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Ymittos Athens, Greece

Nicolatou-Galitis O.,National and Kapodistrian University of Athens | Kouloulias V.,National and Kapodistrian University of Athens | Sotiropoulou-Lountou A.,Saint Savvas Anticancer Hospital | Dardoufas K.,Hygeia Hospital | And 4 more authors.
Open Cancer Journal

Goal of work: This study compared the severity of oral mucositis, pain and xerostomia during and at the completion of radiotherapy in head and neck cancer patients who had received antifungal and antiviral treatment. Patients: The study included 135 patients. Mean total radiotherapy dose was 62.4 Gray. Chemotherapy was administered to 47% of patients. Methods: Oral mucositis was scored weekly, while patients self-evaluated their pain and xerostomia. Cytology smears for the assessment of herpetic infection complicating the ulcers of mucositis were taken from 46 patients. Systemic antifungals and antivirals were administered during radiotherapy, upon clinical, presumptive diagnosis of candidiasis and herpetic infection. Antifungals and antivirals were continued to the end of radiotherapy. Results: Radiotherapy was completed within the preplanned time in 117 patients (87%). During radiotherapy, the prevalence of severe mucositis, pain and xerostomia was 57%, 43% and 29% respectively, and was significantly reduced to 33%, (P<0.001), to 24%, (P<0.001), and to 18%, (P<0.05) at the end of radiotherapy. Antifungals and antivirals were utilized in 70% and 71% of patients, respectively. Viral cytology was positive in 14 of 46 (30.4%) patients. Conclusions: The significant reduction of severe oral mucositis, pain and xerostomia at time of completion of radiotherapy, as compared to during the course of radiotherapy, after the treatment and prevention of candidiasis and herpes, denotes an important role of these infections in radiation-induced mucositis. Limitations of the study are the practical issues of the lack of the verification of the fungal status before and after treatment and of the verification of the viral status in only 47.9% (46 of 96) of the patients with a clinical suspicion of herpetic infection. A controlled study is needed to investigate and further clarify the role of antifungal and antiviral prophylaxis relative to oral mucositis, pain and xerostomia during head and neck RT. © Nicolatou-Galitis et al. Source

Terpos E.,National and Kapodistrian University of Athens | Katodritou E.,Theagenion Cancer Center | Roussou M.,National and Kapodistrian University of Athens | Pouli A.,Saint Savvas Anticancer Hospital | And 11 more authors.
European Journal of Haematology

Objectives: High serum lactate dehydrogenase (LDH) is associated with features of advanced disease and inferior survival in multiple myeloma. It is however unclear whether LDH adds to the prognostic value of International Staging System (ISS) and whether it retains its prognostic significance in patients who are exposed to novel agent-based therapies. Patients/Methods: To address these issues we analyzed 996 consecutive symptomatic patients who were included in the database of the Greek Myeloma Study Group and received frontline treatment between January 1, 1995 and December 31, 2008. Results: The median overall survival (OS) of all patients was 40 months with a clear improvement in those who started treatment after January 1, 2000 (49 vs. 31 months; P < 0.01). A multivariate model showed that LDH, ISS, performance status, age and platelet counts had an independent prognostic value for OS (P < 0.001 for all parameters). The median OS of patients with high (11% of patients) and normal LDH was 15 vs. 44 months (P < 0.001). High LDH was associated with inferior OS within all ISS groups: 22 vs. 76 months for high and normal LDH groups, respectively, in ISS-1 (P < 0.01); 11 vs. 40 months in ISS-2 (P < 0.001) and 17 vs. 27 months in ISS-3 (P < 0.01). The median OS of high and normal LDH groups among patients who received novel agents was 21 vs. 51 months, respectively (P < 0.001). Conclusions: Lactate dehydrogenase is a readily available and inexpensive variable, which has a major impact on the survival of myeloma patients even when they belong to a low or intermediate ISS subgroup and even when they receive novel agent-based therapies. © 2010 John Wiley & Sons A/S. Source

Saratsiotou I.,Saint Savvas Anticancer Hospital | Kordoni M.,Hygeia Hospital | Bakogiannis C.,Hygeia Hospital | Livadarou E.,Chemotherapy Preparation Unit | And 3 more authors.
Journal of Oncology Pharmacy Practice

