Poorly differentiated loco-regionally advanced naso – and oropharyngeal carcinoma: results of neoadjuvant chemotherapy followed by radiotherapy

Over the years 1986–1997, at the Centre of Oncology in Kraków, 82 patients (28 women, 54 men; mean age: 50.8 years) with poorly differentiatied naso- and oropharyngeal carcinoma with metastases to regional nodes (stage III and IV) received neoadjuvant chemotherapy followed by teleradiotherapy. The primary tumour was located in the nasopharynx in 57 patients (69.5%), in the tonsil – in 24 (29.3%), and in the base of the tongue (one patient). Chemotherapy cycles consisted of cisplatin in a dose of 100 mg/m2 administered intravenously on the first day, and 5-f1uorouracil in a dose of 1000 mg/m2 over days 1 to 5. Forty-seven (57.3%) patients received 3 cycles, 25 (30.5%) patients – 2 cycles, 8 (9.8%) patients – 1 cycle. After chemotherapy, patients received conventionally fractionated (200 cGy 5x a week) radiotherapy to the primary tumour (50–65 Gy) and regional nodes (50–70 Gy). The therapy was generally well tolerated, however two patients developed fatal late complications. Improvement in therapy results was observed when comparised with a historical group. Five-year overall survival was 52%. The degree of regression (PR + CR), following neoadjuvant chemotherapy, which appeared to depend on the number of chemotherapy cycles, is the main prognostic factor for this group of patients

Twice a day accelerated irradiation in postoperative treatment of supratentorial grade III and IV astrocytomas in adults

Fourty-seven patients with histologically proven grade III–IV astrocytoma received postoperative accelerated radiotherapy with 2 fractions of 2,65 Gy twice daily, up to total tumor dose of 53 Gy in ten days. The tolerance of the treatment was good, actuarial survival rates at 2, 3 and 5 years were 15%, 9% and 0% respectively

DNA ploidy and tumour cell kinetics as prognostic factors in radiotherapy of cervical carcinoma and malignant gliomas

IntroductionThere is Increasing evidence that in a variety of malignancies proliferative rate and DNA ploidy are prognostic factors in respect to patients survival. Therefore the study was carried out in order to find if the biologic tumour parameters are predictive factors in patient's survival after radiotherapy (RT).MaterialThe proliferative potential and DNA ploidy of 260 squamous cell carcinoma of the cervix (SCC) and 62 gliomas were studied before treatment. Tumour cell proliferation was performed on basis of bromodeoxyuridine labelling index (percentage of labelled S-phase cells, BrdUrdLI), S-phase fraction (SPF), Proliferating index (PI; number of cells in S + G2/M), and predictive potential doubling time the tumour cells (Tpot).MethodTumour samples from biopsy were incubated in vitro with BrdUrd for one hour at 37°C using a high preasure oxygen method. After fixation and staining they were analysed with flow cytometer.ResultsThe difference in the proliferation rate between SCC of the cervix and gliomas was found. The best parameters in assessment of the proliferation proved to be: BrdUrdLI and Tpot. A higher mean BrdUrdLI (10.3%) was shown for cervical tumours than for low-grade gliomas (1.4%). Also shorter mean Tpot of 7.2 days was found in cervical cancers, than in gliomas, Tpot of 43.3 days. The high-grade gliomas presented higher percentage of aneuploidy (70%) than cervical cancers (56%).Cox multivariate analysis showed that fast proliferating cervical cancers (LI>10.3% or Tpot 1.5%, Tpo

Concurrent chemoradiotherapy in limited-stage small-cell lung cancer. Results of a pilot study

Between January 1994 and February 1998, 32, limited-stage small-cell lung cancer patients were treated with concurrent chemoradiotherapy. Follow-up time ranged from 4 to 34 months, (median 14 months). Complete regression was obtained in 22 of the 30 patients, who received at least four courses of EP chemotherapy and a tumour dose of 50 Gy or more. In all, 2-year actuarial disease-free survival was 21 %. Brain metastases occurred in 8 (36.4 %) patients with CR, in 5/7 (71.4 %) patients without prophylactic cranial irradiation (PCI) and in 3/15 (20 %) patients after PCI. The survival rate was lower in patients with PCI, in Whom chest irradiation was started later than one month from the beginning of course 1 of EP chemotherapy. We have suggested a modification of the treatment protocol