Background: Because of the diffuse nature of gliomatosis cerebri (GC), surgery is not suitable, and large field radiotherapy carries the risk of severe toxicity. In this setting, initial chemotherapy warrants further ...Background: Because of the diffuse nature of gliomatosis cerebri (GC), surgery is not suitable, and large field radiotherapy carries the risk of severe toxicity. In this setting, initial chemotherapy warrants further investigation. Methods: The authors treated 63 consecutive patients with GC with initial chemotherapy consisting of either PCV (procarbazine, 60 mg/m2 on days 8 to 21; CCNU, 110 mg/m2 on day 1; and vincristine, 1.4 mg/m 2 on days 8 and 29) or temozolomide (TMZ; 150 to 200 mg/m2 for 5 days every 4 weeks). There were 40 men and 23 women, with a median age of 48 years (range, 17 to 74 years) and a median Karnofsky performance status of 90 (range, 50 to 100). GC was initially present at diagnosis in 49 patients (primary GC), whereas 14 patients with a circumscribed glioma at onset developed secondary GC after a median follow up period of 5.11 years. GC was classified based on the predominant tumor cells as astrocytic, oligodendroglial, or mixed GC. Results: Seventeen patients received 1 to 6 cycles (median, 5) of PCV, and 46 received 2 to 24 courses (median, 13) of TMZ. Grade 3 to 4 hematologic toxicity was seen in 4 of 17 (23.5% ) patients treated with PCV and in 4 of 46 (8.6% ) of those treated with TMZ. Clinical objective responses were observed in 21 of 63 (33% ) patients, and radiologic responses were seen in 16 of 62 (26% ), with no significant difference between the two regimens. For all patients combined, the median progression free survival (PFS) and overall survival (OS) were 16 months and 29 months, respectively. Regardless of the chemotherapeutic regimen, oligodendroglial GC had a better prognosis than astrocytic and oligoastrocytic GC in terms of PFS (p < 0.02) and OS (p < 0.0001). Conclusion: Initial chemotherapy is useful for some patients with gliomatosis cerebri. Temozolomide is well tolerated and appears to be a valuable alternative to procarbazine CCNU vincristine, especially for those with slow growing, low grade GC.展开更多
Background.To report a case of succe ssful management of a FIGO stage III endometrioid carcin oma of the ovary di-agnosed during pregnancy at 22weeks of gestation and treated with initial chemotherapy w hile preservin...Background.To report a case of succe ssful management of a FIGO stage III endometrioid carcin oma of the ovary di-agnosed during pregnancy at 22weeks of gestation and treated with initial chemotherapy w hile preserving the pregnancy.Case.The patient underw ent a planned ce-sarean section at 34weeks after two c ourses of carboplatin.She delivered a healthy baby.At the s ame time,a radical hysterectomy,omentectomy,pelvic and paraaortic lym-phadenectomies and peritonectomie s were carried out.The surgical resection was complete(no macroscopic residual disease).During histologic examination,tr aces of persis-tent disease were found.The patient underwent seven postoperative courses of chemotherapy(carboplatin +pa-clitaxel regimen)after radical surgery.After 18mont hs of follow-up posttreatment,the patie nt remains in complete remission and the childs developme nt is normal.Conclu-sion.Chemotherapy during pregnancywith preservation of the fetus could be considered and should be discussed in case of epithelial ovarian cancer(EOC)diagnosed during the second trimester of the pregnancy.展开更多
Objective.A phase Ⅱ study was conducted to determ inethe efficacy of single agent flavopiridol therapy in patients with recurrent or persistent endometrial adenocarcinoma refractory to established treatments. Methods...Objective.A phase Ⅱ study was conducted to determ inethe efficacy of single agent flavopiridol therapy in patients with recurrent or persistent endometrial adenocarcinoma refractory to established treatments. Methods. Eligible patients with measurable disease who failed primary therapy including one cytotoxic regim en were eligible for the trial.They were treated with single agentflavopiridol (50mg/m2/day,Ⅳ bolus days 1,2,3).Treatm entwas repeatedevery 21days with dose adjustm ents made for toxicity.Patients were treated untilprogression ofdisease oradverseside effects precluded further therapy.Results.A totalof26patientswere enrolled in the study ofwhom ,23patientswere eligible.There were no objective responses.Fivepatients had stable disease (22%),15 (65%)had in-creasing disease,and response could notbe assessed in 3(13%).The mostfrequentside effects included anemia,neutropenia,and diarrhea,allofwhich appeared manage-able.Conclusion.Flavopiridol as a single agent in theabove dosing schedule appears to have minim alactivity assecond-line chem otherapy ofendom etrialadenocarcinoma.展开更多
