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Biomedical subjects

A Ravaioli

Publications and source records attributed to A Ravaioli.

At least 55 records · Page 3Linked to original sources

Synergism between gamma interferon and doxorubicin in a human MDR colon adenocarcinoma cell line.

Recent interest in cancer therapy derives from the ability of interferons to synergistically increase the activity of chemotherapeutic agents. To understand the biological basis of this synergism we evaluated the effects of human recombinant IFN-gamma on the expression of the mdr1 gene and on the cellular growth of a human colon adenocarcinoma cell line (LoVo) and its MDR subline (LoVo/Dx) after coincubation with doxorubicin. Treatment with IFN-gamma showed unchanged levels of MDR1-glycoprotein, no perturbation on cell cycle distribution and a significant reduction of colony formation in both lines (P < 0.05) starting from 100 U/ml. A synergistic effect was observed in the LoVo/Dx cell line when doxorubicin was added after exposure to 0.1-10 U/ml of IFN-gamma. Our data indicate that the effects of IFN-gamma, independent from action on cell proliferation and from modulation of p-glycoprotein expression, are a cause of the synergistic activity between this lymphokine and conventional chemotherapeutic agents such as doxorubicin.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Prognostic factors and survival in non-Hodgkin's lymphomas: the experience of the Istituto Oncologico Romagnolo (IOR).

In an attempt to evaluate natural history, prognostic factors and survival, the data of 340 patients with NHL were collected. 267 patients were evaluable for the analysis of prognostic factors and survival. The tumor samples were reviewed and reclassified according to the Kiel classification. At completion, 180 patients were affected by low-grade (LG)-NHL and 87 patients had high-grade (HG)-NHL. Numerous potential prognostic factors were analysed in univariate and multivariate analyses. Globally 154 patients (57.4%) obtained complete remission (CR) and 65 patients (24.3%) partial remission (PR). The response rate was similar in LG and HG-NHL groups. 5-years survival was 52% for all patients (53% in LG-NHL and 44% in HG-NHL). Median survival was 62 months in LG-NHL and 38 months in HG-NHL (p = n.s.). At the univariate analysis overall survival (OS) in LG-NHL was favourably influenced by age < 65 years (p = 0.004), performance status > 80 (p < 0.02), early clinical stage (p < 0.001), absence of systemic symptoms (p < 0.001), low serum LDH (p < 0.001) and achievement of CR (p < 0.001), while in the HG-NHL only by age (p = 0.005) and achievement of CR (p < 0.001). The multivariate analysis showed early clinical stage, low serum LDH, absence of systemic symptoms and achievement of CR as independent prognostic factors in LG-NHL and only achievement of CR in HG-NHL.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Primary bronchial malignant melanoma. A case report.

A case of primary bronchial malignant melanoma occurred in a 66 years old woman is reported. Because of cough and hemoptysis bronchoscopic examination was performed and and a polypoid mass was found to occlude the right lower bronchus. Histopathologic examination showed the presence of malignant melanoma also confirmed by immuno reactivity with antibodies to S-100 protein and melanoma associated monoclonal antibody HMB45. Clinical history, physical examination and other instrumental investigations failed to find other possible primary sites of the tumour. Primary melanoma of the lung is a very rare condition, but our case seems to satisfy the criteria to be considered in the little group of definite primary melanoma of the lower respiratory tract.

Aged↗

Patterns of Pap smear use in the Rimini area: an analysis of women's attitudes to the test.

The use of the Pap test is a method of the prevention of cervical cancer in our local division of the Sanitary Unit and has been studied with the help of a questionnaire which was completed by women who had adopted this test. The socioeconomic characteristics, level of education, occupation and general attitudes regarding the Pap test as well as how the women had acquired knowledge of the test, have all been examined. From an analysis of the answers, we have been able to trace a precise social, economic and cultural profile of the type of women who take advantage of this test. Principally, we are dealing with women aged 40-49 years, often with children, with a medium to low level of education, who are mainly housewives and white-collar workers. Very few elderly women present themselves for the Pap test. We have noticed that there is a direct decrease in the use of preventive methods, proportional to the increase in age. These results demonstrate that an erratic use of this preventive method, in the absence of an organized screening programme, seems only to involve women who are among those at less risk from cervical cancer.

