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  1. Article ; Online: Which is the best neoadjuvant (pre-surgery) chemoradiation regimen for locally advanced rectal carcinoma? Short or long course of radiation therapy? Do we have new data?

    Koukourakis, Georgios

    Journal of B.U.ON. : official journal of the Balkan Union of Oncology

    2020  Volume 25, Issue 1, Page(s) 51–61

    Abstract: Purpose: Surgical resection is the cornerstone of curative treatment for rectal adenocarcinomas. For extensive invasive tumors, preoperative radiotherapy and chemoradiotherapy have been utilized to promote tumor regression in an attempt to convert a ... ...

    Abstract Purpose: Surgical resection is the cornerstone of curative treatment for rectal adenocarcinomas. For extensive invasive tumors, preoperative radiotherapy and chemoradiotherapy have been utilized to promote tumor regression in an attempt to convert a planned abdominoperineal resection to a sphincter-sparing surgical procedure. In order to find out which of the currently radiation therapy treatment regimen used preoperatively for rectal cancer is the best we conducted a comprehensive literature search.
    Methods: We searched the Cochrane Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE database up to December 2018 for trials comparing the short and long term radiation therapy regimens for rectal carcinoma associated or not with chemotherapy.
    Results: The search of the literature identified 38 papers related to the subject. After analysis and evaluation, 11 eligible trials were included for review. The optimal fractionation and timing of surgery in relation to radiotherapy was still controversial. Randomized trials showed that if surgery is delayed after 5×5 Gy and consolidation chemotherapy is added between 5×5 Gy and surgery, such a combination results in better short term overall survival and lower acute toxicity.
    Conclusion: Long-course radiotherapy with delay seems not to be different than short-course radiotherapy with delay, but prolongs substantially the treatment time.
    MeSH term(s) Chemoradiotherapy/methods ; Humans ; Neoadjuvant Therapy/methods ; Rectal Neoplasms/drug therapy ; Rectal Neoplasms/radiotherapy
    Language English
    Publishing date 2020-04-25
    Publishing country Greece
    Document type Journal Article ; Review
    ZDB-ID 2040386-0
    ISSN 2241-6293 ; 1107-0625
    ISSN (online) 2241-6293
    ISSN 1107-0625
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  2. Article ; Online: HLA-class-I expression loss, tumor microenvironment and breast cancer prognosis.

    Giatromanolaki, Alexandra / Michos, Georgios D / Xanthopoulou, Erasmia / Koukourakis, Michael I

    Cellular immunology

    2024  Volume 399-400, Page(s) 104816

    Abstract: Loss of HLA-class-I molecule expression by cancer cells is a frequent event in human tumors that may lead to immune evasion from cytotoxic T-cells. We examined the expression patterns of HLA-class-I molecules in a series of 175 patients with operable ... ...

    Abstract Loss of HLA-class-I molecule expression by cancer cells is a frequent event in human tumors that may lead to immune evasion from cytotoxic T-cells. We examined the expression patterns of HLA-class-I molecules in a series of 175 patients with operable breast cancer (BCa). Extensive loss of BCa cell HLA-class-I expression was noted 76.6 % of patients (27.5 % complete loss). A significant association of HLA-preservation with high TIL-density (p = 0.001) was documented. Preservation of HLA was evident only in BCa carcinomas with low HIF1α expression and high TIL-density. Cell line experiments (MCF7 and T47D) showed that induction of HLAs in cancer cells following incubation with lymphocytes or IFNγ, was abrogated under hypoxic conditions. HLA-preservation was linked with better distant metastasis-free survival (p = 0.01), which was confirmed also in multivariate analysis (p = 0.02, HR 3.17). Studying the expression of HLA-class-I molecules in parallel with TIL-density and HIF1α expression may identify subgroups of BCa patients who would benefit from immunotherapy.
    Language English
    Publishing date 2024-03-05
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 80094-6
    ISSN 1090-2163 ; 0008-8749
    ISSN (online) 1090-2163
    ISSN 0008-8749
    DOI 10.1016/j.cellimm.2024.104816
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 417: Show issues Location:
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  3. Article: Bevacizumab for Malignant Brain Gliomas. Which is the Current Evidence?