Objective: The purpose of this study was to determine if a suboptimal cytoreduction can be predicted preoperatively in women with advanced ovarian cancer. Study design: All women with stage III/IV epithelial ovarian c...Objective: The purpose of this study was to determine if a suboptimal cytoreduction can be predicted preoperatively in women with advanced ovarian cancer. Study design: All women with stage III/IV epithelial ovarian cancer treated with initial surgery at our hospital between January 1, 1995 and January 1, 2003 were eligible; 56 patients met inclusion criteria and underwent retrospective chart review. Statistical analysis was performed using SPSS. Results: Twenty-nine women (52% ) had optimal cytoreduction (OC), and 27 (48% ) had suboptimal cytoreduction (SC). Women in the SC group had higher median CA- 125 values at surgery (954 SC vs 597 OC, P = .07). Three sites of disease on preoperative CT were reported more frequently in the SC patients; omentum (P = .007), parietal peritoneum (P = .096), and ascites (P = .093). Conclusion: A suboptimal cytoreduction confers no survival advantage to women with advanced ovarian cancer. Thus, these patients may be the best candidates for initial chemotherapy, and identifying them preoperatively becomes important.展开更多
Finding available subclasses in high-dimensional medical databases using clustering techniques is considered as very important one in medical field. Due to similar intensi- ties between the datapoints in high-dimensio...Finding available subclasses in high-dimensional medical databases using clustering techniques is considered as very important one in medical field. Due to similar intensi- ties between the datapoints in high-dimensionality cancer medical database clustering techniques have failed to cluster the available subclasses with less error. Therefore this paper presents suitable fuzzy-based clustering techniques to find available subclasses in high-dimensional prostate and breast cancer databases. In addition this paper presents prototype initialization algorithm to avoid random initialization of initial prototypes. In order to evaluate the performance of proposed clustering techniques experimental study has been performed on benchmark databases. Finally the proposed methods have been successfully implemented to find the subclasses of cancers in prostate and breast cancer databases. The clustering results of proposed methods have been validated by evaluating clustering accuracy.展开更多
文摘Background: Because of the diffuse nature of gliomatosis cerebri (GC), surgery is not suitable, and large field radiotherapy carries the risk of severe toxicity. In this setting, initial chemotherapy warrants further investigation. Methods: The authors treated 63 consecutive patients with GC with initial chemotherapy consisting of either PCV (procarbazine, 60 mg/m2 on days 8 to 21; CCNU, 110 mg/m2 on day 1; and vincristine, 1.4 mg/m 2 on days 8 and 29) or temozolomide (TMZ; 150 to 200 mg/m2 for 5 days every 4 weeks). There were 40 men and 23 women, with a median age of 48 years (range, 17 to 74 years) and a median Karnofsky performance status of 90 (range, 50 to 100). GC was initially present at diagnosis in 49 patients (primary GC), whereas 14 patients with a circumscribed glioma at onset developed secondary GC after a median follow up period of 5.11 years. GC was classified based on the predominant tumor cells as astrocytic, oligodendroglial, or mixed GC. Results: Seventeen patients received 1 to 6 cycles (median, 5) of PCV, and 46 received 2 to 24 courses (median, 13) of TMZ. Grade 3 to 4 hematologic toxicity was seen in 4 of 17 (23.5% ) patients treated with PCV and in 4 of 46 (8.6% ) of those treated with TMZ. Clinical objective responses were observed in 21 of 63 (33% ) patients, and radiologic responses were seen in 16 of 62 (26% ), with no significant difference between the two regimens. For all patients combined, the median progression free survival (PFS) and overall survival (OS) were 16 months and 29 months, respectively. Regardless of the chemotherapeutic regimen, oligodendroglial GC had a better prognosis than astrocytic and oligoastrocytic GC in terms of PFS (p < 0.02) and OS (p < 0.0001). Conclusion: Initial chemotherapy is useful for some patients with gliomatosis cerebri. Temozolomide is well tolerated and appears to be a valuable alternative to procarbazine CCNU vincristine, especially for those with slow growing, low grade GC.
