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Piraeus, Greece

Anna Z.,National and Kapodistrian University of Athens | John K.,National and Kapodistrian University of Athens | Maria T.,National and Kapodistrian University of Athens | George K.,University of Thessaly | And 4 more authors.
Reviews on Recent Clinical Trials | Year: 2012

Background: Bowen's disease is a form of squamous cell carcinoma in situ that can be transformed into invasive squamous cell carcinoma and should be treated according to its anatomical position. The aim of this article is to offer an overview of treatment options with an emphasis on radiation therapy in the treatment of Bowen's disease. Methods and Materials: We performed overview of the literature based on database searches in PubMed/MEDLINE and we included articles till December 2010. Only papers published in English were included. Results: There was no standard fractionation regimen: some physicians prescribed high doses, such as the ones of invasive skin cancer, whereas others prescribed lower doses because of the noninvasive nature of the disease, the sensitive anatomic location (e.g., extremity) and the large treatment area. Various studies demonstrate high rates of tumor control with minimal morbidity following definitive radiation therapy in the treatment of Bowen's Disease. Through a multidisciplinary assessment, the treatment of Bowen's disease can be individualized to optimize patient care. Conclusions: Radiation therapy is an effective treatment option for Bowen's disease of the skin. Local recurrences seem to be equally low in patients treated with high- and low-dose regimens. Radiotherapy preserves normal tissues ensuring a superior esthetic and functional outcome. © 2011 Bentham Science Publishers.

Mavroudis D.,University of Crete | Saloustros E.,Oncology Unit | Malamos N.,Elena Venizelou Hospital | Kakolyris S.,University General Hospital of Alexandroupolis | And 5 more authors.
Annals of Oncology | Year: 2015

Background: Adjuvant trastuzumab in combination with chemotherapy improves survival of women with HER2-positive early breast cancer. In this study, we compared 12 versus 6 months of adjuvant trastuzumab. Patients and methods: Axillary node-positive or high-risk node-negative women with HER2-positive early breast cancer were randomized to receive 12 or 6 months of adjuvant trastuzumab concurrently with dose-dense, granulocyte colony-stimulating factor (G-CSF)-supported docetaxel (75 mg/m2 every 14 days for four cycles). All patients received upfront dose-dense, G-CSF-supported FEC (5-fluorouracil 700 mg/m2, epirubicin 75 mg/m2, cyclophosphamide 700 mg/m2 every 14 days for four cycles). Randomization was carried out before commence of chemotherapy. The primary end point was the 3-year disease-free survival (DFS). Results: A total of 481 patients were randomized to receive 12 months (n = 241) or 6 months (n = 240) of adjuvant trastuzumab. Chemotherapy was completed in 99% and 98% of patients, while trastuzumab therapy in 100% and 96% of patients in the 12- and 6-month groups, respectively. After 47 and 51 months of median follow-up, there were 17 (7.1%) and 28 (11.7%) disease relapses in the 12- and 6-month groups (P = 0.08). The 3-year DFS was 95.7% versus 93.3% in favor of the 12-month treatment group (hazard ratio = 1.57; 95% confidence interval 0.86-2.10; P = 0.137). There was no difference in terms of overall survival and cardiac toxicity between the two groups. Conclusions: Our study failed to show noninferiority for the 6-month arm. The results further support the current standard of care that is administration of adjuvant trastuzumab for 12 months. © The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.

Kastritis E.,National and Kapodistrian University of Athens | Roussou M.,National and Kapodistrian University of Athens | Michael M.,Evangelismos Hospital | Gavriatopoulou M.,National and Kapodistrian University of Athens | And 10 more authors.
British Journal of Haematology | Year: 2010

Summary Serum levels of five angiogenic cytokines were evaluated in 82 patients with primary systemic amyloidosis (AL). Angiopoietin-1, vascular endothelial growth factor, basic fibroblast growth factor and angiogenin were higher in AL patients than in controls (n = 35) and newly-diagnosed, symptomatic, myeloma patients (n = 35). Angiopoetin-1/Angiopoetin-2 ratio was lower in AL compared to controls but higher than in myeloma patients. Angiopoetin-2 correlated with cardiac dysfunction indices; however, none of the angiogenic growth factors was prognostically significant. The increased angiogenic cytokine levels observed in AL seem to represent either a toxic effect of amyloid fibrils or light chains, or a compensatory response to organ dysfunction. © 2010 Blackwell Publishing Ltd.

