Biomedical subjects

J Szántó

Publications and source records attributed to J Szántó.

At least 19 recordsLinked to original sources

PubMed2004

Secretory breast cancer in a 7.5-year old boy.

Breast cancer is extremely rare in children, and consequently no consensus has been reached on the optimal treatment modalities. The medical history and treatment plan for a 7.5-year old male breast cancer patient is described. Radical mastectomy with sentinel node biopsy was performed in October 2002. As no malignant cells were detected in the sentinel node, and no BRCA1-2 mutations were detected, no further radio- or chemotherapy was performed. A "wait-and-see" policy was decided on. Further treatment will be given if this becomes necessary with the development of metastases.

Breast Neoplasms, Male↗

PubMed2001

[Effectiveness of doxorubicin-docetaxel or doxorubicin-cyclophosphamide combination in advanced breast cancer with distant metastasis].

Between June 1996 and March 1998 a multinational multicentric phase III randomised comparative study was made for comparing 1. the effectiveness, 2. the adverse events and 3. the quality of life of two combinations i.e. DD versus DC. 18 patients were treated with DD and 15 patients with DC. Age, tumour stage, visceral involvement, receptor status were well matched in the two groups. Good partial remission was obtained in 10 patients treated with DD whereas only seven remissions were seen in the DC arm. Response duration was similar in the 2 arms. No difference in adverse events was observed.

Adult↗

PubMed2001

[The role of irinotecan in the treatment of advanced colorectal cancer]

PURPOSE: The purpose of the study was the evaluation of efficacy and the side effects of irinotecan in treatment of advanced colorectal cancer. METHODS: The authors presented their experiences with irinotecan in the treatment of 10 patients suffering from advanced colorectal cancer. The dose of irinotecan was 350 mg/m(2) every 21 days. Seven out of ten patients have taken oral fluoroquinolon to investigate its effect on the incidence of febrile episodes in case of febrile neutropenia. Three out of ten patients did not receive any antibiotic. The authors have examined the efficacy and safety of the treatment. RESULTS: One complete remission was obtained. Authors describe the observed side effects and the administered supportive care against serious complications. DISCUSSION: Serious diarrhoea has not been found in case of these 10 patients. The diarrhoea caused by irinotecan can be stopped by loperamide. The authors give accounts of early and following results.

Journal Article↗

PubMed2000

[Irinotecan--experience with second-line treatment in advanced colorectal cancer] .

The prognosis for patients with advanced colorectal cancer who fail to respond to a 5-FU based therapy is poor. About 7% response rate can be achieved with second line therapeutic regiments, the overall survival is about 6-7 months. The aim of authors was to assess the efficacy and toxicity profile of irinotecan (CAMPTO) in patients with advanced colorectal cancer, resistant to 5-FU based chemotherapy. From October 1996 to November 1998 19 previously treated metastatic colorectal cancer patients with documented progression were recruited. Irinotecan was given at a dose of 350 mg/m2 i.v. over 90 min. every 3 week. Tumor response and toxicity were assessed using WHO criteria. Median age: 59.7 years (42-72). Tumor sites: 12/19 colon, 7/19 rectum. 11/19 patients had 1 metastatic site, 8/19 had 2 or more metastatic sites. CR: 0/19, PR: 3/19, MR: 2/19, SD: 10/19, PD: 4/19. Median time to progression was 9.1 months (range 1.5-22). The overall median survival was 15.5 months (range 2.5-37). Grade 3-4 delayed diarrhoea occurred in 26.3% of patients. Grade 3 neutropenia occurred in 15.7% of patients. Preliminary results confirm the clinical value of irinotecan in 5-FU resistant metastatic colorectal cancer with tolerable toxicity profile. Irinotecan should be considered as the basic chemotherapeutic agent for second line treatment of metastatic colorectal cancer.

Adult↗

PubMed2000

The efficacy of a combination of etoposide, ifosfamide, and cisplatin in the treatment of patients with soft tissue sarcoma.

