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  • SAGE Publications  (9)
Medientyp
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  • SAGE Publications  (9)
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Erscheinungszeitraum
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  • 1
    In: Acta Radiologica, SAGE Publications, Vol. 54, No. 7 ( 2013-09), p. 731-738
    Kurzfassung: The level of background parenchymal enhancement around tumor is known to be associated with breast cancer risk. However, there is no study investigating predictive power of parenchymal signal enhancement ratio (SER) around tumor for ipsilateral breast tumor recurrence (IBTR). Purpose To investigate whether the breast parenchymal SER around the tumor on preoperative dynamic contrast-enhanced magnetic resonance imaging (MRI) is associated with subsequent IBTR in breast cancer patients who had undergone breast-conserving treatment. Material and Methods Nineteen consecutive women (mean age, 44 years; range, 34–63 years) with breast cancer who developed IBTR following breast-conserving treatment and 114 control women matched for age, as well as T and N stages were included. We compared the clinicopathologic features of the two groups including nuclear grade, histologic grade, hormonal receptor status, human epidermal growth factor receptor-2 (HER-2) status, lymphovascular invasion, negative margin width, use of adjuvant therapy, and parenchymal SER around the tumor on preoperative DCE-MRI. The SER was measured on a slice showing the largest dimension of the tumor. Multivariate conditional logistic regression analysis was used to identify independent factors associated with IBTR. Results In univariate analysis, ER negativity (odds ratio [OR] = 4.7; P = 0.040), PR negativity (OR = 4.0; P = 0.013), HER-2 positivity (OR = 3.6; P = 0.026), and a parenchymal SER greater than 0.53 (OR = 23.3; P = 0.011) were associated with IBTR. In multivariate analysis, ER negativity (OR = 3.8; P = 0.015) and a parenchymal SER greater than 0.53 (OR = 13.2; P = 0.040) on preoperative MRI were independent factors associated with IBTR. Conclusion In addition to ER negativity, a higher parenchymal SER on preoperative MRI was an independent factor associated with subsequent IBTR in patients with breast cancer who had undergone breast-conserving treatment.
    Materialart: Online-Ressource
    ISSN: 0284-1851 , 1600-0455
    RVK:
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2013
    ZDB Id: 2024579-8
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    Online-Ressource
    Online-Ressource
    SAGE Publications ; 2007
    In:  Tumori Journal Vol. 93, No. 6 ( 2007-11), p. 591-596
    In: Tumori Journal, SAGE Publications, Vol. 93, No. 6 ( 2007-11), p. 591-596
    Kurzfassung: To identify the factors influencing cosmesis after conservative treatment in breast cancer. Methods Retrospective analysis was done on 424 patients who underwent postoperative radiotherapy after conservative surgery for breast cancer from February 1992 to January 2002. Most of the patients underwent quadrantectomy. Whole breast irradiation up to 50.4 Gy was delivered in 28 fractions followed by a 10 Gy boost in 5 fractions to the tumor bed. Regional lymph node irradiation was administered if indicated. Breast cosmesis was scored in 4 tiers. Breast symmetry was analyzed by the relative distance from the sternal notch to the nipple, using photos taken prior to radiotherapy and 2 years after its completion. Median follow-up was 64 months. Results Breast cosmesis was excellent in 15%, good in 63%, fair in 19%, and poor in 3% of the patients. In multivariate analysis, tumors 〉 2 cm ( P = 0.0109), lower quadrant location ( P = 0.0026), lymph node irradiation ( P = 0.0028), and heat exposure ( P = 0.0152) were related to poor cosmesis. The cosmesis score after radiotherapy compared to the pre-radiotherapy score was deteriorated in patients who had undergone lymph node irradiation ( P 〈 0.0001) and heat exposure ( P = 0.0027). Breast symmetry was worse for patients who had tumors 〉 2 cm ( P 〈 0.0001), upper quadrant tumor location ( P 〈 0.0001), chemotherapy in combination with radiotherapy ( P = 0.0136), lymph node irradiation ( P = 0.0006) and heat exposure ( P = 0.0355). Changes in symmetry by radiotherapy were greater for lymph node-irradiated patients ( P 〈 0.0001). Conclusions With larger tumor size, lymph node irradiation, and chemotherapy in combination with radiotherapy, heat exposure was found to have a negative impact on cosmesis in patients undergoing conservative treatment for breast cancer. Patients should therefore be advised to avoid heat exposure after breast irradiation.