Thanopoulou E.,National and Kapodistrian University of Athens | Kotzamanis G.,National and Kapodistrian University of Athens | Pateras I.S.,National and Kapodistrian University of Athens | Ziras N.,Metaxa Hospital | And 7 more authors.
Tumor Biology | Year: 2012

Intercellular adhesion molecule-1 (ICAM-1), a cell adhesion molecule with a key role in inflammation and immunosurveillance, has been implicated in carcinogenesis by facilitating instability of the tumor environment. The K469E single nucleotide polymorphism (SNP) (G>A) affects the ICAM-1 mRNA splicing pattern; the alternatively spliced isoform (ICAM-1-S) lacks transmembrane and intracellular domain, which affects the structural and signal transduction properties. Moreover, the expression of ICAM-1 is transcriptionally regulated by p53, and this SNP has been shown to be related with apoptosis. PCR-RFLP analysis was used to assess the K469E SNP status comparatively in 203 non-small cell lung cancer patients and 175 healthy sex-matched controls. This SNP was examined in relation to tumor kinetic parameters (Ki-67 immunohistochemical evaluation and Tdt-mediated dUTP nick end labeling assay), p53 immunohistochemistry status, and clinicopathological data in patients with operable stages. Both the genotype and allele frequency did not differ significantly between patients and controls. However, patients with the AG/AA genotypes had worse survival (39 vs 45 months, p = 0.036) and tended to be present in advanced stages (p = 0.057). Moreover, the AG/AA genotypes exerted a synergistic effect with aberrant p53 on tumor progression, while the GG genotype retained a better apoptotic index. The AG/AA genotypes correlated with worse survival and advanced stages probably due to defective immunosurveillance and apoptosis. These genetic backgrounds may confer a selective advantage for dissemination of tumor cells with high metastatic potential compared to GG genotype. © 2012 International Society of Oncology and BioMarkers (ISOBM).

Kaloyannidis P.,BMT Unit | Voutiadou G.,BMT Unit | Baltadakis I.,Evaggelismos Hospital | Tsirigotis P.,National and Kapodistrian University of Athens | And 9 more authors.
Biology of Blood and Marrow Transplantation | Year: 2012

Patients with relapsed/progressed Hodgkin's lymphoma (HL) following autologous hematopoietic cell transplantation (AHCT) may not have an invariably dismal outcome as previously considered. In a multicenter retrospective study, we evaluated 126 patients who relapsed/progressed after a median of 5 (1-132) months post first AHCT. Management consisted of irradiation, chemotherapy ± irradiation, second HCT, or palliation. Currently, 53 of 126 (42%) patients are alive for a median of 32 months since relapse/progression and 44 (35%) of them remain progression-free. Interval of <12 months to relapse/progression, presence of B-symptoms, and disease refractoriness at first AHCT failure adversely influenced overall survival (P < .05). The typeof treatment had no impact on survival. Furthermore, to predict the outcome at the time of relapse/progression, we constructed a prognostic model based on 3 factors: interval of <12 months from first AHCT to relapse/progression, presence of B-symptoms, and pre-AHCT disease refractoriness. Patients with 0 to 1 factors achieved a median survival of 70 months compared to 17 months only in those with 2 to 3 factors (P < .001). This study, the largest reported to date, suggests that selected patients with relapse/progression after first AHCT can be rescued with current treatment modalities. However, relapsed/progressed HL following AHCT still poses a therapeutic challenge, and prospective trials are needed to determine the most appropriate approach in this setting. © 2012 American Society for Blood and Marrow Transplantation.

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