    Koukourakis, Georgios V

    Recent patents on inflammation & allergy drug discovery

    2015  Volume 9, Issue 2, Page(s) 136–143

    Abstract: Recently, the improvement of innovative medications named focused treatments represents the consequence of a superior knowledge of the procedures implicated in the modification of physiological tissues in tumor. Focused treatment is known as the therapy ... ...

    Abstract Recently, the improvement of innovative medications named focused treatments represents the consequence of a superior knowledge of the procedures implicated in the modification of physiological tissues in tumor. Focused treatment is known as the therapy which uses specific substances that affect selective mechanisms implicated in tumorigenesis and tumor development. Angiogenesis is important for tumor development and distant metastatic disease and represents a significant aim for modern biological substances. Bevacizumab belongs to humanized recombinant antibody family which obviates vascular endothelial growth factor (VEGF) receptor fastening, and suspending genesis of new vessels and tumor development. Bevacizumab represents the primary antiangiogenic treatment authorized for usage in tumor and has FDA authorization to treat the recurrent glioblastoma multiform since 2009. Bevacizumab's efficiency for treating malignant brain gliomas along with correlated patent appliances related to this agent is discussed below.
    MeSH term(s) Angiogenesis Inhibitors/therapeutic use ; Bevacizumab/therapeutic use ; Brain Neoplasms/drug therapy ; Brain Neoplasms/mortality ; Brain Neoplasms/pathology ; Clinical Trials as Topic ; Drug and Narcotic Control ; Evidence-Based Medicine ; Glioma/drug therapy ; Glioma/mortality ; Glioma/pathology ; Humans ; Molecular Targeted Therapy ; Patents as Topic ; Receptors, Vascular Endothelial Growth Factor/antagonists & inhibitors ; Receptors, Vascular Endothelial Growth Factor/metabolism ; Signal Transduction/drug effects ; Treatment Outcome ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Vascular Endothelial Growth Factor A/metabolism
    Chemical Substances Angiogenesis Inhibitors ; VEGFA protein, human ; Vascular Endothelial Growth Factor A ; Bevacizumab (2S9ZZM9Q9V) ; Receptors, Vascular Endothelial Growth Factor (EC 2.7.10.1)
    Language English
    Publishing date 2015-08-07
    Publishing country United Arab Emirates
    Document type Journal Article ; Review
    ISSN 1872-213X
    ISSN 1872-213X
    DOI 10.2174/1872213x09666150807110031
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Effectiveness of Hyperthermia as Monotherapy and Adjuvant Therapy Approaches Against an

    Petrakis, Georgios / Mantso, Theodora / Koukourakis, Michail I / Panayiotidis, Mihalis I / Botaitis, Sotiris

    Anticancer research

    2022  Volume 42, Issue 5, Page(s) 2363–2374

    Abstract: Background/aim: Despite improvement in current therapies, the 5-year overall survival rate of colorectal carcinoma is still low especially in its metastatic form. On the other hand, hyperthermia has been utilized as a cancer treatment approach to ... ...

    Abstract Background/aim: Despite improvement in current therapies, the 5-year overall survival rate of colorectal carcinoma is still low especially in its metastatic form. On the other hand, hyperthermia has been utilized as a cancer treatment approach to improve overall therapeutic efficacy. In the present study, we have aimed to develop an optimized hyperthermic protocol against an in vitro model of human colon carcinoma, as a single and/or adjuvant treatment approach.
    Materials and methods: We have utilized an in vitro model of human colorectal carcinoma consisting of colorectal carcinoma (HT29, CaCo2) and normal colon epithelial (CCD841CoN) cell lines. Cells were exposed to 45°C, over 120 min, in the presence or absence of chemotherapeutic (5-Fluorouracil, Capecitabine) and targeted (Bevacizumab, Cetuximab) drugs. Cell viability levels were determined by the Alamar-blue assay while determination of cell death, reactive oxygen species (ROS) production, mitochondrial membrane depolarization (ΔΨμ) levels and cell cycle progression were performed by flow cytometry.
    Results: CaCo2 and HT29 cells showed a differential response towards i) cell viability, ii) cell death, iii) ROS and ΔΨμ levels as well as iv) cell cycle distribution, in the presence of hyperthermia alone (monotherapy) or in combination with the above-mentioned drugs (adjuvant therapy). Finally, normal colon epithelial (CCD841CoN) cells remained minimally affected.
    Conclusion: We have developed an optimized experimental hyperthermic protocol, as a promising monotherapy and/or adjuvant therapy approach, with the capacity to potentiate chemotherapeutic as well as targeted drug-induced cytotoxicity against a model of colorectal carcinoma, to a variable degree.
    MeSH term(s) Caco-2 Cells ; Colorectal Neoplasms/drug therapy ; Colorectal Neoplasms/metabolism ; Combined Modality Therapy ; Humans ; Hyperthermia, Induced ; Reactive Oxygen Species/metabolism
    Chemical Substances Reactive Oxygen Species
    Language English
    Publishing date 2022-04-27
    Publishing country Greece
    Document type Journal Article
    ZDB-ID 604549-2
    ISSN 1791-7530 ; 0250-7005
    ISSN (online) 1791-7530
    ISSN 0250-7005
    DOI 10.21873/anticanres.15715
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1642: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  5. Article: Role of radiation therapy in neoadjuvant era in patients with locally advanced rectal cancer.

