Radiotherapy of T4 squamous cell carcinoma of the skin of nasal pyramid.
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Aged↗
Biomedical subjects
R Piccinno
Publications and source records attributed to R Piccinno.
Radiotherapy of skin carcinomas of the pinna: a study of 115 lesions in 108 patients.
BACKGROUND: The possibility of treating skin carcinomas of the pinna with radiotherapy is somewhat under discussion and scarcely known. Therefore the aim of the study was to evaluate the effectiveness and safety of dermatologic radiotherapy in a series of patients affected by basal or squamous cell carcinoma of the pinna. METHODS: A retrospective study was performed on 108 patients affected by 115 carcinomas of the pinna (99 basal cell carcinomas, 16 squamous cell carcinomas) without involvement of the external auditory canal. Radiotherapy was performed with kilovoltage techniques (55-120 kV) and the total doses administered ranged from 45 to 70 Gy (105 Gy in one case only), with different fractionations. RESULTS: The mean follow-up was 28.80 months. Complete remission was obtained in 111 lesions (96.52%) and partial remission in one (0.87%), as evaluated 1 month after the end of radiotherapy. No response was observed in two lesions (1.74%). The response was not evaluable in one lesion (0.87%). During follow up a relapse was observed in 12 lesions (all basal cell carcinomas): nine central and three marginal to the irradiation field. The 5-year cure-rate from the end of radiotherapy was 78%. The cosmetic results were evaluated as good or acceptable in 88.28% of lesions. No complications nor sequelae to the treatment were observed. CONCLUSIONS: The results obtained confirm the possibility of treating epithelial skin neoplasms of the pinna with dermatologic radiotherapy, which can afford high-remission percentages without damaging cartilaginous tissue.
Aged↗
[Expression and prognostic significance in epithelial ovarian cancer].
BACKGROUND: Insulin-like growth factor binding protein-3 (IGFBP-3) is a glycoprotein with specific binding affinity to peptide hormones insulin-like growth factors (IGFs) which are potent mitogens for a variety of cells. IGFBP-3 can inhibit the activities of IGFs by interfering with the interaction between IGFs and their receptor IGF-IR. Epithelial ovarian cancer (EOC) tissues express IGFBP-3, IGFs and IGF-IR. Moreover, high levels of IGF-I and IGF-IR have been shown in epithelial ovarian cancer, and IGF-I stimulates the growth of ovarian cancer. METHODS: We measured IGFBP-3 levels in ovarian cancer tissues of 147 consecutive patients and we examined its association with clinical and pathological features of the disease and patient survival. The average age of the patients in the study was 55 years and the median follow-up time was 37 months. IGFBP-3 levels were measured in the tissue extracts by a commercial ELISA kit and non-parametric statistics and the Cox regression survival analysis were used to determine the associations of IGFBP-3 with clinical and pathologic variables as well as with patient survival. RESULTS: High IGFBP-3 levels resulted significantly associated with some of the favorable prognostic features of the disease, including early clinical stage (p=0.048), small size of residual tumor (p=0.007), and optimal debulking result (p=0.007). High IGFBP-3 was also associated with a significantly reduced risk for disease progression (RR=0.52, p=0.034) and we showed an inverse dose-dependent relationship between IGFBP-3 and disease progression-free survival (p=0.033). However, the association with disease progression-free survival was no longer statistically significant in a multivariate analysis. An association between IGFBP-3 and overall survival was not shown. CONCLUSIONS: This study suggest that IGFBP-3 may play a role in the progression of epithelial ovarian cancer.
Adult↗
[Growth factors in epithelial ovarian cancer].
The aim of this study was to provide an up-to-date review of the knowledge on the role of the main growth factors involved in the onset and progression of epithelial ovarian cancer (Transforming Growth Factor a-TGFa, Trans-forming Growth Factor-TGFb, Epidermal Growth Factor-EGF, Insulin-Like Growth Factor-IGF, Vascular Endothelial Growth Factor-VEGF). Relevant articles published between 1991 and 2001 were identified using the Medline database. Publications identified by the search were reviewed and critically evaluated for their relevance to growth factors role in ovarian cancer. This review may be useful for clinicians wishing to study the biological mechanisms involved in epithelial ovarian neoplasms, in order to evaluate the possible value of Growth Factors as prognostic or predictive markers which could lead to novel therapeutic regimens, fitting individual needs based on single biological variations.
