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B Massidda

Publications and source records attributed to B Massidda.

49 records · Page 3Linked to original sources
PubMed1977

[Hormonal therapy with androgenic steroids in diffuse malignant neoplasms of the breast].

2-alpha-methyl-17-beta hydroxy-androstan-3-one was given to advanced breast cancer patients whose general condition (preterminal in many cases) or haematological picture precluded other cytostatic management. Rapid progression of the tumour was noted in 65%, improvement in 15% and no change in 20%. It is felt that androgens alone should only be given where other more effective treatments are contraindicated. They can be associated with polychemotherapeutic courses to exploit their anabolising and antianaemic activity.

Adult↗
PubMedDate not supplied

5-fluorouracil plus folinic acid with or without ifosfamide in advanced colorectal cancer: a phase II randomized trial.

AIM: This phase II trial evaluated the biomodulation of 5-fluorouracil (5-FU) plus folinic acid (FA) with or without ifosfamide (IFO) in chemotherapy-naive patients with colorectal cancer. PATIENTS AND METHODS: Forty-eight patients were randomized to receive: FA (25 mg/m2 iv bolus days 1 to 3), followed by 5-FU (750 mg/m2 iv bolus days 1 to 3), arm A; or FA (25 mg/m2 iv bolus days 1 to 3), followed by 5-FU (750 mg/m2 iv bolus days 1 to 3) plus IFO (2,000 mg/m2 in 1000 mL 5% dextrose in a 2-hr infusion, days 1 to 3), arm B. Mesna was added during and after IFO to prevent hemorrhagic cystitis. Treatment was repeated every 21 days in both arms. RESULTS: Forty-five patients were assessable for response: in arm A, 5 patients achieved a partial response (overall response, 25%), and in arm B, 2 patients achieved a complete and 1 a partial response (overall response, 12%). Time to failure was 3.5 months (range, 1-38) in patients treated with 5-FU plus FA, and 3 months (range, 1-21) in patients treated with the IFO combination. The median survival time was 13.5 months (range, 1-49 months) in arm A and 16 months (range, 1-43 months) in arm B. Diarrhea, stomatitis and vomiting were the most common nonhematologic toxicities in both arms. The most notable hematologic toxicity was leukopenia; 15% and 20% of patients experienced grade 4 in arm A and arm B, respectively. CONCLUSIONS: IFO does not increase the activity of the 5-FU plus FA combination in advanced colorectal cancer.

Adult↗
PubMedDate not supplied

A phase II study of gemcitabine and tamoxifen in advanced pancreatic cancer.

BACKGROUND: Advanced pancreatic cancer (APC) constitutes a poor-prognosis disease with few and disappointing therapeutic options. In recent years chemotherapy has demonstrated a positive effect on disease-related symptoms with the introduction of a novel pyrimidine analogue, gemcitabine. Moreover there is experimental and clinical evidence that endocrine therapy may play a small but unexplored role in the management of APC. Therefore we performed a phase II study to assess whether the combination of gemcitabine and tamoxifen could be an active and safe schedule for the treatment of APC in terms of response rate and clinical benefits. MATERIALS AND METHODS: Twenty-seven evaluable consecutive patients with locally advanced, unresectable or metastatic adenocarcinoma of the pancreas were treated with gemcitabine (1000 mg/mq given as a short infusion once weekly for 3 consecutive weeks out of every 4 weeks) and tamoxifen (20 mg daily starting the second day after gemcitabine). The treatment was continued until progression or unacceptable toxicity. Evaluation of efficacy included response rate, time to progression, survival and clinical benefit, an integrated measurement of pain parameters, weight and performance status. RESULTS: A partial response was achieved in 11% of patients while 48% experienced stable disease, lasting at least 8 weeks; disease progression was documented in 41% of patients. The median time of progression was 4.5 months; the median survival-time was 8 months and one-year survival was 31%. Clinical benefit was documented in 59% of patients with a median duration of 13 weeks. No gastrointestinal or haematological grade 4 toxicity was observed. In general the treatment showed a satisfactory safety profile and tamoxifen-related toxicity was not documented. CONCLUSION: The combination of gemcitabine and tamoxifen appears to be an innovative therapeutic approach in the management of APC with interesting clinical activity and a good profile of toxicity. This novel schedule of treatment deserves further investigation in large randomized trials to assess if the addition of tamoxifen could improve the therapeutic results of gemcitabine in APC, mostly in term of quality of lfe.

