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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Journal of cancer research and clinical oncology 123 (1997), S. 469-477 
    ISSN: 1432-1335
    Keywords: Key words Non-small-cell lung cancer ; Neoadjuvant therapy ; Regression grading ; Therapy-induced tumour regression ; Spontaneous tumour regression
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In the scope of a prospective multi-centre study after neoadjuvant combined chemotherapy (carboplatin, ifosfamide, etoposide, vindesine) and radiotherapy (45 Gy) 40 resection specimens of locally advanced non-small-cell lung cancer were analysed in order to establish reproducible pathological/anatomical results of tumour regression. Resection specimens of 28 squamous cell carcinomas and 12 adenocarcinomas were investigated using serial sections of the primary lesion. The mean age of the patients was 57 years. The results were compared to spontaneous regressive changes in a control group of 50 untreated non-small-cell lung cancers. Marked scarry fibrosis in the region of the former primary tumour, concentric foci of fresh tumour necroses and surrounding foam cell clusters with transition into vascular granulation tissue could be established as characteristic features of therapy-induced tumour regression, whereas untreated carcinomas revealed necroses with adjoining vital tumour tissue. Using a three-step regression system, 3 tumours could be classified as grade I (no or only slight tumour regression), 10 tumours as grade IIA (marked but incomplete tumour regression, more than 10% vital tumour tissue), 20 tumours as grade IIB (less than 10% vital tumour tissue) and 7 tumours as grade III (complete tumour regression without vital tumour tissue). After a median follow-up period of 32.3 months in patients with grade IIB or III tumour regression (“responders”) the median survival time of 27.9 months was found to be significantly longer than in patients with grade I or IIA tumour regression (“non-responders”) with a median survival period of 13.7 months (log-rank test, P=0.020). The resection specimens analysed, which were obtained 7 weeks (on average) after the end of radiochemotherapy, did not show specific changes due to preoperative therapy, but quite characteristic histological alterations in the former tumour area were registered, which had been induced by combined neoadjuvant radiation and chemotherapy. The grade of therapy-induced tumour regression could be shown to be a significant prognostic factor in non-small-cell lung cancer.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Journal of cancer research and clinical oncology 126 (2000), S. 238-245 
    ISSN: 1432-1335
    Keywords: Key words Non-small-cell lung cancer ; Neoadjuvant therapy ; p53 ; Single-strand conformation polymorphism (SSCP)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In a phase II study for optimizing therapeutic management of locally advanced non-small-cell lung cancer the prognostic and therapeutic relevance of the p53 status was investigated. Biopsy or mediastinoscopy samples, collected prior to neoadjuvant chemoradiotherapy and corresponding resection specimens, were analysed immunohistochemically (CM1 antiserum) for p53 accumulation and molecular biologically (polymerase chain reaction/single-strand conformation polymorphism) for p53 mutations. The results were correlated to the response to therapy (regression grade) and to the survival times. p53 accumulation was found in 41.7% (prior to neoadjuvant therapy) and in 40.0% (after surgery) of the tumours. p53 mutation was demonstrated in 45.4% (prior to neoadjuvant therapy) and in 46.4% (after surgery) of the investigated tumours. Neither before nor after therapy was any correlation to the survival times or to the response to therapy seen in the collective analysed. Thus, such investigations are not suitable for identifying patients with locally advanced non-small-cell lung cancer who might benefit, to different extents, from neoadjuvant therapy.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Journal of cancer research and clinical oncology 123 (1997), S. 469-477 
    ISSN: 1432-1335
    Keywords: Non-small-cell lung cancer ; Neoadjuvant therapy ; Regression grading ; Therapy-induced tumour regression ; Spontaneous tumour regression
