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- Smeland, S, et al.
(författare)
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Scandinavian Sarcoma Group Osteosarcoma Study SSG VIII: prognostic factors for outcome and the role of replacement salvage chemotherapy for poor histological responders
- 2003
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Ingår i: European Journal of Cancer. - 1879-0852. ; 39:4, s. 488-494
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Tidskriftsartikel (refereegranskat)abstract
- From 1990 to 1997, 113 eligible patients with classical osteosarcoma received neo-adjuvant chemotherapy consisting of high-dose methotrexate, cisplatin and doxorubicin. Good histological responders continued to receive the same therapy postoperatively, while poor responders received salvage therapy with an etoposide/ifosfamide combination. With a median follow-up of 83 months, the projected metastasis-free and overall survival rates at 5 years are 63 and 74%, respectively. Independent favourable prognostic factors for outcome were tumour volume < 190 ml, 24-h serum methotrexate > 4.5 muM and female gender. The etoposide/ifosfamide replacement combination did not improve outcome in the poor histological responders. In conclusion, this intensive multi-agent chemotherapy results in > 70% of patients with classical osteosarcoma surviving for 5 years. The data obtained from this non-randomised study do not support discontinuation and exchange of all drugs used preoperatively in histological poor responders. As observed in previous Scandinavian osteosarcoma studies, female gender appears to be a strong predictor of a favourable outcome. (C) 2003 Elsevier Science Ltd. All rights reserved.
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- Elomaa, I, et al.
(författare)
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Five-year results in Ewing's sarcoma. The Scandinavian Sarcoma Group experience with the SSG IX protocol
- 2000
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Ingår i: European Journal of Cancer. - 1879-0852. ; 36:7, s. 875-880
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Tidskriftsartikel (refereegranskat)abstract
- The first Scandinavian protocol for Ewing's sarcoma, SSG IV, resulted in a local control rate of 74% and 5-year metastasis-free survival (MFS) of 43%. The second protocol, SSG IX, was started in order to improve upon these results. It featured four chemotherapy cycles, each consisting of two courses of VAI (vincristine, doxorubicin, ifosfamide) alternating with one course of PAI (cisplatin, doxorubicin, ifosfamide) at 3-weekly intervals. Total treatment time was 35 weeks. Local therapy was given at week 9. Inoperable or non-radically operated patients received hyperfractionated accelerated radiotherapy 1.5 Gy twice daily between chemotherapy courses to a total dose of 42-60 Gy, depending on surgical radicality and tumour localisation. 88 patients were included (58 male, 30 female, mean age 20 years; range 5-65 years). The tumour (73 M0 and 15 M1) was located centrally in 31 patients (35%), in the extremities in 34 (39%) and other sites in 23 (26%) of cases. The median size of tumour was 10 cm (range 2-23), soft tissue was invaded in 87%. Surgery was the local therapy for 60 (68%) patients: amputation in 8 and local excision in 52. The surgical margins were wide in 35 patients, marginal in 14 and intralesional in 3. Radiotherapy was given to 17 non-radically operated patients postoperatively and to 28 patients with inoperable tumours primarily. Histological responses were evaluated in 52 patients. 9 local recurrences were observed (10%). Distant metastases developed in 24 M0 patients (33%). The estimated 5-year MFS was 58% and overall survival (OS) 70% for M0 and 27% and 28% for M1 patients, respectively. Survival was favourable in patients with non-metastatic extremity tumours (90%) and tumours operated with wide margins (90%). Patients with a total necrosis after chemotherapy had a better OS than those with a partial or poor response (P=0.003). The toxicity (World Health Organisation) was acceptable (gastrointestinal G1-2; haematological G3-4). The SSG IX protocol gave better local control and survival rates than the SSG IV. Whether this is due to a higher therapeutic efficacy of the present protocol cannot be ascertained in this comparison with a historical control.
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- Gullström, Martin, 1968, et al.
(författare)
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Seagrass ecosystems in the Western Indian Ocean
- 2002
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Ingår i: Ambio. - 0044-7447 .- 1654-7209. ; 31:7-8, s. 588-596
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Tidskriftsartikel (refereegranskat)abstract
- Seagrasses are marine angiosperms widely distributed in both tropical and temperate coastal waters creating one of the most productive aquatic ecosystems on earth. In the Western Indian Ocean (WIO) region, with its 13 reported seagrass species, these ecosystems cover wide areas of near-shore soft bottoms through the 12 000 km coastline. Seagrass beds are found intertidally as well as subtidally, sometimes down to about 40 m, and do often occur in close connection to coral reefs and mangroves. Due to the high primary production and a complex habitat structure, seagrass beds support a variety of benthic, demersal and pelagic organisms. Many fish and shellfish species, including those of commercial interest, are attracted to seagrass habitats for foraging and shelter, especially during their juvenile life stages. Examples of abundant and widespread fish species associated to seagrass beds in the WIO belong to the families Apogonidae, Blenniidae, Centriscidae, Gerreidae, Gobiidae, Labridae, Lethrinidae Lutjanidae, Monacanthidae, Scaridae, Scorpaenidae, Siganidae, Syngnathidae and Teraponidae. Consequently, seagrass ecosystems in the WIO are valuable resources for fisheries at both local and regional scales. Still, seagrass research in the WIO is scarce compared to other regions and it is mainly focusing on botanic diversity and ecology. This article reviews the research status of seagrass beds in the WIO with particular emphasis on fish and fisheries. Most research on this topic has been conducted along the East African coast, i.e. in Kenya, Tanzania, Mozambique and eastern South Africa, while less research was carried out in Somalia and the Island States of the WIO (Seychelles, Comoros, Reunion (France), Mauritius and Madagascar). Published papers on seagrass fish ecology in the region are few and mainly descriptive. Hence, there is a need of more scientific knowledge in the form of describing patterns and processes through both field and experimental work. Quantitative seagrass fish community studies in the WIO such as the case study presented in this paper are negligible, but necessitated for the perspective of fisheries management. It is also highlighted that the pressure on seagrass beds in the region is increasing due to growing coastal populations and human disturbance from e.g. pollution, eutrophication, sedimentation, fishing activities and collection of invertebrates, and its effect are little understood. Thus, there is a demand for more research that will generate information useful for sustainable management of seagrass ecosystems in the WIO.
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