http://www.ecancermedicalscience.com/This RSS feed lets you know when new articles are added to the ecancermedicalscience website.dev@2cs.com;lowens@brandcastmedia.com;linda.cairns@ifom-ieo-campus.it;gordon.mcvie@ieo.it;jonathan@ecancermedicalscience.com;hannah@ecancermedicalscience.com;susi@ecancermedicalscience.com;susi.burke@cancerintelligence.comenhttp://www.ecancermedicalscience.com/view-article.asp?doi=10.3332/ecancer.2008.96Fri, 26 Sep 2008 00:00:00 GMT
Objectives and Methods: A prospective study was designed to assess the intra-operative (IO) tumor size in 29 patients of breast cancer presenting to a tertiary care center in Delhi, and to compare it with CE, USG, and PE.

Observations and Results: Twenty-nine patients (mean age: 47 years), presenting with invasive duct carcinoma (stage IIIA: 31%, stage IIB: 28%), were included in the study. Comparison with mean IO (4.2 cm) revealed that both USG and PE underestimated tumor size by a mean of 0.35 cm (8.4 %), and 0.45 cm (10.7%) respectively, in most patients. CE tended to overestimate size by 0.82 cm (19.8%). All 3 modalities showed statistically significant correlation with IO (maximum Pearson¡¯s correlation co-efficient for PE=0.937, p<0.001 R2 =0.877, maximum for PE). Two-way analysis of variance revealed mean difference in size to be statistically significant (p=0.000) only between CE and IO.

Discussion: Formalin processing causes changes in tumor dimensions in the breast, causing reduction in tumor size. It may also have a bearing on the assessment of surgical margins in breast conservation surgery. Immediate postoperative measurement of the specimen is ideal. Protocol for specimen fixation should be standardized.
]]>http://www.ecancermedicalscience.com/view-article.asp?doi=10.3332/ecancer.2008.91Fri, 15 Aug 2008 00:00:00 GMT
METHODS: Between June 2004 and February 2007 patients with measurable metastatic melanoma in progression and PS < 1 received TMZ in a dose of 150 mg/m2 qd for 7 days, followed by 7 days off therapy and THA in 200 mg qd, both orally administered. Concomitant treatment with steroids was allowed. PBMCs were collected from the last 14 consecutive patients for evaluation of immune parameters.

RESULTS: 40 screened patients were eligible and evaluable for response and 39 were evaluable for toxicity. 25 patients had asymptomatic and 15 symptomatic brain metastases. The toxicity was primarily grade 1-2 with no grade 4 or treatment related deaths. Four patients had tromboembolic events grade 3. One pt obtained a CR and 5 PR in the CNS, while 2 had CR and 4 PR outside CNS. Overall response rate was 17.5%. We found a significant positive correlation between lymphopenia and objective response.

CONCLUSIONS: The combination treatment was well tolerated but with more frequent thromboembolic events compared to single drug TMZ or THA. The treatment demonstrated activity in CNS as well as outside CNS. The correlation between lymphopenia and objective response needs further investigation.]]>http://www.ecancermedicalscience.com/view-article.asp?doi=10.3332/ecancer.2008.88Thu, 21 Aug 2008 00:00:00 GMThttp://www.ecancermedicalscience.com/view-article.asp?doi=10.3332/ecancer.2008.83Thu, 21 Aug 2008 00:00:00 GMThttp://www.ecancermedicalscience.com/view-article.asp?doi=10.3332/eCMS.2008.81Mon, 9 Jun 2008 00:00:00 GMT
Methods: We conducted a phase II prospective randomised study of short versus prolonged treatment with pentoxifylline (800 mg) and tocopherol (1000 IU) orally once daily in patients with grade 3 toxicity post radical radiotherapy. In addition, all 18 patients received inhaled carbogen (95% oxygen + 5% CO2) over 90 minutes, 5 days per, week for 3 weeks. The primary endpoint was improvement in maximum Lent-Soma toxicity scores.

Results: Maximum Lent-Soma scores improved in six of the eighteen patients (response rate 33%). The proportion of patients responding to treatment in the prolonged treatment arm B was more than double than in the shorter arm A, but this did not reach statistical significance (p 0.321). Two patients who had prolonged treatment (arm B) had complete resolution of their symptoms which was maintained at 2 and 3 years follow up.

Conclusions: We recommend prolonged treatment for 12 months, with PTX and tocopherol in combination with carbogen therapy, in the management of late radiation effects.
]]>http://www.ecancermedicalscience.com/view-article.asp?doi=10.3332/eCMS.2008.80Mon, 28 Jul 2008 00:00:00 GMTThe successful treatment of cancer is a major health and political issue in England & Wales and also in the Major Developed Countries (MDC). All Malignancy deaths by age and gender are analysed to determine how successful the MDC were in reducing cancer deaths between 1979-2002 within the context of the each nations Gross-Domestic-Product-Expenditure-on-Health’ (GDPEH) over the period.

