ABSTRACT
PURPOSE: Multiple drug resistance limits the efficacy of numerous cytotoxic drugs used in the treatment of small cell lung cancer (SCLC). The drug efflux protein ATP-binding cassette transporter B1 (ABCB1) has an important role in this process, and its gene variability may affect chemotherapy outcomes. PATIENTS AND METHODS: This study aimed to evaluate the associations between ABCB1 polymorphisms G2677T/A, C3435T, and their haplotype with progression-free survival (PFS) and overall survival (OS) in 177 SCLC patients treated with cisplatin-etoposide or cyclophosphamide-epirubicin-vincristine chemotherapy. To determine the ABCB1 genotype, allelic specific TaqMan(®) probes were used in a RT-PCR . RESULTS: Patients carrying the G2677T/A TT + TA + AA genotypes (24 %) or the C3435T CT + TT genotypes (72 %) or the 2677T/A-3435T haplotype (40 %) had a longer PFS (Cox regression, P = 0.052, 0.037 and 0.037, respectively); these associations persisted also in multivariate analyses (Cox regression, P = 0.028, 0.037 and 0.030, respectively). Moreover, patients with the C3435T CT + TT genotypes had a longer OS both in univariate and multivariate analysis (Cox regression, P = 0.022 and 0.028, respectively). A trend toward longer OS was noted for the 2677T/A-3435T haplotype (Cox regression, P = 0.051), but its independent value was not confirmed (Cox regression, P = 0.071). CONCLUSIONS: Our study reported a possible predictive value of ABCB1 polymorphisms G2677T/A, C3435T, and their haplotype for longer PFS and OS in Caucasian SCLC patients treated with chemotherapy. However, to be implemented into routine clinical practice, ABCB1 polymorphisms require further validation.
Subject(s)
ATP Binding Cassette Transporter, Subfamily B, Member 1/genetics , Haplotypes , Lung Neoplasms/genetics , Polymorphism, Single Nucleotide , Small Cell Lung Carcinoma/genetics , ATP Binding Cassette Transporter, Subfamily B , Adult , Aged , Aged, 80 and over , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cisplatin/administration & dosage , Cyclophosphamide/administration & dosage , Disease-Free Survival , Epirubicin/administration & dosage , Etoposide/administration & dosage , Female , Gene Frequency , Genotype , Humans , Lung Neoplasms/diagnosis , Lung Neoplasms/drug therapy , Male , Middle Aged , Outcome Assessment, Health Care/statistics & numerical data , Predictive Value of Tests , Prognosis , Proportional Hazards Models , Small Cell Lung Carcinoma/diagnosis , Small Cell Lung Carcinoma/drug therapy , Vincristine/administration & dosageABSTRACT
AIMS: To report the long-term results of oncological safety of breast reconstruction by autologous tissue following mastectomy for invasive breast cancer. METHODS: One-hundred-fifty-six consecutive patients with invasive breast cancer treated with mastectomy and reconstruction by autologous tissue were reviewed throughout (from 1987 to 2003 with median follow up time of 66 months). RESULTS: Median patient age was 45.9 years (range 26-68). The 157 observed tumors had mean diameter of 25+/-19 mm, 70 of them were poorly differentiated, and 137 were invasive ductal carcinoma. Multifocal disease was present in 44 patients. Breast reconstruction was carried out only by autologous tissue (free flaps were used in 95% and free TRAM flap transfer was the most common reconstructive procedure). There was only one local recurrence as first site of recurrence, thus yielding a local recurrence rate of 0.6%. CONCLUSIONS: Breast reconstruction by autologous tissue following mastectomy for invasive breast cancer is an oncologically safe procedure.
Subject(s)
Abdominal Muscles , Breast Neoplasms/surgery , Mammaplasty/methods , Surgical Flaps , Adult , Aged , Female , Follow-Up Studies , Humans , Mastectomy , Middle Aged , Neoplasm Recurrence, Local/epidemiology , Treatment OutcomeABSTRACT
Under the conditions of out health care system it is best to install first small-dose digital fluorographs at urban polyclinics and use as movable plants. The basis of a diagnostic study of pulmonary tuberculosis is to monitor X-ray changes in the process by a series of X-ray images and tomographic scans. At the same time paper imprints obtained by printers (including laser ones) lose as much as 30% of image details so computer images rather than hard paper copies should be used for comparison in practice of the X-ray units of dispensaries. Computers are required for dispensaries: for each X-ray specialist, the head of a unit, deputy head physician in therapeutics so that the use of a digital fluorographic plant should be as much as effective.
