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V Lorusso

Publications and source records attributed to V Lorusso.

119 records · Page 7Linked to original sources
PubMedDate not supplied

Iatrogenic pneumocephalus in a man with undifferentiated nasopharyngeal carcinoma. A case report.

A case of pneumocephalus in a 45-year-old male with undifferentiated rhinopharyngeal carcinoma is described. The patient was initially subjected to radiotherapy and then to transmaxillary resection and a second course of stereotactic radiotherapy for recurrent disease. Lastly, the patient was treated with chemotherapy because of local-regional disease progression. After two cycles of cisplatin, adriablastine and bleomycin, the patient suddenly entered in coma. Cerebral CT scan evidenced the presence of air in the frontal and lateral cornua, in the subarachnoid space of the base cisternae extending to the 7th cervical vertebra. After 8 months of a clinical stationary condition, the patient died. The various treatments used are critically reviewed, and modern therapeutic approaches for the neoplasm and the toxicity involved are discussed. We conclude that in nasopharyngeal carcinoma, for patients who relapse after radiotherapy, successive local-regional therapies (surgery, re-irradiation) should be carefully evaluated to avoid demolishing treatments, which are burdened with severe side effects that might influence the quality of life with only slight improvement of overall survival. Furthermore, the presence of persistant aqueous rhinorrhea in these patients should be carefully evaluated, because it could be an early symptom of a cerebrospinal fluid leak.

Carcinoma↗
PubMedDate not supplied

Mitoxantrone, L-leucovorin and 5-fluorouracil: an effective and well tolerated first-line treatment for advanced breast cancer.

AIMS AND BACKGROUND: The combination of mitoxantrone plus leucovorin/fluorouracil in heavily pretreated patients with advanced breast cancer has shown significant activity and extremely good tolerability. The aim of this study was to evaluate the activity of this combination in patients not previously submitted to chemotherapy. METHODS: From May 1993 to December 1995 we treated 80 patients with advanced breast cancer with a combination of mitoxantrone, l-leucovorin and 5-fluorouracil. All patients had histologically or cytologically proven breast cancer, WHO performance status 0-3, normal hematological parameters and normal serum bilirubin. Prior chemotherapy for metastatic disease was not allowed, whereas adjuvant CMF (cyclophosphamide, methotrexate and 5-fluorouracil) or adjuvant anthracycline (doxorubicin or epirubicin) therapy was allowed; a single prior hormone treatment was permitted. Chemotherapy consisted of mitoxantrone 12 mg/m2 i.v. day 1, l-leucovorin 150 mg/m2 i.v. days 1, 2 and 3 and 5-fluorouracil 350 mg/m2 i.v. days 1, 2 and 3. The courses were repeated every 3 weeks. RESULTS: Objective response (CR + PR) was observed in 46/80 (57%) patients (95% CI, 46%-68%). Complete response (CR) was observed in 21/80 cases (26%). Response was observed in 14/24 (58%) patients with soft tissues as the dominant site of disease, in 22/34 (65%) patients with visceral involvement and in 10/22 (45%) of those with bone as the dominant site of disease. The median duration of response and survival was 9 months (range, 3-16) and 22 months (range, 2-48+), respectively. Toxicity was very manageable, with grade 4 leukopenia and thrombocytopenia in 6/80 (7.5%) and 1/80 (1.25%) patients, respectively, and negligible non-hematological toxicity. CONCLUSIONS: The combination of mitoxantrone, 5-fluorouracil and high-dose l-leucovorin is a safe and effective regimen for first-line treatment of advanced breast cancer.

Adult↗
PubMedDate not supplied

Concurrent modulation of 5-fluorouracil with methotrexate and L-leucovorin: an effective and moderately toxic regimen for the treatment of advanced colorectal carcinoma. A multicenter phase II study of the Southern Italy Cooperative Oncology Group.

