ABSTRACT
A total of 59 patients with hormone-resistent prostatic cancer (HDPC) treated in 1999-2004 entered the trial. Three schemes of first-line chemotherapy were examined for clinical efficacy and toxicity in the above patients. Anticancer combined treatment vinorelbin + cycloplatam was given to 23 patients, mitoxantron + prednisolone--to 23 patients, mitoxantron+cysplatin+prednisolone--to 13 patients. The latter scheme was most effect and toxic. Partial regression of metastases and a 50% decrease in the initial PCA level were seen in 23% cases. Vinorelbin+cycloplatam was less effective and toxic: partial regression of metastases--13%, PSA regression-- 17.4%. The least efficacy and toxicity were observed in the treatment with mitoxantron+prednisolone --.7%. Thus, the above first-line HDPC therapy was most effective but has the highest toxicity in using the scheme mitoxantron+cysplatin+prednisolone.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Prostatic Neoplasms/drug therapy , Aged , Antineoplastic Agents, Hormonal/therapeutic use , Bone Neoplasms/prevention & control , Bone Neoplasms/secondary , Cisplatin/administration & dosage , Drug Resistance, Neoplasm , Humans , Male , Middle Aged , Mitoxantrone/administration & dosage , Organoplatinum Compounds/administration & dosage , Prednisolone/administration & dosage , Prostatic Neoplasms/pathology , Treatment Outcome , Vinblastine/administration & dosage , Vinblastine/analogs & derivatives , VinorelbineABSTRACT
Cystectomy in the treatment of invasive cancer of the urinary bladder is not the only therapeutic modality in this pathology. In selected patients an alternative exists--transurethral resection of the urinary bladder followed by adjuvant concurrent chemotherapy and radiotherapy. The preserving therapy can be recommended to patients over 60 years of age in the presence of a low-grade solitary tumor of a mobile wall of the urinary bladder respectable with preservation of the organ capacity.
Subject(s)
Urinary Bladder Neoplasms/therapy , Adult , Aged , Aged, 80 and over , Chemotherapy, Adjuvant , Combined Modality Therapy , Cystectomy , Female , Humans , Male , Middle Aged , Neoplasm Invasiveness , Neoplasm Recurrence, Local/diagnosis , Treatment Outcome , Urinary Bladder Neoplasms/drug therapy , Urinary Bladder Neoplasms/surgeryABSTRACT
Emergence of regional penile cancer (PC) metastases reduces late survival of PC patients from 94.4 to 83.9%. PC stage can hardly be diagnosed by clinical data significantly. Bilateral inguinal lymphadenectomy is indicated for all PC patients with enlarged and clinically negative regional lymph nodes in poorly differentiated primary tumor (G3) and stages T2-3. Follow-up can be recommended for patients with stage Tis-T1, low and moderate anaplasia (G1-2) of the primary tumor. Metastases to the iliac lymph nodes are an indication to pelvic lymphadenectomy. Preventive removal of the iliac lymph nodes in intact inguinal ones is not justified. Unremovable fixed regional lymph nodes should be exposed to radiotherapy.
Subject(s)
Penile Neoplasms/therapy , Humans , Lymph Node Excision , Lymphatic Metastasis , Male , Neoplasm Staging , Penile Neoplasms/diagnosis , Penile Neoplasms/pathology , Prognosis , RadiotherapyABSTRACT
The results of 5-year screening (1996-2000) for prostatic cancer in 1129 males 40 to 80 years of age are presented. The examination included: measurement of blood levels of prostate-specific antigen (PSA), finger rectal examination, transrectal ultrasonic examination (TRUE) and, on demand, biopsy of the prostatic gland. Prostatic cancer was diagnosed in 1.5, 2.2 and 16% patients having PSA levels of 0-4.0, 4.0-10.0 and 10.0-30.0% ng/ml, respectively. At finger rectal examination prostatic cancer was suspected in 8% examinees, only in 33% of them the diagnosis was verified morphologically. By TRUE evidence 7% examinees were suspected and in 44.3% of them prostatic cancer was confirmed. Thus, biopsy proved necessary in 172 cases of 1129 examinees. In 64 (5.7%) males prostatic cancer was diagnosed and confirmed. Early prostatic cancer in the screened men and those consulted in the outpatient department of the National Cancer Research Center was detected in 77.7 and 22% men, respectively. The conclusion is made that men over 50 years of age should undergo prophylactic examination of the prostatic gland once a year.
