No abstract available

[en] Background: The prognosis for patients with glioblastoma (GB) remains grim. Historically, the median survival has been 6 to 9 months. Recent research has improved the outcome slightly. A computer search of the literature reveals few long-term survivors. Method: Presented here is a case report of a 20-year survivor of GB, with pathologic review to confirm the diagnosis. A battery of molecular studies was performed to develop a molecular profile of this unique patient. Results: The results of the molecular genetic testing for this most unusual patient were as follows: (1) methylguanine methyl transferase (MGMT) was methylated, (2) p53 positive, (3) PTEN tumor suppressor gene positive, (4) protein kinase AKT (pAKT) negative, and (5) epidermal growth factor receptor negative. Conclusion: To our knowledge, this is the longest survival of any patient in the literature whose initial diagnosis was GB. Triple-positive GBM patients (MGMT methylated, PTEN, and p53 positive) are uncommon but may be associated with a better prognosis. Further research is needed to confirm whether this molecular profile is prognostic of prolonged survival. Molecular genetics will determine future treatment and prognosis in GB.

[en] A retrospective study of 197 T3 and T4 squamous cell carcinomas of the larynx presenting between 1969 and 1978 has been undertaken. These patients have in the main been treated by primary radiotherapy with back-up salvage surgery. The aim of the study was to examine survival, and to try to identify reasons for failure of control. Various prognostic factors have been analysed and are discussed. Overall 5-year survival was 53 per cent but patients with nodal disease responded poorly. Subglottic tumours have a better survival than usually reported. Failure to pick up recurrence was the main problem, and in particular a persistently fixed cord carried a very poor prognosis if laryngectomy was delayed. (author)

[en] Published in summary form only

No abstract available

[en] One hundred and thirty patients with Stage I and Stage II supradiagphragmatic Hodgkin's disease treated with mantle irradiation alone were analysed retrospectively. The median followup was 7.4 years with a minimum of three years. The major difference between the clinically staged (CS) and pathologically staged (PS) patients was the transdiaphragmatic relapse which occurred in 33% of CS patients, and 7.5% in PS patients. The actuarial five year relapse free survival (RFs) was 48% for CS patients and 67% for PS patients, but the five year overall survival was 90% for both groups. For PS I and II patients mantle irradiation gives a five year RFs of 67%, thus offering potential for cure in these patients

No abstract available

[en] A systematic review of radiation therapy trials in several tumour types was performed by The Swedish Council of Technology Assessment in Health Care (SBU). The procedures for evaluation of the scientific literature are described separately. This synthesis of the literature on radiation therapy for rectal cancer is based on data from 42 randomized trials and 3 meta-analyses. Moreover, data from 36 prospective studies, 7 retrospective studies and 17 other articles were used. A total of 131 scientific articles are included, involving 25,351 patients. The results were compared with those of a similar overview from 1996 including 15,042 patients. The conclusions reached can be summarized thus: The results after rectal cancer surgery have improved during the past decade. It is likely that local failure rates after 5 years of follow-up at hospitals adopting the TME-concept (TME=total mesorectal excision) have decreased from about 28% to 10-15%. Preoperative radiotherapy at biological effective doses above 30 Gy decreases the relative risk of a local failure by more than half (50-70%). Postoperative radiotherapy decreases the risk by 30-40% at doses that generally are higher than those used preoperatively. There is strong evidence that preoperative radiotherapy is more effective than postoperative. There is moderate evidence that preoperative radiotherapy significantly decreases the local failure rate (from 8% to 2% after 2 years) also with TME. There is strong evidence that preoperative radiotherapy improves survival (by about 10%). There is no evidence that postoperative radiotherapy improves survival. There is some indication that survival is prolonged when postoperative radiotherapy is combined with concomitant chemotherapy. Preoperative radiotherapy at adequate doses can be given with low acute toxicity. Higher, and unacceptable acute toxicity has been seen in some preoperative radiotherapy trials using suboptimal techniques. Postoperative radiotherapy can also be given with acceptable acute toxicity. The long-term consequences of radiotherapy appear to be limited with adequate radiation techniques, although they have been less extensively studied. Longer follow-up periods are needed before firm conclusions can be drawn. Peroperative radiotherapy, preferably preoperative since it is more effective, is routinely recommended for most patients with rectal cancer since it can substantially decrease the risk of a local failure and increases survival. In a primarily non-resectable tumour, preoperative radiotherapy can cause tumour regression allowing subsequent radical surgery. This therapy is routinely indicated. Whether radiochemotherapy is more efficient than radiotherapy alone is not clear, since the results of four small randomized trials are partly conflicting. Preoperative radiotherapy, frequently combined with chemotherapy, has been used to increase the chances of sphincter-preserving surgery in low-lying tumours. The literature is inconclusive with respect to how frequently this occurs. Radiotherapy frequently produces symptom relief in patients with rectal cancer not amendable to surgery

[en] Recent developments in the treatment of colorectal cancer have focused on the role of chemotherapy as systemic treatment in an attempt to prolong survival and improve treatment outcomes for patients. Despite the use of systemic chemotherapy, however, the median survival of patients with metastatic disease has been reported 33 months in maximum. It is important to underline the role of surgery not only by the elimination of the primary tumor, but also of metastasis in the liver. Using correct combination of surgery and chemotherapy for the treatment of metastatic disease, substantial prolongation in the survival can be achieved. Communication between oncologist, surgeon and radiologist as the multidisciplinary approach is crucial for correct management of patients with metastatic liver disease with respect to their maximal benefit. (author)

[en] Ewing's sarcoma, a highly malignant primary bone tumour, is most frequently observed in children and adolescents, aged 4 - 15 years. 90 % of patients are younger than 20 years. Ewing's sarcomas are rare in patients over the age of 40 years. Prognosis is poor, with 5-year overall survival of 55 % to 70 % in localized and not exceeding 20 % in primarily metastatic disease. Patients with primary bone cancers should be evaluated by a multidisciplinary team with demonstrated expertise in the management of such patients. We introduce you a curiose case report of 53 years old patient. (author)