Juozas Kurtinaitis

Vilnius University, Vil'nyus, Vilniaus Apskritis, Lithuania

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Publications (60)185.33 Total impact

  • S Cicėnas, J Kurtinaitis, G Smailytė
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    ABSTRACT: To assess the survival rate of female lung cancer treated at the Institute of Oncology of the Vilnius University, Lithuania during the period between 1996-2005. During the period between 1996-2005, 471 women diagnosed with lung cancer were treated at the Department of Thoracic Surgery and Oncology of the Institute of Oncology, Vilnius University. Data on morphology, stage and treatment was collected from the medical records. All lung cancer cases by histology were classified in two groups: non-small cell lung cancer (includes squamous cell carcinoma, large cell carcinoma, adenocarcinoma and other less common types) and small cell lung cancer. The vital status of the study group was assessed as of December 31, 2007, by passive follow-up, using data from the population registry. It was found that 411 (87.3%) of the patients had died. Survival was estimated according to the Kaplan-Meier method. The median survival of female lung cancer diagnosed during 1996-2005 in Lithuania show to be 8.7 months (8.4 (95% CI 7.2-10.8) months with non-small cell lung cancer and 9.3 (95% CI 6.3-13.0) months with small-cell lung cancer). Survival was more than 20 months in resectable non-small cell lung cancer (stages I, II, IIIA). Non-small cell lung cancer survival in advanced stages was less than 7 months. Small-cell lung cancer patients median survival at limited and extended stages of the disease were 9.5 (95% CI 2.9-18.4) compared to 9.2 (95% CI 6.2-13.7) months. Non-small cell lung cancer patients most frequently were treated by surgery (27.0%), surgery and chemotherapy or radiotherapy (19.6%). Small cell lung cancer patient treatment included chemo and radiotherapy (27.0%), chemotherapy (19.0%), radiotherapy (17.5%), surgery (27.9%). The single center study of female lung cancer diagnosed during 1996-2005 in Lithuania show a significantly better chance of survival in resectable non-small cell lung cancer. Advanced stages of the disease at the time of diagnosis and choice of treatment options of female lung cancer in the country still remains an issue.
    Advances in Medical Sciences 12/2010; 55(2):273-80. DOI:10.2478/v10039-010-0044-1 · 0.96 Impact Factor
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    ABSTRACT: We evaluated the prevalence of BRCA1 founder mutations in unselected cases of breast, ovarian and colon cancer from Lithuania. We identified a founder mutation (4153delA, 5382insC or C61G) in 6% of 235 unselected cases of breast cancer and in 19% of 43 unselected cases of ovarian cancer. Only one patient with a mutation was identified among 178 cases of colon cancer. No mutation was identified among 422 newborn controls. This data indicates that the genetic burden of breast and ovarian cancer attributable to BRCA1 mutations in Lithuania is very high and supports the recommendation that all cases of breast and ovarian cancer in Lithuania be offered genetic testing.