Subject(s)
Mass Screening , Prostatic Neoplasms/diagnosis , Adult , Age Factors , Aged , Aged, 80 and over , Alcohol Drinking/epidemiology , Biopsy , Humans , Male , Middle Aged , Moscow/epidemiology , Prostate/pathology , Prostate-Specific Antigen/blood , Prostatic Neoplasms/blood , Prostatic Neoplasms/diagnostic imaging , Prostatic Neoplasms/epidemiology , Prostatic Neoplasms/mortality , Prostatic Neoplasms/pathology , Russia/epidemiology , Sensitivity and Specificity , Smoking/epidemiology , Time Factors , UltrasonographyABSTRACT
As the literature data give arguments both pro and contra wide use of maximal androgenic block (MAB) in the treatment of prostatic cancer, the authors studied MAB in 200 patients. They came to the conclusion that MAB can be applied in patients with symptoms of disseminated prostatic cancer as neoadjuvant therapy before prostatectomy and as neoadjuvant and adjuvant therapy in planning radiotherapy.
Subject(s)
Androgen Antagonists/therapeutic use , Antineoplastic Agents, Hormonal/therapeutic use , Prostatic Neoplasms/drug therapy , Chemotherapy, Adjuvant , Combined Modality Therapy , Humans , Male , Neoadjuvant Therapy , Neoplasm Metastasis , Prostatectomy , Prostatic Neoplasms/pathology , Prostatic Neoplasms/radiotherapy , Prostatic Neoplasms/surgery , Radiotherapy , Treatment OutcomeABSTRACT
87 patients with urinary bladder cancer (UBC) stage T2-3aN0M0 have received an organ-saving treatment which combined neoadjuvant chemotherapy (methotrexate, adriamycin, vinblastin, cysplatinum) followed by transurethral or open resection of the bladder. The patients were followed up for 3 to 60 months. Recurrent tumors arose in 49(56.3%) patients, at the primary site in 94%. Recurrence-free 5-year survival made up 32.8 +/- 14.1 and 24.2 +/- 15.2% after transurethral and open resections of the bladder, respectively. In patients with a complete response to the neoadjuvant chemotherapy 5-year overall and recurrence-free survival reached 89.0 +/- 11.1 and 68.5 +/- 18.9%, respectively. It is thought valid to consider planning organ-saving treatment only in relation to patients with a complete regression of the tumor after neoadjuvant chemotherapy.
Subject(s)
Urinary Bladder Neoplasms/therapy , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Chemotherapy, Adjuvant , Combined Modality Therapy , Disease-Free Survival , Female , Humans , Male , Middle Aged , Neoplasm Invasiveness , Recurrence , Urinary Bladder Neoplasms/drug therapy , Urinary Bladder Neoplasms/pathology , Urinary Bladder Neoplasms/surgeryABSTRACT
The postoperative outcome and survival were studied in patients operated for renal cancer with involvement of the liver. 9 patients have undergone radical nephrectomy and 12 patients--hepatic resections for direct hepatic involvement (2), synchronous (2) and metachronous (8) metastases of renal cell carcinoma. Right hemihepatectomy was performed in 2 and wedge resection in 10 cases. A complete resection was performed in 8 of 9 patients while one patient with direct hepatic invasion was found to have positive surgical margins. Postoperative lethality was absent but complications occurred in 6 patients: pancreatitis (1), pneumonia (3), hepatic abscess (1), hepatic and renal failure followed by GI bleeding (1). At follow-up, two patients died of progressive disease 4 and 68 months after the surgery and one was lost for follow-up. One patient with positive surgical margins is alive with pulmonary and liver metastases 16 months after surgery. Five patients are alive with no evidence of relapse 6, 10, 12, 19 and 56 months after the operation. Thus, the aggressive surgical approach is justified and should be considered in patients with renal cancer and hepatic involvement.
Subject(s)
Kidney Neoplasms/pathology , Liver Neoplasms/secondary , Liver Neoplasms/surgery , Humans , Postoperative Complications , Survival Analysis , Treatment OutcomeABSTRACT
The results of pharmacological analysis are presented which provide information on the pathogenesis of acute cypermethrin poisoning that involves disturbances in various systems of the organism. These include changes in the system of excitatory amino acids (EAAs) and violation of the free radical generation processes, Na + channel functioning, cholinergic transmission, etc. The screening of drugs belonging to various pharmacological groups influencing the toxicity of pyrethroids (EAA receptor antagonists, antioxidants, Na + channel blockers, M-cholinoreceptor blockers) revealed promising agents for the treatment of cypermethrin poisoning.