Carcinoma↗
[The role of aromatase inhibitors in the treatment of breast neoplasms. An evaluation of clinical efficacy and the tolerability profile].
Constant acquisitions regarding endocrine pathogenesis and the biology of breast neoplasms have led to the evolution of hormone manipulation as a therapeutic option in patients suffering from this disease. There has been a shift from ablative surgical procedures to the use of drugs offering greater clinical efficacy and an improved tolerability profile. Since the late 1970s tamoxifen has been regarded as the gold standard for hormone treatment in hormone-responsive breast neoplasm, but promising new endocrine agents are now being compared in random trials. Of these, the latest generation of aromatase inhibitors appears to gather the widest consensus on the basis of the results published to date. This article aims to review this new category of drugs, illustrating their rationale of use, the results obtained in the treatment of breast neoplasm and the main studies in which they are currently being investigated.
Adult↗
Human kallikrein gene 5 (KLK5) expression is an indicator of poor prognosis in ovarian cancer.
Kallikrein gene 5 (KLK5, also known as KLK-L2), located on chromosome 19q13.4, is one of the newly identified members of the kallikrein gene family, which is a subgroup of the serine protease enzyme family. In normal human tissues, KLK5 is highly expressed in skin, mammary gland and testis. Preliminary RT-PCR analysis has indicated that KLK5 is expressed in a subset of ovarian tumours. We have thus hypothesized that KLK5 may be a new prognostic indicator in ovarian cancer. We have examined the mRNA expression of KLK5 in 142 malignant ovarian tissues. Tumours were pulverized, total RNA was extracted, and cDNA was prepared by reverse transcription. KLK5 was amplified by PCR using gene specific primers, and the identity of the PCR product was verified by sequencing. Ovarian tissues were then classified as KLK5 positive or negative, based on ethidium bromide staining of the PCR product on agarose gels. KLK5 was found to be highly expressed in 58/142 (41%) of ovarian cancer samples while its level of expression was very low in normal ovarian tissues. We found a strong positive relation between KLK5 expression and tumour grade (P = 0.006) and disease stage (P = 0.027). Univariate survival analysis revealed that patients with ovarian tumours positive for KLK5 expression had an increased risk for relapse and death (P = 0.018 and 0.022, respectively). In multivariate analysis, KLK5 expression showed independent prognostic value only in the subset of tumours with lower grade disease (grades I and II). We conclude that KLK5 expression is associated with more aggressive forms of epithelial ovarian carcinoma and has indepdent prognostic value in low grade tumours.
Adult↗
Prognostic value of human kallikrein 10 expression in epithelial ovarian carcinoma.
PURPOSE: Human kallikrein 10 (hK10; also known as the normal epithelial cell-specific 1 gene and protein) is a secreted serine protease, which belongs to the human kallikrein family. It has been reported that hK10 is down-regulated in breast and prostate cancer cell lines and that it may function as a tumor suppressor. Recently, we developed a highly sensitive and specific immunoassay for hK10 and found that this protein is abundantly expressed in ovarian tissue. In this study, we measured quantitatively hK10 levels in ovarian cancer cytosolic extracts and evaluated the prognostic value of this biomarker in ovarian cancer. EXPERIMENTAL DESIGN: Specimens from eight normal ovarian tissues, eight ovarian tissues with benign disease, and 182 ovarian tumors were investigated. RESULTS: hK10 concentration in ovarian tumor cytosols ranged from 0 to 84 ng/mg of total protein, with a median of 2.6. This median was highly elevated in comparison with normal and benign ovarian tissues (P < 0.001). A cutoff of 1.35 ng/mg was selected to categorize tumors as hK10 high and hK10 low. With chi(2) test and Fisher's exact test, high concentration hK10 was found to be associated with advanced disease stage, serous histological type, suboptimal debulking, and large residual tumor (>1 cm; all P < 0.05). hK10 status was additionally correlated with clinical outcome, including progression-free (PFS) and overall survival (OS) using the Cox model. In univariate analysis, we found that patients with hK10 high tumors were more likely to die and relapse, in comparison with patients with hK10 low tumors (hazards ratios for PFS and OS were 1.93 and 2.42, respectively; P < 0.05). Although this correlation disappeared after the entire patient population was subjected to multivariate analysis, it remained significant in the subgroup of patients with stage III/IV ovarian cancer (hazards ratios for PFS and OS were 1.98 and 2.12, respectively; P < 0.05). CONCLUSIONS: Our results indicate that hK10 is a new, independent, unfavorable prognostic marker, especially for late-stage ovarian cancer.
