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Biomedical subjects

E Tucci

Publications and source records attributed to E Tucci.

At least 37 records · Page 2Linked to original sources
PubMed1994

Combination chemotherapy with epirubicin and mitomycin C as first-line treatment in advanced breast cancer.

From December 1988 to February 1991, 112 consecutive patients were submitted to epirubicin + mitomycin C chemotherapy as first-line treatment for advanced breast cancer. Epirubicin (75 mg/m2) was given every 3 weeks and mitomycin C (10 mg/m2) every 6 weeks. Only patients with visceral involvement or with a disease-free interval of less than 12 months were considered eligible. 102 patients were evaluated for response and toxicity in the present analysis. The main sites of involvement were viscera, soft tissues, bone in 71 (69.6%), 19 (18.6%) and 12 (11.8%) patients, respectively. Multiple site involvement was present in 66 (64.7%) cases. A total of 726 courses of therapy were administered (range 2-14; mean 7.2). Follow-up ranged from 96 to 210 weeks (median follow-up 138 weeks). Response rate was complete response (CR): 21.6% [95% confidence interval (CI) +/- 0.8], partial response (PR) 49.0% (95% CI +/- 0.1), stable disease (SD) 12.7% (95% CI +/- 0.1), progressive disease (PD) 16.7% (95% CI +/- 0.1), CR + PR: 70.6% (95% CI +/- 0.1). Median values of survival and time to progression were 79.4 and 42 weeks, respectively. At 2 years, 37.2 +/- 4.7% and 12.8 +/- 3.3% of the patients, respectively, were alive or without evidence of progression. Toxicity was generally mild. One hundred and four (14.3%) cycles in 53 patients were delayed due to haematological (82) or cardiac (3) toxicity, infectious disease (11) or causes not related to the treatment (8).

Adult↗
PubMed1994

[Radiotherapy of limited pulmonary microcytoma in current clinical practice].

The use of thoracic irradiation in the treatment of "limited disease" small-cell lung cancer yields better local control and survival rates than chemotherapy alone, according to meta-analysis studies of randomized clinical trials. Outside experimental studies, however, the role radiotherapy can currently play in the management of this type of cancer is difficult to assess because treatment modalities and patient selection criteria differ greatly. We report on the treatment outcome obtained in the Radiotherapy Department of the University of Siena in a series of 86 patients with small-cell lung cancer consecutively referred, January 1986 to January 1992; after a thorough staging, 46 of them were diagnosed as having a "limited disease". A "sequential" chemo-radiotherapy combination was used: irradiation was delivered after the completion of the initial drug treatment. Twenty-four patients (52.5%) achieved a complete and 22 (47.5%) a partial objective remission after chemotherapy, with acceptable early toxicity rates and severity. Twenty-eight of them received irradiation according to the following selection criteria: objective remission after chemotherapy (19 of 24 complete responders, excluding those with initial pleural effusion or worsening medical status during chemotherapy) and initial large tumor bulk (9 of 22 patients in partial remission). The overall treatment outcome rate (median survival: 18 months, 2-year survival: 28%) is in agreement with that of similar previous studies; toxicity rates are also similar (2% of treatment-related deaths). Survival analysis, according to "performance status" score, chemotherapy schedule and the achievement of complete remission with the initial drug management, exhibited significant differences only relative to the latter parameter. Many recent clinical trials suggest that combined chemo-radiotherapy could improve these results: toxicity is however reported as heavy, with this approach. Some guidelines are here considered, which could make this combination reliable also for current clinical use.

Aged↗
PubMed1994

[The use of polypropylene (Marlex) mesh in ambulatory care of inguinal hernia].

The use of Marlex mesh in the treatment of inguinal hernia produces a series of advantages, if compared with traditional techniques. According to the authors, these advantages can be identified with the ambulatorial treatment of this pathology, with the possibility to use the local anaesthetic, with a minimum postoperating pain, with a possible collaboration of the patients with the surgeon during the operation, and with a considerable reduction of relapses. The authors explain the different steps of their techniques.

Adolescent↗
PubMed1993

Breast-conserving treatment of early breast cancer. Results in a common clinical trial.

Results of large prospective trials, often based on selected series and optimal treatment techniques, indicate that breast conserving therapy is appropriate for most patients with early breast cancer. Questions remain regarding the therapeutic outcome in common practice. We report on a series of 206 consecutive, unselected patients treated with current radiotherapy procedures. The Kaplan-Meier evaluation showed 5- and 8-year survival rates (93%, 91%), distant disease-free survival rates (87%, 85%) and local relapse-free survival rates (90%, 88%) that were comparable to those of the conservative arms in reported randomised trials and to the data from retrospective studies reported by authoritative institutions. However, subanalysis according to prognostic factors such as menopausal status, age and axillary nodal status was of limited value, due to the small number of cases.