    Materialart: Online-Ressource
    ISSN: 0300-8916 , 2038-2529
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2007
    ZDB Id: 280962-X
    ZDB Id: 2267832-3
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 3
    Online-Ressource
    Online-Ressource
    SAGE Publications ; 2004
    In:  Tumori Journal Vol. 90, No. 3 ( 2004-05), p. 299-302
    In: Tumori Journal, SAGE Publications, Vol. 90, No. 3 ( 2004-05), p. 299-302
    Kurzfassung: The purpose of this study was to analyze the efficacy of neoadjuvant fluorouracil-cisplatin chemotherapy combined with radiotherapy for anal cancer. Methods Fourteen patients with epidermoid carcinoma of the anal canal were analyzed. Treatment consisted of three cycles of 5-fluorouracil (1000 mg/m 2 bolus on days 1-5) and cisplatin (60 mg/m 2 bolus on day 1) followed by 50.4 Gy to the pelvis and perineum over 5.5 weeks. Both inguinal lymphatics were irradiated with an identical dose schedule. The median follow-up was 78 months. Results Five-year overall survival rate and sphincter preservation rate was 85.1% and 85.7%, respectively. Response to chemoradiotherapy was the only significant factor with univariate analysis (P = 0.031). There were no complications of RTOG grade 3 or higher. Conclusions Neoadjuvant chemotherapy with a cisplatin-based regimen rather than concurrent regimen plus radiotherapy may decrease complications without compromising survival or sphincter preservation.
    Materialart: Online-Ressource
    ISSN: 0300-8916 , 2038-2529
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2004
    ZDB Id: 280962-X
    ZDB Id: 2267832-3
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 4
    In: Tumori Journal, SAGE Publications, Vol. 97, No. 3 ( 2011-05), p. 280-285
    Kurzfassung: To compare the outcome of concurrent versus sequential administration of cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) chemotherapy and radiotherapy after breast-conserving surgery in early breast cancer. Methods From February 1992 to January 2002, 156 patients underwent CMF chemotherapy and radiotherapy, either concurrently (CCRT group, 88 patients) or sequentially (SCRT group, 68 patients). There was a predilection of patients with a larger tumor (P = 0.0035), with more frequent nodal involvement (P = 0.0686), and younger age (P = 0.0776) in the CCRT group. Results The planned radiotherapy was completed in every patient. No grade 3 or 4 late treatment-related toxicity was observed in the CCRT or SCRT group. Compliance to the treatment as well as cosmetic outcome of the two groups were comparable. Despite more adverse factors for local-regional recurrence in the CCRT group, the 5-year local-regional control rate of the CCRT group was similar to that of the SCRT group (97.7% vs 93.8%, respectively, P = 0.1688). On multivariate analysis, concomitant administration of chemotherapy and radiotherapy was associated with improved local-regional control (P = 0.0463). Conclusions Concurrent administration of CMF chemotherapy and radiotherapy resulted in improved local-regional control over sequential administration without an increase in significant toxicity. Concurrent CMF chemoradiotherapy may serve as a viable option for patients at high-risk of local-regional relapse not suitable for anthracycline or taxane-based chemotherapy.