Adult↗
Results and side effects of dermatologic radiotherapy: a retrospective study of irradiated cutaneous epithelial neoplasms.
BACKGROUND: Ionizing radiation therapy has a well-defined role among several therapeutic options available for the management of cutaneous neoplasms. However, many dermatologists today are not aware of its potential. OBJECTIVE: Our purpose was to evaluate the effectiveness and safety of radiotherapy in a large series of patients with primary malignant epithelial neoplasms (PMENs), who had been subjected to radiotherapy between 1982 and 1995. METHODS: A retrospective study was performed on 1188 patients with a total of 2002 PMENs that had been treated by contact, superficial, and intermediate x-ray therapy. RESULTS: Complete remission was obtained in 98.7% of the irradiated lesions. The 5-year cure rate was 90.73%. Cosmetic results were evaluated as "good" or "acceptable" in 84.01% of the treated lesions. Acute complications occurred in 1.94% and chronic complications in 0.34%. To date, neither radio-induced skin neoplasms nor late stochastic effects have been observed. CONCLUSION: This study confirms that dermatologic radiotherapy is an effective and reliable form of treatment of PMENs and has a favorable cure rate/toxicity ratio.
Adult↗
[Chemoresistance in ovarian cancer. State of the art and future prospects].
Aim of this study was to provide a review of the basic mechanisms of drug resistance in ovarian cancer and novel strategies to modulate drug resistance. Relevant articles published through August 1999 were identified using the Medline data base. Publications identified by the search were reviewed and evaluated critically for their relevance to drug resistance in ovarian cancer. Ovarian cancer patients have high response rates to initial chemotherapy after cytoreductive surgery. However, most will develop resistance to chemotherapy during the course of their treatment. There are multiple mechanisms resulting in drug resistance. Strategies to modulate drug resistance include dose intensity, various pharmacologic agents, and gene therapy.
Antineoplastic Agents↗
Intracavitary contact X-ray therapy of oral HIV-associated Kaposi's sarcoma.
A retrospective study was performed to assess the efficacy and low mucosal toxicity of intracavitary contact X-ray therapy (ICRT), a proposed treatment of small/medium sized lesions of oral HIV-associated Kaposi's sarcoma (HIV-KS). Twenty-six patients with histologically confirmed oral HIV-KS underwent ICRT in the period 1986-1995. No patient received antiblastic or interferon therapy during the radiotherapy or follow-up periods. ICRT was performed according to the usual technical modalities of contact X-ray therapy, but the end of the source of ionizing radiations was introduced into the oral cavity. The total doses administered ranged from 10 to 50 Gy per field, in one or two weekly fractions of 5 Gy each. The follow-up ranged from 1 to 44 months (mean 7.5 months). Complete remission was obtained in 20 cases (76.92%), partial remission in 6 (23.08%) and relapse in one case (3.84%). Pain was relieved in all cases. Mucosal reaction was mild and did not result in any interruption of treatment. Our data suggest that ICRT is an effective and well tolerated treatment. It can be used in the management of oral HIV-KS instead of external radiotherapy, provided that the size and the location of the lesions and the conformation of the palate are suitable to this technique.
AIDS-Related Opportunistic Infections↗
Acrodermatitis chronica atrophicans in an Italian child.
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Acrodermatitis↗
Role of radiotherapy in the treatment of epidemic Kaposi's sarcoma: experience with sixty-five cases.