    Koukourakis, Georgios V

    World journal of gastrointestinal oncology

    2013  Volume 4, Issue 12, Page(s) 230–237

    Abstract: Surgery remains the primary determinant of cure in patients with localized rectal cancer, and total mesorectal excision is now widely accepted as standard of care. The widespread implementation of neoadjuvant short-course radiotherapy (RT) or long-course ...

    Abstract Surgery remains the primary determinant of cure in patients with localized rectal cancer, and total mesorectal excision is now widely accepted as standard of care. The widespread implementation of neoadjuvant short-course radiotherapy (RT) or long-course chemoradiotherapy (CRT) has reduced local recurrence rates from 25% to 40% to less than 10%; Preoperative RT in resectable rectal cancer has a number of potential advantages, most importantly reducing local recurrence, and down-staging effect. In this article making a comprehensive literature review searching the reliable medical data bases of PubMed and Cochrane we present all available information on the role of radiation therapy alone or in combination with chemotherapy in preoperative setting of rectal cancer. Data reported show that in locally advanced rectal cancer the addition of radiation therapy or CRT pre surgically has significantly improved sphincter prevention surgery. Moreover, the addition of chemotherapy to radiation therapy in preoperative setting has significantly improved pathologic complete response rate and loco-regional control rate without improvement in sphincter preserving surgery. Finally, the results of recently published randomized trials have shown a significant improvement of pre- vs postoperative CRT on local control; however, there was no effect on overall survival.
    Language English
    Publishing date 2013-02-26
    Publishing country China
    Document type Journal Article
    ZDB-ID 2573696-6
    ISSN 1948-5204
    ISSN 1948-5204
    DOI 10.4251/wjgo.v4.i12.230
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Effectiveness and Tolerability of Natural Herbal Formulations in the Prevention of Radiation-Induced Skin Toxicity in Patients Undergoing Radiotherapy.

    Koukourakis, Georgios / Pissakas, Georgios / Ganos, Christos G / Sivolapenko, Gregory / Kardamakis, Dimitrios

    The international journal of lower extremity wounds

    2020  Volume 21, Issue 1, Page(s) 75–86

    Abstract: The aim of this study is to investigate the preventive role of 3 herbal formulation products on reducing the incidence of radiation-induced dermatitis in patients undergoing radiotherapy for either breast or head and neck cancer. A total of 59 patients ... ...

    Abstract The aim of this study is to investigate the preventive role of 3 herbal formulation products on reducing the incidence of radiation-induced dermatitis in patients undergoing radiotherapy for either breast or head and neck cancer. A total of 59 patients participated in the study. The novel herbal products, a combination of beeswax, olive oil,
    MeSH term(s) Aloe ; Head and Neck Neoplasms ; Humans ; Quality of Life ; Radiodermatitis/etiology ; Radiodermatitis/prevention & control
    Language English
    Publishing date 2020-06-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2171119-7
    ISSN 1552-6941 ; 1534-7346
    ISSN (online) 1552-6941
    ISSN 1534-7346
    DOI 10.1177/1534734620923912
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    Zs.A 6003: Show issues Location:
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  7. Article ; Online: Radiation therapy for early breast cancer.

    Koukourakis, Georgios

    Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico

    2009  Volume 11, Issue 9, Page(s) 596–603

    Abstract: In women with early-stage breast cancer treated with surgery alone, microscopic residual disease may not be eliminated and can eventually cause life-threatening metastatic recurrence. Radiation therapy has been widely recommended for local control after ... ...

