After a hopefully pleasant summer holiday for all our readers, this 3rd issue of 2002 of our journal brings to your attention two important topics: digestive tract and pediatric cancers.
The article signed by N. Ghilezan focuses on actual progresses in rectal cancer surgery (total mezorectal excision) and the better integration of neoadjuvant chemoradiation based on clinical, histological and molecular prognostic factors resulting in better survival and improved quality of life (less toxicity and higher sphincter preservation).
In the very dynamic field of molecular biology, T.D. Rîşniţă is presenting diagnostic and therapeutic per- spectives opened by the new gene identification technology using DNA microarrays.
The study by Viorica Nagy et al. is a critical retrospective analysis of the authors own experience in cervix carcinoma. On 307 stage IIB-IIIB patients, treated with exclusive radiotherapy or with concomitant chemo- therapy or/and surgery between 1994-1996, the prognostic factors identified are stage, tumor size, presence of pelvic lymphnodes and the histological response to neoadjuvant radio j; chemotherapy.
On a small heterogeneous group of patients with locally advanced or metastatic digestive cancers, treated without surgery, Lianna Kadar and her team from Malmo, finds that the decrease with more than 10% of total body proteins or body protein fraction during antitumor treatment is of prognostic value.
The indications and particular technical difficulties encountered in the radiotherapy of pediatric malignancies are emphasized in the article by Dana Cernea et al.
The case report of a primary vaginal NHL presented by C.D. Olinici et al. highlights the importance of an accurate pretherapeutic histopatological examination.
In the very disputed field of new therapeutic targets, R. Curcă summarizes the recent randomized trials with matrix metalloproteinaze inhibitors. Unfortunately the still inconclusive results are limiting the use of MMI strictly to clinical trials.
From different perspectives – epidemiological (Daniela Coza), economical (Luciana Neamţiu) or clinical
(Viorica Nagy) – our colleagues are providing their synthetic point of view on the scientific meetings they attended in 2002. I invite you to read them as well as the Literature and Book Reviews, as they are quick means for updating our knowledge.
UMPh „I.Haţieganu”, Cancer Institute „Prof I.Chiricuţă” Cluj-Napoca
The present experience confirms the progress registered in the treatment of rectal cancer through a high performance surgery combined with radiochemotherapy either before or after operation. The main therapeutic strategies from Europe and the United States are discussed with emphasis on the clinical results and the present recommendations concerning the individual tumor characteristics and sphincter preservation. The future areas for development are the optimization of the integration of the chemotherapy in the preoperative irradiation, the introduction of new compounds that have demonstrated efficacy in colorectal cancer and of the biological treatments. The pretherapeutic assessment of the molecular profiling of rectal cancer is a very promising tool for an individual therapeutic approach to lower the toxicities, to increase the sphincter preservation and to improve survival. The surgeon and a correct technique are essential components for the treatment of the rectal cancer but is no longer exclusive or concurrential with radiochemotherapy and should integrate in the multiple aspects of the adjuvant treatments for the benefit of the patient.
Key words: radiochemotherapy, rectal cancer.
Radioterapie & Oncologie Medicală, 2002, 3:153-160
Cancer Institute „Prof. I.Chiricuţă”, UMPh „Iuliu Haţieganu” Cluj-Napoca
Brachytherapy remains in Romania a method too rarely used in the treatment of cancer patients, due to lack of tradition and- until recently- absence of widespread adequate infrastructure. Based on a national plan, several radiotherapy centers received last year brachytherapy facilities, mainly HDR units. As the indications and techniques of brachytherapy are evolving each day, covering various oncological and non-oncological fields, it is mandatory to precisely know their possibilities and their limits. Focusing on interstitial brachytherapy, a general presentation of the techniques and indications is given, as a basis for integrate this therapeutic approach for patients who might benefit of it.
Key words: interstitial brachytherapy, indications, techniques.
