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Koukourakis G.,Saint Savvas Anticancer Institute of Athens | Zacharias G.,Laboratory of Hematology | Petridis A.,Metaxa Cancer Hospital of Piraeus
Journal of B.U.ON. | Year: 2015

Purpose: The aim of the current study was to evaluate the efficacy and tolerability of hypo-fractionated whole breast radiation therapy in patients with early breast cancer. Methods: Searching electronically PubMed and the Cochrane Central Register we made a comprehensive literature review regarding the randomized controlled phase III trials for hypo-fractionated radiation therapy in early breast cancer. Results: The collected and analyzed data showed that a short course of hypo-fractionated radiation therapy in early breast cancer patients is as effective as the conventional long course regarding tumor response as well as long term side effects. Conclusion: More data are needed about the usage and integration of a boost treatment for higher-risk women receiving neo-adjuvant or adjuvant chemotherapy, or the results in special subgroups such as women with large breast size.

Koukourakis G.V.,Saint Savvas Anticancer Institute of Athens
Recent Patents on Inflammation and Allergy Drug Discovery | Year: 2012

During the last decade, the development of new drugs known as targeted therapies was the result of a better understanding of the processes involved in the transformation of normal cells into cancer. The term targeted therapy refers to drugs that selectively target specific molecular pathways involved in tumourigenesis or tumour progression. Angiogenesis is important for tumour growth and metastasis and is an important target for new biological agents. Bevacizumab is a humanised recombinant antibody that prevents vascular endothelial growth factor (VEGF) receptor binding, and inhibits angiogenesis and tumour growth. On February 26, 2004, the FDA (Food and Drug Administration) approved Bevacizumab as first-line treatment for patients with metastatic colorectal cancer. The integration of targeted therapies in the treatment of colon cancer has resulted in significant improvements in efficacy outcomes. Bevacizumab was the first antiangiogenic therapy approved for use in cancer and received accelerated FDA approval for the treatment of recurrent glioblastoma multiform in 2009. The efficacy of Bevacizumab in the treatment of metastatic colorectal cancer and recurrent glioblastoma multiform is presented in this review article. The structural characteristics and selectivity profiles of this antiangiogenic drug and those disclosed in related patent applications are also summarised in this article. © 2012 Bentham Science Publishers.

Koukourakis G.,Saint Savvas Anticancer Institute of Athens | Kouloulias V.,National and Kapodistrian University of Athens
Clinical and Translational Oncology | Year: 2010

Non-Hodgkin's lymphoma as a primary testicular neoplasm accounts approximately 9% of all testicular malignant tumours and about 1-2% of all non-Hodgkin's lymphoma. This neoplasm is the most common malignant tumour of the testis in the elderly. The most common histotype in primary forms is the diffuse large B-cell lymphoma, whereas more aggressive histologies such as Burkitt's lymphoma are principal founded in cases of secondary involvement of the testis. Regarding clinical presentation, the most common sign is a unilateral painless scrotal swelling, sometimes with sharp scrotal pain or hydrocele. In patients with advanced stage, the systematic B symptoms are present in 25-41% of all cases. In 35% of patients, bilateral testicular involvement is detected. In more advanced stages with para-aortic lymph-node involvement, ascites and abdominal pain is evident. Despite the fact that responses to doxorubicin- containing chemotherapy, especially in early stages, show good results, relapses are often seen, and the prognosis of this tumour is very poor. Testicular lymphoma often disseminates to other extranodal organs, such as contralateral testis, central nervous system (CNS), lung, pleura, Waldeyer's ring and soft tissue. For patients with limited disease, the recommended first-line treatment is orchiectomy followed by rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) combination chemotherapy, with central nervous system (CNS) prophylaxis and prophylactic irradiation of the contralateral testis. In more advanced or relapsed disease, management should follow the worldwide recommendations for nodal diffuse large B-cell lymphoma (DLBCL). Here we present a review of this tumour.

Koukourakis G.V.,Saint Savvas Anticancer Institute of Athens | Koukourakis G.V.,National and Kapodistrian University of Athens | Kelekis N.,National and Kapodistrian University of Athens | Kouvaris J.,National and Kapodistrian University of Athens | And 2 more authors.
Recent Patents on Inflammation and Allergy Drug Discovery | Year: 2010

The majority of cancer patients will receive radiation therapy treatment at some stage during their malignancy. An acute skin reaction represents a common post radiation side effect with different grade of severity. In order to investigate the optimal methods to prevent and manage acute skin reactions related to radiation therapy we have conducted a systematic review on this topic. It seems that skin washing, including gentle washing with water alone with or without mild soap, should be permitted in patients receiving radiation therapy, to prevent acute skin reaction. In addition, a low dose (i.e., 1%) corticosteroid cream may be beneficial in the reduction of itching and irritation. We have concluded that there is insufficient evidence to support or refute specific topical or oral agents for the prevention or management of acute skin reaction. There is a need for further research to review treatments that have produced promising results in the reviewed research studies and to evaluate other commonly recommended topical treatments. The purpose of this patent and literature review is to advocate the current management of acute skin reaction. © 2010 Bentham Science Publishers Ltd.

Demiroz C.,Uludag University | Demiroz C.,University of Michigan | Vainshtein J.M.,University of Michigan | Koukourakis G.V.,University of Michigan | And 12 more authors.
Head and Neck | Year: 2014

Background Management of head and neck carcinoma from unknown primary (HNCUP) remains controversial, with neck dissection and radiotherapy (RT) or definitive RT both commonly used. The purpose of this study was to characterize HNCUP and retrospectively compare outcomes for patients treated with neck dissection+RT versus definitive RT. Methods From 1994 to 2009, 41 patients with HNCUP underwent either neck dissection+RT (n=22) or definitive RT±concurrent chemotherapy (n=19) at our institution. Treatment outcomes were compared using Kaplan-Meier methods and log-rank test. Results There were no differences between patients treated with neck dissection+RT and definitive RT in overall survival (OS), progression-free survival (PFS), locoregional relapse-free survival (LRFS), freedom from locoregional failure (FFLRG), or freedom from distant failure (FFDF). Among 17 patients who underwent neck dissection+RT for whom human papillomavirus (HPV) status could be determined, HPV(+) patients trended toward improved OS (p=.06) and PFS (p=.15). Conclusion Neck dissection and postoperative RT resulted in similar outcomes as definitive RT. The prognostic implications of HPV(+) nodes in HNCUP are similar to those in oropharyngeal primary cancers. © 2013 Wiley Periodicals, Inc. Head Neck 36: 1589-1595, 2014 © 2013 Wiley Periodicals, Inc.

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