Surgical treatment of advanced ovarian cancer.

BACKGROUND: The classical treatment for advanced ovarian cancer (OC) consists of a optimal cytoreductive surgery (when the postoperative residual tumor is under 1 cm.), followed by adjuvant chemotherapy based on platinum or paclitaxel derivatives. The 5-year survival rate in case of advanced OC with secondary peritoneal carcinomatosis (PC) is below 25%. The treatment of PC (interpreted as a local-regional disease and not as a systemic disease) is based on an aggressive surgical act (a full or maximal cytoreduction without residual tumor), followed by local chemotherapy or hypertermic intraperitoneal chemotherapy. This is a retrospective study which reassesses the surgical treatment of advanced OC within the period January 2004 - December 2010 in the Center of General Surgery and Liver Transplantation within Fundeni Institute. METHODS: In the period January 2004 - December 2010 in the Center of General Surgery and Liver Transplantation within Fundeni Institute were operated 405 patients with advanced ovarian cancer. In 105 patients (25.9%) intraperitoneal chemotherapy with Cisplatin was performed. RESULTS: Overal survival was calculated for a subsample of 297 patients, for whom it was possible to properly ensure the follow-up, being of 43 months in the patients with intraperitoneal chemotherapy (p = 0.02) and 37 months in the patients without intraperitoneal chemotherapy. CONCLUSIONS: The maximal cytoreduction associating IPCH is an aggressive multidisciplinary therapeutic approach in advanced OC, reserved for difficult cases, considered in the past without solution. In properly selected cases, this shows a clear increase in survival rate.

Biomathematical approach of (188)Re radiopharmaceutical therapy characterization.

PURPOSE: In order to optimize radioimmunotherapy (RIT) as a cancer treatment modality, it is necessary to select the appropriate radionuclide and the biomolecule carrier. We have developed the radiolabeling with (188)Re (beta emitter) of anti-carcinoembryonic antigen (CEA) monoclonal antibody (Mab) for targeting CEA-producing tumors. MATERIALS AND METHODS: Labeling was realized by the addition of Na(188)ReO(4) eluted from (188)W- (188)Re generator to a preformulated biomolecule in SH prereduction form in the presence of supplemental stannous ions. Wistar London rats were used for the biological studies. For the mathematical processing of the obtained results we used interpolation functions, as well as the different organs under investigation. Used were those interpolation functions for which the standard error is zero, correlation coefficient is the unit and the analytic expression emphasize generally exponential forms (the differential equations specific to the radioactive biodistribution have exponential integral curves as solutions). RESULTS: The achieved radiochemical purity was 92-96%. The resulting solutions had a pH value 5-7 and were used for intravenous (i.v.) administration. The optimum field of interpolation functions was determined, comprising Hoerl, Modified Hoerl, Heart Capacity, Gaussian, Logistic, and Exponential type models. The optimum model existing in that field was also determined in the condition in which the ratio between absolute error of the biodistribution surface/the mean surface of the optimum biodistribution was minimal. CONCLUSION: The obtained optimum model has a predictive character, allowing the identification of the moment to which the maximum percent value for every other time point in the considered time interval t(o)-t(f). This mathematical model can be used for every other pharmacokinetic paradigm.

Evaluation of the metabolic balance in type 1 (insulin-dependent) diabetics, by assay of the hair biochemical components.

A new method of long-term retrospective evaluation of the metabolic balance in type 1 diabetic was based on the variations of the hair biochemical components. Glucose, proteic sulfur and amino acid assays were performed in two consecutive hair segments, proximal and distal, of 1.5 cm each. The differences between the glucose and the sulfur values in the two segments correlated with the HbA1 levels (r = +0.971 and r = +0.957, respectively), being statistically significant in both situations (p less than 0.001). The hair components assay permits to follow up the diabetics' metabolic balance on longer time periods than by determination of the HbA1 values.