BACKGROUND: Successful chemotherapy for patients with soft tissue sarcoma (STS) has been limited by a lack of active drugs. The most effective single agents are doxorubicin, dacarbazine, and, more recently, ifosfamide. Previously the most widely used combination has been CYVADIC (cyclophosphamide, vincristine, doxorubicin, and dacarbazine). In one randomized trial, ifosfamide was superior to cyclophosphamide; two nonrandomized studies also reported favorable results. Etoposide monotherapy was successful in 8%; the effectiveness of cisplatin was 5-23%. In view of these findings, the authors treated STS patients with an etoposide, cisplatin, and ifosfamide (VIP) combination. METHODS: The eligibility criteria included histologically confirmed, inoperable, metastatic or locally recurrent STS; a World Health Organization (WHO) performance status of 0-2; a maximum age of 75 years; and progressive, measurable disease. A total of 104 patients were treated from January 1990 to June 1997. The median age of the patients was 42.4 years. The patients were treated with a combination of etoposide (100mg/m(2) for 5 days), ifosfamide (2000 mg/m(2) for 2 days), and cisplatin (20mg/m(2) for 5 days) once a month via a peripheral vein. The treatment response and the toxicity were assessed according to WHO criteria. RESULTS: Of 104 evaluable patients, 47 responded. The overall response rate was 46% (complete response: 10%; partial response: 36%). In 43 patients the disease remained stable (41%). Remission duration was 4.6 months. Toxicity was moderate. The main adverse events were alopecia (100%), nausea and vomiting (73%), and leukopenia (29%). CONCLUSIONS: This new combination is promising for the treatment of patients with advanced STS.

Adult↗

PubMed2000

Pleomorphic liposarcoma of a young woman following radiotherapy for epithelioid sarcoma.

A case of a metachronous epithelioid sarcoma and pleomorphic liposarcoma in a young woman is described. The first tumor was an epithelioid sarcoma (ES) with focal rhabdoid features localised in the left calf while the second lesion developed seven years later in the same region was diagnosed as pleomorphic liposarcoma resembling myxofibrosarcoma ( myxoid variant of malignant fibrous histiocytoma ) predominantly composed of moderately differentiated spindle cells. Multiple foci of uni- and plurivacuolated lipoblasts were seen. Following the resection of ES the patient received 57 Gy radiation to the region, therefore we regarded the second tumor as a radiation induced liposarcoma. A further interesting feature of this case is that the development of pleomorphic liposarcoma preceded by 6 months the solitary right parabronchial metastasis of ES and after 4 months of metastasectomy a third tumor developed at the site of the first lesion. This tumor showed dedifferentiation toward pleomorphic malignant fibrous histiocytoma. Our case represents a unique case of postirradiation liposarcoma developed on the base of ES.

Adolescent↗

PubMed1999

Changes in apoptotic and mitotic activity in rectal carcinoma after short-term cytostatic therapy as possible predictive factors.

Fifteen patients with rectal adenocarcinoma were endoscopically biopsied and given short-term [5 fluorouracil (5FU) (600 mg/m2) and Ca-Folinate (60 mg/m2) for two days] cytostatic therapy. Seven days later the tumor was resected or a second biopsy was performed. Apoptotic and mitotic indices were determined in the tumor tissue before and after the short-term chemotherapy. The patients were treated thereafter with long-term, intermittent 5 FU administration and followed up clinically for 4-13 months. Three patients showed progression of the disease, twelve improved or showed no tumor progression. An increase of the apoptotic index and decrease of the mitotic index after the short-term cytostatic treatment were seen in the tumor tissue of responder cases. Non-responders showed increase or no change in mitotic activity, and decrease or no change in apoptotic activity. These findings suggest that apoptotic and mitotic response to short-term cytostatic therapy may be additional predictive factor in rectal adenocarcinoma.

Adenocarcinoma↗

PubMed1998

[Low-dose leucovorin and interferon-alpha as modulators of 5-fluorouracil for adjuvant chemotherapy of colorectal cancer].

It has recently been published the results of a prospective, comparative study for adjuvant chemotherapy of 164 colorectal cancer patients. Pathological stages were Dukes B 79, C 85 of the cases. The site of primary tumour was colon 108, rectum 56 of the patients. The treatment protocols were as follows: 425 mg/m2 5-fluorouracil plus 20 mg/m2 leucovorin on days 1-5 at 28 days cycles six times (LV group). The IFN group received the same chemotherapy completed with weekly 3 x 3 MIU interferon alpha. Both treatment groups were well balanced. The mean follow up time was 38.1 months. There were 91 patients of relapse and 65 deaths this time. The time to progression was 15 months in the LV group and 12.7 months in the IFN group (p < 0.05). The mean survival time was 24 months in the LV group compared to 22.3 of the IFN group. The frequency and sites of relapses did not differ statistically between the both groups. The preoperative CEA-level was elevated in 42 cases. The mean survival time was 26.4 months in the cases having normal CEA-level compared to 16.1 months of the cases with high-level (p < 0.001). The side-effects were transient and mild, while in the group treated with interferon were more instances of fever, fatigue, flu-like syndrome, psychic disorders, depression and agitation. The administration of interferon had to be interrupted in 4 cases. The results of interim analysis suggest choosing the so-called Mayo protocol for the standard adjuvant treatment of colorectal cancer.