Purpose. The aim of this prospective observational study was to investigate the patterns of treatment adherence to orally administered chemotherapy of patients being treated for cancer.Methods. Patients were asked to participate in the survey during their visits to the study centers' pharmacists or doctors to obtain their oral medication from April 2008 until May 2009. The data were collected using a self-reported anonymous 7-page long questionnaire, which contained questions about their demographic profile, disease and treatment characteristics, and side-effects and adherence information, both intentional and nonintentional.Results. 99 Patients completed the questionnaire. Missing values ranged from 1% to 8%. Unintended nonadherence to therapy was reported by 19 patients. The most important factor correlating with unintended nonadherence was the patient's belief regarding treatment effectiveness since only 16.7% of the patients believing that their treatment is effective reported nonadherence as opposed to 62.5% for those that did not believe that treatment is effective (p=0.03). Intentional nonadherence was reported by 14 patients The most important factor correlating to intentional nonadherence was time since disease diagnosis, as nonadherence was reported by 33.3% of the patients having the disease less than 6 months, compared to 16.7% for those between 6 and 24 months and 8.3% for those between 2 and 5 years (p=0.01).Conclusion. Greek patients seem to have similar nonadherence pattern as in other countries. Confidence in treatment efficacy appeared as a significant adherence determinant. © 2011 The Author(s). Source

Fostira F.,National Diagnostics | Konstantopoulou I.,National Diagnostics | Mavroudis D.,University of Crete | Tryfonopoulos D.,Saint Savvas Anticancer Hospital | And 2 more authors.
Clinical Genetics

Currently, hereditary breast cancer is being attributed to more than 20 genes of differing penetrance. Although BRCA1 and BRCA2 are still the genes of reference for breast cancer susceptibility, extreme breast cancer phenotypes may be the result of deleterious alleles of other genes. Here, we report three families with early-onset breast cancer that were initially referred for BRCA1/BRCA2 genetic testing. They were diagnosed with breast cancer at an extraordinarily early age. On the basis of their extensive family history, which included multiple cancer types, and their Her2 status, they were suspected for Li-Fraumeni syndrome. Indeed, all three probands were found to harbor TP53 tumor suppressor gene mutations. These included p.C275X, described here for the first time, as well as p.R213X and p.Y220C, which have been described in the past. Our conclusion is that decisions on genetic analysis for inherited early onset breast cancer should always be based on detailed pedigree information, combined with Her2 status. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. Source

Terpos E.,National and Kapodistrian University of Athens | Anargyrou K.,251 General Air Force Hospital | Katodritou E.,Theagenion Cancer Center | Kastritis E.,National and Kapodistrian University of Athens | And 14 more authors.
International Journal of Cancer

The circulating levels of several angiogenic cytokines [angiopoietin-1 (Ang-1), angiopoietin-2 (Ang-2), vascular endothelial growth factor (VEGF), angiogenin and basic fibroblast growth factor (bFGF)] were evaluated in 174 consecutive patients with newly diagnosed, symptomatic, multiple myeloma (MM). Circulating levels of Ang-1/Ang-2 were reduced in myeloma patients compared to controls, whereas VEGF and angiogenin levels were increased. Reduced angiopoietin-1/angiopoietin-2 ratio correlated with advanced disease features including international staging system (ISS)-3 stage, renal impairment and extensive bone disease. Based on immunohistochemical results in 20 patients (10 with the higher and 10 with the lower values of circulating angiopoietin-2) we found that angiopoietin-2 is expressed by myeloma cells and correlates with increased microvessel density in subsets of patients. Furthermore, Ang-1/Ang-2 ratio correlated with survival. Patients with circulating Ang-1/Ang-2 below or equal to the median value (6.03) had a median survival of 26.3 months compared to 53 months of all others (p = 0.002). Interestingly, this was mainly observed in patients who received first-line therapy with novel agent-based regimens (65% of our patients). Furthermore, a subset of ISS-3 patients with serum Ang-1/Ang-2 above the median value had favourable prognosis (median survival: 45 months versus 17 months of all others; p = 0.0001). The multivariate analysis revealed that low Ang-1/Ang-2 ratio could independently predict for inferior survival in our cohort of patients (relative risk (RR) 2.07, 95% CI 1.50-2.42; p < 0.001). These results highlight the role of angiopoietins pathway in the biology of MM and reveal novel targets for the development of antimyeloma agents. Copyright © 2011 UICC. Source

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