Histopathological and biochemical comparisons of the protective effects of amifostine and l-carnitine against radiation-induced acute testicular toxicity in rats.

The aim of this study was to compare the radioprotective efficacies of amifostine (AMI) and l-carnitine (LC) against radiation-induced acute testicular damage. Thirty Wistar albino rats were randomly assigned to four groups: control (n = 6), AMI plus radiotherapy (RT) (n = 8), LC plus RT (n = 8) and RT group (n = 8). The rats were irradiated with a single dose of 20 Gy to the scrotal field. LC (300 mg/kg) and AMI (200 mg/kg) were given intraperitoneally 30 min before irradiation. The mean seminiferous tubule diameters (MSTDs) were calculated. Testicular damage was evaluated histopathologically using Johnsen's mean testicular biopsy score criteria. Malondialdehyde (MDA) and glutathione levels were measured in tissue samples. AMI plus RT and LC plus RT groups had significantly higher MSTDs than those in the RT group (p = .003 and p = .032 respectively). MDA values of both AMI plus RT and LC plus RT groups were significantly lower than those in RT group (p < .004 and p < .012 respectively). As a result, AMI and LC have a similar radioprotective effect against radiation-induced acute testicular damage, histopathologically and biochemically.

Can radiation-induced chronic oxidative stress in kidney and liver be prevented by dimethylsulfoxide? Biochemical determination by serum and tissue markers.

PURPOSE: To investigate the protective effects of dimethylsulfoxide (DMSO) on chronic oxidative stress in the liver, kidney and serum with biochemical parameters such as malondialdehyde (MDA), advanced oxidation protein product (AOPP), catalase, glutathione (GSH), and free-thiols (F-SH). METHODS: Thirty Wistar albino female rats were randomly divided into 3 groups: group I (control, n=10), group II (irradiation-alone group, n=10) and group III (DMSO and irradiation group, n=10). Rats in groups II and III were irradiated with a single dose of 6 Gy to the entire liver and right kidney. Group III received DMSO 4.5 g/kg by intraperitoneal injection 30 min before irradiation. At the end of the 24th week, the rats were sacrificed and their trunk blood, kidney and liver tissues were collected. RESULTS: Group II rats showed increased levels of lipid peroxidation and protein oxidation, with decreased GSH, FSH and catalase levels in all specimens when compared with group I. Serum and kidney MDA and AOPP levels were significantly lower in group III when compared with group II. However, serum and kidney GSH and F-SH levels were significantly higher in group III when compared with group II. The additive effect on catalase was seen only in the serum. CONCLUSION: DMSO is a protective agent on chronic oxidative stress in the serum and kidney tissue. No oxidant or antioxidant effect of DMSO in the liver was seen.

Acute radiation effect in the brain in infant rats: Neurocognitive and histopathological examination.

PURPOSE: The aim of the present study was to evaluate the radiation-induced cognitive dysfunction and the radioprotective effect of amifostine (AMI) in the brain of infantile rats. METHODS: Thirty 2-week-old rats were randomly assigned into 3 groups of 10 rats each. Group 1: control (CONT), group 2: radiation alone (RT), and group 3: AMI before radiation (AMI+RT). The rats in the RT and AMI+RT groups were irradiated individually with a single dose of 20 Gy. All animals were evaluated by using the Morris water maze test to evaluate of their cognitive functions. Histopathological analyses of the hippocampus were also carried out after euthanasia. RESULTS: The study showed that the place navigational function and the spatial probe test were not significantly different between the groups. CONCLUSION: It can be said that it is very important to determine when the radiation-induced brain injury is formed. From a clinical perspective, the patients can be intervened before irreversible functional deficits are formed and may be amenable to treatment.

Prognostic factors for renal cell carcinoma: Trakya University experience from Turkey.

The purpose of the present study is to evaluate the prognostic factors of patients with renal cell carcinoma. The treatment results such as distant metastasis-free survival and overall survival of 59 previously untreated patients were retrospectively analysed. Median follow-up was 17.5 months (3.8-88.5 months). Overall survival was 22.4 months (3-87 months). Distant metastasis developed in 35 (59%) patients. The Eastern Cooperative Oncology Group (ECOG) performance status (P=0.022), tumour size (P=0.025) and lymphatic invasion (P<0.0001) were significantly effective prognostic factors for distant metastasis-free survival on multivariate analysis. Related to overall survival, gender (P=0.025), ECOG performance status (P=0.027), nuclear grade (P=0.002), tumour size (P=0.029), T stage (P=0.044), nodal involvement (P=0.003), surgical margin (P=0.046), renal sinus invasion (P<0.0001), perineural growth (P=0.001) and lymphatic invasion (P<0.0001) were significant prognostic factors on univariate analysis. Gender (P=0.008), ECOG performance status (P=0.027), tumour size (P=0.025) and lymphatic invasion (P<0.0001) retained their significance on multivariate analysis. We concluded that the most important prognostic factors for patients with renal cell carcinomas are ECOG performance status, tumour size and lymphatic invasion.

