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Kluska A, Tomasik B, Moszynska-Zielinska M, Zytko L, Tracz N, Spych M, Fijuth J, Gottwald L. Prospective analysis of the impact of adjuvant treatment with external beam radiation therapy and vaginal brachytherapy on health-related quality of life in patients with early-stage endometrioid endometrial carcinoma. Ginekol Pol 2023:VM/OJS/J/91602. [PMID: 36929785 DOI: 10.5603/gp.a2023.0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/27/2022] [Accepted: 10/31/2022] [Indexed: 03/18/2023] Open
Abstract
OBJECTIVES Our study evaluates the impact of adjuvant treatment with external beam radiotherapy (EBRT) combined with vaginal high dose rate brachytherapy (HDR BT) on health related quality of life (HRQL) in patients with early stage endometrioid endometrial carcinoma. MATERIAL AND METHODS From March 2019 to February 2021, 60 patients were enrolled with early stage endometrioid endometrial carcinoma, and qualified to adjuvant treatment after hysterectomy. HRQL was assessed using the EORTC QLQ-C30 questionnaire, with the endometrial cancer-specific HRQL module EORTC QLQ-EN24. Questionnaires were completed in four timepoints during adjuvant radiotherapy. RESULTS A significant decrease in mean global health status / quality of life (p < 0.001) and role functioning (p = 0.028) was noted, as assessed in EORTC QLQ-C30 scale. Among the EORTC QLQ-C30 symptoms scales, significant differences were noted in the fatigue scale (p = 0.003), pain scale (p = 0.001), constipation scale (p < 0.001) and diarrhea scale (p < 0.001) over time. The EORTC QRQ-EN24 analysis showed significant deterioration in the urological symptoms scale (p < 0.001), gastrointestinal symptoms scale (p < 0.001) and in the mean pain in back and pelvis scale (p = 0.003). CONCLUSIONS Adjuvant radiotherapy in patients with early-stage endometrioid endometrial cancer after hysterectomy is associated with worse quality of life, especially due to the toxicity of the treatment in relation to the gastrointestinal tract and urinary system.
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Affiliation(s)
- Adam Kluska
- Brachytherapy Department, Greater Poland Cancer Centre, Poznan, Poland.
| | - Bartlomiej Tomasik
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Poland
| | | | - Leszek Zytko
- Department of Teleradiotherapy, Regional Cancer Centre, Copernicus Memorial Hospital of Lodz, Poland
| | - Natalia Tracz
- Department of Radiotherapy and Oncological Gynecology, Greater Poland Cancer Center, Poznan, Poland, Poland
| | - Michal Spych
- Department of Radiotherapy, Chair of Oncology, Medical University of Lodz, Poland, Poland
| | - Jacek Fijuth
- Department of Radiotherapy, Chair of Oncology, Medical University of Lodz, Poland, Poland.,Department of Teleradiotherapy, Regional Cancer Centre, Copernicus Memorial Hospital of Lodz, Poland
| | - Leszek Gottwald
- Department of Radiotherapy, Chair of Oncology, Medical University of Lodz, Poland, Poland.,Department of Teleradiotherapy, Regional Cancer Centre, Copernicus Memorial Hospital of Lodz, Poland
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Kluska A, Papis-Ubych A, Fijuth J, Loga K, Spych M, Gottwald L. Intraorbital extraocular metastasis of breast cancer 11 years after mastectomy - case report and review of the literature. J OBSTET GYNAECOL 2018; 39:126-128. [PMID: 29893150 DOI: 10.1080/01443615.2018.1455078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Adam Kluska
- a Department of Radiotherapy and General Oncology, Regional Cancer Center , Copernicus Memorial Hospital of Lodz , Lodz , Poland.,b Department of Radiotherapy, Chair of Oncology , Medical University of Lodz , Lodz , Poland
| | - Anna Papis-Ubych
- a Department of Radiotherapy and General Oncology, Regional Cancer Center , Copernicus Memorial Hospital of Lodz , Lodz , Poland
| | - Jacek Fijuth
- b Department of Radiotherapy, Chair of Oncology , Medical University of Lodz , Lodz , Poland.,c Department of Teleradiotherapy, Regional Cancer Center , Copernicus Memorial Hospital of Lodz , Lodz , Poland
