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Biomedical subjects

M Bussi

Publications and source records attributed to M Bussi.

At least 19 recordsLinked to original sources

Results of chemotherapy plus external reirradiation in the treatment of locally advanced recurrences of nasopharyngeal carcinoma.

Between 1982 and 1991, 16 patients with recurrent cancer of the nasopharynx were treated with chemotherapy (CT) and radiotherapy (RT). All patients had received prior RT (45-69, 30 Gy). According to rTNM there were three rT2, one rT3 and 12 rT4. 5 patients were N1. Reirradiation (12-46 Gy, mean: 28) started 3-4 weeks after CT (2-6 cycles of different combinations), but 2 cases involved concomitant therapy. Out of 16 patients 7 had complete response (CR) (43.7%), 7 partial response and 2 no response. Statistically significant prognostic factors for obtaining CR were time of relapse and response to initial CT. Median duration of CR was 22+ months (9-64+). Failures at primary site occurred in 3 patients, 2/2 of those receiving CT without platinum compounds and 1/5 of other ones, with statistically significant difference in local recurrence free-survival between the two groups. Two- and 3-year actuarial overall survival were 28% and 10%. Rates of disease-free survival were 17% and 8%, respectively. The acute toxicity was generally mild. No central nervous system damage or radiation-induced myelitis were observed in survivors.

Adult

Immunological investigations on tonsillar and peripheral blood lymphocytes after adeno-tonsillectomy. Possible suggestions for phenotypical and functional differences.

The phenotypical and functional aspects of tonsillar (TMNC) and peripheral blood mononuclear cells (PBMNC) obtained from 40 patients who had undergone adeno-tonsillectomy for different tonsillar diseases were investigated. TMNC and PBMC were separately tested at the time of surgery; then a further investigation on the peripheral blood lymphocytes was performed three months after surgery. The most interesting findings are presented and discussed with particular attention to their clinical implications.

Adenoidectomy

The effect of preoperative local interleukin-2 (IL-2) injections in patients with head and neck squamous cell carcinoma. An immunological study.

Clinical, immunological, immunophenotypical, pathological and molecular biological studies were performed on tumor infiltrating lymphocytes (TIL) and lymph node lymphocytes (LN-ly) of 8 patients with squamous cell carcinoma of the oral cavity and oropharynx treated with 10 daily locoregional injections of low doses of IL-2 before surgery. No complications were seen during or after surgery. In 3 cases the LN-ly showed a moderate LAK activity, higher in the LN-ly omolateral to the tumor and near the IL-2 injection site; in 2 of these 3 patients a good LAK activity was induced after 6-day culture with IL-2. The LN-ly derived from nodes next to the tumor showed a decreased NK activity and proliferative ability both in basal conditions and after in vitro lymphokine challenging. LN-ly of 2 IL-2 treated patients showed high levels of mRNA encoding for IL-2-R, while it was absent in 2 untreated cases. Immunophenotypical studies on TIL showed statistically improved levels of CD25+ and LAK1+ cells in treated cases. Clusters of CD11c+ (macrophages) cells were seen close to the neoplastic sheets.

Aged

Peri and intratumoral macrophage infiltration in laryngeal carcinoma. An immunohistochemical study.

The role of macrophages infiltrating tumor tissue is still poorly explained; the data available are sparse and, to the best of our knowledge, there is no study relating the characteristics of such infiltration to tumor evolution and final outcome. We decided to investigate the spatial relationships between macrophages and neoplastic tissue and their possible prognostic significance on a series of laryngeal carcinomas (98 patients) all of which were operated in our Department and had a follow-up of at least 3 years. In order to identify the macrophage infiltration, formaline-fixed/paraffin-mounted specimens of the tumor were treated with MoAb HAM56. No statistically significant relationship could be established between the degree of macrophage infiltration and the clinical outcome (recurrence), even when the N status was taken into account (N- vs. N+). However, a clear trend was observed when the analysis was confined to grade 3 cases, where the presence of a significant number of macrophages was correlated with a higher probability of recurrence.

Cell Movement

[Anterior craniofacial resection in the treatment of malignant nasal-paranasal sinus tumors with intracranial extension].

Nasal and paranasal sinus tumors extending through the cribriform plate to the overlying dura of the frontal lobe can be successfully treated by anterior craniofacial resection. During the period from 1986 to 1990, 14 patients (11 males, 3 females, age 18-67) with nasal/paranasal tumors extended to the nasal basis underwent craniofacial resection. From a histological point of view these patients were classified as follows: --8 adenocarcinomas --2 squamous cell carcinomas --2 esthesioneuroblastomas --1 cylindroma --1 haemangiopericytoma. In 6 of the 14 patients post-operative complications were encountered, 3 being resolved. Radical surgery was realised in 12 cases; post-operative radiotherapy was performed in 7. No contraindications were found because of previous chemo- and/or radiotherapy, even if it had been performed as treatment. Four of the patients died because of recurrences between the 6th and 20th month after surgery; 5 patients (all adenocarcinoma subjects) are disease-free respectively 8, 16, 17, 22 and 24 months after surgery.