Subject(s)
Daphnia/drug effects , Insecticides/poisoning , Pyrethrins/poisoning , Animals , Drug Evaluation, Preclinical , Poisoning/etiology , Poisoning/prevention & controlSubject(s)
Androgen Antagonists/therapeutic use , Anilides/therapeutic use , Antineoplastic Agents/therapeutic use , Prostatic Neoplasms/drug therapy , Aged , Aged, 80 and over , Androgen Antagonists/administration & dosage , Anilides/administration & dosage , Antineoplastic Agents/administration & dosage , Antineoplastic Agents, Hormonal/administration & dosage , Antineoplastic Agents, Hormonal/therapeutic use , Goserelin/administration & dosage , Goserelin/therapeutic use , Humans , Injections, Subcutaneous , Male , Middle Aged , Nitriles , Prostate-Specific Antigen/blood , Prostatic Neoplasms/blood , Randomized Controlled Trials as Topic , Tablets , Testosterone/blood , Time Factors , Tosyl CompoundsABSTRACT
PURPOSE: The results of different conservative organ-sparing methods - radiotherapy, chemotherapy and radiochemotherapy - in the treatment of penile carcinoma were studied. MATERIALS AND METHODS: Conservatively treated 223 patients with penile carcinoma seen in three hospitals between 1959 and 1996 years were studied retrospectively. Among them 155 received radiotherapy, 33 chemotherapy, and 35 radiochemotherapy. RESULTS: The local control was achieved in 135 (60.5%) of 223 patients. The difference in local control rate among these three groups of patients has not reached statistical significance. The efficacy of conservative treatment was highly associated with three factors: tumor size, grade and patient's age. Overall, 24 of 135 patients (17.7%) had local recurrence. Ten patients (4.5%) developed regional metastases. The recurrence rate did not correlate with tumor size and grade and was similar for all treatment modalities. Long-term results of each method were approximatley equal and 5-year survival varied from 78 to 88%. CONCLUSION: Conservative organ-sparing treatment of early-stage penile carcinomas is justified. Failure should be corrected by surgery without compromising survival.
Subject(s)
Penile Neoplasms/therapy , Adult , Aged , Aged, 80 and over , Humans , Male , Middle Aged , Retrospective Studies , Treatment OutcomeSubject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Germinoma/surgery , Lymph Node Excision , Testicular Neoplasms/surgery , Chemotherapy, Adjuvant , Germinoma/drug therapy , Germinoma/secondary , Humans , Lymphatic Metastasis , Male , Orchiectomy/methods , Retroperitoneal Space , Testicular Neoplasms/drug therapy , Testicular Neoplasms/pathology , Treatment OutcomeSubject(s)
Brain Neoplasms/secondary , Carcinoma, Renal Cell/secondary , Craniotomy , Kidney Neoplasms/pathology , Adult , Brain Neoplasms/diagnosis , Brain Neoplasms/surgery , Carcinoma, Renal Cell/diagnosis , Carcinoma, Renal Cell/surgery , Female , Humans , Kidney Neoplasms/diagnostic imaging , Kidney Neoplasms/surgery , Male , Middle Aged , Nephrectomy , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
Solution of 5-aminolevulinic acid (5-ALA) and D-Light unit (Karl Storz GmbH & Co) were used for fluorescent control over radicality of transurethral resection (TUR) of the urinary bladder. TUR with the fluorescent control was performed in 85 patients. The new procedure allowed to remove tumors undetectable at standard TUR in 46(54.1%) patients. Sensitivity and specificity of the method was 98.7 and 76.3%, respectively. 5-ALA-induced fluorescence used to control radicality of bladder TUR reduced the number of recurrences within 12 postoperative months 2-fold.
Subject(s)
Aminolevulinic Acid , Cystoscopy/standards , Photosensitizing Agents , Urinary Bladder Neoplasms/pathology , Administration, Intravesical , Adult , Aged , Aged, 80 and over , Aminolevulinic Acid/administration & dosage , Female , Fluorescence , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/prevention & control , Photosensitizing Agents/administration & dosage , Sensitivity and Specificity , Urethra , Urinary Bladder Neoplasms/surgeryABSTRACT
The trends in male urinary and genital cancer morbidity and mortality are specified. Statistics on separate malignant urological diseases are provided. In 1996 the number of patients with cancer of male urinary and sex organs reached 31.700. A growth in morbidity was due rather to a higher risk to develop the disease than because of changes in the population age. Urological cancer reduces mean life span of Russian population by 2 months, and the patients' life terminates 10-19 years earlier. Financial losses due to deaths of urological cancer stand as high as 197 million roubles as estimated in 1990 prices.