    Materialart: Online-Ressource
    ISSN: 0300-8916 , 2038-2529
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2011
    ZDB Id: 280962-X
    ZDB Id: 2267832-3
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 5
    Online-Ressource
    Online-Ressource
    SAGE Publications ; 2006
    In:  Tumori Journal Vol. 92, No. 3 ( 2006-05), p. 269-269
    In: Tumori Journal, SAGE Publications, Vol. 92, No. 3 ( 2006-05), p. 269-269
    Materialart: Online-Ressource
    ISSN: 0300-8916 , 2038-2529
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2006
    ZDB Id: 280962-X
    ZDB Id: 2267832-3
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 6
    Online-Ressource
    Online-Ressource
    SAGE Publications ; 2010
    In:  Tumori Journal Vol. 96, No. 1 ( 2010-01), p. 28-33
    In: Tumori Journal, SAGE Publications, Vol. 96, No. 1 ( 2010-01), p. 28-33
    Kurzfassung: The purpose of the study was to retrospectively evaluate the outcome according to the sequencing of radiotherapy and chemotherapy after mastectomy in high-risk patients with breast cancer. Methods From January 1986 through September 2000, 275 women with stage I-IIIB breast cancer were treated with chemotherapy and radiotherapy after mastectomy. The patients were divided into four groups. Chemotherapy was given first in 116 patients (CTRT), concurrent chemoradiotherapy in 77 (CCRT), sandwich therapy in 65 (SAND), and radiotherapy first in 17 (RTCT). Prognostic factors such as age, primary tumor size and nodal status were not statistically different among the four groups. There was a higher proportion of patients with close or positive margins in CCRT and RTCT groups than in the CTRT and SAND groups (22/77, 5/17 vs 3/116, 2/65, P 〈 0.001). Results Median follow-up was 145 months (range, 10–210). Five-year overall and disease-free survival were 69.4% and 56.1%, respectively. Survival outcomes were not statistically different among the four groups (5-year overall/disease-free survival, 68.0%/63.0%, 71.3%/60.8%, 65.0%/48.1%, 81.9%/58.8%, in CTRT, CCRT, SAND, and RTCT, respectively) (P = 0.3422/P = 0.6333). The incidence of local-regional recurrence was not different in the early radiotherapy group (CCRT/RTCT, 11%/12%) and delayed radiotherapy group (CTRT/SAND, 7%/8%). Conclusions This study suggests that in these high-risk breast cancer patients after mastectomy, delay in the start of radiotherapy does not increase local-regional recurrence, and the final survival outcomes are not affected by the sequencing of chemotherapy and radiotherapy.
    Materialart: Online-Ressource
    ISSN: 0300-8916 , 2038-2529
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2010
    ZDB Id: 280962-X
    ZDB Id: 2267832-3
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 7
    In: Tumori Journal, SAGE Publications
    Kurzfassung: To investigate the prognostic impact of sarcopenia on the survival of patients with locally advanced pancreatic cancer (LAPC) treated with concurrent chemoradiotherapy (CCRT). Methods: We retrospectively reviewed 299 patients diagnosed with LAPC and treated with definitive CCRT from 2000 to 2015. Skeletal muscle index (SMI) was measured using computed tomography scans and sarcopenia was defined as SMI 〈 29.6 cm 2 /m 2 for women and 〈 36.2 cm 2 /m 2 for men. The significance of sarcopenia for progression-free survival (PFS) and overall survival (OS) was evaluated. Results: Sarcopenia was present in 29 patients (9.7%). In multivariate analysis, sarcopenia was a significant factor for PFS ( p = 0.043). Although sarcopenia was not a significant factor for OS ( p = 0.121) in multivariate analysis, long-term survivors were observed only in the no sarcopenia group (OS at 60 months: 9.5% vs 0%, p 〈 0.001). Conclusion: In patients undergoing CCRT for LAPC, sarcopenia is an independent factor for adverse prognosis.