Adenocarcinoma

[Recurrences of epithelial tumors of the head and neck: review of the literature and a critical analysis of the problem].

Recurrence is a tumor renewal in a previously treated field or surgical wound after a disease-free period. The present work investigates loco-regional recurrences. In the first part of the work the most frequent recurrence sites, types and their characteristics (i.e. infiltrating, exophytic, ulcerating) are studied along with the problems in clinical and pathological diagnosis, new diagnostic imaging (CT and MR) and the UICC classification system. The second part of the work is dedicated to examining classical treatments (surgery, radiotherapy, chemotherapy and radiochemotherapy associations) as well new therapies (i.e. cryosurgery, hyperthermia, immunotherapy, photodynamic therapy). A review of the literature is made for indications, results and complications. An extensive study of the cases of the Head and Neck Group of the University of Turin during the 1983-1990 period is also reported. This experience is based on 312 cases: 68 (oropharynx and larynx) treated by surgery, 51 (neck nodes and stomal recurrences) treated by radiotherapy and hyperthermia, 35 (neck nodes) by hyperthermia alone, 168 (all sites) by chemotherapy and 20 by immunotherapy. In the third part of this work supportive therapies and practical problems are reported. In conclusion a therapeutic approach is proposed in relation to the site of the recurrence and previous treatments.

Antineoplastic Combined Chemotherapy Protocols

Specific lymphokine responses in cervical nodes of patients with laryngeal cancer.

The role of lymphokines in modulating the immune response in patients suffering from neoplastic disease is still controversial. Recent studies indicate that in patients with head and neck cancer, a decrease in LIF (leukocyte migration inhibiting factor) production is usually present in advanced disease. In this study, the authors investigate: the LIF production in lymphocytes derived from the peripheral blood and cervical nodes of patients with laryngeal carcinoma by using an autologous pattern (i.e., for each patient, the specific LIF production was challenged by means of an autologous cell extract derived from his own tumor); the influence of histologically confirmed cervical node metastases on LIF production. Our results indicate that: There is a significant decrease in LIF production in patients with histologically proven cervical node metastases as compared to patients with no metastatic foci. The decrease of LIF production is related to the presence of mononuclear adherent cells. When the latter are removed, there is a significant reversal of specific LIF suppression. The possible meaning of the data is discussed.

Cell Adhesion

Evaluation of blocking mechanisms against immunological responses in patients with laryngeal carcinoma.

The specific tumor-induced leukocyte inhibition factor (LIF) production in laryngeal cancer patients has been investigated before and after the removal of adherent cells in order to evaluate the existence of a suppressor activity; 20 patients served as subject. The LIF production, after challenging the lymphocytes with 3MKC1 autologous tumor extracts, was significant in 12 patients and showed a further significant increase after the removal of adherent cells. In 3 patients with no previous significant LIF production, there was a conversion to significance when the adherent cells were removed. The other patients did not show any significant variation. These data seem to suggest the existence of a suppressor activity exerted by adherent cells in laryngeal cancer patients on LIF production.

Aged

Specific LIF production in laryngeal cancer patients: evidence of suppressor activity exerted by adherent cells.

The specific tumor-induced LIF production in 30 laryngeal cancer patients has been investigated before and after the removal of adherent cells to evaluate the existence of a suppressor activity. LIF production, after challenging lymphocytes with 3 M KCI autologous tumor extracts, was significant in 16 patients and showed a further significant increase after removal of adherent cells. A conversion to significance when the adherent cells were removed was shown in 6 patients, with no previous significant LIF production. These data suggest the existence of a suppressor activity exerted by adherent cells on LIF production in laryngeal cancer patients.

Antigens, Neoplasm

Prospects and limitations of systematic monitoring in patients with laryngeal cancer.

The authors report the first results concerning the systematic use of "immunological monitoring" in patients suffering from well-developed laryngeal cancer. The authors have also studied, in 50 cases in different stages of development, the activity of T-cells using the cutaneous tests (BCG, PPD, PHA and SK-SD), the E-rosette test and the PHA-induced lymphocytic blastization test (it is well known that the T-cells are responsible for a cytotoxic effect against neoplastic cells). The authors have also studied the activity of B-lymphocytes by means of the EA and EAC rosette test and of IgG, IgA, IgM and complement serum titles. They have observed a progressive depression of the T-cell activity after surgical intervention, whereas the B-cell activity in several cases tends to increase. The authors discuss these immunological results and the possibility that these findings may represent the basis for a complementary immunotherapy following the surgical treatment and/or radiotherapy or chemotherapy. Finally, the authors discuss the possibilities and the limitations of these immunological methods from the point of view of clinical application.

B-Lymphocytes