| | - Karolina Loga
- a Department of Radiotherapy and General Oncology, Regional Cancer Center , Copernicus Memorial Hospital of Lodz , Lodz , Poland.,b Department of Radiotherapy, Chair of Oncology , Medical University of Lodz , Lodz , Poland
| | - Michal Spych
- a Department of Radiotherapy and General Oncology, Regional Cancer Center , Copernicus Memorial Hospital of Lodz , Lodz , Poland.,b Department of Radiotherapy, Chair of Oncology , Medical University of Lodz , Lodz , Poland
| | - Leszek Gottwald
- b Department of Radiotherapy, Chair of Oncology , Medical University of Lodz , Lodz , Poland.,c Department of Teleradiotherapy, Regional Cancer Center , Copernicus Memorial Hospital of Lodz , Lodz , Poland
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Chalubinska-Fendler J, Graczyk Ł, Piotrowski G, Tomasik B, Wyka K, Spych M, Papis-Ubych A, Fendler W, Fijuth J. PO-0744: LBP is predictive for long-term cardiac complications in breast cancer patients. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31054-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Chalubinska-Fendler J, Graczyk L, Spych M, Wyka K, Papis-Ubych A, Luniewska-Bury J, Fendler W, Fijuth J. MiR-215 as a Biomarker of Radiation-Induced Cardiac Toxicity. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Tomasik B, Braun M, Bienkowski M, Spych M, Papis-Ubych A, Klonowicz M, Jesien-Lewandowicz E, Wisniewski K, Bobeff E, Jaskolski D, Jesionek-Kupnicka D, Kordek R, Fijuth J. Clinical and Molecular Risk Factors for Glioblastoma Multiforme in the Era of New WHO CNS Tumors Classification. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Chalubinska-Fendler J, Fendler W, Spych M, Wyka K, Luniewska-Bury J, Fijuth J. Lipopolysaccharide-binding protein is efficient in biodosimetry during radiotherapy of lung cancer. Biomed Rep 2016; 5:450-454. [PMID: 27699012 DOI: 10.3892/br.2016.739] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 06/16/2016] [Indexed: 12/25/2022] Open
Abstract
The aim of the present study was to determine if the serum levels of early markers of inflammation, such as interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and lipopolysaccharide-binding protein (LBP) were correlated with the radiation dose received by the pulmonary and mediastinal structures of patients with non-small cell lung cancer (NSCLC). This pilot study included 26 patients with NSCLC who received total radiation doses ranging from 54 to 74 Gy (2.0 Gy/fraction). Cytokines were measured at baseline by enzyme-linked immunosorbant assay, and following administration of total doses of 20 and 40 Gy. A control group of 26 participants was sampled for comparisons with patient baseline cytokine levels. Only data from the 40-Gy cytokine blood levels of patients with NSCLC were identified to be correlated with histograms of the parameters of each patient's radiotherapy protocol. The IL-6, TNF-α and CRP median baseline levels of the patients with NSCLC were significantly higher than those of the controls (all P≤0.01). No differences were observed between the LBP levels of the patients and controls [median, 36.34 (25-75%; 31.35-39.27) vs. 36.92 (30.20-44.05) µg/ml, respectively; P=0.42]. No significant differences in the levels of the four cytokines between baseline, and at 20 and 40 Gy were observed [IL-6 (P=0.19); TNF-α (P=0.68); CRP (P=0.44) and LBP (P=0.29)]. LBP was significantly and positively correlated with the mean radiation dose to the lung (r=0.409; P=0.038), and showed a positive correlation with the percentage of lung volume exposed to at least 20 Gy of the planned radiation dose (r=0.3536; P=0.0764). CRP levels were positively correlated with the mean radiation dose to the esophagus (r=0.404; P=0.041); however, IL-6, TNF-α and CRP were not significantly associated with other lung dosimetry parameters. Thus, LBP levels were correlated with radiation exposure of pulmonary tissues, and LBP may be a marker that warrants further investigation on radiotoxicity in NSCLC patients.
