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G Bacci

Publications and source records attributed to G Bacci.

At least 163 records · Page 9Linked to original sources

The treatment of localized Ewing's sarcoma: the experience at the Istituto Ortopedico Rizzoli in 163 cases treated with and without adjuvant chemotherapy.

Eighty consecutive patients with localized Ewing's tumor treated with adjuvant chemotherapy for two years plus local tumor control were retrospectively reviewed. Adjuvant chemotherapy protocol was constant for all patients, but local treatment consisted of amputation, resection (complete or incomplete) plus radiotherapy, or radiotherapy alone. The follow-up ranged from 21--101 months (mean = 50 months). The mortality rate and incidence of metastasis were significantly lower than in a comparable group of 83 patients previously treated by radiotherapy, or surgery plus radiotherapy but without chemotherapy. The percentage of local recurrence was not significantly different between the two groups. Of the patients treated with adjuvant chemotherapy, the percentage of local recurrence and metastases was much lower when the primary lesion was located in the extremities and when this lesion was treated by conservative surgery followed by irradiation. This was also true when the resection was not complete. Little discrepancy in functional results was observed using either resection plus radiotherapy or radiotherapy alone. The above data suggest that in treating Ewing's sarcoma, conservative surgery, even incomplete, can play an important role when associated with radiotherapy and adjuvant chemotherapy.

Adolescent↗

Full-lung tomograms and bone scanning in the initial work-up of patients with osteogenic sarcoma. A review of 126 cases.

The value of full-lung tomograms and of bone scanning in the initial work-up of patients with osteogenic sarcoma is evaluated in 126 consecutive cases observed at the Bone Tumor Center of the Istituto Ortopedico Rizzoli from July 1976 to December 1980. Full-lung tomograms and bone scanning showed unsuspected metastases in 3 patients and 2 patients respectively. False abnormal results were observed in 4 cases by tomography and in 3 cases by bone scan. The authors conclude that in osteosarcoma, the yields of full-lung tomography and of bone scanning are small in detecting unsuspected lung and bone metastases at the time of presentation. It therefore appears improbable that the improvements recently observed in this tumor with adjuvant chemotherapy are the result of unintentional case selection bias due to these examinations not having been performed in the historical group.

Adolescent↗

Frequency and prognostic value of HLA antigens in osteosarcoma patients.

A homogeneous group of 53 Caucasian subjects with high-grade osteosarcoma (OS) was typed for HLA-A and B locus antigens. Although no significant differences in the distribution of these antigens were found in comparison with 425 local controls, a trend towards an increase of HLA-B18 and decrease of HLA-B12 was observed. All the patients underwent amputation plus adjuvant chemotherapy and among the 29 patients with a follow-up longer than one year, 9 out of 10 subjects with HLA-A3 antigens developed metastases within a few months. None of the OS patients had the HLA-A3, B7 haplotype which is present in linkage-disequilibrium in the control population.

Adolescent↗

Primary non-Hodgkin's lymphoma of bone: results in 15 patients treated by radiotherapy combined with systemic chemotherapy.

The authors report on the results obtained in 15 patients with primary non-Hodgkin's lymphoma (NHL) of bone treated by radiotherapy and polychemotherapy; 86% of the patients (13 of 15) were continuously disease-free at a median follow-up of 70 months (42-104). No local recurrence was observed. The necessity of clearly distinguishing primary non-Hodgkin's lymphoma of bone from Ewing's sarcoma is discussed.

Adolescent↗

The treatment of osteosarcoma of the extremities: twenty year's experience at the Istituto Ortopedico Rizzoli.

Twenty year's (1959-1979) experience in the treatment of osteosarcoma at the Bone Tumor Center of the Istituto Ortopedico Rizzoli is presented. During this period 433 cases were recorded, but only 266 were considered. All the patients underwent surgery but after 1970 whole-lung irradiation (1971), immunotherapy (1971), and chemotherapy (1972 onward) were added as adjuvant therapies on a nonrandomized basis. In the group treated with surgery alone the prognosis was very poor: 10% survived nine years or more after the diagnosis, an average disease-free interval of 7.7 months and an average survival time of 13 months. Monolateral whole-lung irradiation had negative results and was abandoned after six cases. Adjuvant immunotherapy with irradiated autologous tumor cells gave moderately positive results in 16 patients, but only by delaying the appearance of first metastases, therefore increasing the time of survival. Adjuvant chemotherapy was performed with three different protocols: one protocol with ADM only and two protocols using VCR + MTX (at medium dose) + ADM, administered according to two different schedules. Superimposable results were obtained with these three regimens. With equal follow-up, the percentage of continuously disease-free patients treated with adjuvant chemotherapy was significantly higher than that of patients treated with surgery alone (P less than 0.001). The patients in the chemotherapy group who had relapses showed a prolonged time (mean = 12.3 months) to the onset of the first metastasis. Adjuvant chemotherapy caused virtually no morbidity and no deaths. Reference is made to the advantages of a large and homogeneous caseload deriving from a single institution to avoid preselection bias and evaluate the effectiveness of new therapeutic approaches when patient randomization has not been employed.