Radioterapie & Oncologie Medicală, 2002, 3:161-171
„MediRo „ Foundation Cluj-Napoca, Department of Molecular Biology
The use of microarrays, small spots of DNA fixed to glass slides or nylon membranes, promise to provide fundamental new information for cell and molecular biology. Microarray technology provides a tool to potentially identify and quantitate levels of gene expression for all genes in an organism. Base-pairing (i.e., A- T and G-C for DNA; A-U and G-C for RNA) or hybridization is the underlining principle of DNA microarray. An array is an orderly arrangement of samples. It provides a medium for matching known and unknown DNA samples based on base-pairing rules and automating the process of identifying the unknowns.
Key words: DNA chip, Molecular genetics, DNA sequencing, Polymorphism analysis.
Radioterapie & Oncoiogie Medicală, 2002, 3:172-182
Viorica N agyl,2, N. Todor1
1Cancer Institute „Prof. I.Chiricuţă” Cluj-Napoca,
2UMPh „Iuliu Haţieganu” Cluj-Napoca
The purpose of this study is to evaluate some prognostic factors of 307 patients with locally advanced cervical cancer. stage IIB-IIIB, treated at the Radiotherapy II Departement of the Cancer Institute „I.Chiricuţă” Cluj-Napoca, between 1994-1996. Clinical stage (the overall 5-year survival for stage lIB was 88%, stage IlIA 59% and stage IIIB 39%), cervical tumour size (5- year survival 78% for tumours ~ 3 cm vs 39% for> 3 cm) and pelvic lymph node status (the 5-year survival rate 39% in case of pelvic lymph node metastases vs 86% for negative lymph nodes) were found as significant prognostic factors. Further randomized studies have to confirm ours results.
Key words: prognostic factors, stage, tumour size, lymph node status.
Radioterapie & Oncologie Medicală, 2002, 3:183-189
Lianna Kadar1, J. Borjessow2, S. Mattssow2, Maria Albertsson1
1Departments of Oncology and
2Radiation Physics, Lund University, Malmö University Hospital, Malmö, Sweden
The aim of the study was to see if total body protein or body protein fraction (total body protein I body weight) and its change during anti-tumor treatment have any prognostic value in patients with gastrointestinal cancer.
Twenty-four patients with gastrointestinal tumors were included in the study. Half of the patients had loco-regional disease and half had metastasized disease. Using in vivo prompt gamma neutron activation of nitrogen, measurements of body protein were carried out on two occasions during ongoing anti-tumor treatment. The patients with loco-regional disease increased their body protein fraction with 3,9% as a mean. The patients with metastasized disease decreased, as an average, their body protein fraction with 7,8%. The changes for the two groups were statistically significant (p<0,03). All patients whose total body protein or body protein fraction decreased by more than 10% had tumor progression and most of them died within two years after diagnosis.
Key words: Gastrointestinal tumors, prognosis, total body protein, body weight.
Radioterapie & Oncologie Medicală, 2002, 3: 190-196
C.D.Olinicil,2, Angela Răşinariu2, Cristina Cebotaru2, O.Coza2
1Dept. of Pathology. UMPh „I.Haţieganu”;
2Cancer Institute „Prof I.Chiricuţă„. Cluj-Napoca
This paper reports a follicle center lymphoma, mixed small and large cell (grade II) of the vagina in a 52-year-old patient. After polychemotherapy followed by radiotherapy an adequate clinical response was achieved. We discuss the importance of the recognition of this entity, the differential diagnosis from other neoplastic and non-neoplastic diseases. the
treatment and the prognosis.
Key words: vagina, follicle center lymphoma. treatment, prognosis.
Radioterapie & Oncologie Medicală. 2002. 3:201-203
Cancer Institute „Prof I.Chiricuţă” Cluj-Napoca
Matrix metaloproteinase inhibitors (MMPls) is a novel family of compounds which retard tumor growth and metastatic spread. This paper presents the latest developements in clinical research regarding MMPIs, with focus on pancreatic cancer.
Key words: matrix metaloproteinase inhibitors, MMPIs, pancreatic, cancer.
Radioterapie & Oncologie Medicală. 2002, 3:204-207