AIMS AND BACKGROUND: Methotrexate (MTX) and leucovorin (LV) can enhance the cytotoxicity of 5-fluorouracil (5FU) by modifying its metabolic pathway inside target cells. Some preclinical studies and clinical trials have suggested that the concurrent or sequential double modulation of 5FU by means of MTX and LV may give a higher activity than single biochemical modulations. The purpose of our phase II study was to assess the activity and toxicity of a biweekly regimen including MTX, levo-LV and 5FU in colorectal cancer patients. METHODS: From July 1994 to May 1997, 100 consecutive patients affected by advanced or metastatic colorectal carcinoma were given MTX, 750 mg/m2 iv (2-h infusion) on day 1, and levo-LV, 250 mg/m2 iv (2-h infusion) followed by 5FU, 800 mg/m2 iv bolus on day 2, every two weeks. Patients were treated until complete response or progressive disease was documented, or for a maximum of 16 courses. RESULTS: Among 97 eligible patients, 5 complete and 25 partial responses were obtained, giving an overall response rate of 31% (95% exact confidence limits, 22-41%). Response rate was significantly higher in patients with a good (ECOG scale 0) than with a poor (ECOG scale 1 or 2) performance status (40% versus 17%, P <0.02). Median time to treatment failure was 27 weeks, median survival time was 63 (95% confidence limits, 54-71) weeks, and 2- and 3-year probability of survival were 34% and 12%, respectively. Performance status was the only pretreatment characteristic significantly affecting the outcome of patients. Indeed, median survival time was 94 weeks for patients with a performance status = 0 and 37 weeks for patients with a performance status > or = 1 (P<0.05). Toxicity of the treatment was low and manageable; grade 3 to 4 leukopenia affected 8% of patients, whereas grade 3 diarrhea and mucositis occurred in 5% and 4%, respectively. CONCLUSIONS: The double biochemical modulation of 5FU by MTX and levo-LV is at least as effective as, and probably more effective than, the single modulation by MTX or by LV. It may therefore represent a therapeutic option for the palliative treatment of patients with advanced colorectal carcinoma.

Adult↗
PubMedDate not supplied

Delayed onset of pseudotumor cerebri syndrome 7 years after starting human recombinant growth hormone treatment.

PURPOSE: To report a case of pseudotumor cerebri (PTC) following treatment with human recombinant growth hormone (GH). METHODS: A 42-year-old man who developed pseudotumor cerebri 7 years after starting human recombinant GH treatment is presented. RESULTS: The patient's medical history was significant for hypophyseal dwarfism with a serious deficit of GH, hypogonadotropic hypogonadism, and hypothyroidism. In 1996 he started taking GH, testosterone, and L-thyroxine. Fundus examination showed disc edema in the left eye. GH was discontinued, and acetazolamide therapy was initiated. At the 3-month follow-up the acuity without correction was patch and the unilateral papilledema had resolved. CONCLUSIONS: Pseudotumor cerebri or idiopathic intracranial hypertension is an uncommon and complex disorder. The diagnosis is possible when important criteria symptoms and signs are met. Several conditions and risk factors are associated with PTC. The most recently recognized risk factor is GH therapy.

Adult↗
PubMedDate not supplied

Serum levels of ceruloplasmin, properdin factor B and copper in lymphoma patients.

The serum levels of Ceruloplasmin (CER), Properdin Factor B (PFB) and Copper (CU) were evaluated in a series of 40 patients with Hodgkin's Disease and 46 patients with non-Hodgkin's lymphoma. Concentrations of CER and PFB were determined by rate nephelometry and CU concentrations by the bathocuproine colorimetric method. The results obtained demonstrated that CER, together with the well documented CU, can be used for monitoring Hodgkin's Disease.

Adolescent↗
PubMedDate not supplied

A new protocol of iron therapy combined with epoetin alpha as a treatment for preoperative autologous blood donation in gynaecological tumor surgery.

The use of epoetin alpha and sodium ferrous gluconate has been shown to be a safe and effective treatment which can be used to avoid allogeneic blood transfusions and to plan short term elective surgery. In this study the authors submitted 20 patients, scheduled to undergo surgery for gynaecological tumors, to a program of pre-operative autologous blood donation. All the patients received both epoetin alpha and sodium ferrous gluconate in the pre- and post-donation period. Epoetin alpha was administered subcutaneously at a dose of 200 IU/kg thrice a week during the week before and after autologous blood donation (400 ml). Sodium ferrous gluconate was administered intravenously shortly before the first and fourth administration of 125 mg epoetin alpha, and shortly before the third and sixth administration of 62.5 mg epoetin alpha. Surgery was scheduled to be performed 10-15 days after the last epoetin alpha administration, i.e. within 15-20 days from blood donation. All the patients were tested for the following blood chemistry parameters: hematocrit, haemoglobin, sideraemia and ferritin at treatment start, before donation, at treatment end, before autologous blood infusion and on the third and seventh day after surgery. No patient receiving epoetin alpha required allogeneic blood transfusion, as both the hematocrit and haemoglobin values remained normal. Epoetin alpha was observed to be a safe and effective treatment to be used in autologous blood donation programs in all patients scheduled to undergo surgery. It limits the decrease of hematocrit values following autologous blood donation thus enabling all the patients, who for a variety of reasons refuse allogeneic blood infusion, to predeposit autologous blood shortly before the date scheduled for surgery.