Adolescent↗

Multiple-drug chemotherapy for the primary treatment of osteosarcoma of the extremities.

Fifty-five cases of osteosarcoma of the extremities were treated between 1972 and 1976 by combined surgery and chemotherapy (vincristine, adriamycin and methotrexate in medium doses) for 18 months. The follow-up ranges from 30 to 80 months (mean = 48 months). Twenty-six patients remained free from any evidence of disease, two had local recurrences but no metastases and 27 had metastases (four of these also had local recurrences). In 12 patients, the metastases appeared after the end of chemotherapy. Both metastases and local recurrences were more frequent in patients who had segmental bone resection (7/8) than in those treated by more radical surgery (22/47). Comparison with an "historical" group (94 osteosarcoma patients treated by operation alone in our Institute between 1960 and 1971) showed that the percentage of patients free from evidence of disease was higher in the group who receiving chemotherapy. In addition, the appearance of metastases in this group was delayed (mean = 16 months) as compared with the historical controls (mean = 8 months). On the other hand, after the same kind of operative treatment, the rate of local recurrences and the time of their appearance was almost identical in both groups.

Adolescent↗

Adjuvant multiple drug chemotherapy for osteosarcoma of the extremity: a 6 year report.

Fifty-five cases of osteosarcoma of the extremities were treated between 1972 and 1976 with combination surgery and polychemotherapy (vincristine, adriamycin and methotrexate at medium doses) for 18 months. Their follow-up presently ranges between 30 and 80 months (mean = 48 months). Twenty-six patients remained free from disease signs, 2 showed local recurrence but no metastases, and 27 exhibited metastases (4 of these also had local recurrences). In 12 patients, the metastases appeared after the end of chemotherapy. Both metastases and local recurrences were more frequent in those patients submitted to segmental bone resection (7/8) than in those treated by more radical surgery (22/47). Comparison with a historical group (94 osteosarcoma patients treated with surgery alone at our Institute between 1960 and 1971) revealed that, during the follow-up period considered, the percentage of patients free from disease signs was higher in the group that also received chemotherapy. In addition, in this group metastatic appearance was delayed (mean = 15 months) as compared to historical controls (mean = 8 months). On the other hand, after the same kind of surgery, the rate of local recurrences and the time of their appearance was practically the same in both groups.

Adolescent↗

Ewing's sarcoma (a review of 195 cases).

The authors discuss their findings resulting from an analysis of a large series (195 cases) of Ewing's sarcoma. In particular they compare the clinical and radiographic pictures and prognosis prior to and after the introduction of adjuvant chemotherapy. This reveals such marked differences in the past and present features of this neoplasm that some of our previous criteria and attitudes to diagnosis and treatment have undergone radical reappraisal.

Adolescent↗

Adjuvant chemotherapy in the treatment of clinically localised Ewing's sarcoma.

The results are presented of thirty-seven patients with Ewing's sarcoma; ten were treated by a combination of operation, radiotherapy and cyclic chemotherapy, the remainder by radiotherapy and chemotherapy but without operation. The drugs, vincristine, cyclophosphamide and adriamycin were used in combination and were continued for two years. The follow-up ranged from twelve to sixty-two months. The mortality rate and the incidence of metastases were both markedly lower than in a comparable previous series treated by radiotherapy alone, or by operation plus radiotherapy, but all without chemotherapy. The percentage of local recurrences and of metastases was much higher in the twenty-seven patients who had radiotherapy and adjuvant chemotherapy, than in the ten in whom operation was also performed. It is suggested that on the basis of these results (and on theoretical grounds) treatment should consist of radiotherapy combined with chemotherapy plus, whenever feasible, operative excision of the primary tumour.

Adolescent↗

Adjuvant chemotherapy associated with surgery in the treatment of osteosarcoma. Preliminary results.

The results are presented of thirty five cases of osteosarcoma in which radical surgery was associated with cyclic chemotherapy with vincrystin, adriamycin and methotrexate. Nine patients had pulmonary metastases at intervals of from three to twenty one months after operation; of these, seven died between six and twenty six months after operation. The remaining twenty six patients are in good health and show no signs of disease at follow up varying from twelve to forty eight months. The mortality rate and the percentage of patients with pulmonary metastase from six to forty eight months after operation are notably lower than in a previous series treated by surgery only.

Adolescent↗

[The association of local radiation therapy and systemic chemotherapy in the treatment of clinically localized Ewing's sarcoma].

The results obtained in 12 cases of still clinically localized Ewing's sarcoma by associating radiation therapy of the primary focus with intermittent systematic chemotherapy are reported. Two of these patients presented pulmonary and bone metastases 12 and 14 months respectively after bioptic diagnosis while the remaining ten were in good health and free from metastasis at between 6 and 28 months (average 16 months) after biopsy. Although it is considered necessary to make further observations before the association's validity is certain, it is considered that on this basis and on the basis of the few cases reported in the literature than the association of rationally conducted systematic chemotherapy with local radiation therapy will extend the onset time of metastasis and so increase average survival in Ewing's sarcoma.

Adolescent↗