Adult↗
PubMed1993

Conventional versus high-dose epidoxorubicin as single agent in advanced breast cancer.

Between March 1986 and December 1987, two groups of consecutive patients with advanced breast cancer underwent epidoxorubicin (Epidx) monochemotherapy. Twenty-three patients (group A) received Epidx at a dose of 60 mg/m2 and 27 (group B) at a dose of 120 mg/m2 (i.v. every 3 weeks). No patient had undergone anthracycline treatment before entering the study. Age ranged from 39 to 70 years (mean 52) in group A and from 35 to 69 (mean 50 in group B). The main sites of involvement were liver (5 patients in group A and 10 in group B), lung (4 and 5 patients, respectively), bone (7 and 8 patients, respectively), and soft tissue (6 and 5 patients, respectively). The number of courses of therapy ranged from 4 to 10 (mean 7.4) in group A and from 3 to 10 (mean 6.6) in group B. Tumor response and toxic effects were graded according to World Health Organization criteria. CR + PR were 35% in group A and 67% in group B (chi square = 3.862, p < 0.05). Results were analyzed at 130 weeks from the beginning of the therapy. At this time, survival was 9% in group A and 15% in group B, with a median survival time of 61 weeks (range 18-130) and 77 weeks (range 24-130), respectively. No patient in group A showed cardiac toxicity higher than grade 2 during or after the treatment, whereas in group B, 2 patients developed congestive heart failure after a cumulative Epidx dose of 1080 and 1200 mg/m2. Treatment delays, to allow recovery of white blood cells, were infrequent and occurred only in patients previously subjected to chemotherapy. No patient required hospitalization for sepsis, and alopecia was reversible in all patients. Our data demonstrate that there is a relationship between Epidx dose and response rate in advanced breast cancer.

Adult↗
PubMed1992

Unfavorable experience with hypofractionated radiotherapy in unresectable lung cancer.

The use of a reduced number of large-sized fractions in radiotherapy (hypofractionation) is usually associated with poor therapeutic results and severe adverse effects, in accord with radiobiologic concepts. However by some authors unresectable lung cancer patients have been treated with hypofractionated radiotherapy with the main aim of "convenience". Result and damage rates are reported to be comparable to those of conventional treatment. In our experience, based on palliative irradiation of 86 advanced-stage, nonmicrocytoma patients, objective remission rates, subjective and performance status improvement, and survival overall were as poor as could be expected in this kind of presentation, with no striking impact of this treatment modality. Severe adverse effects were shown by a large proportion of cases involving skin and soft tissues of the chest wall (40%) and lungs (55.5%). The incidence of severe damage was in agreement with BED (biologic effective dose) values, differently from other experiences of radiotherapeutic management of advanced lung cancer with large fractions.

Adult↗
PubMed1992

Carboplatin and vindesine in advanced non-small cell lung cancer. A feasibility study.

Twenty-eight patients affected by advanced non-small cell lung cancer (NSCLC) were enrolled in a feasibility study evaluating toxicity and activity of carboplatin-vindesine combination chemotherapy, according to two different schedules. Fourteen patients were treated with carboplatin 350 mg/m2 monthly and vindesine 3 mg/m2 weekly for 5 doses, then every other week (schedule 1). The activity observed was promising with 3 partial remissions, but the toxicity was substantial, preventing full dose administration in 11 out of 14 patients. The subsequent 14 patients were treated with carboplatin 350 mg/m2 monthly and vindesine 3 mg/m2 on days 1 and 8 of each cycle. Activity was maintained with 4 partial remissions and toxicity was quite tolerable, allowing all patients to receive the planned treatment. The combination of carboplatin 350 mg/m2 on day 1 and vindesine 3 mg/m2 on days 1 and 8 seems active and well tolerated in advanced NSCLC patients and deserves further evaluation in a larger phase II study.

Adult↗
PubMed1992

Serum epidemiological trial on the prevalence of the anti-cytomegalovirus antibodies in patients under substitutive treatment with hemodialysis and CAPD.

The detection of IgG and IgM anti-cytomegalovirus is very important when movements of serum transaminases are noted in absence of positivity for virus of hepatitis in uremic patients on substitutive treatment; in our patients, we have noted a positivity of 67% for the IgG class. Cytomegalic infection must be taken into consideration for the high parenteral transmissibility in addition to the high grade of immunodepression of uremic patients.