BACKGROUND: Treatment of Kaposi's sarcoma (KS) associated with HIV infection should improve often disfiguring lesions, with an acceptable cosmetic outcome; relieve associated signs and symptoms (pain and edema); and have no adverse effects on the patient's already impaired immune status. OBJECTIVE: Our purpose was to determine the role of x-ray therapy in the treatment of KS. METHODS: Contact x-ray therapy and half-deep x-ray therapy were used to treat 594 lesions in 65 patients with KS, who were observed for 1 to 43 months (mean, 9 months). RESULTS: Complete remission was achieved with pigmentation in 405 lesions (68.3%), with good cosmetic results in 105 (17.7%), and with hypopigmentation in three (0.5%). In 80 lesions (13.5%) only size reduction or pain palliation were achieved. Fourteen lesions (2.4%) relapsed 2 to 9 months after treatment. CONCLUSION: X-ray therapy is well tolerated and meets the specified requirements for the treatment of KS.
Adult↗
Parapsoriasis in two children: a clinical, immunophenotypic, and immunogenotypic study.
Parapsoriasis has been described rarely in childhood; a few reports mention this condition as preceding early mycosis fungoides. We report a boy age 15 and a girl age 8 years with different clinical features of parapsoriasis who were followed clinically and histologically for about four years. Immunophenotyping of the skin infiltrate and a T cell receptor gene rearrangement analysis were performed on each. The infiltrate was composed mainly of CD4+ and CD45+ lymphocytes in the first patient and of CD8+ and CD45+ in the second. No T cell receptor gene rearrangements were found. The paucity of knowledge about the evolution of this entity in childhood and its relationship to mycosis fungoides makes follow-up critical. The importance of immunophenotyping and immunogenotyping is particularly stressed.
Adolescent↗
A case of segmental macular neurofibromatosis.
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Child↗
Radiotherapy of cutaneous B cell lymphomas: our experience in 31 cases.
PURPOSE: Since cutaneous B cell lymphomas belong mostly to low or intermediate histologic grade of malignancy and have low tendency to spreading, a local treatment such as radiotherapy appears to be a suitable choice in the management of the disease. The authors have reviewed their cases to verify this statement. METHODS AND MATERIALS: 31 patients affected by cutaneous B cell lymphomas classified as IE stage according to Ann Arbor received radiotherapy with orthovoltage techniques with total doses per field ranging from 10 to 40 Gy (median dose 30 Gy). All the patients had a minimum follow-up of 2 years. RESULTS: All the target skin lesions underwent complete remission. In 10 patients (32.2%) the clinical remission is still lasting. In 21 cases (67.8%) a disease relapse was observed: only at skin in other sites than those previously treated in 17 (81%), at skin and lymph nodes in two cases (9.5%), at skin, bone, and lymph node in one case (4.7%), at skin and bowel in one case (4.7%). The extracutaneous involvement occurred in cases with lesions of intermediate grade malignancy. After a new course of radiotherapy for skin lesions only, and chemotherapy, surgery or megavoltage radiotherapy for the other involvements, on the whole 21 patients (67.8%) got a complete remission. CONCLUSION: On the basis of their results and of a review of the literature, the authors propose radiotherapy as the choice treatment of primary cutaneous B cell lymphomas.
Adult↗
Palmoplantar keratoderma of Unna-Thost: response to biotin in one family.
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Adolescent↗
Cutaneous and oral lesions in 32 children after renal transplantation.
A variety of skin and oral mucosal lesions appearing in patients after renal transplantation have been reported in the literature. Because most of these data pertain to adults, we studied a group of children with kidney transplants to investigate the occurrence of skin and/or oral mucosal lesions, compare them with those observed in adults, and contribute to the knowledge of the pathogenesis of these disorders. Our series consisted of 32 patients aged 5 to 18 years, all of whom had skin and/or oral mucosal lesions that were classified as being either drug induced, probably related to uremia, or due to other causes. A possible relationship between drug-induced lesions and the therapeutic immunosuppressive regimen in use was investigated. In addition, two formerly unreported lesions were seen in these patients: hypertrophy of lingual fungiform papillae and onychoschizia. The former occurred only in children receiving cyclosporine. Compared with adults, the frequency of gingival hypertrophy was higher and that of infectious disease was lower.
Adolescent↗
Immunologic investigations in eight patients with incontinentia pigmenti.
We studied eight patients with incontinentia pigmenti to investigate the possibility of immunologic abnormalities. In six patients a defect of polymorphonuclear chemotaxis was revealed; lymphocyte subpopulations, serum immunoglobulin levels, and peripheral eosinophils were within normal limits. We hope these findings will stimulate further investigations into the mechanisms involved.
Adolescent↗