Agnieszka Żyromska

Tumour surface area as a prognostic factor in primary and recurrent glioblastoma irradiated with 192Ir implantation

Summary Background To evaluate the impact of tumour surface area (TSA) on survival of patients treated with 192 Ir implantation for glioblastoma multiforme (GBM). Methods/Materials The analysis of survival and prognostic factors was performed based on a retrospective study group of 120 patients (74 males and 46 females; mean age 53 years; mean KPS score 74.6) irradiated with 192 Ir for GBM between 1999 and 2003. There were 72 (60%) patients with recurrent and 48 (40%) with primary inoperable tumour. Patients with recurrences were initially treated with surgery and external beam radiotherapy (EBRT; mean total dose (MTD) 53.5Gy). Individuals with primary inoperable glioblastoma underwent EBRT (MTD 37.2Gy) after brachytherapy completion. All patients were irradiated with 192 Ir with a total dose of 15Gy given in 5 fractions. Results For the total group of patients 1-year and 2-year survival were 22% and 11%, respectively, with a median survival time (MST) of 6.1 months. The multivariate Cox analysis of the best fit (Chi 2 =22.98, p=0.000041) distinguished such variables as: patient age (p=0.002), performance status (p=0.04) and tumour surface area (p=0.04) to significantly affect survival. Patients with TSA 2 had better prognosis compared to those with TSA≥90cm 2 (p Conclusions Tumour surface area is an independent prognostic factor in patients irradiated with 192 Ir for glioblastoma multiforme. TSA less than 90cm 2 predicts significantly longer survival and appears to be a more powerful prognostic variable than tumour volume.

Fertility impairment in radiotherapy

Infertility as a result of antineoplastic therapy is becoming a very important issue due to the growing incidence of neoplastic diseases. Routinely applied antineoplastic treatments and the illness itself lead to fertility disorders. Therapeutic methods used in antineoplastic treatment may cause fertility impairment or sterilization due to permanent damage to reproductive cells. The risk of sterilization depends on the patients sex, age during therapy, type of neoplasm, radiation dose and treatment area. It is known that chemotherapy and radiotherapy can lead to fertility impairment and the combination of these two gives an additive effect. The aim of this article is to raise the issue of infertility in these patients. It is of growing importance due to the increase in the number of children and young adults who underwent radiotherapy in the past. The progress in antineoplastic therapy improves treatment results, but at the same time requires a deeper look at existential needs of the patient. Reproductive function is an integral element of self-esteem and should be taken into account during therapy planning.

The side effects of hormonal therapy at the patients with prostate cancer.

Prostate cancer is one of most frequent malignant tumours at men. The androgen-deprivation therapy is the part of cancer treatment. It could be used both in the early stage of prostate cancer and in the bone metastates. From this reason the antiandrogen drugs waste systematically grows. Unfortunately androgen-deprivation therapy has numerous side effects such as: the inferior quality of live, sexual disturbances, the fatigue, the anaemia, the bone mineral density loss and the increase of the risk of breaks the bone, the increase of body mass, insulinresistance, hypercholesterolemia, the increase risk of cardiac disorders. The aim of this article is the introduction of the reader with possibly complications androgen-deprivation therapy and with possibilities in diagnosis and treatment.

Intracranial plasmacytoma presenting as glioblastoma multiforme

Plasma cell tumors are a heterogeneous group of neoplasms that includes multiple and isolated plasmacytomas and other immunoproliferative diseases. An extremely uncommon form of the disease are solitary extramedullary plasmacytomas (SEPs) of the central nervous system (CNS) which account for less than 1% of all malignant tumors and about 14% of hematological malignancies. A 37-year-old man came to the casualty department due to generalized seizures and a several-week history of a numbness of the left shoulder and left upper limb. Apart from severe obesity (weight 140 kg), he was otherwise healthy. Computed tomography (CT) of the head revealed a contrast-enhanced mass of 2.5 cm in diameter with surrounding edema in the right hemisphere. The patientwas administeredananti-edema treatment and a control CT revealed a contrast-enhancing mass with dimensions of 37 mm 32 mm 36 mm sur-

Differential relationship between two hypoxia markers: HIF-1α and GLUT1 and classic prognostic factors in invasive breast carcinoma

Background: Tumor hypoxia is an adverse prognostic factor which promotes cancer aggressiveness and limits its radio- and chemosensitivity. The aim...

The role of postoperative radiotherapy in prostate cancer patients

Aim of the study The aim of the study was to evaluate the effectiveness of postoperative radiotherapy in prostate cancer patients with unfavorable prognostic factors. Material and methods In the years 2002–2008, 121 consecutive prostate cancer patients underwent radical prostatectomy and postoperative radiotherapy. The median dose was 64 Gy (range: 60–72 Gy). Biochemical and clinical progression-free survival were estimated. Univariate and multivariate analyses were used to analyze clinicopathological variables associated with treatment failure. Results The median follow-up was 27 months. Three-year bPFS was 72%. On univariate analysis it was influenced by: extracapsular tumor extension (60% vs. 75%, p = 0.0232), seminal vesicles invasion (52% vs. 85%, p = 0.00041), Gleason score ≥ 7 (65% vs. 86%, p = 0.044) and the use of hormonal therapy (50% vs. 80%, p = 0.0058). On multivariate analysis bPFS was associated with: TNM stage (HR = 3.19), postoperative hormonal therapy (HR = 2.6), total irradiation dose (HR = 0.82) and the maximum pretreatment level of prostate-specific antigen (PSA) (HR = 0.95). Three-year cPFS was 84%. On univariate analysis it was influenced by: preoperative PSA level > 10 ng/ml (75% vs. 90%, p = 0.04), vascular-nerve bundles involvement (63% vs. 88%, p = 0.0031), adjacent organs infiltration (50% vs. 85%, p = 0.018) and the use of postoperative hormonal therapy (62% vs. 90%, p = 0.02). On multivariate analysis cPFS was associated with: TNM stage (HR = 2.68), postoperative hormonal therapy (HR = 3.61) and total irradiation dose (HR = 0.78). Conclusions Postoperative radiotherapy in patients with unfavorable prognostic factors provides good biochemical and local control. Total irradiation dose and postoperative hormonal therapy are important treatment factors influencing prognosis.