Aged↗
PubMedDate not supplied

[Clinical guidelines for the management of gastrointestinal stromal tumors].

Treatment of gastrointestinal stromal tumors (GIST) has been revolutioned by the recently discovered molecular mechanism responsible for the oncogenesis of this disease. In addition, due to the rapid progress at molecular and clinical level observed in the last few years, there is a need to review the current state of the art in order to delineate appropriate guidelines for the optimal management of these tumors. A panel of experts from several specialities, including medical oncology, surgery, pathology, molecular biology and imaging, were invited to participate in a meeting to present and discuss a number of pre-selected questions, and to achieve a consensus according to the categories of the National Comprehensive Cancer Network (NCCN) and the Standard Options Recommandations (SOR) of the French Federation of Cancer Centers. Generally, consensus points were from categories 2A of the NCCN and B2 of the SOR. Conventional histologic examination with immunohistochemistry for CD117, CD34, SMA, S-100 and desmin is considered standard. Molecular analysis for the identification of KIT and PDGFRA mutation may be indicated in CD117-negative GIST. Complete tumor resection with negative margins is the optimal surgical treatment. Adjuvant imatinib should be considered an experimental approach. Neoadjuvant imatinib is also experimental, although its use may be justified in unresectable or marginally resectable GIST. Imatinib should be started in metastatic or recurrent disease, and should be continued until progressive disease or drug intolerance. In these cases, sunitinib can be used. The optimal criteria for the assessment and monitoring of GIST undergoing imatinib therapy are not well known, but they should include reduction in tumor size and disease stabilization, as well as reduction of tumor density on CT scan and metabolic activity on PET scan.

Antineoplastic Agents↗
PubMedDate not supplied

Histopathological study of a case of systemic angiofollicular hyperplasia (Castleman's disease).

This report describes the nodal and hepatic lesions observed in a patient with generalized disorders that had been histologically diagnosed as a systemic angiofollicular hyperplasia. The diagnostic morphological findings were observed in the nodes of the axilla and were represented by diffuse marked plasmacytosis, prominence of the germinal centres, preservation of the architecture with a reactive proliferation of blood vessels and fibrous tissue in interfollicular areas.

Aged↗
PubMedDate not supplied

Ethinyl estradiol and medroxyprogesterone treatment in advanced breast cancer: a pilot study.

Twenty patients with disseminated breast cancer unresponsive to conventional chemotherapy and chemohormonotherapy were treated with an alternating sequential schedule of ethinyl estradiol and medroxyprogesterone on the basis of correlations between hormones and estrogen and progestin receptors. Of 19 evaluable patients, six underwent partial or complete remission, while five others showed minor responses.

Breast Neoplasms↗
PubMedDate not supplied

[Current trends in the treatment of Graves' disease].

Between 1973 and 1992 153 patients with Graves' disease were observed at the Surgery and Oncology Institute-Cagliari University. 103 underwent subtotal (70) or total (33) thyroidectomy, while 50(after 1985) were submitted to radioactive-iodine therapy. Surgical indications were failure of antithyroid drug therapy, signs of compression and large size goitre. Until 1988, all patients were submitted to subtotal thyroidectomy with thyroid remnant of about 8 g. From 1988 the choice of total thyroidectomy came out from: similar complications (paralysis of recurrent nerve and hypoparathyroidism), lack of relapse and suppression of risk of occult carcinoma. After subtotal thyroidectomy definitive hypoparathyroidism in 1 patient (1.8%), transitory hypoparathyroidism in 5 (9.4%), clinical hypothyroidism in 17 (31.5%), recidive hyperthyroidism in 3 patients (5.5%) were observed. After total thyroidectomy 1 patient presented definitive paralysis of recurrent nerve (3%), 1 definitive hypoparathyroidism (3%), 8 transitory hypoparathyroidism (24%): small (44 patients) or large goitre (3 patients) or relapse (3 patients) were indications to radioactive-iodine therapy. At median follow-up of 16 months no relapses of hyperthyroidism were observed, while clinical signs of hypothyroidism were present in 33% of patients. Authors stress that, after a first attempt with antithyroid drugs therapy, radioiodine treatment is elective in Graves' disease. Surgery still remains the treatment of choice during pregnancy, in patients with large goitres, signs of compression or in presence of scintigraphic "cold" area.