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Affiliation(s)
| | - Wojciech Fendler
- Department of Biostatistics and Translational Medicine, Medical University of Łódź, 91-738 Łódź, Poland
| | - Michal Spych
- Department of Radiotherapy, Medical University of Łódź, 93-509 Łódź, Poland
| | - Krystyna Wyka
- Department of Paediatrics, Oncology, Haematology and Diabetology, Medical University of Łódź, 91-738 Łódź, Poland
| | | | - Jacek Fijuth
- Department of Radiotherapy, Medical University of Łódź, 93-509 Łódź, Poland
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Chalubinska-Fendler J, Fendler W, Spych M, Luniewska-Bury J, Mlynarski W, Fijuth J. Availability and outcomes of radiotherapy in Central Poland during the 2005-2012 period - an observational study. BMC Cancer 2015; 15:214. [PMID: 25884958 PMCID: PMC4389344 DOI: 10.1186/s12885-015-1236-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 03/20/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Using a cross-database integrative approach, we performed an epidemiological analysis in a representative region of central Poland to evaluate the availability of radiotherapy (RTx) and overall survival of adult patients undergoing RTx for cancer. METHODS Epidemiological data on cancer incidence in the 2005-2012 period were obtained from the Nationwide Cancer Registry. Using data from the Ministry of Internal Affairs, we collected survival information of all patients treated in the only centre providing RTx for a region inhabited by approximately 2.6 million people. RESULTS After filtering out individuals on the basis of exclusion criteria, the final dataset covered 17,736 patients. Availability of RTx increased marginally, from 23.5% (2005) to 24.4% (2011, R = 0.39, p = 0.38), with the highest values noted in patients with cervical (78.5%), prostate (70.6%) and breast cancer (62.7%). However, due to the decreasing population of the region, we noted increasing disparity in the likelihood of receiving RTx depending on the patient's area of residence, with rural areas becoming progressively more neglected. The best prognosis was noted among patients with breast or prostate cancer with 5-year OS rates reaching 81.2% and 83.3%, respectively. Multivariate analysis controlling for type of diagnosis and patient age showed a time-dependent improvement in outcomes (HR(95% CI): 0.96(0.94-0.98); p < 0.0001). CONCLUSIONS Availability of RTx in Poland is still below that reported by developed European centres. Survival of patients undergoing radical RTx has gradually improved, although it is still below that of leading RTx departments, potentially due to delayed diagnosis or organisational barriers, necessitating further investigations.
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Affiliation(s)
| | - Wojciech Fendler
- Department of Paediatrics, Oncology, Haematology and Diabetology, Medical University of Lodz, Lodz, Poland.
| | - Michal Spych
- Department of Radiotherapy, Medical University of Lodz, 4 Paderewskiego Street, 93-509, Lodz, Poland.
| | - Jolanta Luniewska-Bury
- Department of Radiotherapy, Medical University of Lodz, 4 Paderewskiego Street, 93-509, Lodz, Poland.
| | - Wojciech Mlynarski
- Department of Paediatrics, Oncology, Haematology and Diabetology, Medical University of Lodz, Lodz, Poland.
| | - Jacek Fijuth
- Department of Radiotherapy, Medical University of Lodz, 4 Paderewskiego Street, 93-509, Lodz, Poland.