Adult↗
PubMed1989

Chemo-radiotherapeutic management of advanced head and neck cancer.

Stage III and IV head and neck cancer patients usually achieve poor therapeutic results after radiotherapy. The search for more effective treatment modalities is justified, provided that tolerance is not lower than that of the usual radiation therapy schedules. Chemotherapy has been shown to be effective, and cis-platinum and bleomycin based treatments are reported to result in objective remissions in a substantial proportion of cases. There is also experimental evidence of a radiosensitizing activity of cis-platinum. Thirty-five locally advanced head and neck cancer patients were given combined chemo-radiotherapeutic treatment consisting of a cis-platinum and bleomycin induction followed by a standard radiotherapy course integrated with weekly administrations of cis-platinum. Before radiotherapy, an overall 48.5% objective remission rate was achieved, that rose to 85.8% after completion of the entire treatment, with a 31.5% complete response rate. Incidence and severity of radiation mucositis seem not to be increased, and systemic toxicity is very low, with the adopted drug administration schedule. Overall results do not show any obvious superiority over those of radiotherapy alone.

Aged↗
PubMed1989

Fetal intracranial calcifications.

In utero sonographic visualization of fetal intracranial calcifications during the second trimester is reported. Its diagnostic process, which included percutaneous umbilical cord blood sampling and fetal paracentesis, is described.

Brain Diseases↗
PubMed1989

[CT assessment of encephalic and suprarenal spread of "operable" pulmonary neoplasms. Preliminary results].

Computed Tomography (CT) was employed to evaluate the incidence of brain and adrenal gland metastases in 74 patients (not-small cell lung cancer) staged for surgery. Nine patients presented one or more asymptomatic brain metastases, 4 adenocarcinomas, 3 epidermoid, 2 adenosquamous. In 6 cases adrenal gland masses were found, only one of which was confirmed as a secondary lesion at biopsy. The authors conclude that brain CT is useful in the preoperative staging of lung cancers, independent of the histology of the primary lesion. An accurate assessment of the utility of CT of the adrenal glands requires a larger sample of patients due to the high incidence of benign adrenal gland masses.

Adrenal Gland Neoplasms↗
PubMed1988

Weekly epirubicin in advanced breast cancer.

Twenty-nine advanced breast cancer patients, considered unable to tolerate conventional cytotoxic chemotherapy, were treated with a weekly schedule of epirubicin (15 mg/m2 i.v.). All patients were fully evaluable. A remission of 34.5% was observed (2 CR; 8 PR), with a median duration of response of 9 months (range, 3-24 months). Side effects were mild, and on the whole the toxicity was negligible. This regimen showed a favorable therapeutic ratio in our series and seems active and well tolerated even in elderly and/or poor performance status patients.

Adult↗
PubMed1988

Unresectable retroperitoneal malignant fibrous histiocytoma: prolonged complete remission following chemoradiotherapy.

Two cases of unresectable retroperitoneal malignant fibrous histiocytoma (MFH) achieving a prolonged complete remission by a combination of chemotherapy (adriamycin plus cyclophosphamide) and abdominal irradiation are reported. Although an optimal treatment policy for such cases has not been established, on the basis of data currently available, chemotherapy regimens including anthracyclines seem the most reliable therapeutic approach in unresectable and/or metastatic MFH.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

Radiation therapy and chemotherapy in the management of testicular seminoma: a review.

Since the early '50s, radiation therapy has been regarded as the mainstay of treatment for testicular seminoma. In the last decade, however, several reports claimed optimal control (about 80% of lasting complete remissions) of advanced disease with cisplatin-containing chemotherapy regimens, consequently questioning the opportunity of irradiation in bulky retroperitoneal presentation. The respective role of radiotherapy and chemotherapy in the management of advanced locoregional seminoma has been reviewed, in view of the fact that our data, previously unpublished, show a 10-year disease-free survival probability of 70% for 27 bulky stage II patients submitted to irradiation. On the grounds of currently available data, a prospective randomized trial of chemotherapy versus radiotherapy in stage II testicular seminoma seems justified, in order to identify the optimal treatment policy for this disease.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Intracavitary cisplatin in malignant cardiac tamponade.

A case of lung cancer presenting with cardiac tamponade is reported. Lasting control of the malignant effusion was achieved by means of intracavitary cisplatin following pericardiocentesis. The patient presented an objective response to subsequent systemic chemotherapy and died 10 months after the diagnosis because of disseminated cancer, without clinical or instrumental findings of pericardial effusion.

Adenocarcinoma↗