https://www.cs.ubbcluj.ro/~gabis/DocDiplome/Bayesian/PIIS0167814007005221.pdf

Application of the Naïve Bayesian Classifier to optimize treatment decisions

Treatment outcome and prognostic factors of adult glioblastoma multiforme

To evaluate the feasibility, safety and efficacy of daily temozolomide concurrent with postoperative radiotherapy in malignant glioma. From 11/1999 to 03/2003, n = 81 patients aged 15–72 years (median 52 years, Karnofsky score 80–100% in 83%) suffering from primary glioblastoma (n = 47), anaplastic astrocytoma (n = 6), anaplastic oligodendroglioma (n = 16), and recurrent glioma (n = 12) were treated. Patients with primary gliomas received a combination of postoperative radiotherapy (60 Gy/1.8- to 2.0-Gy fractions) and daily oral temozolomide (75 mg/m2) at all irradiation days (30–33 doses), while recurrent tumors were treated with 45–60 Gy and temozolomide. Initially, 6/81 patients had daily temozolomide doses of 50 mg/m2. In total, 70/81 patients (86%) completed both radio- and chemotherapy. Grade 1 nausea/vomiting was seen in 28%, grade 2 in 11%, grade 3 in 1%. Antiemetics were applied in 41%. Hematologic toxicities were observed as follows: leukopenia grade 3/4 1%, lymphopenia grade 3/4 46%, thrombopenia grade 3/4 1%. Two patients under dexamethasone suffered herpes encephalitis after one and 16 doses of temozolomide (75 mg/m2). Median survival was 15 months for glioblastoma. In oligodendroglioma patients, a 4-year survival rate of 78% was observed. Postoperative radiochemotherapy with 30–33 daily doses of temozolomide (75 mg/m2) is safe in patients with malignant glioma. The combined schedule is effective in oligodendroglioma patients and may prolong survival in glioblastoma. Effort should be taken to minimize corticosteroid doses, since both steroids and temozolomide lead to immunosuppression.

Efficacy and Toxicity of Postoperative Temozolomide Radiochemotherapy in Malignant Glioma

Even after surgery and radiotherapy, malignant gliomas still have a poor prognosis. The authors report on their experience with IORT in 71 patients. From May 1992 to February 2004, 71 patients with malignant gliomas were treated with IORT. 26 patients suffered from grade III gliomas, 45 patients from glioblastomas (GBM). IORT was carried out using a standard electron tube and 9- to 18-MeV electrons. 52/71 patients who were primarily treated received 20 Gy IORT + 60 Gy postoperative radiotherapy, 19/71 patients with recurrences only received IORT (20–25 Gy). The complication rates were 1.4% for wound infections and 5.6% for hemorrhage. Median disease-specific survival amounted to 14.9 months (gliomas III) and 14.2 months (GBM). The 2-year survival rates amounted to 26.9% (gliomas III) and 6.8% (GBM; p = 0.0296). Total versus subtotal resection had no significant influence on survival (p = 0.0741), nor had age, sex, tumor site, performance status, size, primary versus recurrence, and radiation dose. A comparison to a conventionally treated patient group did not show a significant survival improvement. 3 months after treatment, initial symptoms had improved in 59% (hemiparesis), 50% (aphasia), 50% (hemianopsia), and 60% (convulsions). IORT has been shown to be feasible; perioperative complication rates were not increased. Survival was generally not improved compared to a historical control group. Recurrences achieved the same survival as primary tumors, and GBM also had a slightly increased survival, thus being possible indications for IORT.

12 years' experience with intraoperative radiotherapy (IORT) of malignant gliomas.

Background: Cervical cancer, in women, is the second most common cancer world wide, next to breast cancer. During the treatment of carcinoma cervix, anemia is selectively frequent and its origin is complex combining hemorrhage, iron deprivation, inflammatory reactions and infection. The objective of this study is to evaluate the role of epoetin in correction of anemia and on treatment outcomes in patients with advanced cervical cancer receiving concurrent chemoradiotherapy. Results: A total of 120 patients were enrolled in the study of which 60 patients were randomized to receive epoetin beta in the treatment arm and 60 patients were in control arm where epoetin beta was not given. Total two and three patients absconded during treatment from treatment and control arm respectively; therefore total evaluable patients were 115. Mean Hb at baseline in the control arm was 10.70 +/- 0.62 g/dl and 10.45 +/- 0.43 g/dl in the treatment arm (p = NS). At the end of treatment mean Hb increased by 1.55 g/dl in patient...

Role of recombinant human erythropoietin in patients of advanced cervical cancer treated "by chemoradiotherapy".

