ABSTRACT
The aim of this study was to investigate serum levels of IL-2, IL-6 and IL-10 in the pretreatment period and to determine if high IL-2, IL-6, IL-10 levels correlate with the outcome in patients with Non-Hodgkin's Lymphoma (NHL) in the post treatment period. Forty-three patients with the diagnosis of aggressive NHL were included in our study. In all cases initial treatment consisted of CHOP. Patients who failed initial therapy and relapsed from CR were treated with the ESHAP regimen or autologous bone marrow transplantation. The median follow-up duration was 127 weeks (20-228 weeks). There was a negative relationship between the failure-free survival and IL-2 levels (p<0.01). IL-2 levels were negatively correlated with overall survival (p<0.02). There was no relationship between the failure-free survival and IL-6 and IL-10 levels. IL-6 and IL-10 levels did not affect overall survival. In conclusion, in patients with lymphoma, the immune system tries to control the progression of tumor thus leading to high IL-2 levels.
Subject(s)
Interleukin-10/blood , Interleukin-2/blood , Interleukin-6/blood , Lymphoma, Non-Hodgkin/blood , Lymphoma, Non-Hodgkin/diagnosis , Aged , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cisplatin/administration & dosage , Cyclophosphamide/administration & dosage , Cytarabine/administration & dosage , Disease Progression , Disease-Free Survival , Doxorubicin/administration & dosage , Enzyme-Linked Immunosorbent Assay , Etoposide/administration & dosage , Female , Follow-Up Studies , Humans , Lymphoma/drug therapy , Lymphoma, Non-Hodgkin/mortality , Male , Methylprednisolone/administration & dosage , Middle Aged , Prednisone/administration & dosage , Prognosis , Regression Analysis , Time Factors , Treatment Outcome , Vincristine/administration & dosageABSTRACT
An unusual case of a lytic, expanding lesion of the manubrium with histological diagnosis of aneurysmal bone cyst in a 13-year-old girl is presented. After a recurrence following primary surgery, the patient was treated successfully by external beam radiotherapy. A total dose of 25.2 Gy was delivered using conventional fractionation (1.8 Gy day(-1)) to the whole sternum. She remains recurrence- and symptom-free 46 months after the end of the treatment. This is the sixth patient with primary aneurysmal bone cyst in the sternal region, the first paediatric patient for this location, and the first case of its kind treated exclusively by radiotherapy ever reported in the literature. The histopathological, radiological and clinical findings of the patient are presented, relevant literature is reviewed, and radiotherapeutic management of such lesions is discussed.
Subject(s)
Bone Cysts, Aneurysmal/radiotherapy , Sternum , Adolescent , Bone Cysts, Aneurysmal/diagnostic imaging , Bone Cysts, Aneurysmal/pathology , Female , Humans , Sternum/diagnostic imaging , Sternum/pathology , Tomography, X-Ray ComputedABSTRACT
PURPOSE: To determine the maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) of twice-weekly gemcitabine (TW-G) when administered in conjunction with fixed dose amifostine (A) during external radiotherapy (RT) in patients with advanced pancreatic cancer. METHODS AND MATERIALS: Ten patients with previously untreated, locally advanced, or asymptomatic-metastatic pancreatic adenocarcinoma were enrolled in this study. RT was delivered by using the standard four-field technique (1.8 Gy daily fractions, 45 Gy followed by a boost of 5.4 Gy, in 5-1/2 weeks). The starting dose of TW-G was 60 mg/m(2) (i.v., 30-min infusion), which is equal to the upper limit of previously reported MTD of TW-G when given without A during RT. A was given just before the TW-G, at a fixed dose of 340 mg/m(2) (i.v., rapid infusion). TW-G doses were escalated by 30-mg/m(2) increments in successive cohorts of 3 to 6 additional patients until DLT was observed. Toxicities were graded using the Radiation Therapy Oncology Group and National Cancer Institute Common Toxicity Criteria, version 2.0. RESULTS: In general, therapy was well tolerated in patients treated at the first two dose levels of 60 mg/m(2) and 90 mg/m(2). The DLT of TW-G given in conjunction with A during RT were neutropenia, thrombocytopenia, and nausea/vomiting at the dose level of 120 mg/m(2). Of the 10 patients eligible for a median follow-up of 10 months, 5 remain alive; 1 complete responder, 3 partial responders, and 1 with stable disease. CONCLUSION: A dose of TW-G at a level of 90 mg/m(2) produced tolerable toxicity and it may possess significant activity when delivered in conjunction with 340 mg/m(2) dose of A during RT of the upper abdomen. Due to the higher MTD of TW-G seen in our study, we consider that the A supplementation may optimize the therapeutic index of TW-G-based chemoradiotherapy protocols in patients with pancreatic carcinoma.