文摘Background.To report a case of succe ssful management of a FIGO stage III endometrioid carcin oma of the ovary di-agnosed during pregnancy at 22weeks of gestation and treated with initial chemotherapy w hile preserving the pregnancy.Case.The patient underw ent a planned ce-sarean section at 34weeks after two c ourses of carboplatin.She delivered a healthy baby.At the s ame time,a radical hysterectomy,omentectomy,pelvic and paraaortic lym-phadenectomies and peritonectomie s were carried out.The surgical resection was complete(no macroscopic residual disease).During histologic examination,tr aces of persis-tent disease were found.The patient underwent seven postoperative courses of chemotherapy(carboplatin +pa-clitaxel regimen)after radical surgery.After 18mont hs of follow-up posttreatment,the patie nt remains in complete remission and the childs developme nt is normal.Conclu-sion.Chemotherapy during pregnancywith preservation of the fetus could be considered and should be discussed in case of epithelial ovarian cancer(EOC)diagnosed during the second trimester of the pregnancy.
文摘Objective.A phase Ⅱ study was conducted to determ inethe efficacy of single agent flavopiridol therapy in patients with recurrent or persistent endometrial adenocarcinoma refractory to established treatments. Methods. Eligible patients with measurable disease who failed primary therapy including one cytotoxic regim en were eligible for the trial.They were treated with single agentflavopiridol (50mg/m2/day,Ⅳ bolus days 1,2,3).Treatm entwas repeatedevery 21days with dose adjustm ents made for toxicity.Patients were treated untilprogression ofdisease oradverseside effects precluded further therapy.Results.A totalof26patientswere enrolled in the study ofwhom ,23patientswere eligible.There were no objective responses.Fivepatients had stable disease (22%),15 (65%)had in-creasing disease,and response could notbe assessed in 3(13%).The mostfrequentside effects included anemia,neutropenia,and diarrhea,allofwhich appeared manage-able.Conclusion.Flavopiridol as a single agent in theabove dosing schedule appears to have minim alactivity assecond-line chem otherapy ofendom etrialadenocarcinoma.
文摘Objective: The purpose of this study was to determine if a suboptimal cytoreduction can be predicted preoperatively in women with advanced ovarian cancer. Study design: All women with stage III/IV epithelial ovarian cancer treated with initial surgery at our hospital between January 1, 1995 and January 1, 2003 were eligible; 56 patients met inclusion criteria and underwent retrospective chart review. Statistical analysis was performed using SPSS. Results: Twenty-nine women (52% ) had optimal cytoreduction (OC), and 27 (48% ) had suboptimal cytoreduction (SC). Women in the SC group had higher median CA- 125 values at surgery (954 SC vs 597 OC, P = .07). Three sites of disease on preoperative CT were reported more frequently in the SC patients; omentum (P = .007), parietal peritoneum (P = .096), and ascites (P = .093). Conclusion: A suboptimal cytoreduction confers no survival advantage to women with advanced ovarian cancer. Thus, these patients may be the best candidates for initial chemotherapy, and identifying them preoperatively becomes important.
文摘Finding available subclasses in high-dimensional medical databases using clustering techniques is considered as very important one in medical field. Due to similar intensi- ties between the datapoints in high-dimensionality cancer medical database clustering techniques have failed to cluster the available subclasses with less error. Therefore this paper presents suitable fuzzy-based clustering techniques to find available subclasses in high-dimensional prostate and breast cancer databases. In addition this paper presents prototype initialization algorithm to avoid random initialization of initial prototypes. In order to evaluate the performance of proposed clustering techniques experimental study has been performed on benchmark databases. Finally the proposed methods have been successfully implemented to find the subclasses of cancers in prostate and breast cancer databases. The clustering results of proposed methods have been validated by evaluating clustering accuracy.
