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Volum 20 Numarul 2, 2014

39 Dear RSRMO members

Ovidiu Coza

41 Experimental Model for the Irradiation of Tissular Flaps in Small Animals

Ioana-Carmen Brie1, George Dindelegan2, Gabriel Kacso1,2, Aurel Chis1, Victor Bogdan1, Ana-Maria Fatiol1, Calin Precup2, Catalin Popa3, Nicolae Todor1, Valentin Cernea1,2

1) Prof. Dr. Ion ChiricutaInstitute of Oncology, Cluj-Napoca; 2) Iuliu HatieganuUniversity of Medicine and Pharmacy, Cluj-Napoca; 3) Technical University, Cluj-Napoca, Romania

Background: There is no common point of view regarding the way of applying reconstructive methods as part of the multidisciplinary treatment in oncology. The relationship between surgical treatment and radiotherapy is very important, knowing that radiotherapy leads to issue changes that negatively impacts on the reconstructive techniques. The experimental studies on the radiation effects on tissue flaps and biocompatible materials are justified by the serious problems that occur in reconstructive surgery performed in irradiated areas. Aim: to evaluate the tissular reaction to radiation in the presence of implanted materials, in order to establish an experimental model for the irradiation of tissular flaps in small animals. Material and methods: 25 Wistar rats from the Biobasis of the Iuliu Hatieganu University of Medicine and Pharmacy (UMF) were distributed in 5 groups. Fasciocutaneous and muscular flaps were surgically prepared, implanted either with titan clips or pieces of two different biomaterials and irradiated with electron beams. At different intervals of time after radiotherapy the tissular reaction to irradiation in the presence of implanted materials was evaluated. Results: Macroscopically, the local appearance was variable, from flap necrosis to the complete integration of the flap into the tissular defect. Microscopically, a mild inflammatory reaction was noted early postoperatively. Later, an important proliferation of the connective tissue and fibrosis of the muscular tissue containing the metallic implants developed. Conclusion: Our experimental model is appropriate and can be used for the study of tissue reactions and tolerance to radiation in the presence or absence of implanted materials.

Key words: experimental model, implants, irradiation

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47 Radiochemotherapy versus Radiochemotherapy plus Surgery in Stage IIB Cervical Cancer. A Phase III Single Institution Randomized Trial

Patricia Şuteu1, Claudia Ordeanu1, Ovidiu Coza1,2, Alin Rancea1,2, Alexandru Trăilă1, Nicolae Todor1, Viorica Nagy1,2

1) Prof. Dr. Ion Chiricuţă Oncology Institute; 2) Iuliu Haţieganu University of Medicine and Pharmacy,

Cluj-Napoca, Romania

Background: In the Prof. Dr. Ion Chiricuţă Oncology Institute, treatment of stage IIB cervical cancer usually comprises surgery after radiochemotherapy (RCT). Aim: To compare the overall survival (OS), disease-free survival (DFS) and treatment failures after exclusive RCT versus RCT+surgery in patients with stage IIB cervical cancer included in a phase IIb single institution randomized trial. Material and methods: During September 2006- November

2010, 111 patients with histologically confirmed cervical cancer stage IIB were randomly assigned in 2 arms: 59 in arm A with RCT+surgery and 52 in arm B with exclusive RCT. Treatment failure was defined as local recurrence, lymph node metastasis (lombo-aortic, supraclavicular) or organ metastasis.

Results: The median age was 47 years and the median follow-up was 66.3 months. Eleven patients (9.9%) died: 6 (10.16%) in arm A, 5 (9.61%) in

arm B; 2 deaths were not cervical-cancer related. The 5-year OS was 92% in arm A and 89% in arm B (p=0.6). The 5-year DFS rates were 88% in arm B and 89% in arm A (p=0.76). There were 12 (11%) treatment failures: 6 (10.16%) in arm A and 6 (11.53%) in arm B (p=0.82). Local recurrence was

observed in 4 (7.69%) cases in arm B and one (1.69%) case in arm A. Distant metastases occurred in 5 patients (8.47%) in arm A and 2 (3.84%) in arm

  1. Conclusions: Despite a higher local recurrence rate in patients without surgery, there are no statistically significant differences between the two treatment modalities, regarding OS, DFS and treatment failure.

Key words: cervical cancer, stage IIB, radiochemotherapy, surgery, survival.

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54 Lymphangiosis Carcinomatosa Peritumorales (L) – Marker of Lymphatic Nodule Metastasing, with a Fundamental Role in the Prognosis and Therapy of Mammary Cancer

Gabriel Macicasan1, Stephan Falk2, Egon Lieb1, Petru Matusz3

1) Frauenklinik, Akademisches Lehrkrankenhaus Heilig Geist Frankfurt am Main; 2) Institut für Pathologie Frankfurt am Main Germany; 3)University of Medicine and Pharmacy, Timisoara, Romania

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60 Study of HPV in Cervix Pathology

Elisabeta Pătcaş¹, Simona Mihuţiu², Teodor Maghiar², Adela Pătcaş³

1) Gavril Curteanu Clinical Hospital Radiotherapy Department Oradea; 2) Faculty of Medicine and Pharmacy University of Oradea; 3) Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca

Purpose: Prospective study to assess the presence of HPV in cervix pathology, especially in cancer patients. Material and Methods: This study

evaluated the presence of HPV in 192 cases: 115 cases of carcinoma, 62 cases with dysplasia and 15 cases with pelvic inflammation from January 2010

to August 2014. We discussed the neoplasm cases vs the comparison group, by demographic, clinical and paraclinical parameters. The DNA isolation, HPV detection and genotyping was done at the Residence Laboratory Oradea with PCR technique. We analysed the cases by age, environment, stage of disease and by overall survival. We determined 3 types of HPV positive: high risk, low risk, undetermined risk and association . Results: The HPV positive cases were 52.17 % in patients with cervix carcinoma. The HPV positive prevalence by age shows 61.54 % between 31-40 years and 100 % under 30 years. The stage III FIGO patients with HPV positive were 55% and 26.67 % stage II. The most frequent type of HPV high risk positive was 16HR at 23 patients: 56.1 % , followed by 18HR at 3 patients: 7.31% and 45HR at 2 patients : 48.8%. Associations were found between 16 + 33 HR: 12.2 % , 16+31 HR: 4.88 % . We analysed also the mortality and the survival follow-up in patients with HPV positive and negative. Conclusions: In our study HPV positive cases had the worst prognosis . HPV – 16 HR was the most frequent type and we observed asociations between the HR , LR ,UD types.

Key words: HPV, cervix cancer

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63 Rectal Cancer – Therapeutic Guidelines from the “Prof. Dr. Ion Chiricuta”Oncological Institute

Alina Simona Muntean1, Calin Cainap1,2, Catalin Vlad1,2, Patriciu Achimas1,2, Vasile Popita 1, Alexandu Irimie1,2

1) Institute of Oncology “Prof. Dr. Ion Chiricuta”Cluj-Napoca; 2) The “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania

Approved by the Gastrointestinal Tumor [Board of the “Prof. Dr. Ion Chiricuta”Oncological Institute: Stefan Hica, Alina- Simona Muntean, Rancea Alin, Calin Cainap, Liliana Resiga, Vasile Popita].

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69 Report of the RSRMO President 2013 – 2014

71 Guidance for Authors