The comparison of acute toxicity in 2 treatment courses: Three-weekly and weekly cisplatin treatment administered with radiotherapy in patients with head and neck squamous cell carcinoma.

The most appropriate cisplatin treatment schedule delivered with radiotherapy in patients with head and neck squamous cell carcinoma (HNSCC) is unknown. The aim of this study was to compare the acute toxicity and its impact on the course of the treatment, administered cisplatin and radiation doses, the length of hospitalization and supportive drugs administration in patients with HNSCC receiving 2 different cisplatin treatment schedules administered with radiotherapy.In this retrospective analysis, 104 patients with HNSCC were enrolled. Patients received radiation concurrently with 100 mg/m cisplatin administered 3-weekly (n = 50; group A) or 35 to 40 mg/m cisplatin administered weekly (n = 54; group B). Chemoradiotherapy was performed in locally and/or regionally advanced disease (stage III-IV), in a definitive radical upfront setting (71.1%) or after surgical resection in patients with high-risk factors (28.8%).Both study groups were equally distributed in terms of age, gender, stage of the disease, Eastern Cooperative Oncology Group performance score, chronic diseases and primary tumor site. The schedule of cisplatin dosing did not influence the duration of hospitalization, the number of additional supportive drugs (antibiotics, opioids) administered or total doses of received radiotherapy. However, postponement of radiotherapy due to adverse events was significantly more frequent in patients treated with 35/40 mg/m (55.56% vs 32%; P = .015). Furthermore, patients treated with weekly treatment schedule received lower total cisplatin dose (160 mg/m) in comparison to those treated with the 3-weekly schedule (200 mg/m). Grade 3 and 4 mucositis occurred more frequently in patients treated in group A (70% vs 50%; P = .037). Leukopenia was also observed more frequently in group A (88% vs 72.2%; P = .04), however there was no difference in grade 3/4 leukopenia between both study arms. There was no statistically significant difference in any other adverse effects.These results do not demonstrate the advantage of modified weekly schedule over standard 3-weekly cisplatin treatment plan. However, severe mucositis occurred more frequently in patients receiving 3-weekly cisplatin, both chemotherapy schedules seemed to present similar toxicity. Due to conflicting efficacy and toxicity, the results and compliance of weekly and 3-weekly cisplatin schedules should be evaluated in further randomized, controlled trials and retrospective studies.

[Lymphoma of the thyroid in a patient with autoimmune thyroiditis and Sjögren's syndrome--case report]. / Chloniak tarczycy u chorej na autoimmunologiczne zapalenie tarczycy i zespól Sjógrena--opis przypadku.

We present the case of a 74 year old patient suffering from primary Non Hodgkin's lymphoma of the thyroid and Sjogren's syndrome. A massively enlarging goitre, causing breathlessness in a female patient previously treated for autoimmune inflammation of the thyroid (Hashimoto's disease) and Sjogren's syndrome, indicated the need for a fine needle aspiration biopsy (FNA) of the thyroid gland. Non Hodgkin's lymphoma of the thyroid was diagnosed and chemotherapy was begun. After 10 months of cytostatic treatment clinical tests and imaging indicated complete local regression. However, two months after cessation of chemotherapy the patient suffered a relapse of the disease owing to infiltration of the central nervous system. During the course of palliative radiotherapy the patient died. The main purpose for presenting this case was to describe the problem of primary lymphoma of the thyroid in cases of autoimmune disease. As many years of immunisation may lead to carcinogenesis it is important to raise awareness among medical staff with regard to cases of chronic autoimmune disease. In cases of Hashimoto's autoimmune disease of the thyroid, monitoring of the anti-thyroid antibodies is indicated, at least annually, as an increase in the concentration of these antibodies over a period of at least seven years would suggest further development of autoimmune disease. If such conditions are accompanied by tumours of the thyroid, surgery should be considered. It is worth keeping in mind that the thyroid can be a site for extra-lymphatic lymphoma.

[Non-Hodgkin lymphoma located in supraorbital skin region]. / Przypadek chloniaka nieziarniczego zlokalizowanego w okolicy nadoczodolowej.

PURPOSE: Periorbital skin alterations can be of inflammatory and neoplastic origin. In very rare cases Non-Hodgkin lymphomas occur in this region. We describe a patient with a rare subtype of the Non-Hodgkin lymphoma, which was diagnosed by ophthalmologists. MATERIAL AND METHODS: A 65 years old female patient visited an ophthalmologist because of a tumor within the left supraorbital skin area. She complained about subjective deterioration of vision. During the ophthalmologic examination we found a full visual acuity in both eyes with no bulbar pathology. Tumor biopsy and an immunocytochemical examination determined the diagnosis of an NK blastic lymphoma. The patient was treated with CHOP chemotherapy. RESULTS AND CONCLUSIONS: It is believed that the rare NK blastic lymphoma develops from NK progenitor cells. When the periorbital skin is involved, the secondary edema can lead to narrowing of the palpebral fissure and to subjective vision deterioration. In these cases ophthalmologists can be the first medical specialists visited.

[Evaluation of a risk of a cross-reactivity with Echinococcus multilocularis-specific Em2plus antigen in patients with liver cancer]. / Ocena ryzyka wystepowania niespecyficznych reakcji krzyzowych z antygenem Em2plus Echinococcus multilocularis u pacjentów z nowotworami watroby.

The incidence of non-specific reactions with E. multilocularis antigen in patients with liver malignancies, and the risk of a supradiagnosis of alveolar echinococcosis (AE) in space-occupying lesions in the liver due to neoplastic proliferative diseases were studied. Analysis of specific IgG serum antibody against Em2plus antigenic complex was performed in 11 AE patients in comparison to 76 individuals with malignant neoplasms of abdominal or extra-hepatic location, including some patients with primary hepatocellular cancer or distant metastases to liver, and 42 patients with benign hepatic lesions. Only one false borderline result was reported in a case with colorectal cancer, and dissemination to liver. Low risk of false positive results with E. multilocularis-specific Em2plus antigen in patients with liver malignancies makes the test valuable for practical reasons in a differential diagnosis of irregular tumor masses visualized by imaging techniques.

[Role of adhesion molecules in a determination of progression stages and clinical prognosis of patients with Echinococcus multilocularis]. / Rola czasteczek adhezyjnych w ocenie stopnia zaawansowania i prognozowania klinicznego przypadków Echinococcus multilocularis.

Alveococcosis in humans is characterized by a tumor-like growth with a tendency to infiltration of neighbouring organs or metastases formation in the lungs and brain. The study aimed to improve on the clinical evaluation of patients with alveolar echinococcosis (AE) and to determine the risk of metacestode spreading to adjacent tissues or distant organs by a detection of adhesion molecules involved in the tumorigenesis process. Serum concentrations of sPECAM-1, sVCAM-1 and sE-selectin adhesion molecules were studied in 8 AE patients in comparison to 75 cases with malignant neoplasms, including cases with tumors of hepatic and extra-hepatic location. The adhesion molecules were found to be early predictive markers of the active, tissue infiltrated alveococcosis with the risk of parasite spreading through the circulation. High serum levels of soluble PECAM-1 molecule were strongly related to the advanced, progressive disease and the fatality of patients' clinical prognosis.