    Clinical Genetics 02/2010; 78(4):373-6. DOI:10.1111/j.1399-0004.2010.01404.x · 3.65 Impact Factor
  • Cancer Research 12/2009; 69(24 Supplement):6047-6047. DOI:10.1158/0008-5472.SABCS-09-6047 · 9.28 Impact Factor
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    ABSTRACT: Male breast cancer is a rare disease in Lithuania, comprising less than 0.2% of malignan-cies among men. During the last decade, there has been no change in the frequency of the disease, with 10–15 cases registered every year during 1988–2006, and only 16 of the more than 8000 new cases in 2006 presented male breast carcinoma. Data published in the Cancer Incidence in Five Continents during 1978–2002 show no changes in the variability of the rate of incidence of male breast carcinoma either. Materials and methods. Th is investigation analyzed 100 male patients with breast car-cinoma treated during the period 1988–2006 in two clinics: Institute of Oncology at Viln-ius University and Hospital of Oncology at Kaunas University of Medicine. Th e average age of the patients was 67.5 years (range, 31–90 years). Th e patients were grouped according to the progression of the disease: 13 patients in stage I, 41 patients in stage II, 31 patients in stage III, and 15 patients in stage IV. Th e type of cancer was as follows: invasive ductal carcinoma was the most frequent (68 cases), lobular carcinoma in 9 cases, and adenocar-cinoma in 6 cases. Th e most common method of treatment was modifi ed mastectomy by Madden (75 cases). Furthermore, 53 patients received a combined treatment: 23 patients were treated with radiotherapy, 9 patients with chemotherapy, 14 patients received radio-therapy and chemotherapy, and 14 patients were treated with tamoxifen. Results. Th e status of the patients was validated up to December 31, 2007 by checking the active follow-up examinations as well as utilizing the assistance and results of primary health care centers and the population registry. Th e overall survival rates were calculated using mortality issues as primary endpoints. Th e overall 5-year survival rate of all male pa-tients with breast carcinoma was estimated to be 42.7%. Th e 5-year survival rate of the pa-tients in stages I and IIA was 71.9% and 79.5%, respectively, and in stage IIB 53.5%. Lower survival rates (15.8% and 11.2%) were observed in stage IIIA and stage IIIB, respectively. None of the patients in stage IV survived beyond 5 years. A 2-year survival rate of 6.7% was the best estimate of this group. Conclusion. Th e overall survival rate of male breast cancer patients treated at two ma-jor medical centers of Lithuania was estimated to be below 50%. Th e low survival rate can be explained by late detection of advanced cases and the lack of innovation during cancer treatment.
    12/2009; 16:119-123. DOI:10.2478/v10140-009-0017-5
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    ABSTRACT: To compare acute gastrointestinal (GI) and genitourinary (GU) toxicity between patient groups with localized prostate adenocarcinoma, treated with conventionally fractionated (CFRT) and hypofractionated (HFRT) three-dimensional conformal external-beam radiotherapy (3D-CRT). 91 patients were enrolled into a randomized study with a minimum follow-up of 3 months. 44 men in the CFRT arm were irradiated with 74 Gy in 37 fractions at 2 Gy per fraction for 7.5 weeks. 47 men in the HFRT arm were treated with 57 Gy in 17 fractions for 3.5 weeks, given as 13 fractions of 3 Gy plus four fractions of 4.5 Gy. The clinical target volume (CTV) included the prostate and the base of seminal vesicles. The CTV-to-PTV (planning target volume) margin was 8-10 mm. Study patients had portal imaging and/or simulation performed on the first fractions and repeated at least weekly. No acute grade 3 or 4 toxicities were observed. The grade 2 GU acute toxicity proportion was significantly lower in the HFRT arm: 19.1% versus 47.7% (chi(2)-test, p = 0.003). The grade 2 GU acute toxicity-free survival was significantly better in the HFRT arm (log-rank test, p = 0.008). The median duration of overall GI acute toxicity was shorter with HFRT: 3 compared to 6 weeks with CFRT (median test, p = 0.017). In this first evaluation, the HFRT schedule is feasible and induces acceptable or even lower acute toxicity compared with the toxicities in the CFRT schedule. Extended follow-up is needed to justify this fractionation schedule's safety in the long term.
    Strahlentherapie und Onkologie 11/2009; 185(11):715-21. DOI:10.1007/s00066-009-1982-z · 2.73 Impact Factor
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    ABSTRACT: Standardised tables of aggregated data were collected from 15 European national or regional cervical screening programmes and key performance indicators computed as reported in European Union (EU) Guidelines, 2nd edition. Cytological results varied widely between countries both for the total proportion of abnormal tests (from 1.2% in Germany (Mecklenburg-Vorpommern) to 11.7% in Ireland-Midwest Region) and for their distribution by grade. Referral rates for repeat cytology (ranging from 2.9% of screened women in the Netherlands to 16.6% in Slovenia) or for colposcopy (ranging from 0.8% in Finland to 4.4% in Romania-Cluj) and the Positive Predictive Value (PPV) of colposcopic attendance (ranging from 8% in Romania-Cluj to 52% in Lithuania) were strongly influenced by management protocols, in particular for atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesion (LSIL) cytology. However, cytology-specific PPV also showed remarkable variability. The detection rate of CIN2+ histology ranged from <0.1% of screened women in Poland to >1% in England and Denmark. Low attendance for colposcopy after referral was observed in some east-European countries. These comparisons may be useful for improving the performance of cervical screening in general and more so if new screening technologies and vaccination for Human Papillomavirus are introduced. Overall, quality was better in countries that have operated organised programmes for a longer time, plausibly as a result of long-lasting monitoring and quality assurance activities. Therefore, the availability of these data, the first comparing European countries, and the increased number of countries that can provide such data (only five in 2004) represent progress. Nevertheless, there is a clear need to standardise the cytological and histological classifications used in screening, as well as data registration systems across Europe.