Adult↗

[The role of colposcopy in the diagnosis of HPV infection].

Human papillomavirus (HPV) has been implicated as an important etiologic factor in cervical carcinoma. This study evaluates the efficacy of colposcopy in the detection of cervical lesions with koilocytosis features. Colposcopy, cervical smears and biopsy specimens from 217 women seen in our department between January-December 1991 were examined. The colposcopy examination detected 77.5% of the viral presence the histological diagnosis detected 85% of HPV, but the cytologic smears showed only 52% of infection. The data suggests that colposcopy is a good examination to evidence koilocytosis infection.

Adult↗

[Cervico-vaginal screening in some Local Sanitary Units of the Emilia-Romagna region].

Some Local Sanitary Units (USL) of the Emilia-Romagna region were contacted to define cervical screening variables, such as adequacy of smear technique, data collection and evaluation, laboratory quality control modalities of invitations to screening. Our data show there are a lot of deficiencies in the present management of the cervical program in Romagna. The most serious inadequacies concern data evaluation, follow-up, cytologic quality control, modalities of active invitations of women to screening. The survey has confirmed the need for launching organized programs of cervical screening to promote their efficacy of diagnosis and therapy.

Adult↗

Primary lymphoma of the central nervous system.

Primary lymphoma of the central nervous system (CNS) represents a pathology that is no longer considered rare, also in the light of its high correlation with the human immunodeficiency virus (HIV) syndrome reported recently. Often the correct diagnosis of the disease is difficult to reach, owing to the wide spectrum of non-lymphoma pathologies from which it should be differentiated and the invasiveness of some diagnostic techniques. The biologic aggressiveness of the neoplasm often makes a combined radio-chemotherapeutic approach necessary. In contrast, surgical resection does not seem to provide any significant benefit. The clinical experience reported here, together with a review of the most recent literature, lead the authors to suggest the opportunity of treating primary lymphoma of the CNS with the most active and modern chemotherapeutic protocols in association with traditional treatments to obtain an improvement in overall survival.

Aged↗

High-dose etoposide and autologous bone marrow transplantation as intensification treatment in small cell lung cancer: a pilot study.

A pilot study was conducted in which 15 patients with small cell lung cancer (SCLC) with limited or extended disease were treated with high dose etoposide (600 mg/m2 daily for 3 consecutive days) followed by autologous bone marrow transplantation (ABMT). Twelve patients underwent a double graft. All had achieved complete or partial remission with conventional induction chemotherapy (adriamycin and etoposide, plus cisplatin in five cases). After ABMT six of the 15 patients did not receive radiotherapy to the chest; all but four patients received prophylactic brain irradiation. No toxic deaths were recorded during the period of aplasia. Eleven patients relapsed and died after ABMT. The median time to death was 18 months. One other patient died at 13 months of unknown cause. At the present time three patients are alive and free of disease at 54, 51 and 47 months respectively. This pilot study shows that high dose etoposide and ABMT is well tolerated as late intensification for responsive SCLC. Definite conclusions about its precise role in therapy cannot yet be drawn.

Adult↗

Radioligand-labeled binding assay and immunochemical assay for estrogen receptor in 115 human breast cancers.

The aim of this study was to evaluate the results obtained from a new enzyme immunoassay (Abbott-ER-EIA) for the determination of estrogen receptor levels in tumor cytosols in comparison with the currently used DCC method. One hundred and fifteen consecutive primary breast cancer specimens were examined; 66 of the women were postmenopausal and 49 were premenopausal. A good correlation (r = 0.88, p less than 0.001 and a slope of 1.3) was found between ER-EIA and the steroid binding assay (DCC). When these data were analyzed according to menopausal status, no differences were observed for the slopes and correlation coefficients in pre' and postmenopausal groups. The ER-EIA appears to produce results comparable to those obtained with the conventional DCC method for the determination of ER in breast tumor cytosols.

Breast Neoplasms↗

Gastric cancer: histopathologic patterns according to Lauren's classification in a high-risk area and distribution by residence.