Adult↗
PubMedDate not supplied

Prognostic relevance of ploidy and proliferative activity evaluation by flow cytometry in poor prognosis non-Hodgkin's lymphomas.

The DNA content and S-phase fraction (SPF) of pathological paraffin-embedded lymph node tissue from 47 patients with poor prognosis non-Hodgkin's lymphoma (NHL) were analyzed by flow cytometry (FCM). Fifteen of 42 evaluable cases proved to be aneuploid. The DNA aneuploidy was not correlated with age, histology, stage, presence of systemic symptoms, clinical response or overall survival (OS) of patients. Mean SPF evaluated in 35 cases was 22.9%. After 78 months of follow-up, nine patients with diploid low SPF tumors had a significantly longer disease-free survival (DSF) with respect to the group of patients (33 cases) with aneuploid or diploid high SPF tumors (100% vs 59%; log rank test, p = 0.04).

Adult↗
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Bulky mediastinal Hodgkin's disease: results of a combined modality approach (ABVD/MOPP alternating chemotherapy plus radiation therapy).

BACKGROUND: Bulky mediastinal involvement is a challenging presentation of Hodgkin's disease (HD). Radiotherapy alone has provided a good response rate but also a high percentage of recurrences, and therefore many studies have been initiated to evaluate combined modality treatment. METHOD: In a prospective study 23 stage IIA/IIIB HD patients treated with ABVD/MOPP alternating chemotherapy and radiotherapy were evaluated with regard to overall (OS) and disease-free survival (DFS), acute and long-term toxicity. RESULTS: A 95% CR rate was obtained. Ten-year actuarial OS and DFS were 83 and 91%, respectively. Two patients (8.8%) relapsed 8 and 9 months after achieving CR. One patient (4.4%) died following severe bone marrow failure 25 months after diagnosis. No clinically evident acute or chronic cardiac or pulmonary toxicity was evident, and no second malignancies were observed. At the end of therapy 7/14 evaluable women became amenorrheal and remained so at their last follow-up. Two male patients were considered azoospermic on the basis of laboratory evaluation at the end of therapy, and after 68 and 122 months, respectively; 4 of 5 male patients had sexual intercourse freely but did not fertilize their partners. CONCLUSIONS: In our opinion and in agreement with available literature, chemotherapy has a fundamental place alongside radiotherapy in the treatment of bulky mediastinal HD. Combined modality treatment improves the disease-free survival obtained with radiotherapy or chemotherapy alone. In our experience a high percentage of patients (83%) can be considered cured without the need for second-line therapy. However, long-term and especially gonadal toxicity greatly influence the quality of life of these patients. Therefore treatment must be personalized according to age, sex, cardiopulmonary status and desire to preserve reproductive function.

Actuarial Analysis↗
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Correlation between HPLC-determined lonidamine serum levels and clinical response in patients with advanced ovarian cancer.

Lonidamine is an energolytic derivative of indazolcarboxilic acid which has been demonstrated to enhance cisplatin activity in ovarian cancer cell lines either sensitive or resistant to this drug, thus suggesting the potential reverting activity of the mechanisms of drug resistance. A study was performed on nine patients with advanced ovarian cancer treated with lonidamine (LND) plus cisplatin (CDDP) as salvage therapy after the failure of first-line platinum containing chemotherapy. Serum LND was determined with a high-performance liquid chromatography (HPLC) method. The objective clinical response included one complete and three partial responses (overall response 44%). High LND serum levels were observed in three of four responding patients. The serum LND concentrations for these patients, detected one hour after the first and second dose administrations, were 15.2 +/- 1.1 and 14.6 +/- 1.4 micrograms/ml, respectively. Toxicity was mild to moderate, except for myalgia. The high serum levels of lonidamine detected in three of four responding patients suggests that the syngerism between LND and CDDP observed ovarian cancer cell lines may be confirmed in clinical practice. However, the potential role of LND in enhancing CDDP activity can be definitely established in large randomized trials.

Adult↗