    European journal of cancer (Oxford, England: 1990) 09/2009; 45(15):2659-70. DOI:10.1016/j.ejca.2009.07.022 · 4.82 Impact Factor
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    ABSTRACT: A case-control study of hematological malignancies was conducted among Chernobyl liquidators (accident recovery workers) from Belarus, Russia and Baltic countries to assess the effect of low- to medium-dose protracted radiation exposures on the relative risk of these diseases. The study was nested within cohorts of liquidators who had worked around the Chernobyl plant in 1986-1987. A total of 117 cases [69 leukemia, 34 non-Hodgkin lymphoma (NHL) and 14 other malignancies of lymphoid and hematopoietic tissue] and 481 matched controls were included in the study. Individual dose to the bone marrow and uncertainties were estimated for each subject. The main analyses were restricted to 70 cases (40 leukemia, 20 NHL and 10 other) and their 287 matched controls with reliable information on work in the Chernobyl area. Most subjects received very low doses (median 13 mGy). For all diagnoses combined, a significantly elevated OR was seen at doses of 200 mGy and above. The excess relative risk (ERR) per 100 mGy was 0.60 [90% confidence interval (CI) -0.02, 2.35]. The corresponding estimate for leukemia excluding chronic lymphoid leukemia (CLL) was 0.50 (90% CI -0.38, 5.7). It is slightly higher than but statistically compatible with those estimated from A-bomb survivors and recent low-dose-rate studies. Although sensitivity analyses showed generally similar results, we cannot rule out the possibility that biases and uncertainties could have led to over- or underestimation of the risk in this study.
    Radiation Research 01/2009; 170(6):721-35. DOI:10.1667/RR1231.1 · 2.45 Impact Factor
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    Leukemia research 09/2008; 33(4):587-8. DOI:10.1016/j.leukres.2008.07.024 · 2.69 Impact Factor
  • Revue d Épidémiologie et de Santé Publique 09/2008; 56(5):286-287. DOI:10.1016/j.respe.2008.06.109 · 0.66 Impact Factor
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    ABSTRACT: Monitoring population-based cancer survival is an essential component in the evaluation of cancer control, but subject to an inherent delay in the reporting of the most recent survival estimates with traditional techniques of analysis. We examined survival trends between the years 2000 and 2004 for 20 common cancers based on follow-up data from 12 cancer registries from diverse areas of Europe using model-based period analysis techniques. Between 2000 and 2004, marked rises were seen in 5-year relative survival amongst patients with prostate, breast and colorectal cancer, which were statistically significant in 10, 8 and 7 of the 12 participating cancer registries, respectively. For cancer sites amenable to effective early detection and treatment, major geographical differences in patient prognosis still persisted, with a lower survival generally observed in Eastern European countries. Model-based period analysis enables the timely monitoring of recent trends in population-based cancer survival. For colorectal and breast cancers, the identified rises in survival are probably (at least partly) explained by the improvements in clinical care and the management of the disease. Nevertheless, persisting geographic differences do point to the potential for a further reduction in the burden of cancer throughout Europe, towards which improvements in diverse areas of care, including secondary prevention, access to advances in treatment as well as subspecialisation and regionalisation of oncologic care may all contribute.
