Terms Of Survival Improvement Research Articles

Does primary tumor resection improve survival for patients with sarcomas of pelvic bones, sacrum, and coccyx who have metastasis at diagnosis ?

Recent studies demonstrated that primary tumor resection (PTR) improves survival of patients with metastatic bone sarcomas. However, it remains quite unclear regarding the role of PTR in the treatment of sarcomas of pelvic bones with synchronous metastasis at diagnosis. Using the Surveillance, Epidemiology, and End Results Program, we enrolled a total of 385 patients with sarcomas of pelvic bones, sacrum, and coccyx who have metastasis at initial diagnosis, including 139 patients with osteosarcoma, 176 with Ewing sarcoma, and 70 with chondrosarcoma. Association between PTR and disease-specific survival (DSS) were investigated using the univariable and multivariable Cox regression models. Hazard ratio (HR) and 95% confidence interval (CI) were reported. Representative institutional PTR strategies and clinical outcomes for patients with metastatic pelvic sarcomas from our cancer center were displayed. The usage rate of PTR was 28.1% (39/139) in osteosarcoma, 13.6% (24/176) in Ewing sarcoma, and 41.4% (29/70) in chondrosarcoma with synchronous metastatic lesions. PTR was not associated with an improved DSS for metastatic pelvic osteosarcoma (HR = 0.686, 95% CI = 0.430 ~ 1.094, P = 0.113) and Ewing sarcoma (HR = 0.580, 95% CI = 0.291 ~ 1.154, P = 0.121). The use of PTR was associated with an improved DSS for metastatic pelvic chondrosarcoma (HR = 0.464, 95% CI = 0.225 ~ 0.954, P = 0.037). Primary lesion resection may provide a survival benefit for metastatic chondrosarcoma, but not for osteosarcoma and Ewing sarcoma of pelvic bones, sacrum, and coccyx. This population-based study recommends an active surgical intervention for metastatic chondrosarcoma while non-surgical treatment for metastatic osteosarcoma and Ewing sarcoma of the pelvis in terms of survival improvement.

Myeloma ASH 2010 highlights

the questions and for the sake of clarity they have been discussed together. These results should be examined in the context of the current approaches for managing myeloma. Broadly, the treatment strategy for myeloma consists of an ‘‘induction therapy’’ aimed at rapid control of the disease followed by a consolidation strategy that may include stem cell transplant (SCT), followed by maintenance strategies where appropriate [2]. This should be complemented by full supportive care to ameliorate the effect of myeloma-related end organ damage and other potential complications. We present some of the most exciting findings form the meeting, grouping them in the context of treatment steps for better perspective of their impact on daily practice. Initial Therapy of Myeloma The results from several Phase 2 and Phase 3 trials were presented looking at the efficacy of different combinations in previously untreated patients. In general, the different trials examined two, three, and four drug combinations that included both new and old drugs. Cavo et al. presented the results of a randomized trial that compared bortezomib, thalidomide and dexamethasone with thalidomide and dexamethasone as initial therapy of newly diagnosed MM followed by double autologous stem cell transplantation and further consolidation therapy [3]. Initial treatment consisted of three 21-day cycles of thalidomide (100–200 mg/day) along with dexamethasone (320 mg/cycle) with (TD) or without bortezomib 1.3 mg/m 2 twice weekly (VTD). Patients then had stem cells collected with cyclophosphamide and growth factors, followed by tandem ASCT with Mel 200 conditioning. Patients received thalidomide and dexamethasone between the ASCT and then received three 5-week cycles of thalidomide and dexamethasone with or without bortezomib 1.3 mg/m 2 weekly. Overall, 236 patients were randomized to VTD and 238 to the TD arm. There was a progressive increase in the depth of response during each phase of therapy with nCR or better rates of 31%, 52%, 55%, and 62% after induction, 1st ASCT, 2nd ASCT, and consolidation respectively with VTD; all of which was significantly better than TD (11%, 31%, 41%, and 45%, respectively). Addition of bortezomib to TD resulted in a 39% relative reduction in the risk of progression with no difference in the overall survival after a median follow-up duration of 36 months. Subgroup analysis showed that the impact of t(4;14) on progression free survival (PFS) was not evident among patients getting bortezomib, unlike TD suggesting a beneficial effect of the drug on patients with this high-risk

The effect of 100 Hz magnetic field combined with X-ray on hepatoma-implanted mice

Our previous cellular experiments demonstrated that 100 Hz magnetic field (MF) was effective at enhancing apoptosis of liver cancer cells BEL-7402 induced by X-ray irradiation. This study was performed to further explore the possible synergism between 100 Hz MF and X-ray in treatment of hepatoma-implanted Balb/c mice. 100 Hz MF exposure with a mean flux density of 0.7 mT was performed inside an energized solenoid coil. Six MV X-ray irradiation was generated using a linear accelerator. Tumor growth and survival of mice implanted with H22 cells were evaluated by measuring the tumor diameters and overall days of survival. Six groups treated with 100 Hz MF or X-ray alone or a combination of MF and X-ray were examined. Furthermore, the effects of different numbers of MF exposure periods on tumor growth and mice survival were examined when combined with 4 Gy X-ray. Data referring to overall survival days and tumor diameters of the above groups were compared using log-rank test and Student's t-test. Our results showed that five periods of combined 100 Hz MFs and 4 Gy X-ray could significantly extend the overall days of survival and reduce the tumor size compared to MF or X-ray alone. Also, a greater number of 100 Hz MF exposure periods could further improve the survival and inhibit tumor growth in hepatoma-implanted mice when combined with 4 Gy X-ray. In conclusion, these findings suggested that 100 Hz MF could possibly synergize with 4 Gy X-ray in terms of survival improvement and tumor inhibition in hepatoma-implanted mice.

Bronchoplasty versus carinoplasty: the oncological value of two methods

The authors have reconsidered the clinical problem of centrally located lung tumors from the advanced point of view of tracheobronchoplastic surgical approach. Fifty-two selected patients were classified according to the primary site and stage of disease and critically evaluated according to the results of surgical treatment. Lobar bronchoplastic procedures for the limited number of Stage I and II patients have the same long-term survival as simple lobectomies for more peripheral lung tumors. Tracheal carinal procedures, which represent the bulk of clinical concern, in spite of the high quality of surgical technique already achieved, still await new insights before the present limited results in terms of survival improvement.