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In the scope of a prospective multi-centre study after neoadjuvant combined chemotherapy (carboplatin, ifosfamide, etoposide, vindesine) and radiotherapy (45 Gy) 40 resection specimens of locally advanced non-small-cell lung cancer were analysed in order to establish reproducible pathological/anatomical results of tumour regression. Resection specimens of 28 squamous cell carcinomas and 12 adenocarcinomas were investigated using serial sections of the primary lesion. The mean age of the patients was 57 years. The results were compared to spontaneous regressive changes in a control group of 50 untreated non-small-cell lung cancers. Marked scarry fibrosis in the region of the former primary tumour, concentric foci of fresh tumour necroses and surrounding foam cell clusters with transition into vascular granulation tissue could be established as characteristic features of therapy-induced tumour regression, whereas untreated carcinomas revealed necroses with adjoining vital tumour tissue. Using a threestep regression system, 3 tumours could be classified as grade I (no or only slight tumour regression), 10 tumours as grade IIA (marked but incomplete tumour regression, more than 10% vital tumour tissue), 20 tumours as grade IIB (less than 10% vital tumour tissue) and 7 tumours as grade III (complete tumour regression without vital tumour tissue). After a median follow-up period of 32.3 months in patients with grade IIB or III tumour regression (“responders”) the median survival time of 27.9 months was found to be significantly longer than in patients with grade I or IIA tumour regression (“non-responders”) with a median survival period of 13.7 months (log-rank test,P=0.020). The resection specimens analysed, which were obtained 7 weeks (on average) after the end of radiochemotherapy, did not show specific changes due to preoperative therapy, but quite characteristic histological alterations in the former tumour area were registered, which had been induced by combined neoadjuvant radiation and chemotherapy. The grade of therapy-induced tumour regression could be shown to be a significant prognostic factor in non-small-cell lung cancer.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
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  • 4
    ISSN: 1432-1963
    Keywords: Schlüsselwörter Nichtkleinzellige Lungenkarzinome ; Neoadjuvante Therapie ; Therapieinduzierte Tumorregression ; Spontanregression ; Regressionsgrading ; Key words Non-small cell lung cancer ; Neoadjuvant therapy ; Therapy-induced tumor regression ; Spontaneous tumor regression ; Grading of tumor regression
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In the scope of a multi-center-study 35 resection specimens from patients with locally advanced non-small cell lung cancer after neoadjuvant chemotherapy and radiation were processed histologically and graded according to the following regression grading system: grade I: no or only slight, in general spontaneous tumor regression, grade II a: incomplete tumor regression with more than 10 % and grade II b less than 10 % vital tumor tissue as well as grade III: complete tumor regression. In 15 patients with grade II a to III tumor regression roughly concentric foci of various size with a sequence of central tumor necrosis, narrow foam cell rim, vascular granulation tissue and peripheral scar formation were demonstrated as characteristic feature of response to neoadjuvant therapy. In patients with grade II b to III tumor regression (“responders”) median survival time of 27.9 months was significantly longer than in patients with grade I to II a tumor regression (“non-responders”) with a median survival time of 12.7 months.
    Notes: Zusammenfassung Im Rahmen einer Multicenterstudie zur Therapieoptimierung lokal fortgeschrittener nichtkleinzelliger Lungenkarzinome wurden Resektionspräparate von 35 Patienten nach neoadjuvanter Chemo- und Radiotherapie histologisch aufgearbeitet und dem folgenden Regressionsgrading zugeordnet: Grad I: keine oder nur geringe, i. allg. spontane Tumorregression, Grad II a: unvollständige Tumorregression mit mehr als 10 % und Grad II b: weniger als 10 % vitalem Tumorgewebe sowie Grad III: komplette Tumorregression. Bei 15 Patienten der Regressionsgrade II a bis III konnten als charakteristischer Ausdruck eines Ansprechens auf die neoadjuvante Therapie verschieden große angedeutet kokardenförmige Herde mit zentraler Tumornekrose, meist schmalem Schaumzellsaum, gefäßreichem Granulationsgewebe und peripherer Vernarbung nachgewiesen werden. Bei den als „Responder“ zusammengefaßten Patienten der Regressionsgrade II b und III lag mit 27,9 Monaten eine signifikant längere mediane Überlebenszeit vor als bei den als „Nonresponder“ zusammengefaßten Patienten der Regressionsgrade I und II a mit 12,7 Monaten.
    Type of Medium: Electronic Resource
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