A new schedule of fotemustine in temozolomide-pretreated patients with relapsing glioblastoma

In the present study we investigated the feasibility and effectiveness of a new biweekly schedule of fotemustine (FTM) in patients with recurrent glioblastoma, after at least one previous treatment. The primary endpoint was progression-free survival at 6 months; secondary objectives were clinical response, overall survival, disease-free survival, and toxicity. Forty patients (median age 52.8 years; median Karnofsky Performance Status at progression 90) underwent second-line chemotherapy with FTM. Selected patients were previously treated with a standard radiotherapy course with concomitant temozolomide (TMZ). After tumor relapse or progression proven by magnetic resonance imaging (MRI), all patients underwent chemotherapy with FTM, given intravenously at dose of 80 mg/m2 every 2 weeks for five consecutive administrations (induction phase), and then every 3 weeks at 100 mg/m2 as maintenance. A total of 329 infusions were administered; the median number of cycles administered was 8. All patients completed the induction phase, and 29 patients received at least one maintenance infusion. Response to treatment was assessed using MacDonald criteria. One complete response [2.5%, 95% confidence interval (CI): 0–10%], 9 partial responses (22.5%, 95% CI: 15–37%), and 16 stable diseases (40%, 95% CI: 32–51%) were observed. Median time to progression was 6.7 months (95% CI: 3.9–9.1 months). Progression-free survival at 6 months was 61%. Median survival from beginning of FTM chemotherapy was 11.1 months. The schedule was generally well tolerated; the main toxicities were hematologic (grade 3 thrombocytopenia in two cases). To the best of our knowledge, this is the first report specifically dealing with the use of a biweekly induction schedule of FTM. The study demonstrates that FTM has therapeutic efficacy as single-drug second-line chemotherapy with a favorable safety profile

Radiotherapy as Definitive Treatment of Patients with Primary Vulvar Carcinoma Unfit for Surgery and with Recurrent Vulvar Carcinoma After Primary Radical Surgery: Results of a Retrospective Single-center Study.

To assess the outcome of patients with vulvar carcinoma unfit for surgery treated with radiotherapy for primary disease and for those with recurrent disease after primary surgery. PATIENTS AND METHODS: The study was conducted on 16 patients with primary disease and 31 with recurrent disease. RESULTS: An objective response and long-term control were obtained in 43.8% and 18.8% of patients with primary carcinoma. Median survival after primary radiotherapy was 15 months. An objective response and long-term control were achieved in 100% and 20% of the 15 patients with local recurrence. Only two out of the 13 patients with groin recurrence were recovered by salvage treatment, and all three patients with distant recurrence died of their disease. Median survival after relapse in the 31 patients was 33 months. CONCLUSION: Radiotherapy achieves unsatisfactory results in patients with primary vulvar carcinoma who are unfit for surgery as well as in those with recurrent disease after surgery

The Role of Medicinal Mushrooms in Brain Cancer Therapies: Review

Medicinal mushrooms are considered an unlimited source of polysaccharides (mainly β-glucans) and polysaccharide-protein complexes and possess various immunological and anticancer properties. In addition, their use in integrative medicine leads to a clear reduction of side effects in patients undergoing chemotherapy or radiotherapy. The literature reports a number of beneficial effects of using mushrooms as health supplements in patients affected by highgrade glioma. The effects of medicinal mushrooms on side effects in patients with brain cancer and a case study report are also described in this review

Analysis of failures in patients with FIGO stage IIIc1-IIIc2 endometrial cancer.

To assess the pattern of failures in patients with FIGO stage IIIc(1)-IIIc(2) endometrial cancer. PATIENTS AND METHODS: Data were retrospectively analyzed for 34 patients with this malignancy who underwent extra-fascial total hysterectomy, bilateral salpingo-oophorectomy and pelvic/para-aortic node dissection. Postoperative treatment consisted of radiotherapy in 5 patients, 6 cycles of chemotherapy in 9, and 3-4 cycles of chemotherapy followed by radiotherapy in 20. The median follow-up of survivors was 33 months (range, 6 to 133 months). RESULTS: Tumour relapsed in 14 out of 34 patients (41.2%). Median time to recurrence was 17 months (range, 9.5-42 months). Vaginal recurrence developed in 2 patients (5.9%), distant recurrence in 5 (14.7%), pelvic node recurrence in 3 (8.8%) and para-aortic recurrence in 7 (20.6%). Two patients had multiple sites of recurrence. Distant failure occurred in 11.1% of the patients who received 6 cycles of chemotherapy versus 20.0% of those who had 3-4 cycles of chemotherapy followed by radiotherapy. Five-year overall survival was 60.5%, and, in particular, it was 62.5% for stage IIIc(1) and 57.0% for stage IIIc(2). CONCLUSION: FIGO stage IIIc(1)-IIIc(2) endometrial cancer relapses in approximately 40% of cases, and distant sites and para-aortic nodes represent the most common sites of failure