A total of 1061 advanced gastric cancers with histologic confirmation, diagnosed from 1973 to 1982 at the Morgagni-Pierantoni Hospital (Forlì) were reclassified according to Lauren, and histologic types were related to the source of the histologic specimen, sex, age at diagnosis, place of birth and residence. This large case series showed a high percentage of intestinal type cancers, consistent with the high risk for gastric cancer which characterizes the area under study. Intestinal type carcinomas tend to be represented more in the older age groups, in males and in subjects born in the Forlì province and resident in hilly and mountainous areas. The distribution over time of biopsy specimens in this case series showed an increased use of gastroscopy for diagnosis in the population under study.

Adult↗

Combination chemotherapy in advanced ovarian carcinoma.

Ovarian carcinoma is the fifth most common cause of death among women in western countries. It is often diagnosed in an advanced stage (FIGO Stage III and IV) and requires effective chemotherapy as first-line treatment. The advent of cis-platin combined with adriamycin and cyclophosphamide has remarkably increased the response rate in advanced disease. The authors report 31 cases of epithelial ovarian neoplasia, without prior chemotherapy, treated with cis-platin, adriamycin and cyclophosphamide (PAC I). Of the 30 evaluable patients, 15 had clinical complete remissions (cCR = 50%), 10 clinical partial remissions (cPR = 33%) and 5 no response (NR = 17%). The total response (cCR + cPR) was equal to 83%. Twelve of the 15 patients in cCR underwent second-look laparotomy; in 8 of these cases, histologic and cytologic confirmation of CR was obtained. PAC I was found to be a highly effective therapeutic regimen with moderate toxicity. The individual toxicity reported was gastroenteric (nausea and vomiting), but transitory. No chronic toxic side-effects from cisplatin or adriamycin were noted. However, more definitive results must be obtained to verify its impact on the prolongation of survival.

Adult↗

Primary gastric lymphoma: a review of 45 cases.

Primary gastric lymphoma accounts for about 2% of gastric neoplasms. The prognosis of patients affected with non-Hodgkin's gastric lymphoma appears better than for other lymphatic sites. In a retrospective study, the authors have analyzed 45 patients, by evaluating the histopathologic characteristics and relative prognostic factors. The main factors significantly influencing 5-yr survival are: serosal penetration (31.17% vs. 71.2%, P less than 0.05), regional lymph node involvement (53.07% vs. 68%), and clinical stage of disease (IE: 85.6%, IVE:10%, P less than 0.001). The histologic characteristics, the high or low grade of malignancy, and patient age can also be considered important prognostic factors, but not statistically significant in our series of cases. Comparison between overall survival and disease-free survival of patients in stages IE and IIE who underwent surgery alone, with those who had chemotherapy and/or radiotherapy after surgery shows a higher survival (85.6%) of the group who had combined treatments, even though this difference is not statistically significant.

Adult↗

Chemotherapy of advanced gastric cancer: a study of 43 consecutive cases treated with fluorouracil, adriamycin and mitomycin C (FAM).

All consecutive patients with advanced gastric carcinoma who came to the Oncology Dept. of the "L. Pierantoni Hospital" in Forlì, between June 1, 1980 and August 30, 1983, were treated with 5-fluorouracil, adriamycin and mitomycin C (FAM). None of the patients had previously received chemotherapy. The dominant location of metastasis was the liver in 21 pts (48.8%), the abdomen in 15 pts (34.8%) and distant organs in 7 pts (16.2%). The schedule of FAM regimen used was: 5 Fluorouracil, 600 mg/m2, days 1, 8, 29, 36; Mitomycin C 10, mg/m2, day 1; Adriamycin, 30 mg/m2, days 1, 29. Complete remission (CR) was reached in 2 pts (4.6%) with a median length of response (m.l.r.) of 55 weeks (range 20-90), partial remission (PR) in 9 pts (20.9%) with a m.l.r. of 15.1 weeks (2.2-60), no change (N.C.) in 19 pts (44%) with a m.l.r. of 10 weeks (2.2-54) and progression (P) in 13 pts (30.2%). Median survival of patients in CR + PR considered together was 48 weeks (12 months), for the NC pts 20 weeks (5 months) and for those in P 14.1 weeks (3.5 months). The authors reached the conclusion that gastric carcinoma may be treated with FAM both for palliation and to improve survival even if in a small number of patients.