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Chalubinska-Fendler J, Fendler W, Luniewska-Bury J, Mlynarski W, Spych M, Fijuth J. Tackling the Turmoil of Transformation: Radiation Oncology in Poland. Int J Radiat Oncol Biol Phys 2014; 90:480-6. [DOI: 10.1016/j.ijrobp.2014.05.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 05/18/2014] [Accepted: 05/22/2014] [Indexed: 11/15/2022]
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Gottwald L, Pasz-Walczak G, Piekarski J, Szwalski J, Kubiak R, Spych M, Suzin J, Tyliński W, Sęk P, Jeziorski A. Membrane expression of trail receptors DcR1 and DcR2 in the normal endometrium, endometrial atypical hyperplasia and endometrioid endometrial cancer. J OBSTET GYNAECOL 2014; 34:346-9. [DOI: 10.3109/01443615.2014.889667] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Gottwald L, Danilewicz M, Fendler W, Suzin J, Spych M, Piekarski J, Tylinski W, Chalubinska J, Topczewska-Tylinska K, Cialkowska-Rysz A. The AgNORs count in predicting long-term survival in serous ovarian cancer. Arch Med Sci 2014; 10:84-90. [PMID: 24701219 PMCID: PMC3953966 DOI: 10.5114/aoms.2013.36753] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2011] [Revised: 05/19/2011] [Accepted: 06/09/2011] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The value of argyrophilic nucleolar organizer regions (AgNORs) to predict survival in patients with ovarian cancer has not been clearly explained yet. The aim of study was to assess the value of analysis of the mean number of AgNORs per nucleus (mAgNOR) and mean percentage of nuclei with five or more AgNORs per nucleus (pAgNOR) in the prediction of disease-free survival (DFS) and overall survival (OS) in patients with serous ovarian cancer. MATERIAL AND METHODS The study examined 52 patients treated for serous ovarian cancer with a follow-up period of 2-143 months. After silver staining paraffin specimens from primary surgery, mAgNOR and pAgNOR in cancer cells were counted and analyzed. Age, grading, radicality of surgery and FIGO staging were analyzed as covariates. RESULTS Mean mAgNOR equaled 4.4 ±0.9 and pAgNOR equaled 42.2 ±20.8%. Both mAgNOR and pAgNOR were the lowest in G1 tumors. The mAgNOR and pAgNOR were lower in stage I than stage IV cancers. The DFS and OS rates were respectively 15.4% and 21.2%. In univariate analysis FIGO staging, grading, and pAgNOR were associated with worse prognosis, while radicality of surgery remained a significant protective factor in terms of DFS. Higher FIGO staging and older age worsened OS. In multivariate analysis FIGO staging remained significantly associated with both DFS (HR 1.98; 95% CI 1.05-3.71) and OS (HR 1.76; 95% CI 1.00-3.10), while age affected OS rates (HR 1.78; 95% CI 1.04-2.95). CONCLUSIONS mAgNOR and pAgNOR are useful markers of cellular kinetics. Prospective studies in larger populations are needed to confirm these results in terms of AgNORs' effects on survival.
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Affiliation(s)
- Leszek Gottwald
- Department of Radiotherapy, Chair of Oncology, Medical University of Lodz, Poland
| | - Marian Danilewicz
- Department of Nephropathology, Division of Morphometry, Medical University of Lodz, Poland
| | - Wojciech Fendler
- Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Poland
| | - Jacek Suzin
- Department of Gynecology and Gynecologic Oncology, I Chair of Obstetrics and Gynecology, Medical University of Lodz, Poland
| | - Michal Spych
- Department of Radiotherapy, Chair of Oncology, Medical University of Lodz, Poland
| | - Janusz Piekarski
- Department of Surgical Oncology, Chair of Oncology, Medical University of Lodz, Poland
| | - Wieslaw Tylinski
- Department of Gynecology and Gynecologic Oncology, I Chair of Obstetrics and Gynecology, Medical University of Lodz, Poland
| | - Justyna Chalubinska
- Department of Radiotherapy, Chair of Oncology, Medical University of Lodz, Poland
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Chalubinska-Fendler J, Fendler W, Spych M, Luniewska-Bury J, Mlynarski W, Fijuth J. OC-0573: Availability and outcomes of radiotherapy in central Poland. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30679-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gottwald L, Szwalski J, Piekarski J, Pasz-Walczak G, Kubiak R, Spych M, Suzin J, Tyliński W, Sęk P, Jeziorski A. Membrane expression of the death ligand trail receptors DR4 and DR5 in the normal endometrium, endometrial atypical hyperplasia and endometrioid endometrial cancer. J OBSTET GYNAECOL 2013; 33:512-8. [PMID: 23815209 DOI: 10.3109/01443615.2013.790886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
To assess membrane expression of DR4 and DR5 in the normal endometrium (NE), endometrial atypical hyperplasia (EAH) and endometrioid endometrial cancer (EEC), the study examined 101 patients: 20 NE, 14 EAH and 67 EEC. The expression of DR4 and DR5 was examined and presented as the total score (TS). DR4 expression was seen in 18 NE, 11 EAH and 10 EEC. DR5 expression was seen in 20 NE, 13 EAH and 21 EEC. A strong correlation between type of endometrial tissue and TS of both receptors was identified. In EEC TS of DR4 and DR5 was not related to grading, staging or survival. Malignant transformation in the endometrium is related to reduction of membrane DR4 and DR5 expression. The level of membrane staining of the receptors in EEC is not dependent on grading and staging, and is not sufficient to predict survival in EEC patients.