    Abstract In women with early-stage breast cancer treated with surgery alone, microscopic residual disease may not be eliminated and can eventually cause life-threatening metastatic recurrence. Radiation therapy has been widely recommended for local control after breast-conserving surgery (BCS) and after a complete mastectomy in women at high risk of recurrence. However, even with widespread support for these recommendations within the medical community, they are not always heeded. Because local recurrence, when detected early, can often be treated with additional surgery alone, some physicians and patients still elect to avoid radiation therapy. It was felt, based upon individual trial data, that radiation therapy did not affect overall survival, but just decreased local relapse. The meta-analysis, published in the December 17/2005 Lancet, analysed individual data from 42,000 women, collected during 78 different randomised trials conducted since 1985. The availability of extensive 15-year survival data allowed the investigators to quantify the relationship between successful local control and long-term survivorship. Moreover, individual trials all show a benefit in local control and some trends toward survival advantages. The pooled meta-analysis of breast conservative surgery with or without radiation therapy Vinh Hung (2004) demonstrates a significant impact on local relapse and a small but significant impact on survival. It is considered that after BCS and in certain cases after mastectomy, radiation therapy is the standard treatment for improved local control and longterm survival.
    MeSH term(s) Breast Neoplasms/mortality ; Breast Neoplasms/pathology ; Breast Neoplasms/radiotherapy ; Breast Neoplasms/surgery ; Carcinoma/mortality ; Carcinoma/pathology ; Carcinoma/radiotherapy ; Carcinoma/surgery ; Combined Modality Therapy ; Female ; Humans ; Mastectomy/methods ; Meta-Analysis as Topic ; Neoplasm Staging ; Randomized Controlled Trials as Topic ; Survival Analysis
    Language English
    Publishing date 2009-09-22
    Publishing country Italy
    Document type Evaluation Study ; Journal Article ; Review
    ZDB-ID 2397359-6
    ISSN 1699-3055 ; 1699-048X
    ISSN (online) 1699-3055
    ISSN 1699-048X
    DOI 10.1007/s12094-009-0410-2
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    Zs.A 6644: Show issues Location:
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  8. Article: Has bevacizumab (Avastin) given extra therapeutic gain in metastatic colorectal cancer and malignant brain gliomas? Systematic review answering this question.

    Koukourakis, Georgios V

    Recent patents on inflammation & allergy drug discovery

    2011  Volume 6, Issue 1, Page(s) 70–77

    Abstract: During the last decade, the development of new drugs known as targeted therapies was the result of a better understanding of the processes involved in the transformation of normal cells into cancer. The term targeted therapy refers to drugs that ... ...

    Abstract During the last decade, the development of new drugs known as targeted therapies was the result of a better understanding of the processes involved in the transformation of normal cells into cancer. The term targeted therapy refers to drugs that selectively target specific molecular pathways involved in tumourigenesis or tumour progression. Angiogenesis is important for tumour growth and metastasis and is an important target for new biological agents. Bevacizumab is a humanised recombinant antibody that prevents vascular endothelial growth factor (VEGF) receptor binding, and inhibits angiogenesis and tumour growth. On February 26, 2004, the FDA (Food and Drug Administration) approved Bevacizumab as first-line treatment for patients with metastatic colorectal cancer. The integration of targeted therapies in the treatment of colon cancer has resulted in significant improvements in efficacy outcomes. Bevacizumab was the first antiangiogenic therapy approved for use in cancer and received accelerated FDA approval for the treatment of recurrent glioblastoma multiform in 2009. The efficacy of Bevacizumab in the treatment of metastatic colorectal cancer and recurrent glioblastoma multiform is presented in this review article. The structural characteristics and selectivity profiles of this antiangiogenic drug and those disclosed in related patent applications are also summarised in this article.
    MeSH term(s) Angiogenesis Inhibitors/pharmacology ; Angiogenesis Inhibitors/therapeutic use ; Animals ; Antibodies, Monoclonal, Humanized/pharmacology ; Antibodies, Monoclonal, Humanized/therapeutic use ; Bevacizumab ; Brain Neoplasms/drug therapy ; Brain Neoplasms/pathology ; Colorectal Neoplasms/drug therapy ; Colorectal Neoplasms/pathology ; Glioma/drug therapy ; Glioma/pathology ; Humans ; Molecular Targeted Therapy ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Patents as Topic ; Vascular Endothelial Growth Factor A/antagonists & inhibitors
    Chemical Substances Angiogenesis Inhibitors ; Antibodies, Monoclonal, Humanized ; Vascular Endothelial Growth Factor A ; Bevacizumab (2S9ZZM9Q9V)
    Language English
    Publishing date 2011-09-30
    Publishing country United Arab Emirates
    Document type Journal Article ; Review ; Systematic Review
    ISSN 1872-213X
    ISSN 1872-213X
    DOI 10.2174/187221312798889284
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Evidence based radiation therapy for locally advanced resectable and unresectable gastric cancer.

