Mark J Krasna - Academia.edu (original) (raw)
Papers by Mark J Krasna
Annals of the American Thoracic Society, May 1, 2008
BMC Surgery, Jul 12, 2014
Annals of the American Thoracic Society, May 1, 2008
Annals of cardiothoracic surgery, Mar 1, 2017
Journal of Oncology Practice, Nov 1, 2016
Lung Cancer, Apr 1, 2010
Despite advances in Stage III NSCLC, the mortality from the disease remains &... more Despite advances in Stage III NSCLC, the mortality from the disease remains >70%. Disease recurrence can occur both locally and systemically. Trimodality therapy may improve outcome by maximizing local control. The purpose of this study was to perform a phase I trial of bortezomib (PS-341, Velcade) in addition to chemotherapy with carboplatin AUC=2 and paclitaxel 50mg/m(2) and concurrent radiotherapy (61 Gy) as induction treatment in a trimodality approach. Patients with pathologically documented Stage III a (N2) or selected IIIb (N3) disease were eligible. Bortezomib was administered on days 1, 4, 15, 18 during the 6-week induction chemoradiotherapy. Cohorts of three patients were entered and observed for toxicity during chemoradiotherapy and for 2 weeks afterwards. Surgical resection was attempted in the patients who had mediastinal sterilization. All patients were to receive consolidation chemotherapy with carboplatin AUC=6 and paclitaxel 200mg/m(2). Twelve patients in three cohorts were enrolled. The addition of bortezomib was well tolerated, with no unexpected toxicities during the induction phase. However, there were three postoperative deaths (two pneumonitis and one from failure of the bronchopulmonary flap). The trial was halted as a consequence of these toxicities. While this approach was well tolerated in terms of acute toxicity, the apparently delayed toxicity was severe and unpredictable. It does not appear that bortezomib can be safely administered as part of preoperative chemoradiotherapy for lung cancer. However, there was a high incidence of complete pathologic response and cautious exploration of this agent in the non-operative setting is appropriate.
The Journal of Thoracic and Cardiovascular Surgery, Jul 1, 2013
Proceedings of the National Academy of Sciences of the United States of America, Apr 15, 1993
Southern Medical Journal, Oct 1, 1996
European Surgery-acta Chirurgica Austriaca, Jun 1, 2005
SummaryBACKGROUND: To evaluate the feasibility and effects of mini-thoracotomy focus cleaning (MT... more SummaryBACKGROUND: To evaluate the feasibility and effects of mini-thoracotomy focus cleaning (MTFC) in the management of cavitary pulmonary tuberculosis or tuberculoma. METHODS: The mini-thoracotomy approach was adopted in 18 patients, ranging in the age from 25 years to 75 years (median, 47.5 years) with cavitary pulmonary tuberculosis or pulmonary tuberculoma who had undergone long-term anti-tuberculosis therapy or needed a re-treatment. Eight patients with chronic fibro-cavitary pulmonary tuberculosis and 10 patients with pulmonary tuberculoma underwent focus cleaning, irrigation and folding suture. RESULTS: There was no operative mortality. All patients studied were cured clinically, with their sputum negative for bacteria and pulmonary shadows subsiding. The duration of the procedure ranged from 30 to 120 min (median, 75 min), intraoperative blood loss ranged from 100 to 200 ml (median, 153 ml). The postoperative stay in the hospital was from 21 to 42 days (median, 30 days). Follow-up for 1–4 years (median, 2.5 years) found no complications and recurrence. CONCLUSIONS: MTFC is a safe, effective and technically feasible procedure to ensure minimal surgical invasion for controlling pulmonary tuberculosis or tuberculoma by protecting pulmonary functions in the patients studied.ZusammenfassungGRUNDLAGEN: Das Ziel dieser Untersuchung war, die Machbarkeit und Wirksamkeit der Fokus-Sanierung via Mini-Thorakotomie zur Therapie einer kavernösen Lungentuberkulose zu prüfen. METHODIK: Der Mini-Thorakotomie-Zugang wurde in 18 Patienten angewendet (Alter, 25–75 Jahre; median, 47,5 Jahre). Die Patienten hatten eine kavernöse Lungentuberkulose oder ein Lungentuberkulom nach tuberkulostatischer Therapie oder waren Patienten, die auf diese Therapie nicht angesprochen haben. 8 Patienten mit chronischer kavernöser Lungentuberkulose und 10 Patienten mit Tuberkulom haben sich der Fokus-Sanierung, Spülung und Faltnaht unterzogen. ERGEBNISSE: Es gab keine operative Mortalität. Alle Patienten waren klinisch saniert, hatten keinen Nachweis für Bakterien im Sputum, im Röntgen hatten die Lungenschatten abgenommen. Die Dauer der Operation betrug 30–120 min (median, 75 min), der intraoperative Blutverlust war 100–200 ml (median, 153 ml). Der postoperative Spitalsaufenthalt betrug 21–42 Tage (median, 30 Tage). Das Follow-up nach 1–4 Jahren (median, 2,5 Jahre) zeigte keine Komplikation und kein Rezidiv der Grunderkrankung. SCHLUSSFOLGERUNGEN: MTFC ist eine sichere und technisch machbare Methode zur Therapie der Lungentuberkulose oder des Tuberkuloms bei Schonung der Lungenfunktion.