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Affiliation(s)
- L Gottwald
- Department of Radiotherapy, Medical University of Lodz, ul. Paderewskiego 4, 93 – 509 Lodz, Poland.
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Gottwald L, Danilewicz M, Suzin J, Wagrowska-Danilewicz M, Spych M, Tylinski W, Topczewska-Tylinska K, Piekarski J, Kazmierczak-Lukaszewicz S, Cialkowska-Rysz A. Assessment of the argyrophilic nucleolar organizer region area/nucleus ratio in ovarian serous epithelial adenomas, borderline tumors and cancers. Arch Med Sci 2013; 9:79-85. [PMID: 23515230 PMCID: PMC3598139 DOI: 10.5114/aoms.2013.33066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2010] [Revised: 09/06/2010] [Accepted: 09/26/2010] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION There is a need to assess the value of the novel potentially useful biomarkers in ovarian tumors. The aim of study was to assess the value of sAgNOR analysis in ovarian serous epithelial tumors. MATERIAL AND METHODS The analysis was performed in ovaries from 113 patients treated operatively due to serous ovarian tumors (30 adenomas, 14 borderline tumors and 69 cancers). After silver staining of paraffin specimens from surgery, sAgNOR in tumor cells was analyzed. Additionally, the value of the argyrophilic nucleolar organizer region area/nucleus ratio (sAgNOR) in the prediction of disease-free survival (DFS) and overall survival (OS) in 52 patients with serous ovarian cancer with complete follow-ups in November 2009 was evaluated. Age, grading, radicality of surgery and FIGO staging were analyzed as additional factors. RESULTS SAGNOR IN ADENOMAS, BORDERLINE TUMORS AND CANCERS WAS IN THE FOLLOWING RANGES: (0.73 ±0.23) × 10(6), (0.81 ±0.18) × 10(6) and (0.96 ±0.33) × 10(6) [AgNOR/cm(2)] respectively. In cancers from G1 to G3 sAgNOR was (1.02 ±0.32) × 10(6) (G1), (0.98 ±0.37) × 10(6) (G2) and (0.82 ±0.24) × 10(6) (G3) [AgNOR/cm(2)] respectively. In univariate analysis, but not in multivariate analysis, staging negatively correlated with better DFS and OS. sAgNOR, age of patients, grading and radicality of surgery were not associated with DFS or OS in either univariate or multivariate analysis. CONCLUSIONS sAgNOR analysis is not sufficient to precisely characterize cellular kinetics in serous ovarian tumors, and the analysis of sAgNOR, mAgNOR and pAgNOR should be performed commonly. The prognostic significance of sAgNOR in patients with serous ovarian cancer was not proven.
