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Cybulska-Stopa B.,Klinika Nowotworow Ukladowych I Uogolnionych | Rolski J.,Klinika Nowotworow Glowy I Szyi | Ziobro M.,Klinika Nowotworow Ukladowych I Uogolnionych | Hetnal M.,Zaklad Radioterapii
Wspolczesna Onkologia | Year: 2010

Between 1980 and 2000, 30 patients with lymphoblastic lymphoma were treated at the Medical Oncology Clinic of the Centre of Oncology (Krakow Division). At first the APO and Coleman's treatment protocols were used. In 1993, in order to improve treatment results, a modification of Coleman's regimen was introduced, i.e. the dose of doxorubicin was intensified. In the original Coleman's regimen doxorubicin is admini stered at the dose of 50 mg/m 2 on days 1, 22 and 57 of the induction phase. According to our modification doxorubicin was administered on days 1, 15, 29, 43 and 57 of the induction phase. Complete remission of malignancy was achieved in 20 patients (67%). Partial remission was achieved in 3 patients (10%). In total, objective remission (CR + PR) was achieved in 23, i.e. 77% of treated patients, 37% survived 2 years and 33% survived 5 years. The most common adverse events observed during therapy were haematological complications: anaemia, granulocytopenia and thrombocytopenia. They were the cause of one treatment-related death (neutropenic fever). Hyperglycaemia was observed due to use of high doses of steroids in the chemotherapy regimens under consideration. Increased intensity of anthracycline administration in our modification of Coleman's regimen was not associated with increased frequency of cardiological complications; however, the total dose did not exceed the acceptable cumulative dose of this medication.

To determine predictive and prognostic value of p53, Ki-67 and EGFR in patients with advanced oral cavity and oropharyngeal cancer treated with induction chemotherapy. The data form 40 patients with advanced oral cavity and oropharyngeal cancer treated between January 1988 and December 1997 were analyzed retrospectively. All patients received 1 to 3 cycles of induction chemotherapy (ICHT) consisting of cisplatin and fluoruracil. Twenty two patiemts (68%) underwent subsequent radical radiotherapy. Histologic and immunohistochemical analyzes of p53, Ki-67 and EGFR were performed in all patients. Response to induction chemotherapy was obtained in 18 patients (45%). None of the analyzed factors significantly influenced the chance to obtain the response to chemotherapy. The 3-year loco-regional control and overall survival rates in the group of 22 patients treated radically were 20% and 23%, respectively. Lack of EGFR expression is favorable prognostic factor for overall survival in patients with advanced oral cavity and oropharyngeal cancer treated with induction chemotherapy.

Recognition of the characteristic and the prognostic value of HPV (human papillomavirus) infection in oropharyngeal cancer is one of the greatest successes of head and neck oncology during recent years. Histoclinical and molecular appearance of HPV-related tumours are different as compared to typical squamous cell head and neck cancers. HPV-related oropharyngeal cancer often occurs in younger groups of patients with relatively high socioeconomic status. Performance status is usually excellent or good. HPV-related cancers are more sensitive for radiotherapy and chemotherapy. Finally, outcome in HPV-related oropharyngeal cancer is significantly better in comparison to typical head and neck cancers. This has been confirmed in many clinical analyses. HPV-positive status was connected with 2.5-4 times reduced risk of death. This fact supports investigations of the less aggressive treatment options which would be less toxic and similarly effective as compared to standard radiotherapy or concomitant chemoradiotherapy. Review of the concepts and the most important clinical trials dedicated to treatment de-escalation in HPV-related oropharyngeal cancer was made. All are in progress and currently there is not sufficient data to recommend any less toxic regimen for routine clinical practice. It's very important to remember that better prognosis does not necessarily mean satisfactory outcome of less aggressive regimens. Results of well planned, prospective, randomised trials, like RTOG 1016, are needed to establish the optimal treatment for HPV-related oropharyngeal cancer. © Polskie Towarzystwo Onkologiczne.

Kwapisz D.,Klinika Nowotworow Pluca i Klatki Piersiowej | Kawecki A.,Klinika Nowotworow Glowy I Szyi | Krzakowski M.,Klinika Nowotworow Pluca i Klatki Piersiowej
Nowotwory | Year: 2013

Surgery is the treatment of choice for patients with early-stage non-small-cell lung cancer. A proportion of patients cannot undergo surgery due to comorbid conditions and - in this situation - radical radiotherapy may be an alternative method of treatment. Compared with conventional photon irradiation proton beam treatment - either three-dimensional conformal or intensity-modulated radiation therapy - allows for dose escalation with reduction of the dose delivered to normal tissues. Proton beam therapy is safe and effective for treating patients with non-small-cell lung cancer. Clinical studies confirm the feasibility of proton irradiation for early-stage non-small-cell lung cancers and further trials are being performed in locally advanced tumors. In this paper, we present the physical aspects and the preliminary data from dosimetric and clinical studies for proton beam therapy in stage I-III non-small-cell lung cancer on the basis of the available literature.

Jassem J.,Medical University of Gdansk | Duchnowska R.,Klinika Onkologii | Kawecki A.,Klinika Nowotworow Glowy I Szyi | Krajewski R.,Klinika Nowotworow Glowy I Szyi | And 7 more authors.
Nowotwory | Year: 2014

Surveillance after oncological treatment constitutes a necessary element of comprehensive cancer care. Determining optimal follow-up schedules, including their cost effectiveness, is critical on clinical, organisational and economic grounds. Owing to a lack of prospective clinical studies providing the highest level of evidence, in most cancers optimal surveillance schemes cannot be determined. Hence, currently most recommendations are based on retrospective studies and expert opinions. In Poland comprehensive and uniform recommendations on post-treatment surveillance in cancer patients are not available. This article, prepared by a group of experts in oncology and family medicine, presents a proposal for the follow-up schemes after treatment in major solid malignancies in adults. © Polskie Towarzystwo Onkologiczne.

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