Method
Incidence rates of new cancers in England & Wales are examined for 1979-80 to 2003-04 to highlight extent of the problem. Set in the context of GDREH for each MDC 1980-2002 as an indicator of how each nation has responded to the challenge of cancer. The changing cancer mortality rates for England & Wales are compared with each MDC by age and sex using WHO All Malignancies mortality rates over the period 1979-81 to 2000-02. Chi square tests are used to compare outcomes between England & Wales with each MDC.

Results
1] Men’s All Age malignancy incidence in England & Wales rose 48% and women’s 51% with notable rises for females aged 15-34 and 55-74years.
2] Every MDC increased GDPEH substantially UK up to 9.3% but remains 8th of ten MDC and still below the MDC average (9.85%).
3] England & Wales men’s average (15-74years) deaths were 3rd highest in 1979-81 but fell to 8th by 2000-02 declining significantly more than 7 other MDC.
England & Wales women’s average (15-74 years) rates were highest in 1979-81 and in 2000-02 but declined significantly more than most MDC in every age band from 35-74 years.
4] Most MDC countries men’s rates declined significantly more than their women’s except Japan and Spain but the improvements in men’s cancer death were not matched in women’s rates especially the 35-54’s.
Conclusions: Rising incidence poses problems for every MDC but especially for England & Wales as does the relatively low Anglo-Welsh GDPEH whilst poorer women’s results should be a matter of concern for most MDC. The reductions in cancer deaths reflects well on all front-line services indicating what can be achieved with improved GDDPEH but should not obscure the challenge of the rising incidence of cancer.]]>http://www.ecancermedicalscience.com/view-article.asp?doi=10.3332/eCMS.2008.74Fri, 15 Feb 2008 00:00:00 GMT
This study compares sentinel lymph-node biopsy carried out at the time of removal of the primary breast tumour, under general anaesthetic, with sentinel lymph-node biopsy carried out under local anaesthetic prior to the main operation.

It compares the total cost of the two treatment approaches, in terms of average income and of their impact on the subsequent programming of operations and hence on waiting lists and income.]]>http://www.ecancermedicalscience.com/view-article.asp?doi=10.3332/ecancer.2008.67Wed, 6 Feb 2008 00:00:00 GMTWe have previously reported the favourable effect of transdermal estradiol (E2), relative to oral conjugated equine oestrogen (CEE), on ultrasensitive C-reactive protein after 12 months of treatment in a retinoid-placebo controlled two-by-two randomised breast cancer prevention trial (ref). Here we investigate the changes in lipids and clotting profile in patients of the same trial.

Methods and Results:
Recent postmenopausal women were randomised to either oral CEE 0.625 mg/d and placebo (n=55), CEE and fenretinide 200 mg/d (n=56), transdermal E2 50 µg/d and placebo (n=59), or E2 and fenretinide 200 mg/d (n=56). Sequential medroxyprogesterone acetate 10 mg/d was given in each group. After 12 months there was a statistically significant effect of the route of administration of hormone replacement therapy (HRT) on fibrinogen levels the median percent change being -5.7% with CEE and -1.1% with E2 (P=0.012). Total cholesterol decreased in all arms (P<0.0001). HDL-C decreased significantly with transdermal E2 (P=0.006) compared to oral CEE and with fenretinide relative to placebo (P<0.001). Triglycerides exhibited an opposite modulation by HRT route, with a 21.4% median increase with oral CEE and an 8.6% reduction with transdermal E2 (P<0.0001). Antithrombin-III showed a 4% borderline significant reduction in the fenretinide arm relative to placebo, irrespective of HRT administration route (P=0.055).

Conclusions:
Our data indicate that transdermal E2 may be preferable to oral CEE based on its safer cardiovascular risk profile. Fenretinide modified some cardiovascular risk biomarkers and confirmed a safer profile compared to other retinoids.]]>http://www.ecancermedicalscience.com/view-article.asp?doi=10.3332/eCMS.2008.66Mon, 21 Jan 2008 00:00:00 GMT
This article discusses the ACGT's approach to collecting and dealing with genomic data. It also looks at the ACGT's ultimate objective providing a unified technological infrastructure which will facilitate the seamless and secure access and analysis of multi-level clinical and genomic data enriched with high-performing knowledge discovery operations and services.

