The aim of the study was to evaluate the value of clinical prognostic factors for survival of patients with invasive urinary bladder cancer treated with radical cystectomy, chemotherapy, and radiotherapy. Material and methods. A total of 115 patients with invasive urinary bladder cancer were analyzed. Twenty-three patients with invasive urinary bladder cancer (pT2–T4) were treated according to the protocol of a prospective clinical study. In all the cases, transurethral resection was followed by radiation and chemotherapy. A total dose of 54–60 Gy of radiotherapy was delivered by daily fractions of 1.8–2.0 Gy each. Simultaneous chemotherapy was started on the same day as radiotherapy; gemcitabine at a dose of 175–300 mg/m2 was delivered once a week intravenously for 6 weeks. Individual patient data was analyzed in a retrospective part of the study. Radical cystectomy was performed to 46 patients with invasive urinary bladder cancer, and radiotherapy was delivered to 46 patients. Inclusion criteria for patients into a prospective or retrospective trial were equal. We evaluated a prognostic value of various clinical factors for patients treated with radical cystectomy, chemoradiation with gemcitabine, and radiation alone. Results. The 3-year overall survival in the cystectomy group was 51.1%, in the chemoradiation group 38.0%, and in the radiotherapy group 26.9% (P=0.001). In univariate analysis in the chemoradiation group, completion of treatment according to the protocol showed a significant influence on overall survival (P=0.03). In the radiation group, completion of treatment according to the protocol showed a significant influence on overall survival too (P=0.01). In the radical cystectomy group, an important factor was a complete or incomplete TUR (P=0.02). Multivariate analysis showed a significance of hydronephrosis (P=0.03) and T stage (P=0.04) in the radiation therapy group. Comorbidity was found to be an independent prognostic factors in the chemoradiation group (P=0.02). Conclusions. The best 3-year overall survival was in the radical cystectomy group. Chemoradiation with gemcitabine could be offered as an alternative to patients refusing cystectomy. Better overall survival in the chemoradiation group was for patients without comorbidities and when treatment protocol was completed.
The aim of this article is to inform about cancer treatment-induced bone loss, to identify patients at risk and those that can benefit from bone targeted treatment as well as highlight the importance of the multidisciplinary approach in the bone health in cancer care. Patients with breast cancer treated or intended to be treated with aromatase inhibitors belong to a high-risk group because their fracture risk increases up to 30% due to a significant decrease in bone mineral density within 6-12 months after the start of hormonal treatment. To evaluate bone status and predict risk for fractures, lateral thoracic and lumbar spine X-ray imaging, bone mineral density measurement by dual energy X-ray absorptiometry at the lumbar spine L1-L4 vertebrae and/or hip and fracture risk factors assessment are mandatory tests prior to hormonal treatment. Morbidity and mortality associated with bone loss can be prevented with appropriate screening, lifestyle interventions, and therapy. Algorithm for the management of bone health in breast cancer patients was established in Lithuania to screen patients with increased risk for bone loss and to provide adequate specific osteoporosis treatment.
The purpose of this article is overview of currently available knowledge found in literature about the chemoradiation for locally advanced cervical cancer.Cervical cancer is the third most commonly diagnosed cancer and the fourth leading cause of cancer death in females worldwide. Despite the available prevention and early detection strategies, carcinoma of the uterine cervix is still diagnosed as locally advanced disease in a considerable proportion of patients. Standart treatment of locally advanced cervical cancer is cisplatin-based chemoradiation. Unfortunately, results of the treatment are not sufficient and cancer relapses are frequent. New cytostatics regimens either alone or in combination with cisplatin are searching as radiosensitizers with concurrent radiotherapy. Neoadjuvant/induction chemotherapy, adjuvant/consolidation chemotherapy strategies, molecular agents targeting critical pathways are under investigation in clinical trials to improve results of the treatment.The purpose of this article is overview of currently available knowledge found in literature about the chemoradiation for locally advanced cervical cancer.Key words: locally advanced cervical cancer, chemoradiation, adjuvant/consolidation chemotherapy, neoadjuvant/induction chemotherapy.Chemospindulinis vietiškai išplitusio gimdos kaklelio vėžio gydymas Straipsnio tikslas – apžvelgti ir pateikti šiuo metu prieinamoje literatūroje sukauptas žinias apie konservatyvų chemospindulinį vietiškai išplitusio gimdos kaklelio vėžio gydymą.Gimdos kaklelio vėžys yra trečia dažniausiai pasaulyje nustatoma moterų vėžio forma ir ketvirta pagal dažnį moterų mirties nuo vėžio priežastis. Nepaisant profilaktikos priemonių bei patikros programos, nemaža dalis gimdos kaklelio vėžio atvejų nustatoma jau vietiškai išplitusios IIB–IVA stadijos. Šiuo metu vietiškai išplitusio gimdos kaklelio vėžio gydymo standartas – suderintas chemospindulinis gydymas cisplatinos pagrindu. Deja, gydymo rezultatai nėra patenkinami, atkryčio dažnis išlieka didelis. Siekiant geresnių gydymo rezultatų atlikta ir atliekama daug klinikinių tyrimų, spindulinio gydymo metu taikant naujus citostatikus ar jų derinius su cisplatina, tiriama neoadjuvantinės/indukcinės bei adjuvantinės/konsoliduojančios chemoterapijos reikšmė, „taikinių“ terapijos panaudojimo galimybė.Reikšminiai žodžiai: vietiškai išplitęs gimdos kaklelio vėžys, chemospindulinis gydymas, adjuvantinė/konsoliduojanti chemoterapija, neoadjuvantinė/indukcinė chemoterapija.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.