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Affiliation(s)
- Leszek Gottwald
- Department of Radiotherapy, Chair of Oncology, Medical University of Lodz, Poland
- Department of Radiotherapy, Regional Cancer Center, Copernicus Memorial Hospital of Lodz, Poland
| | - Marian Danilewicz
- Department of Nephropathology, Division of Morphometry, Medical University of Lodz, Poland
| | - Jacek Suzin
- Department of Gynecology and Gynecologic Oncology, First Chair of Obstetrics and Gynecology, Medical University of Lodz, Poland
| | | | - Michal Spych
- Department of Radiotherapy, Chair of Oncology, Medical University of Lodz, Poland
- Department of Radiotherapy and General Oncology, Regional Cancer Center, Copernicus Memorial Hospital of Lodz, Poland
| | - Wieslaw Tylinski
- Department of Gynecology and Gynecologic Oncology, First Chair of Obstetrics and Gynecology, Medical University of Lodz, Poland
| | | | - Janusz Piekarski
- Department of Surgical Oncology, Chair of Oncology, Medical University of Lodz, Poland
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Spych M, Gottwald L, Jesień-Lewandowicz E, Sztajer S, Fijuth J. Response to postoperative radiotherapy as a prognostic factor for patients with low-grade gliomas. Oncol Lett 2012; 4:455-460. [PMID: 22970043 DOI: 10.3892/ol.2012.759] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Accepted: 03/05/2012] [Indexed: 11/05/2022] Open
Abstract
Due to the favorable natural history in patients with low-grade gliomas (LGGs), there is no consensus on the treatment strategy following maximal safe surgical resection. A number of studies have been conducted to identify prognostic factors in patients treated for LGG. The present study evaluated the treatment outcomes as well as prognostic factors and their impact on overall survival (OS) and disease-free survival (DFS). We retrospectively reviewed 30 consecutive patients treated for LGG at the Department of Radiotherapy from February 2008 to July 2011. The patients underwent surgical intervention and postoperative radiotherapy. The response to radiotherapy was evaluated from six to eight weeks after the end of treatment using MRI analysis. Kaplan-Maier analysis was used for OS and DFS estimation. The endpoint was mortality as a result of any cause. Within a median follow-up of 21.8 months, 9 patients (30%) with disease progression were reported. The two- and five-year DFS and OS was 85.2 and 68.3% for DFS, and 84.3 and 63.4% for OS, respectively. The response to radiotherapy, evaluated in an MRI study, was found to be highly correlated with OS (p<0.0001). We also observed a significantly higher OS in patients with disease progression treated with salvage chemotherapy after the end of radiotherapy (p=0.08). Improved outcome among patients with LGG may be predicted by response to radiotherapy evaluated by MRI following termination of treatment.
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Affiliation(s)
- Michal Spych
- Radiotherapy Department, Chair of Oncology, Medical University of Lodz, Lodz, Poland
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Gottwald L, Sęk P, Piekarski J, Pasz-Walczak G, Kubiak R, Szwalski J, Spych M, Suzin J, Tyliński W, Topczewska-Tylinska K, Jeziorski A. Construction of a tissue microarray with two millimeters cores of endometrioid endometrial cancer: factors affecting the quality of the recipient block. Biotech Histochem 2012; 87:512-8. [PMID: 22909182 DOI: 10.3109/10520295.2012.712160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
The tissue microarray (TMA) method currently is not used to render a primary diagnosis of cancer, but its scientific value has been proved in studies of various cancer types. TMA technology still is not used often for uterine tumors, however. We investigated the repeatability of histological diagnosis of endometrioid endometrial cancer (EEC) using conventional histology and TMA using 2 mm cores. We examined EEC tissues from 171 patients. Formalin fixed, paraffin embedded tissue donor blocks from EEC specimens were selected and examined histologically. Duplicate 2 mm tissue cores were inserted into a TMA recipient block. EEC tissues were examined as hematoxylin-eosin stained sections from the TMAs. EEC tissue was identified in the TMAs in 158 cases (92.4%) and not found in 13 cases (7.6%). On the TMA slides, both EEC positive cores were identified in 129 cases (75.4%), but only one core in 29 cases (17.0%). Among 342 biopsies of the donor blocks (each case in duplicate), EEC was found in 287 cases (83.9%) using the TMA: 124/146 (84.9%) with superficial infiltration, 153/178 (86.0%) with deep myometrial infiltration, and 10/18 (55.6%) without myometrial infiltration. We concluded that two 2 mm tissue cores from a biopsy of a donor block inserted into a TMA recipient block were sufficient to diagnose EEC in more than 90% of cases. EEC was identified in the TMAs with similar frequency with respect to superficial and deep myometrial infiltration. Cases without myometrial infiltration were identified less often.