Adjuvants, Pharmaceutic↗

PubMed1994

Chemotherapy of advanced breast cancer.

The treatment of clinically overt metastatic breast cancer, despite several treatment modalities (biological response modifiers, megatherapy with autologous bone marrow transplantation, growth factors, new agents, etc.) is in a static phase. In the decision-making one has to consider the patient's age, her menstrual state, the metastatic site, previous adjuvant and/or postoperative treatment modalities. Roughly there are two treatment forms, the hormonal and the cytostatic ones. Endocrine therapy should be given as follows: 1. only for low risk group, 2. gestagen or antiestrogen therapy is the choice for the first step, 3. if there is a progression in 3 months, the hormonal treatment should be changed to cytostatic combination, 4. if there is a progression beyond 3 months further hormonal therapy can be considered. The efficacy of endocrine therapy is 30%. In patients with advanced breast cancer chemotherapy provides a response rate of 30 to 60%, however total survival of the patients does not improve substantially. Doxorubicin containing regimens are more effective, however no response in total survival can be obtained. New plant alkaloids and altered treatment forms will probably influence survival. Taking all these into consideration one has to decide on the quality of life of the breast cancer patients.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1992

[Experience with surgical treatment of osteosarcoma].

The authors treated 79 patients with osteosarcoma by surgery and chemotherapy 1975 through 1991. The appearance, localization and differential diagnosis are discussed. Attention is called to the doctor's delay. The effective pre- and postoperative chemotherapy decreased the incidence of the lung metastases and increased the survival rate (71% 3 years overall survival and 41% 5 years survival) and made the limb-sparing surgery possible. The development of the reconstructive surgical technique and new designs of tumor endoprostheses enabled us to perform limb-sparing surgery in more than one third of the cases at the same survival chance. The limb-sparing means a decisive change in the quality of the rehabilitation of the osteosarcoma patients.

Adolescent↗

PubMed1992

Pain killing with calcitonin nasal spray in patients with malignant tumors.

The physiological role of calcitonin is the preservation of osseal integrity by reducing the osteoclast activity. On the other hand, this 32 amino acid peptide acts as an analgetic drug in cancer caused by osteolytic metastases. In previous studies using injection form the pain killing activity was observed in 65% of the patients. As medical assistance is required for this treatment form, it was decided to compare the pain reducing activity of nasal spray with the ampule form. It was found that 300 MRC units of nasal spray equalled 100 MRC units injection. The pain killing activity was observed in 53.8% of the patients. The reduction in quantity of other analgetics used daily was 48.5%. The average decrease of the pain duration (in h) was 42.5%. The pain intensity measured by visual analogue scale dropped to 2.13 from 3.00. The results are similar to the analgetic effect observed in the injection form. Taking this into consideration, calcitonin nasal spray is highly recommended instead of ampules.

Administration, Intranasal↗

PubMed1991

Follicular cancer of the thyroid gland.

Between 1965 and 1987 the authors studied the survival of 169 patients (130 females, 39 males) suffering from follicular thyroid cancer. It is established that the factors favorably influencing the course of the disease are as follows: age below 40 years, female sex, tumor location inside the thyroid capsule. Radical surgery does not affect the survival, though it prolongs the time to the onset of metastases. In women below 40 years of age, iodine treatment performed within 1.5 months following surgery does not increase the effectiveness; therefore, its routine application is not recommended. In case of local metastases associated with hindered swallowing or respiration, external beam radiotherapy is indicated. Hormone substitution ensuring TSH restriction results in improved prognosis.

Adenocarcinoma↗

PubMed1990

Effect of toremifene in breast cancer patients. Preliminary communication.

Toremifene, an antiestrogenic drug administered at three dose levels (60, 120, and 300 mg/day) was investigated in 17 postmenopausal patients with advanced breast cancer previously treated with hormonal and/or cytostatic therapy. The drug proved to be well tolerated at all dose levels without any serious side effects even on prolonged administration. Neither response nor side effects have shown any dose dependency in this small group of patients.

