Synchronous extraskeletal Ewing's sarcoma/PNET and gallbladder carcinoma : a case report and literature review

Ewing’s sarcoma (ES) and primitive neuroectodermal tumour (PNET) are now considered to be the same tumour and usually occur in long bones. Extraskeletal Ewing’s sarcoma is an extremely rare neoplasm, accounting for 1% of soft tissue sarcomas, with most common location in the thorax. Gallbladder cancer (GBC) represents the most common type among the biliary tract cancers with a poor prognosis even among patients undergoing aggressive therapy. We present study of extraskeletal ES/PNET found in the hilus of the liver of an elderly, diagnosed one month prior with GBC woman. The patient underwent two cycles of chemotherapy SAIME/SAVAC for ES and thereafter was operated. During three-year follow-up no recurrence of ES/PNET has been reported. However, two years after chemotherapy the patient suffered a relapse of adenocarcinoma of the gallbladder and thus received palliative chemotherapy of gemcitabine and cisplatin. After 16 months of recurrence she died. To the best of our knowledge, this is the first case of ES/PNET located in the hilus of the liver and as a synchronous neoplasm

Pilot testing and preliminary psychometric validation of the Polish translation of the EORTC INFO25 questionnaire : validation of the Polish version of INFO25-pilot study

The quality of information that oncological patients receive from health care professionals is an underestimated issue in Poland and Eastern European countries. There is lack of sufficient data on this subject. The European Organization for Research and Treatment of Cancer (EORTC) supplies a new tool for measuring the quality of information provided to cancer patients. The purpose of the study is the translation into Polish, pilot testing and preliminary validation of the EORTC information module (INFO25). Following the EORTC translation procedures, forward and back translations of the questionnaire were performed (English → Polish, Polish → English). The intermediate version of the INFO25 was pilot-tested together with the general questionnaire of quality of life (EORTC QLQ-C30). Reliability, validity and known-group comparison tests were performed. A total of 21 patients with different cancer diagnoses were recruited into the study (7 women and 14 men; mean age of 60,2 years, age range 25–73 years). Apart from filling out the INFO25, patients were interviewed about the difficulties with answering every questionnaire item. Patients' comments were analyzed and minor language changes were made to the initial translation. The internal consistency of the INFO25 showed a reliability of 0,78. The final version of the Polish translation of the INFO25 module was obtained and approved by the EORTC Quality of Life Department. It can now be used in clinical setting and for scientific purposes

Macrocytosis during sunitinib treatment predicts progression-free survival in patients with metastatic renal cell carcinoma

Sunitinib, a multi-targeted receptor tyrosine kinase inhibitor, is a first-line treatment for metastatic renal cell carcinoma (mRCC) in patients in ‘low’ and ‘intermediate’ Memorial Sloan Kettering Cancer Center and Heng risk groups. Disruptions of hematopoiesis, such as anemia, neutropenia, and thrombocytopenia, are typically observed during sunitinib treatment. When it comes to RBC parameters, an increase in mean cell volume (MCV) tends to occur, meeting the criteria for macrocytosis in some patients (MCV > 100 fL). We examined changes in RBC parameters of 27 mRCC patients treated with sunitinib (initial dose of 50 mg/day, 6-week treatment: 4 weeks on, 2 weeks off) and correlated them with progression-free survival time (PFS). Patients who had macrocytosis after 3 treatment cycles had significantly longer PFS than those whose MCV stayed less than 100 fL (not reached vs. 11.2 months, p < 0.001). We also found a correlation between MCV values after the first and third treatment cycles and the risk of progression: HR of 0.9 (0.81–0.99) and 0.76 (0.65–0.90) per 1 fL increase in MCV, respectively. The mechanism of MCV elevation during sunitinib treatment has not yet been fully explained. One of the probable causes is sunitinib’s inhibitory influence on c-Kit kinase, as is the case with imatinib. For mRCC patients, this phenomenon could help predict PFS, but since our sample was small, further studies are essential