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Affiliation(s)
- L Gottwald
- Department of Palliative Radiotherapy and Palliative Medicine, Copernicus Memorial Hospital, Lodz, Poland.
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Gottwald L, Dukowicz A, Spych M, Misiewicz B, Piekarski J, Misiewicz P, Moszynska-Zielinska M, Chalubinska-Fendler J. Central nervous system metastases from epithelial ovarian cancer. J OBSTET GYNAECOL 2012; 32:585-9. [DOI: 10.3109/01443615.2012.693981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Gottwald L, Dukowicz A, Piekarski J, Misiewicz B, Spych M, Misiewicz P, Kazmierczak-Lukaszewicz S, Moszynska-Zielinska M, Cialkowska-Rysz A. Bone metastases from gynaecological epithelial cancers. J OBSTET GYNAECOL 2012; 32:81-6. [PMID: 22185545 DOI: 10.3109/01443615.2011.619672] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of this study was to investigate the clinical features and prognosis in patients with gynaecological epithelial cancers metastasised to bones. A total of 26 patients were studied retrospectively. Clinical and pathological data were analysed along with a follow-up. It was found that the interval from primary diagnosis of cancer until bony relapse varied between 0 and 163 months (31.4 ± 36.8). Bone metastases were solitary in 11 cases and multifocal in 15 cases. A total of 14 patients demonstrated only bony metastases while 12 had both bony and non-bony metastases. The time to follow-up from the diagnosis of osseous relapse varied between 1 and 43 months (10.0 ± 10.4). During follow-ups, 13 patients died and 13 patients survived. In both univariate and multivariate analyses, synchronous non-bony metastases and symptomatic treatment without oncological therapy impaired prognosis. It was concluded that even in the presence of multiple bone metastases, some patients may benefit from radiotherapy, chemotherapy or a combination of both, rather than palliative care alone, providing they do not have additional soft tissue metastases.
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Affiliation(s)
- L Gottwald
- Palliative Care Unit, Department of Palliative Medicine, Chair of Oncology, Medical University of Lodz, ul. Ciolkowskiego 2, 93-509 Lodz, Poland.
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Gottwald L, Dukowicz A, Piekarski J, Pasz-Walczak G, Spych M, Kazmierczak-Lukaszewicz S, Cialkowska-Rysz A. Isolated metastasis to the foot as an extremely rare presenting feature of primary endometrial cancer. Arch Med Sci 2012; 8:172-4. [PMID: 22457693 PMCID: PMC3309455 DOI: 10.5114/aoms.2012.27299] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Revised: 08/15/2010] [Accepted: 09/06/2010] [Indexed: 11/17/2022] Open
Affiliation(s)
- Leszek Gottwald
- Palliative Care Unit, Chair of Oncology, Medical University of Lodz, Poland
- Department of Palliative Medicine, Regional Cancer Centre, Copernicus Memorial Hospital of Lodz, Poland
- Gynaecological Cancer Outpatient Clinic, Regional Cancer Centre, Copernicus Memorial Hospital of Lodz, Poland
| | - Andrzej Dukowicz
- Department of Palliative Medicine, Regional Cancer Centre, Copernicus Memorial Hospital of Lodz, Poland
| | - Janusz Piekarski
- Department of Surgical Oncology, Chair of Oncology, Medical University of Lodz, Poland
| | | | - Michal Spych
- Department of Radiotherapy, Chair of Oncology, Medical University of Lodz, Poland
- Department of Teleradiotherapy, Regional Cancer Centre, Copernicus Memorial Hospital of Lodz, Poland
| | - Sylwia Kazmierczak-Lukaszewicz
- Palliative Care Unit, Chair of Oncology, Medical University of Lodz, Poland
- Department of Palliative Medicine, Regional Cancer Centre, Copernicus Memorial Hospital of Lodz, Poland
| | - Aleksandra Cialkowska-Rysz
- Palliative Care Unit, Chair of Oncology, Medical University of Lodz, Poland