Adult↗

PubMed1990

Coincidental papillary carcinoma of the thyroid in two sisters.

A coincidentally occurring papillary cancer of the thyroid in two sisters is discussed. No clinical, biochemical or chromosomal changes were found in these cases which could have shown any inheritable feature. It is concluded that, in contrast with the previous data, the simultaneous manifestation is not a peculiar feature but a fortuitous appearance.

Adult↗

PubMed1990

Investigation of anti-D antibody dependent cell mediated cytotoxicity in patients with thyroid cancer.

Anti-D dependent cellular cytotoxicity (ADCC) of peripheral mononuclear blood cells was measured in 69 thyroid cancer patients belonging to one of the main subtypes, and in 11 age-matched controls with benign thyroid disease. Independently of cancer subtype, tumor status, previous operation, age and sex, no differences in ADCC were observed. Further studies are warranted to clarify the cause of the constant ADCC levels.

Adult↗

PubMed1989

[Follow up of thyroglobulin levels in patients with surgically treated, highly differentiated thyroid cancer].

The highly differentiated thyroid tumours account for 0.80 percent of all human malignancies. The papillary and follicular tumour tissues of this tumour type are relatively benign, hormone dependent and beside their treatment specificity they secrete the tumour specific thyreoglobulin. Thus it becomes possible to follow the development of metastases, the effectiveness of therapy applied as well as the history of the disease. The authors studied the change of thyreoglobulin level in 153 patients with highly differentiated thyroid cancer. In 29 of 32 metastatic patients pathologically elevated (70 to 100 ng/ml) thyreoglobulin level was observed. This proves the 91 percent specificity of the method in verified metastatic tumours. Compared to the total body scintigraphy 3 false negative cases were found. The authors establish that, irrespective of the site of metastasis, the thyreoglobulin level is higher in the follicular than in the papillary subtype. It is concluded that the measurement of the serum thyreoglobulin level is a suitable marker of the highly differentiated thyroid cancer since it represents the local recurrence of distant metastases with a significant increase while the therapy-resultant tumour diminution with a marked decrease, respectively.

Adenocarcinoma↗

PubMed1989

[Trends in the hormonal therapy of thyroid cancer].

The highly differentiated thyroid cancers account for 0.70% of malignancies. Their management is primarily hormonal, in addition to the percutaneous irradiation and application of iodine isotope. This method is not aimed at the inhibition of the potential artificial hypothyreosis but mainly at the prevention of the tumour development or tumorous dissemination. The authors, in case of their 28 patients with the above diagnosis, tried to clarify if the TRH-tolerance TSH-level determination promotes the optimal patient management, the ideal hormone substitution lasting for several years. Their results suggest that the drugs containing L-thyroxin prove to be most effective in the clinical practice. Their optimal dose is 2.8-3.0 micrograms/kg. The study of the TRH-sensitized TSH-level does not primarily facilitate the ideal hormone substitution but may decrease the "unnecessary" amount of thyroid hormone-containing drugs. In view of the fact that the hormonal treatment may last even several decades for a patient, the authors considering economic points as well, do not reject the TRH-tolerance TSH-study. In their opinion the more favourable solution may be provided by the wide-scale application of the IRMA-TSH.

Humans↗

PubMed1989

Postoperative thyroglobulin level determination to follow up patients with highly differentiated thyroid cancer.

The highly differentiated thyroid tumours account for 0.80% of all human malignancies. The papillary and follicular tumour tissues of this tumour type are relatively benign, hormone-dependent and beside their treatment specificity they secrete the tumour-specific thyroglobulin. This it becomes possible to follow the development of metastases, the effectiveness of therapy applied as well as the history of the disease. The authors studied the change of thyroglobulin level in 153 patients with highly differentiated thyroid cancer. In 29 of 32 metastatic patients a pathologically elevated (70-100 ng/ml) thyroglobulin level was observed. This proves the 91% specificity of the method in verified metastatic tumours. Compared to the total body scintigraphy 3 false-negative and 6 false-positive cases were found. The authors establish that, irrespective of the site of metastasis, the thyroglobulin level is higher in the follicular than in the papillary subtype. It is concluded that the measurement of the serum thyroglobulin level is a suitable marker of the highly differentiated thyroid cancer since it indicates local recurrence or distant metastases by a significant increase while therapy-resultant tumour diminution is accompanied by a marked decrease.

Adult↗