Subject(s)
Urogenital Neoplasms/epidemiology , Female , Humans , Male , Russia/epidemiology , Survival Rate , Urogenital Neoplasms/mortality , Urogenital Neoplasms/pathologyABSTRACT
450 males aged over 50 years free of urological symptoms were screened for prostatic cancer using three techniques; finger rectal examination (FRE), transrectal ultrasound investigation (TUI), assay for prostatic specific antigen in the serum (SPSA). SPSA quantities under 4 ng/ml, 4-10 ng/ml, 10-20 ng/ml, over 20 ng/ml were registered in 206(45.8%), 135(30%), 69(15.4%) and 40(8.8%) patients, respectively. Detectability of prostatic cancer increases by 33,37.9, 45.5, 69.2% due to TUI, FRE, TUI + FRE, all the three methods, respectively. Prostatic biopsy was needed in 102 (22.7%) cases. From the 450 examinees, prostatic cancer was diagnosed in 25 (5.6%). SPSA was high in all of them, higher than 10 ng/ml in 92%. 20 (80%) of 25 patients with cancer had early stages of the disease (TI-2). The study is going on.
Subject(s)
Mass Screening/methods , Prostatic Neoplasms/prevention & control , Adult , Aged , Aged, 80 and over , Biopsy , Humans , Male , Mass Screening/statistics & numerical data , Middle Aged , Palpation , Prostate/diagnostic imaging , Prostate/pathology , Prostate-Specific Antigen/blood , Prostatic Neoplasms/diagnosis , Prostatitis/diagnosis , Prostatitis/prevention & control , Rectum , UltrasonographyABSTRACT
Up-to-date approaches to treatment of disseminated prostatic cancer are discussed, including the experience of the use of maximum androgen blockade in 120 patients. The procedure may be recommended to start hormonal therapy in such patients with.
Subject(s)
Androgen Antagonists/therapeutic use , Antineoplastic Agents, Hormonal/therapeutic use , Antineoplastic Agents/therapeutic use , Prostatic Neoplasms/drug therapy , Aged , Androgen Antagonists/administration & dosage , Antineoplastic Agents/administration & dosage , Antineoplastic Agents, Hormonal/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Double-Blind Method , Drug Therapy, Combination , Gonadotropin-Releasing Hormone/analogs & derivatives , Humans , Male , Meta-Analysis as Topic , Middle Aged , Orchiectomy , Prostatic Neoplasms/mortality , Prostatic Neoplasms/surgery , Randomized Controlled Trials as Topic , Receptors, Androgen/drug effects , Time FactorsABSTRACT
The role of neoadjuvant chemotherapy for invasive transitional cell carcinoma (TCC) of the bladder is not determined yet. M-VAC and CMV regimens have a complete response rate of 10-47% with an overall response reaching 80%. In 16.7-35% of all the responders and 42.9-92% of the complete responders a functioning bladder can be preserved. The influence of neoadjuvant chemotherapy on long-term survival is questionable. Nevertheless, the authors conclude that neoadjuvant chemotherapy is feasible in patients with invasive TCC as it improves the results of following surgery and in some cases enables an organ sparing operation.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Transitional Cell/drug therapy , Neoadjuvant Therapy , Urinary Bladder Neoplasms/drug therapy , Carcinoma, Transitional Cell/mortality , Carcinoma, Transitional Cell/surgery , Cisplatin/therapeutic use , Combined Modality Therapy , Doxorubicin/therapeutic use , Etoposide/therapeutic use , Follow-Up Studies , Humans , Lomustine/therapeutic use , Methotrexate/therapeutic use , Neoplasm Recurrence, Local , Time Factors , Urinary Bladder Neoplasms/mortality , Urinary Bladder Neoplasms/surgery , Vinblastine/therapeutic useABSTRACT
The authors review case histories of 23 patients with leydigomas selected from records on 134 patients with nongerminogenic testicular tumors. Malignancy occurred in 6 cases. Two cases with uni- and bilateral testicular involvement are reported. The course of leydigoma in children is described.