    Materialart: Online-Ressource
    ISSN: 0300-8916 , 2038-2529
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2020
    ZDB Id: 280962-X
    ZDB Id: 2267832-3
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 8
    In: Tumori Journal, SAGE Publications, Vol. 97, No. 3 ( 2011-05), p. 341-344
    Kurzfassung: To evaluate the effect of the surgery-radiotherapy interval (SRI) on local control in node-negative breast cancer patients treated with breast-conserving surgery and adjuvant radiotherapy without chemotherapy. Methods From February 1992 to January 2002, 171 patients with node-negative breast cancer underwent breast-conserving surgery and adjuvant radiotherapy without chemotherapy. The whole breast was irradiated up to 50.4 Gy in 28 fractions followed by a 10-Gy boost to the tumor bed. Forty-four patients received tamoxifen in addition to radiotherapy. Patients were divided into 2 groups according to the length of SRI: 〈 6 weeks (128 patients) versus ≥6 weeks (43 patients). The median follow-up period was 87 months (range, 22–167). Results The 8-year local control rates of patients with SRI 〈 6 weeks and ≥6 weeks were 94.5% and 92.7%, respectively (P = 0.1140). When age, tumor size, resection margin status, combination with hormonal therapy, and SRI were incorporated into the Cox proportional hazards model, SRI 〈 6 weeks and age at diagnosis ≥40 years were associated with increased local control (P = 0.0343 and 0.0264, respectively). In the subgroup analysis, SRI 〈 6 weeks was correlated with a higher local control rate for patients aged 〈 40 years (P = 0.0142). Among older patients, however, there was no statistical difference in local control according to SRI (P = 0.6655). Treatment interval had no impact on overall and distant metastasis-free survival. Conclusions Early radiotherapy within 6 weeks of breast-conserving surgery is associated with increased local control in patients with node-negative breast cancer not undergoing chemotherapy.
    Materialart: Online-Ressource
    ISSN: 0300-8916 , 2038-2529
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2011
    ZDB Id: 280962-X
    ZDB Id: 2267832-3
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 9
    Online-Ressource
    Online-Ressource
    SAGE Publications ; 2005
    In:  Tumori Journal Vol. 91, No. 6 ( 2005-11), p. 493-497
    In: Tumori Journal, SAGE Publications, Vol. 91, No. 6 ( 2005-11), p. 493-497
    Kurzfassung: To evaluate the influence of radiation therapy target volume on the treatment outcome of adjuvant chemoradiotherapy for pancreatic cancer after curative resection. Methods Between February 1987 and July 2001, 70 patients treated with curative resection and adjuvant chemoradiotherapy for pancreatic adenocarcinoma were analyzed. There were 49 males and 21 females, with a median age of 57 years. Whipple's operation was performed in 44 patients, pylorus-preserving pancreaticoduodenectomy in 14, distal pancreatectomy in 9, and subtotal pancreatectomy in 3. Postoperative adjuvant radiotherapy was given up to 40 Gy at 2 Gy per fraction with a two-week planned rest. Intravenous 5-fluorouracil (500 mg/m 2 /day) was given on days 1 to 3 of each split course of radiotherapy. Until 1991, whole pancreas or preoperative tumor volume and retroperitoneal lymph nodes were irradiated (extended field, n = 14). Thereafter, the target volume included the retroperitoneal lymph nodes and the involved pancreatic resection margin (limited field, n = 56). The median follow-up period of all the patients was 16 months (range, 2-99). Results The overall 2- and 5-year survival rate of all patients was 29.7% and 14.0%, respectively. According to the radiotherapy target volume, the median survival time was 14 months in the extended field group and 16 months in the limited field group ( P = 0.65). Conclusions From the viewpoint of the target volume of radiotherapy, a limited field did not worsen the treatment outcome, although the survival rate was poor in both groups.
    Materialart: Online-Ressource
    ISSN: 0300-8916 , 2038-2529
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2005
    ZDB Id: 280962-X
    ZDB Id: 2267832-3
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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