Adult↗
PubMedDate not supplied

Usefulness of pyridinium crosslinks and CA 15-3 as markers in metastatic bone breast carcinoma.

Numerous tumor markers such as CEA, MCA, CA 15-3 have been assayed in breast cancer patients to detect relapse at a preclinical stage and most of all to monitor the treatment of the advanced disease. Since they are not site-specific, pyridinium crosslink dosage has recently been reported as a specific bone resorption marker in several non neoplastic diseases. The aim of this study was to evaluate the urinary pyridinium crosslink levels in breast cancer with or without osseous involvement, and to correlate it with serial doses of CA 15-3. 285 breast cancer patients (226 free of disease and 59 with bone metastases) were measured for both pyridinoline and CA 15-3. In the metastatic patients the mean values of the two markers were significantly higher than in non evident disease patients (P = < 0.01 and p = < 0.001 respectively). Abnormal values over the normal were found in 22% for pyridinoline and 11% for CA 15-3 in patients free of disease while the normal values observed in patients with bone metastases were 22% for pyridinoline and 39% for CA 15-3. Tandem dosage of CA 15-3, was highly sensitive but site-aspecific, and pyridinoline, which is bone specific, may be useful chiefly in the monitoring of breast cancer treatment, since many physiological conditions such as age, menopausal status and variation over 24 hours, and cost effectiveness will influence the use of pyridinoline during follow-up.

Adult↗
PubMedDate not supplied

Early detection of the anthracycline-induced cardiotoxicity. A non-invasive haemodynamic study.

Anthracyclines are the most frequent cause of iatrogenic congestive heart failure ranging from acute reversible minor, irreversible reduction in the left ventricular ejection fraction and death despite preventive measures. Sensitive methods are needed to detect earliest preclinical cardiotoxicity along with the development of new protective agents. Thirty breast cancer patients were randomly treated with q 21 120 mg/m2 Epirubicin (EPI) x 3, alone (10 patients), or + ICRF-187 (1000 mg/m2) (10 patients) or + C0Q10 (50 mg/day) (10 patients) and monitored by Thoracic Electrical Bioimpedance (TEB) cardiography before (T0) and at the end of chemotherapy (T1), then at 1, 3, 6 months of follow up (F1, F2, F3). a) The group treated with EPI alone showed, between F1-F2, a significant (p < 0.05) decrease in Stroke Index (S1). Acceleration Index (ACI) and a significant (p < 0.05) increase in Systemic Vascular Resistance Index (SVRI), while between F2 and F3 it showed a significant (p < 0.05) recovery in S1 and ACI. b) The group treated with EPI + ICRF-187 showed, between F1 and F2 a significant decrease in S1 and ACI (p < 0.05, p < 0.01 respectively) and a significant (p < 0.05) increase in SVRI: between F2-F3 ACI had a significant (p < 0.05) recovery: c) The group treated with EPI +C0Q10 showed no modification in Sl, ACI, and SVRI during the study. The ejection Fraction (EF) remained unchanged during the study in all the groups. C0Q10 seems to prevent early decreases in cardiac performance and contractiling, thus avoiding an SVRI increase, while ICRF-187 did not. Since ICRF-187 acts by binding iron, we deem that the earliest cardiac involvement, may occur before iron overload; therefore the role of ICRF-187 and C0Q10 in acute or chronic heart toxicity was correlated with high-dose anthracycline and needs to be further investigated.

Adult↗