Leczenie raka płuca u chorych w podeszłym wieku

Lung cancer is the most common malignant neoplasm both in the world and Poland. More than half of non--small-cell and small-cell cancer cases are diagnosed in the over 65 years old patients. Although large number ofthe incidence in the population of elderly persons the standards of treatment are not established. In this articlelocoregional treatment (surgery, radiotherapy) and systemic treatment (chemotherapy, target therapy) in the elderlypatients with non-small-cell and small-cell cancer are discussed.Rak płuca jest najczęstszym nowotworem złośliwym na świecie i w Polsce. Ponad połowa przypadków zarówno niedrobnokomórkowego, jak drobnokomórkowego raka płuca jest rozpoznawana u pacjentów powyżej 65 roku życia. Mimo dużej liczby zachorowań w populacji ludzi starszych wciąż nie ma wypracowanych standardów leczenia w tej grupie wiekowej. W pracy omówiono leczenie lokoregionalne (chirurgia, radioterapia) i leczenie systemowe (chemioterapia, terapie celowane) u starszych chorych na niedrobnokomórkowego i drobnokomórkowego raka płuca

Oxaliplatin treatment and peripheral nerve damage in cancer patients : a Polish cohort study

Introduction: Oxaliplatin‑induced neurotoxicity is the single main dose‑limiting factor in the treatment of colorectal cancer. The degree of neurotoxicity may be either acute and reversible or observed as cumulative and chronic peripheral nerve damage leading to peripheral neuropathy (PNP), walking difficulties, extremity hypersensitivity, tingling and numbness, and increased pain sensation. Aim: The aim of this paper is to determine and compare the ratio of clinical versus subclinical PNP cases in colorectal patients who underwent oxaliplatin treatment. Materials and Methods: Thirty‑two colorectal cancer patients were enrolled in the study. Patients received chemotherapy either as folinic acid and 5‑fluorouracil and oxaliplatin or capecitabine and oxaliplatin regimen. Electroneurophysiological tests were performed before the treatment and after the 4th cycle when the risk of peripheral nerve damage increases. All patients were subject to a standard neurological examination and a semi‑structured questionnaire interview. Results and Discussion: Following oxaliplatin treatment, 21 (66.6%) of all patients presented neurological symptoms and/or electrophysiologically measured signs of PNP; of those, 7 patients (33.4%) displayed only electrophysiological changes and the remaining 14 patients (66.6%) presented fully symptomatic PNP - 4 patients were new neuropathy cases while the other 10 patients were previously diagnosed with PNP and showed signs of further neuronal deterioration and progressing sensory and motor dysfunction. Conclusion: Our study lays ground for further larger scale longitudinal studies on oxaliplatin neurotoxicity and its prevention. We believe that early diagnosis of oxaliplatin‑induced neurotoxicity is essential in the prevention of irreversible nerve damage and should be prioritized when assessing and evaluating treatment so that adequate adjustment may be made

Increased mean corpuscular volume as a predictor of response during bevacizumab treatment

Background: Remission during sunitinib (a multikinase inhibitor and antiangiogenic drug) treatment correlates with appearance of macrocytosis. There are some suggestions that bevacizumab, an antiangiogenic drug, may result in macrocytosis as well. There are no published data available on the influence of bevacizumab on macrocytosis. This paper attempted to answer the question: does bevacizumab induce macrocytosis being a predictor of the response? Methods: Between August 2008 and August 2011, 53 patients (29 male and 24 female) were treated with bevacizumab in the combination with chemotherapy at the Oncological Department, University Hospital in Krakow, Poland. Efficacy of bevacizumab was assessed on the basis of the computer tomography scans performed every 3 months within the period of 12 months. Concurrently, mean corpuscular volume (MCV) was evaluated and correlated to the response of the treatment. Results: The percentage increase of MCV compared to baseline at 3, 6, 9 and 12 months was 3.7%, 9.2%, 8.7% and 11.8% respectively. The mean value of baseline MCV was 85.3 fl. The mean value of MCV at 3, 6, 9 and 12 months was 90.5 fl, 93 fl, 91.8 fl and 93.1 fl respectively. Macrocytosis did not occur in our study but an increase of MCV was observed within bevacizumab therapy. It was closely related to the response of the treatment. It seems that an increase of MCV can be a predictive agent of bevacizumab response. Conclusion: Bevacizumab does not induce macrocytosis. Increased MCV after treatment with bevacizumab is related to the treatment response. MCV can be a predictor of the response during bevacizumab treatment. A small number of the observed patients requires further investigations