By doing so it is expected that the influence of genetic variation in oncogenesis will be revealed the molecular classification of cancer and the development of individualised therapies will be promoted and finally the in-silico tumour growth and therapy response will be realistically and reliably modelled.]]>http://www.ecancermedicalscience.com/view-article.asp?doi=10.3332/eCMS.2008.65Tue, 26 Feb 2008 00:00:00 GMTBackground. Previous studies showed that after breast conserving surgery for breast cancer , Radiotherapy may be applied to the portion of the breast where the primary tumor was removed (partial breast irradiation - PBI) avoiding the irradiation of the whole breast. We developed a procedure of PBI consisting in a single high dose of radiotherapy of 21Gy with electrons equivalent to 58-60Gy in fractionated doses, delivered during the surgical session by a mobile linear accelerator, positioned close to the operating bed.
Patients and methods From July 1999 to December 2006, 1246 patients with primary carcinoma less than 2.5 cm in diameter mostly over 48 years were treated with Electron IntraOperative Radiotherapy (ELIOT) at a single dose of 21Gy.
Results. After a follow-up from 0.3 to 94.7 months (median 26), 24 patients (1.9 %) showed a local recurrence and 22 developed distant metastases. 16 patients died, 7 for breast carcinoma and 9 for others causes. The 5 years crude survival was 96.5%. Six cases (0.5%) developed serious breast fibrosis which resolved in two-three years. Other 40 patients suffered for mild fibrosis. Cosmetic results were good.
Conclusions. ELIOT is a safe method for treating conservatively operated breasts, avoids the long period of postoperative radiotherapy greatly improving the quality of life and reduces the cost of Radiotherapy. ELIOT reduces radiation to normal surrounding tissues and deep organs. Results on short-term and middle-term toxicity are good. Data on local control are encouraging.]]>http://www.ecancermedicalscience.com/view-article.asp?doi=10.3332/eCMS.2008.64Fri, 2 May 2008 00:00:00 GMTAn institutional task force on Upper Gastrointestinal Tumours is active at the European Institute of Oncology (EIO). Members decided to collect in a document the institutional guidelines on management of liver tumours (primary and metastatic). This article is aimed at presenting the current treatment guidelines as well as ongoing research protocols and trials in this field at EIO.

Methods:
A steering committee convened to assign tasks to individual members. Contributions from experts in each treatment area were collected in a single document, in order to produce a draft for subsequent review from the aforementioned committee. Six drafts have been discussed and the final version approved.

Results:
Surgical, Medical Oncology, Interventional Radiology, Nuclear Medicine and Radiation Therapy approaches, their roles in management of liver tumours and ongoing research trials are presented and discussed in this article.

Conclusions:
At the European Institute of Oncology a multi-disciplinary integrated approach to liver tumours is a standard and several research ongoing projects are currently active in this field.]]>http://www.ecancermedicalscience.com/view-article.asp?doi=10.3332/eCMS.2008.63Tue, 8 Jul 2008 00:00:00 GMT
Patients and methods: Women with stage I-II breast cancer treated with adjuvant adriamycin and cyclophosphamide (AC) from 1990-1995 were identified in a provincial breast cancer database. Cases were classified into 4 cohorts 1: all cycles delivered at full dose and on time 2: one single dose reduction or dose delay 3: >1 dose reduction or dose delay 4: <2 cycles of chemotherapy delivered.

Results: 484 eligible cases were identified (cohort 1: n = 268 2: n= 88 3: n= 89 4: n= 39). Slight imbalances in lymph node status (p=0.05) and adjuvant hormonal therapy (p=0.05) were observed between the cohorts. 55% (267/484) of the patients had node-positive disease and 33% (158/484) were ER+. 45% of cases had a reduction in DI. With a median follow-up of 9.6 years, there were no significant differences in relapse-free survival (p=0.94), breast cancer-specific survival (p=0.87) or overall survival (p=0.86) between the 4 cohorts. Outcomes were independent of hormone receptor status.

Conclusions: Although toxicity related reductions in the DI of adjuvant AC chemotherapy for early stage breast cancer are common, they did not appear to significantly impact on clinical outcomes in this population-based cohort of women with stage I-II breast cancers.
]]>http://www.ecancermedicalscience.com/view-article.asp?doi=10.3332/eCMS.2008.61Thu, 29 Nov 2007 00:00:00 GMTPatients and Methods – This study is a prospective randomized controlled trial. 100 women with breast cancer who needed axillary dissection were randomized into the LigaSureTM or conventional axillary dissection group. Level I to III lymph node dissection was performed. A closed suction drain was always placed in the axilla and removed after 6-8 days or when fluid amount was < 60 cc in the previous 24 hours.
Results – There were no significant differences between the two groups when considering the duration of surgical procedure: average duration was 70.7 ± 24.66 minutes for LigaSureTM patients, while in the conventional dissection group the mean was 70.6 ± 22.47 minutes (p=0.98). Total amount of drained fluid was 624.49 cc in the LigaSureTM axillary dissection group and 792.96 in the conventional ALND group; this difference did not achieve statistical significance (p=0.09); the duration of draining was also similar with no statistical difference (p=0.15).
Conclusions – The present study did not show clear advantages in LigaSureTM use for ALND, although it represents a good haemostatic device, especially in abdominal surgery.