    Koukourakis, Georgios V

    World journal of gastrointestinal oncology

    2011  Volume 3, Issue 9, Page(s) 131–136

    Abstract: Despite the fact that gastric cancer is decreasing in incidence in the United States, it remains one of the most commonly diagnosed and most fatal cancers worldwide. In localised disease, surgery remains the cornerstone of treatment. Nevertheless, the ... ...

    Abstract Despite the fact that gastric cancer is decreasing in incidence in the United States, it remains one of the most commonly diagnosed and most fatal cancers worldwide. In localised disease, surgery remains the cornerstone of treatment. Nevertheless, the low overall survival rates at 5 years due to locoregional and distant recurrences has led to a large debate regarding the role of radiation therapy and chemotherapy in addition to curative resection. Recent data have shown that, even with improved surgical techniques, locoregional failure rates in these patients ranged between 57% and 88%. Failures were noted in the gastric bed, regional nodes, gastric remnant, anastomosis and duodenal stump, all of which can be encompassed in a regional radiation field, indicating the need of further locoregional treatment. In this article, a comprehensive literature review of the reliable medical databases of PubMed and Cochrane is made and we present all available information on the role of radiation therapy in the preoperative and postoperative setting of gastric cancer. Data reported show that in locally advanced gastric cancer the addition of radiation therapy post surgery has significantly improved disease-free survival as well as overall survival. Moreover, in unresectable gastric cancer, the combination of radiation therapy with chemotherapy has significantly improved mean and overall survival rates. The role of radiation therapy in patients with resectable gastric cancer is being further evaluated in ongoing phase III trials.
    Language English
    Publishing date 2011-10-09
    Publishing country China
    Document type Journal Article
    ZDB-ID 2573696-6
    ISSN 1948-5204 ; 1948-5204
    ISSN (online) 1948-5204
    ISSN 1948-5204
    DOI 10.4251/wjgo.v3.i9.131
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  10. Article: Evidence based whole breast hypo-fractionated radiation therapy in patients with early breast cancer.

    Koukourakis, Georgios / Zacharias, Georgios / Petridis, Aristides

    Journal of B.U.ON. : official journal of the Balkan Union of Oncology

    2015  Volume 20, Issue 2, Page(s) 473–478

    Abstract: Purpose: The aim of the current study was to evaluate the efficacy and tolerability of hypo-fractionated whole breast radiation therapy in patients with early breast cancer.: Methods: Searching electronically PubMed and the Cochrane Central Register ... ...

    Abstract Purpose: The aim of the current study was to evaluate the efficacy and tolerability of hypo-fractionated whole breast radiation therapy in patients with early breast cancer.
    Methods: Searching electronically PubMed and the Cochrane Central Register we made a comprehensive literature review regarding the randomized controlled phase III trials for hypo-fractionated radiation therapy in early breast cancer.
    Results: The collected and analyzed data showed that a short course of hypo-fractionated radiation therapy in early breast cancer patients is as effective as the conventional long course regarding tumor response as well as long term side effects.
    Conclusion: More data are needed about the usage and integration of a boost treatment for higher-risk women receiving neo-adjuvant or adjuvant chemotherapy, or the results in special subgroups such as women with large breast size.
    MeSH term(s) Breast Neoplasms/radiotherapy ; Dose Fractionation ; Evidence-Based Practice ; Female ; Humans ; Randomized Controlled Trials as Topic
    Language English
    Publishing date 2015-03
    Publishing country Greece
    Document type Journal Article
    ZDB-ID 2040386-0
    ISSN 2241-6293 ; 1107-0625
    ISSN (online) 2241-6293
    ISSN 1107-0625
    Database MEDical Literature Analysis and Retrieval System OnLINE

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