Koukourakis G.,Anticancer Institute of Athens Saint Savvas |
Kouloulias V.,National and Kapodistrian University of Athens |
Zacharias G.,General Hospital of Corinth |
Sotiropoulou-Lontou A.,Anticancer Institute of Athens Saint Savvas |
Koukourakis M.,Democritus University of Thrace
Clinical and Translational Oncology | Year: 2011
Nowadays in modern oncology there is a tendency towards therapies that target organ preservation. Organ preservation protocols have become standard in the treatment of laryngeal carcinoma, oesophageal cancer, breast carcinoma and soft tissue sarcomas. The three-combined therapy consisting of a transurethral resection of the bladder tumour followed by concomitant chemoradiotherapy has been shown to be an attractive alternative for bladder preservation in selected patients with muscle-invasive bladder cancer. In order to evaluate the organ preservation approaches in muscle-invasive bladder cancer we have conducted a comprehensive literature review. Data reported from the studies have shown that bladder preservation therapy with a trimodality approach is safe and effective. Moreover, such an approach provides patients with the opportunity to maintain an intact and functional bladder with a survival rate similar to that of radical cystectomy.
Koukourakis G.,Saint Savvas Anticancer Institute |
Zacharias G.,General Hospital of Corinth
Journal of B.U.ON. | Year: 2011
In man, nicotine is commonly consumed via smoking cigarettes, cigars or pipes. The addictive liability and pharmacological effects of smoking are primarily mediated by the major tobacco alkaloid nicotine. There are elevated serum cadmium and lead levels in smokers resulting in glomerular dysfunction. There is a constant and direct attack of various cigarette smoke reagents on the oral epithelial cells, which gradually accumulate and may cause a stepwise malignant transformation. The association between cigarettes and lung cancer has been proven by large cohort studies. Tobacco use has been reported to be the main cause of 90% of male and 79% of female lung cancers. Ninety percent of deaths from lung cancer are estimated to be due to smoking. This review describes the implication of nicotine, smoking, smoke extracts and other tobacco constituents on oral cancers, lung cancer and cancers of the urinary tract. © 2011 Zerbinis Medical Publications.
Farmaki K.,General Hospital of Corinth |
Berdoukas V.,Childrens Hospital of Los Angeles
European journal of Clinical and Medical Oncology | Year: 2010
Advances in the management of transfusion-dependent thalassemia major have resulted in increased survival, principally through reduction in iron-related cardiac disease. The newer challenges include the reduction and reversal of the endocrinopathies. Some early progress has been reported and has been associated with improved ability to identify organ-specific iron load and increasing the intensity of the chelation regimes. In particular, the combination of desferrioxamine and deferiprone has shown to be particularly valuable. By reducing total body iron to normal levels, some endocrinopathies have been reversed and the incidence of new morbidities has been reduced. Larger trials that will use different approaches to chelation and most likely different combinations promise to demonstrate further improvements and reductions in morbidity. They will also clarify the relative toxicities that may present with the achievements of very low total iron body stores. Irrespective of the regimes prescribed, it will be essential for these to be acceptable to patients so that the overall survival can be improved even further and for the approaches to be effective in achieving the required aims.
Berdoukas V.,Childrens Hospital of Los Angeles |
Farmaki K.,General Hospital of Corinth |
Wood J.C.,Divsion of Cardiology |
Coates T.,Childrens Hospital of Los Angeles
Expert Review of Hematology | Year: 2011
Over the last 20 years, the management of thalassemia major has improved to the point where we predict that the patients life expectancy will approach that of the normal population. These outcomes result from safer blood transfusions, the availability of three iron chelators, new imaging techniques that allow organ-specific assessment of the degree of iron overload and improvement in the treatment of hepatitis. The ability to prescribe any of the three chelators, as well as their combinations, has led to a more effective reduction of the total body iron. The ability to determine the amount of iron in the liver and heart by MRI has allowed the prescription of the most appropriate chelation regime for the patient and has allowed the reconsideration of the comfort zones. Thus, normalizing iron stores not only prevents new morbidities but also reverses many complications, such as cardiac failure, hypothyroidism, hypogonadism, impaired glucose tolerance and Type 2 diabetes, therefore improving survival and patients quality of life. Furthermore, outcomes should continue to improve in the future. Starting relatively intensive chelation in younger children may prevent short stature and abnormal pubertal maturation, as well as other iron-related morbidities. In addition, further information should become available on the use of other combinations in chelation treatment, some of which have only been used in a very limited fashion so far. New safe oral chelators may also become available that may offer additional ease of use. All these advances in management do require absolute cooperation and understanding on behalf of childrens parents and subsequently the adult themself. Only with such cooperation can normal long-term survival be achieved as it is likely that adherence to treatment is the primary barrier to longevity. © 2011 Expert Reviews Ltd.
Papakonstantinou G.,General Hospital of Corinth
Memo - Magazine of European Medical Oncology | Year: 2013
The promise of all targeted therapies is the specific induction of cytotoxicity in malignant cells without adversely affecting normal tissues. Antibody-drug conjugates (ADCs) consist of a monoclonal antibody chemically linked to an anticancer agent, and are a niche class of drugs that raise great expectations, particularly as oncology drugs. Brentuximab vedotin and trastuzumab emtansine, both recently US Food and Drug Administration approved, open a promising new area in the therapy of hematologic malignancies and solid tumors. Further improvement of bioengineering and development of preclinical and clinical data are the challenges for the next generation of ADCs. © 2013 Springer-Verlag Wien.