Adult↗

Intraductal papillomas: diagnostic and surgical procedures.

A series of 98 patients with spontaneous nipple discharge, is reported. Diagnosis was based on: clinical examination, cytology of breast secretion, mammography and galactography. Surgical resection was recommended in the following cases: galactographic evidence of intraductal papilloma or papillomatosis, dubious or positive cytology, persisting hemorrhagic or sero-hemorrhagic secretion. The injection of vital staining before the operation allowed the precise location of the lesion. In the group of patients studied ten cases of ductal carcinomas (5 in situ and 5 smaller than 1 cm), 4 cases of atypical intraductal hyperplasia, 13 cases of solitary papilloma and 22 cases of multiple papillomatosis were diagnosed.

Breast Neoplasms↗

A retrospective study of FAM regimen in 38 patients with advanced gastric cancer.

Gastric carcinoma has a very poor prognosis, with a survival rate at 5 years of 13%. Various chemotherapy regimens have been used in the advanced stages of the disease. The best results were obtained using the FAM combination. We treated 38 patients with advanced measurable gastric cancer using the FAM combination and obtained 23.67% complete plus partial remission (CR + PR) (32% with more restrictive criteria for eligible patients) and 34% no change. The median length of response was 30 weeks in CR patients (range 20-100) and 26 weeks (range 12-34) in PR patients. Responsive patients (CR + PR) had a median survival of 12.3 months (range 5-22) compared to nearly 4 months (range 2-8) for unresponsive patients.

Adult↗

Inflammatory breast carcinoma: results from sixteen patients treated with chemo-radiotherapy and surgery.

Inflammatory breast carcinoma is a dramatic tumour with a five-year survival rate of almost 3%. Various therapeutic approaches have been made for this neoplasia: surgery, radiotherapy and chemotherapy, alone or in combination. The best results were obtained with the use of a multidisciplinary approach. The authors developed a treatment in which chemotherapy and radiotherapy, together with surgery, are used. After three cycles of CMF (cyclophosphamide, methotrexate, 5-fluorouracil) the patients with partial remission, no change or disease progression were changed to adriamycin + vincristine plus radiotherapy. Surgery was performed on patients with complete remission or partial remission after chemo-radiotherapy. After surgery, maintenance chemotherapy was used with the more active drugs. The actuarial survival rate at 5 years was 30.65% and median survival 34 months.

Antineoplastic Combined Chemotherapy Protocols↗

Gastric carcinoma: preliminary data of a cooperative program for early diagnosis.

The results of a program of early gastric cancer detection, carried out in the Oncologic Institutes of Genoa, Forlì and Florence, are evaluated. General practitioners screened subjects, according to possible anamnestic and clinical risk indicators (age, family history, previous gastric lesions, digestive complaints, etc.). The diagnostic consisted of medical examinations, endoscopy with cytology and/or directed biopsy, and possibly air contrast barium X-ray. Of 3,180 subjects examined, 224 had gastric cancers (7 %), 29 of which were early cancers, and 688 had high risk lesions; 1,478 cases of other pathology were detected. The authors stress that the proportion of early cancer is clearly higher than that found in routine diagnosis, yet still lower compared to the results of screening programs carried on the general population. Moreover, the high diagnostic sensitivity of each method in early gastric cancer detection and, on the other hand, the difficulties in the detection of high risk lesions, which require systematic multiple biopsies, are emphasized.

Adult↗

N-nitroso compound precursors and gastric cancer: preliminary data of a study on a group of farm workers.

An epidemiological research on gstric cancer mortality rates carried out in the town of Forì is reported. The results are significant as regards the relation between the urban and rural areas, and show a higher risk for gastric cancer in the rural area. Salivary nitrite measurement in 92 farm workers showed particularly high values (over 30 ppm in 4 individuals). Analysis of histological findings in biopsies performed during endoscopy in 46 persons of the group studied showed a great number of CAG and CAG + IM in asymptomatic individuals.

Adult↗