Erythropoietin and radiotherapy in lung cancer patients.

PURPOSE: To evaluate the effectiveness of recombinant human erythropoietin (rhEPO) in relation to low hemoglobin (Hb) level, overall tumor response rates, and rhEPO adverse events in patients with lung cancer undergoing radiotherapy (RT). PATIENTS AND METHODS: Thirteen consecutive patients were included. All of them had measurable tumor before RT. 150 IU/kg of rhEPO-alpha or -beta were administered 3 times per week, 7-10 days before RT. The target Hb value was 13 g/dl. Tumor response was assessed 6 weeks after completion of RT. RESULTS: Response to rhEPO was seen 62% (n=8) of the patients. Weekly mean Hb increment was 0.69 g/dl (range 0.42-1). The mean Hb value during RT was 13.2 g/dl (range 9-14.7) in responding patients, and 10.7 g/dl (range 9.7-11.8) in non-responding patients (p=0.005). Overall response rates to RT were significantly higher in responding than in non-responding patients (p=0.034). CONCLUSION: rhEPO increased Hb levels in lung cancer patients undergoing RT. However, safety, and more importantly, indications need further clarifications.

Radiographic size versus surgical size of renal masses: which is the true size of the tumor?

PURPOSE: The size of a renal neoplasm is important for staging, prognosis and selection of appropriate treatment. Our aim was to determine whether there is a discrepancy between the radiographic and pathological size of renal tumors. PATIENTS AND METHODS: The maximum size of 35 resected renal tumors was measured by computed tomography (CT) by 2 independent observers. The radiographic and pathological sizes were compared by size range and tumor radiological features. RESULTS: Although the radiographic and pathological size for all tumors was not statistically different (7.50 vs. 6.25 cm, p=0.452), the average radiographic size was larger than pathological tumor size in tumors smaller than 7 cm. Solid tumors showed more reduction in size (17.02%) compared with cystic and necrotic tumors (p=0.731). Only the radiographic size of ill-defined tumors was smaller than their pathological size (average 33.33%; p=0.865). The influence of tumor side (left or right kidney) and its location within the kidney did not influence the degree of decrease (p=0.147 and p=0.981, respectively). CONCLUSION: A reduction in the size of renal tumors is observed in tumors<7 cm, which is explained by vasoconstriction during the temporary renal artery occlusion, surface hypothermia and blood loss during the operation. If this reduction of size is secondary to surgery, the radiographic size of renal tumors should be considered in staging and selecting the appropriate treatment for tumors<7 cm for which the decision of surgical approach depends on the size of the tumor.

Prognostic factors other than the performance status and age for glioblastoma multiforme: a single-institution experience.

PURPOSE: To evaluate the survival of patients with glioblastoma multiforme (GBM) and analyse the prognostic factors influencing survival. PATIENTS AND METHODS: Seventy-eight consecutive patients with GBM treated with radiotherapy (RT) and temozolomide (TMZ) (in 21 patients) between 1999 and 2006 were retrospectively analysed. RESULTS: Sixty-seven (85.5%) patients had undergone gross total or subtotal resection before RT. The median overall survival was 9.8 months, and significantly influenced by age (p=0.02), Karnofsky performance status (p=0.001), RT (p<0.0001), gender (p=0.02), concomitant TMZ (p=0.003), RT waiting time (p=0.014), and treatment time (p=0.01) in univariate analysis. In multivariate analysis, older age (p=0.03), male gender (p=0.01), absence of concomitant TMZ (p=0.008), RT dose below 60 Gy (p=0.03), RT waiting time more than 20 days (p=0.01), and treatment time more than 76 days (p=0.0072) were poor prognosticators. CONCLUSION: This study emphasizes the importance of female gender, dose and duration of RT, and RT waiting time in patients with glioblastoma multiforme.

Chemotherapy and cerebrovascular disease.

Cerebrovascular disease is common in cancer patients. Some tumors are at high risk for cerebrovascular complications. The development of cerebrovascular disease may be provoked by cancer treatment. No well-planned prospective studies about other causes of thrombosis are available, although various case reports about thrombosis related to chemotherapy have been published. L-asparaginase, cisplatin, 5-fluorouracil (5-FU) and methotrexate are anticancer agents which are reported to relate to stroke. The mechanisms by which antineoplastic agents may lead to stroke include endothelium toxicity and abnormalities of coagulation factors. Also, brain hemorrhages that could result from chemotherapy effects on the hemostatic system were reported. Besides, it is difficult to determine whether stroke is caused by chemotherapy or cancer itself. Clinicians deal not only with problems originating from cancer itself, but also with the complications resulting from its treatment. Treatment-induced cerebrovascular disorders affect quality of life and survival in cancer patients. For this reason, cancer treatment should be planned by taking into consideration the possibility of cerebrovascular complications.