- Department of Palliative Medicine, Regional Cancer Centre, Copernicus Memorial Hospital of Lodz, Poland
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Spych M, Serbiak B, Rychter A, Jesien-Lewandowicz E, Gottwald L, Fijuth J. Post-operative radiochemotherapy in patients with gastric cancer: one department's experience of 56 patients. Br J Radiol 2011; 84:457-63. [PMID: 21304007 DOI: 10.1259/bjr/25406515] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Prognosis in patients with locally advanced stomach cancer undergoing surgery alone is poor. High local failure rates in gastric cancer have been reported of up to 70%. When a relapse occurs, attempts at curative treatment are generally unsuccessful. A retrospective analysis was performed in order to determine whether post-operative radiochemotherapy improves treatment results in patients with locally advanced gastric cancer. METHODS Between November 2004 and July 2008, 56 patients with clinical Stage IB-IV cancer of the stomach underwent curative gastrectomy and adjuvant radiochemotherapy. Patients with distant metastases were excluded from the analysis. The total radiation dose was 45.0 Gy. The chemotherapy regimen comprised a 5 day cycle of 5-fluorouracil at 425 mg m(-2) and leucovorin at 20 mg m(-2). Overall survival and disease-free survival, as well as toxicity, were estimated for all patients. RESULTS Within the study group there were 7 (13%) local recurrences, 4 (7%) distant metastases and 8 (14%) local and distant relapses. The 2 year overall survival was 48%. A total of 19 (34%) patients developed Grade 3 gastrointestinal toxicity. There were no treatment-related deaths. CONCLUSION Post-operative radiochemotherapy is an effective and safe regimen in patients with curatively resected locally advanced gastric cancer.
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Affiliation(s)
- M Spych
- Radiotherapy Department, Medical University of Lodz, Lodz, Poland.
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Jesien-Lewandowicz E, Spych M, Fijuth J, Kordek R. Solitary brain metastasis of an occult and stable small-cell lung cancer in a schizophrenic patient: a 3-year control. Lung Cancer 2011; 69:245-8. [PMID: 20537425 DOI: 10.1016/j.lungcan.2010.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Revised: 04/29/2010] [Accepted: 05/02/2010] [Indexed: 10/19/2022]
Abstract
Small-cell lung cancer is a highly aggressive carcinoma, with poorer prognosis in patients with brain metastases. We present the case of a 49-year-old woman diagnosed with a cerebellar tumour which, following surgery, was revealed to be a metastatic small-cell lung carcinoma. Subsequent CT and PET scanning showed a small, isolated 8 mm nodule in the upper lobe of the right lung. The patient was suffering from schizophrenia and has been treated with clozapine for 17 years. Because of the unusual presentation, there was no therapy given for the primary tumour at the time, and systemic therapy or surgery was discussed. However, 18 months later, the nodule was slightly larger (14 mm), and surgery was performed. On pathology examination, the tumour was presented as a typical small-cell carcinoma. Standard chest irradiation with systemic chemotherapy was given. At the time of writing, 39 months after diagnosis of metastatic small-cell carcinoma, the patient is disease free. However, this case is unusual in that a long-term observation of a small stable primary tumour in the lung took place without any therapy being given. This case strongly supports the thesis that small-cell lung cancer may comprise a heterogeneous group of tumours with different biological properties. The proapoptotic effect of clozapine may be also taken into account.
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