Keywords – breast carcinoma; breast cancer surgery; axillary dissection; seroma; drain; haemostasis; LigaSure.]]>http://www.ecancermedicalscience.com/view-article.asp?doi=10.3332/eCMS.2008.60Thu, 15 Nov 2007 00:00:00 GMThttp://www.ecancermedicalscience.com/view-article.asp?doi=10.3332/eCMS.2007.58Tue, 16 Oct 2007 00:00:00 GMT
Sixteen patients (59%) had synchronous and 11 (41%) metachronous metastases. During pre-operative chemotherapy tumour regression occurred in 10 cases (37%); stable disease (SD) in a further 10 patients (37%) and progressive disease (PD) developed in 7 cases (26%). The 5 year overall survival for NACT responders was 64% and only 15% for non-responders (p=0.044).

The response to chemotherapy is likely to be a significant prognostic factor affecting survival after liver resection for cure.]]>http://www.ecancermedicalscience.com/view-article.asp?doi=10.3332/eCMS.2008.57Thu, 17 Jan 2008 00:00:00 GMT
Methods: Mothers of 2668 children with solid tumours included in the Manchester Children’s Tumour Registry, 1954-1996 were traced and followed up to 31st December 2000 through the UK National Health Service Central Register. Standardised Incidence Ratio(SIR), P-values and 95% confidence intervals were calculated from age and calendar year-specific female breast cancer incidence rates for England and Wales.

Results: There was a significant excess of breast cancer in mothers overall(SIR=1.3,95%CI=1.0-1.5) mainly due to mothers of children with rhabdomyosarcoma (RMS) (SIR=2.2, 95%CI=1.0-4.0), skin cancer(SIR=7.9, 95%CI=2.9-17.1), and central nervous system tumours(SIR=1.2, 95%CI=0.9-1.8). Maternal breast cancer risk was associated with late age at birth of the index child and male sex and young age at diagnosis in the index child. Risk was highest in the 10 years following the birth of the index. The pattern was seen most strongly in mothers of children with embryonal RMS.

Conclusion: There are excesses of breast cancer in mothers of children with solid tumours in general and specifically in RMS, skin and CNS. There appears to be a temporal relationship between certain tumours in children and breast cancer in their mothers, suggesting a origin of their respective pregnancy. We propose a mother-fetal
interaction mechanism to explain this association.]]>http://www.ecancermedicalscience.com/view-article.asp?doi=10.3332/eCMS.2007.56Fri, 21 Sep 2007 00:00:00 GMTThis paper reports on original results of the ACGT integrated project focusing on the design and development of a European Biomedical Grid infrastructure in support of multicentric, post genomic clinical trials on Cancer. Post-Genomic clinical trials (CTs) use multilevel clinical and genomic data and advanced computational analysis and visualization tools to test hypothesis in trying to identify the molecular reasons for a disease and the stratification of patients in terms of treatment.
The paper provides a presentation of the needs of users involved in post-genomic CTs, and presents indicative scenarios which drive the requirements of the engineering phase of the project. Subsequently, the initial architecture specified by the project is presented and its services are classified and discussed. A range of such key services, including the Master Ontology on Cancer which lies at the heart of the integration architecture of the project, are presented. Special efforts have been taken to describe the methodological and technological framework of the project, enabling the creation of a legally compliant and trustful infrastructure.
Finally, a short discussion of the forthcoming work is included and the potential involvement of the cancer research community in further development or utilization of the infrastructure is described.]]>http://www.ecancermedicalscience.com/view-article.asp?doi=10.3332/eCMS.2007.48Wed, 15 Aug 2007 00:00:00 GMT
In human studies, FDG PET images, in either the fasting state or the glucose-loaded state, have demonstrated that [18F]FDG uptake in tumor is decreased, and thus the PET image quality is impaired when plasma glucose levels are increased. All these results suggest that patients should fast before FDG PET studies and their plasma glucose concentration needs to be considered when assessing tumour glucose metabolism. Minn reported contrasting data about the difference behaviour of FDG in lymphomatous disease, reporting that insulin does not induce major changes in glucose uptake of lymphomatous tissue.

We report two cases of lymphoma patients that underwent [18F]FDG PET/Computed Tomography ([18F]FDG PET/CT) for chemotherapy response evaluation. Both [18F]FDG PET/CT scans were negative about the known lesions but showed increased and diffuse FDG uptake in muscles. This led us to investigate better the fasting condition founding the assumption of glucose. [18F]FDG PET/CT was repeated 3-4 days after and pathological uptake in the lymphomatous lesions was revealed, in both cases.

We demonstrate that euglycemic state is a necessary condition that have to be tested before [18F]FDG administration as the knowledge of the timing of fasting that should be, at least, of 6 hours.]]>