cancer Department of Cancer Centre in Warsaw between 1994 and 1998 fifty three patients with recurrent or metastatic laryngeal cancer were treated with methotrexate-based chemotherapy. Chemotherapy protocol consist of methotrexate, vinblastine, 5-fluorouracil, bleomycin, cyclophosphamide and steroids used every two weeks. Before treatment, unresectable local recurrence was observed in 35 patient and distant secondaries in 18 others. Tolerance of treatment was acceptable. Partial regression of the tumor was obtained in 30% of patients. Improvement of the quality of life was observed in 66%. Presented program is an effective alternative to supportive treatment in patients with recurrent or metastatic laryngeal cancer.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma/drug therapy , Carcinoma/secondary , Laryngeal Neoplasms/drug therapy , Laryngeal Neoplasms/pathology , Neoplasm Recurrence, Local/drug therapy , Adult , Aged , Female , Humans , Male , Middle Aged , Time Factors , Treatment Outcome
4.
Otolaryngol Pol ; 54 Suppl 31: 31-2, 2000.
Article in Polish | MEDLINE | ID: mdl-10974837

ABSTRACT

The aim of the study is to analyse the effect of anti-inflammatory treatment in patients treated with chemotherapy for advanced head and neck cancer. 110 patients treated in the Head and Neck Department in CO in Warsaw were entered to study. Pain, dyspnoea, inflammatory reaction foetor ex ore, fever were assessed. Clinical response was positive in 67% of patients, microbiological improvement was positive in 44% and subjective response in 68% of patients.


Subject(s)
Anti-Inflammatory Agents/therapeutic use , Head and Neck Neoplasms/drug therapy , Opportunistic Infections/drug therapy , Staphylococcal Infections/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Head and Neck Neoplasms/complications , Humans , Mouth/microbiology , Opportunistic Infections/complications , Staphylococcal Infections/complications
5.
Med Oncol ; 13(4): 199-205, 1996 Dec.
Article in English | MEDLINE | ID: mdl-9152970

ABSTRACT

The aim of this study was to evaluate tolerability and efficacy of Leucomax (Sandoz/Schering Plough) used for neutropenia in patients with small cell lung cancer (SCLC) treated with etoposide and cisplatin. The potential influence of granulocyte-macrophage colony stimulating factor (GM-CSF) on chemotherapy relative dose intensity (RDI) was also evaluated. The chemotherapy used was the following, cisplatin 50 mg m-2 i.v. 1 and 7 day, etoposide 170 mg m-2 i.v. 3-5 days, q 3-4 weeks. Patients received a median of six cycles (range 2-8) over 4-36 weeks (median: 20). Thirty-two consecutive patients were treated, six were excluded. Eleven patients received GM-CSF 5 micrograms kg-1 s.c. due to absolute neutrophil count (ANC), 1000/mm3 until recovery (ANC > 2000 mm3) or during 7 days, and thereafter prophylactically 24 hours post subsequent chemotherapy cycles for 7 days. Four patients received single GM-CSF course during the terminal disease phase. In 11 patients, there was no neutropenia requiring GM-CSF during the whole treatment course. Toxicity of chemotherapy was high, including thrombocytopenia, neutropenia, anaemia, mucositis, fever and hypotension. GM-CSF toxicity was the following, first dose reaction-one patient, local erythema-two patients, arthralgia-one patient, hypotension, chills, fever requiring GM-CSF discontinuation one patient RDI of cisplatin/etoposide was 0.77/0.62 in GM-CSF group, and 0.90/ 0.80 in patients who didn't receive Leucomax. Overall objective response rate to chemotherapy and complete response rate were 80% (21/26), 26% (7/26) and median survival of all patients was 10 months. Median disease free survival was 8 months. Four patients are alive, two patients lost during progression, 20 died. Administration of GM-CSF did not appear to improve RDI of chemotherapy, overall response rate (RR) nor survival in this phase I/II clinical study. RDI of chemotherapy was reduced in patients receiving GM-CSF due to thrombocytopenia and/or extrahaematologic toxicity of chemotherapy.


Subject(s)
Carcinoma, Small Cell/drug therapy , Granulocyte-Macrophage Colony-Stimulating Factor/therapeutic use , Lung Neoplasms/drug therapy , Neutropenia/drug therapy , Adult , Aged , Antineoplastic Agents, Phytogenic/administration & dosage , Antineoplastic Agents, Phytogenic/adverse effects , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Carcinoma, Small Cell/mortality , Chi-Square Distribution , Cisplatin/administration & dosage , Cisplatin/adverse effects , Drug Resistance, Neoplasm , Etoposide/administration & dosage , Etoposide/adverse effects , Female , Granulocyte-Macrophage Colony-Stimulating Factor/adverse effects , Humans , Lung Neoplasms/mortality , Male , Middle Aged , Survival Analysis
6.
Eur J Surg Oncol ; 17(6): 575-80, 1991 Dec.
Article in English | MEDLINE | ID: mdl-1743306

ABSTRACT

Preliminary experience based on the results of a pilot study on preoperative concurrent continuous i.v. infusion chemotherapy and radiotherapy for squamous cell carcinoma of the oesophagus in eight consecutive patients is presented. Chemotherapy consisted of 5-fluorouracil and cisplatin. Radiotherapy (Co-60) was delivered to a total dose of 3000 cGy. Clinical tolerance was good in four of eight patients, but poor in the remaining four, including three septic deaths. Oesophagectomy was performed in five patients with no postoperative deaths. Postoperative complications (Horner syndrome, hydrothorax, abdominal wound dehiscence) were observed in three cases. The response was categorized as complete (CR), partial (PR) or stable disease (SD), based on a comparison of the initial and immediate preoperative imaging studies and on the presence of tumour degeneration and/or necrosis in pathological examination of operative specimens. CR was observed in 1/8 patients, PR in 4/8 and SD in 3/8. Concurrent preoperative chemo- and radiotherapy may be effective as a neo-adjuvant or remission-inducing modality in the combined treatment of oesophageal carcinoma, however, it may also lead to fatal complications.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Squamous Cell/drug therapy , Carcinoma, Squamous Cell/radiotherapy , Esophageal Neoplasms/drug therapy , Esophageal Neoplasms/radiotherapy , Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Carcinoma, Squamous Cell/surgery , Cisplatin/administration & dosage , Combined Modality Therapy , Esophageal Neoplasms/surgery , Female , Fluorouracil/administration & dosage , Humans , Male , Middle Aged , Pilot Projects , Postoperative Complications , Radiotherapy/adverse effects
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