Seminars in Oncology, Apr 1, 2008
Surgical Oncology Clinics of North America, Jul 1, 2016
The Annals of Thoracic Surgery, Dec 1, 1995
Surgical laparoscopy, endoscopy & percutaneous techniques, Jun 1, 1991
Surgical Oncology Clinics of North America, Jul 1, 2016
Annals of the American Thoracic Society, May 1, 2008
BMC Surgery, Jul 12, 2014
Annals of the American Thoracic Society, May 1, 2008
Annals of cardiothoracic surgery, Mar 1, 2017
Journal of Oncology Practice, Nov 1, 2016
Lung Cancer, Apr 1, 2010
Despite advances in Stage III NSCLC, the mortality from the disease remains &... more Despite advances in Stage III NSCLC, the mortality from the disease remains >70%. Disease recurrence can occur both locally and systemically. Trimodality therapy may improve outcome by maximizing local control. The purpose of this study was to perform a phase I trial of bortezomib (PS-341, Velcade) in addition to chemotherapy with carboplatin AUC=2 and paclitaxel 50mg/m(2) and concurrent radiotherapy (61 Gy) as induction treatment in a trimodality approach. Patients with pathologically documented Stage III a (N2) or selected IIIb (N3) disease were eligible. Bortezomib was administered on days 1, 4, 15, 18 during the 6-week induction chemoradiotherapy. Cohorts of three patients were entered and observed for toxicity during chemoradiotherapy and for 2 weeks afterwards. Surgical resection was attempted in the patients who had mediastinal sterilization. All patients were to receive consolidation chemotherapy with carboplatin AUC=6 and paclitaxel 200mg/m(2). Twelve patients in three cohorts were enrolled. The addition of bortezomib was well tolerated, with no unexpected toxicities during the induction phase. However, there were three postoperative deaths (two pneumonitis and one from failure of the bronchopulmonary flap). The trial was halted as a consequence of these toxicities. While this approach was well tolerated in terms of acute toxicity, the apparently delayed toxicity was severe and unpredictable. It does not appear that bortezomib can be safely administered as part of preoperative chemoradiotherapy for lung cancer. However, there was a high incidence of complete pathologic response and cautious exploration of this agent in the non-operative setting is appropriate.
The Journal of Thoracic and Cardiovascular Surgery, Jul 1, 2013
Proceedings of the National Academy of Sciences of the United States of America, Apr 15, 1993
Southern Medical Journal, Oct 1, 1996
European Surgery-acta Chirurgica Austriaca, Jun 1, 2005
SummaryBACKGROUND: To evaluate the feasibility and effects of mini-thoracotomy focus cleaning (MT... more SummaryBACKGROUND: To evaluate the feasibility and effects of mini-thoracotomy focus cleaning (MTFC) in the management of cavitary pulmonary tuberculosis or tuberculoma. METHODS: The mini-thoracotomy approach was adopted in 18 patients, ranging in the age from 25 years to 75 years (median, 47.5 years) with cavitary pulmonary tuberculosis or pulmonary tuberculoma who had undergone long-term anti-tuberculosis therapy or needed a re-treatment. Eight patients with chronic fibro-cavitary pulmonary tuberculosis and 10 patients with pulmonary tuberculoma underwent focus cleaning, irrigation and folding suture. RESULTS: There was no operative mortality. All patients studied were cured clinically, with their sputum negative for bacteria and pulmonary shadows subsiding. The duration of the procedure ranged from 30 to 120 min (median, 75 min), intraoperative blood loss ranged from 100 to 200 ml (median, 153 ml). The postoperative stay in the hospital was from 21 to 42 days (median, 30 days). Follow-up for 1–4 years (median, 2.5 years) found no complications and recurrence. CONCLUSIONS: MTFC is a safe, effective and technically feasible procedure to ensure minimal surgical invasion for controlling pulmonary tuberculosis or tuberculoma by protecting pulmonary functions in the patients studied.ZusammenfassungGRUNDLAGEN: Das Ziel dieser Untersuchung war, die Machbarkeit und Wirksamkeit der Fokus-Sanierung via Mini-Thorakotomie zur Therapie einer kavernösen Lungentuberkulose zu prüfen. METHODIK: Der Mini-Thorakotomie-Zugang wurde in 18 Patienten angewendet (Alter, 25–75 Jahre; median, 47,5 Jahre). Die Patienten hatten eine kavernöse Lungentuberkulose oder ein Lungentuberkulom nach tuberkulostatischer Therapie oder waren Patienten, die auf diese Therapie nicht angesprochen haben. 8 Patienten mit chronischer kavernöser Lungentuberkulose und 10 Patienten mit Tuberkulom haben sich der Fokus-Sanierung, Spülung und Faltnaht unterzogen. ERGEBNISSE: Es gab keine operative Mortalität. Alle Patienten waren klinisch saniert, hatten keinen Nachweis für Bakterien im Sputum, im Röntgen hatten die Lungenschatten abgenommen. Die Dauer der Operation betrug 30–120 min (median, 75 min), der intraoperative Blutverlust war 100–200 ml (median, 153 ml). Der postoperative Spitalsaufenthalt betrug 21–42 Tage (median, 30 Tage). Das Follow-up nach 1–4 Jahren (median, 2,5 Jahre) zeigte keine Komplikation und kein Rezidiv der Grunderkrankung. SCHLUSSFOLGERUNGEN: MTFC ist eine sichere und technisch machbare Methode zur Therapie der Lungentuberkulose oder des Tuberkuloms bei Schonung der Lungenfunktion.
Seminars in Oncology, Apr 1, 2008
Surgical Oncology Clinics of North America, Jul 1, 2016
The Annals of Thoracic Surgery, Dec 1, 1995
Surgical laparoscopy, endoscopy & percutaneous techniques, Jun 1, 1991
Surgical Oncology Clinics of North America, Jul 1, 2016