To evaluate prognostic factors in patients with
glioblastoma treated with postoperative or primary
radiotherapy. From 1989 to 2000, a total of 100 patients underwent
irradiation as part of their initial treatment for glioblastoma.
All patients had undergone surgery or biopsy followed by
conventional external-beam radiotherapy. 85 patients who
received the planned dose of irradiation (60 Gy in 30 fractions)
were analyzed for the influence of prognostic factors. 73/85
(86%) of patients were given postoperative irradiation, while
12/85 (14%) of patients were primarily treated with radiotherapy
after biopsy. The median overall survival was 10.1 months (range,
3.7–49.8 months), the 1- and 2-year survival rates were 41% and
5%, respectively. Univariate analysis revealed age ≤ 55 years (p
 12 g/dl
(p = 0.009), and pre-radiotherapy dose of dexamethasone ≤ 2
mg/day (p = 0.005) to be associated with prolonged survival. At
multivariate analysis, younger age (p < 0.001), higher Hb
level (p = 0.002), lower dose of dexamethasone (p = 0.026), and
a hemispheric tumor location (p = 0.019) were identified as
independent prognostic factors for longer survival. The median
survival for patients with an Hb level > 12 g/dl was 12.1
months compared to 7.9 months for those with a lower Hb level.
Contingency-table statistics showed no significant differences
for the two Hb groups in the distribution of other prognostic
factors. The results indicate that lower Hb level prior to
radiotherapy for glioblastoma can adversely influence prognosis.
This finding deserves further evaluation.

Prognostic impact of hemoglobin level prior to radiotherapy on survival in patients with glioblastoma.

Presented is a retrospective analysis of 27 patients with plasma cell neoplasms of the spine treated by surgery. Multiple myeloma was confirmed in 22 (81%) and solitary plasmacytoma in 5 patients (19%), assessed at the time of surgery. Nineteen patients (70%) with the preliminary diagnosis of malignancy of unknown etiology were admitted for surgery. In 23 patients (85%) the essential symptom was back pain, which preceded surgery by an average of 4 months. Thirteen patients (48%) were bedridden due to tumor spinal cord compression, on average for 7 days before undergoing surgery. Only 5 out of 13 bedridden patients (38%) regained the ability to walk after surgery and 8 patients (62%) remained bedridden despite successful surgical decompression of the spinal cord. The difference of survival of the patients between bedridden and able to walk prior to surgery was statistically significant (Cox's F-Test = 0.005). Key words: plasma cell neoplasia, spinal cord compression, late diagnosis, outcome.

Diagnosis and surgical therapy of plasma cell neoplasia of the spine.

The authors present a rare and unusual case of complication, migration of osteosynthetic material for stabilization, titanium rod, which was used for stabilization of comminutive fracture of the first lumbar vertebra. This rod migrated from the retroperitoneal space to the pleural cavity. The removal of this rod was carried out by videothoracoscopy.

/pdf/case-unusual-migration-of-osteosynthetic-material-1ned5liffw.pdf

Case: unusual migration of osteosynthetic material.

od 1/2007 do 6/2010 pomoci perkutanni vertebroplastiky. 
Material a metodika: U 13 nemocných (3 muži a 10 žen), median věku 65 let, bylo celkem osetřeno 18 obratlových těl v oblasti thorakolumbalni 
pateře. Sledovali jsme bolesti pomoci VAS (visual analoque scale), cetnost komplikaci, funkcni výstup nemocných (stejný, 
zlepsený, zhorsený) a spotřebu analgetik (zvýsena, stejna, snižena). Nemocni byli osetřeni na angiografickem kompletu transpedikularnim 
ci posterolateralnim přistupem. 
Výsledky: Provedeni perkutanni vertebroplastiky mělo statisticky významný vliv na pokles bolesti po výkonu (p = 0,002). Přitom jsme 
neprokazali žadnou symptomatickou komplikaci, k asymptomatickemu uniku kostniho cementu mimo obratlove tělo doslo u 11 % 
nemocných. 
Zlepseni urovně života udavalo 100 % nemocných. Sniženi spotřeby analgetik jsme prokazali u 92 % nemocných a u zbývajicich 8 % 
zůstala spotřeba analgetik stejna. 
Zavěr: Perkutanni vertebroplastika je miniinvazivni zakrok s minimem komplikaci a rychlým nastupem analgetickeho efektu u nemocneho.

Použití perkutánní vertebroplastiky u pacientů s mnohočetným myelomem - zkušenosti jednoho centra

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Papers

Prognostic impact of hemoglobin level prior to radiotherapy on survival in patients with glioblastoma.

Diagnosis and surgical therapy of plasma cell neoplasia of the spine.

Case: unusual migration of osteosynthetic material.

Použití perkutánní vertebroplastiky u pacientů s mnohočetným myelomem - zkušenosti jednoho centra