    European Journal of Cancer 08/2008; 44(10):1463-75. DOI:10.1016/j.ejca.2008.03.010 · 4.82 Impact Factor
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    ABSTRACT: This study presents the summary of historical exposures, measurement practice and evolution of the recording of the individual doses of medical radiation workers during 1950-2003 in Lithuania. The aim of this study is to present occupational exposure of medical radiation workers in Lithuania since the earliest appearance period. Data from publications have been used for the earliest two periods prior to 1969; data from the archives of the largest hospitals, for the period 1970-1990 and data from Lithuanian Subdivision of Individual Dosimetry of Radiation Protection Center, for the period 1991-2003. The analysis of the data obtained from personal records allows to conclude that the average annual effective dose of Lithuanian medical radiation workers was greatly reduced in radiology, radiotherapy and nuclear medicine in all occupational categories from 1950 to 2003. During the last period 1991-2003 extremity doses clearly decreased and after 1994 were no longer present in Lithuania.
    Radiation Protection Dosimetry 04/2008; 130(2):239-43. DOI:10.1093/rpd/ncm490 · 0.86 Impact Factor
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    Giedre Smailyte, Juozas Kurtinaitis
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    ABSTRACT: The aim of this study was to describe and to compare the cancer mortality rates in urban and rural residents in Lithuania. Cancer mortality has been studied using the materials of the Lithuanian cancer registry. For the period 1993-2004 age-standardized urban and rural population mortality rates (World standard) were calculated for all malignant neoplasm's and for stomach, colorectal, lung, prostate, breast and cervical cancers. The annual percentage change (APC) was calculated using log-linear regression model, two-sided Mantel-Haenzel test was used to evaluate differences in cancer mortality among rural and urban populations. For males in rural population cancer mortality was higher than in urban (212.2 and 197.0 cases per 100000) and for females cancer mortality was higher in urban population (103.5 and 94.2 cases per 100000, p < 0.05). During the study period the age-standardized mortality rates decreased in both sexes in urban residents. The decreasing mortality trend in urban population was contributed by decline of the rates of lung and stomach cancer in male and breast, stomach and colorectal cancer in female. Mortality rates in both urban and rural population were increasing for prostate and cervical cancers. This study shows that large rural and urban inequalities in cancer mortality exist in Lithuania. The contrast between the health of residents in urban and rural areas invites researchers for research projects to develop, implement, and enhance cancer prevention and early detection intervention strategies for rural populations.
    BMC Public Health 02/2008; 8:56. DOI:10.1186/1471-2458-8-56 · 2.32 Impact Factor
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    ABSTRACT: Ionizing radiation at very high (radio-therapeutic) dose levels can cause diseases other than cancer, particularly heart diseases. There is increasing evidence that doses of the order of a few sievert (Sv) may also increase the risk of non-cancer diseases. It is not known, however, whether such effects also occur following the lower doses and dose rates of public health concern. We used data from an international (15-country) nuclear workers cohort study to evaluate whether mortality from diseases other than cancer is related to low doses of external ionizing radiation. Analyses included 275 312 workers with adequate information on socioeconomic status, over 4 million person-years of follow-up and an average cumulative radiation dose of 20.7 mSv; 11 255 workers had died of non-cancer diseases. The excess relative risk (ERR) per Sv was 0.24 [95% CI (confidence intervals) -0.23, 0.78] for mortality from all non-cancer diseases and 0.09 (95% CI -0.43, 0.70) for circulatory diseases. Higher risk estimates were observed for mortality from respiratory and digestive diseases, but confidence intervals included zero. Increased risks were observed among the younger workers (attained age <50 years, identified post hoc) for all groupings of non-cancer causes of death, including external causes. It is unclear therefore whether these findings reflect real effects of radiation, random variation or residual confounding. The most informative low-dose radiation study to date provides little evidence for a relationship between mortality from non-malignant diseases and radiation dose. However, we cannot rule out risks per unit dose of the same order of magnitude as found in studies at higher doses.
    International Journal of Epidemiology 10/2007; 36(5):1126-35. DOI:10.1093/ije/dym138 · 9.20 Impact Factor
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    ABSTRACT: A 15-Country collaborative cohort study was conducted to provide direct estimates of cancer risk following protracted low doses of ionizing radiation. Analyses included 407,391 nuclear industry workers monitored individually for external radiation and 5.2 million person-years of follow-up. A significant association was seen between radiation dose and all-cause mortality [excess relative risk (ERR) 0.42 per Sv, 90% CI 0.07, 0.79; 18,993 deaths]. This was mainly attributable to a dose-related increase in all cancer mortality (ERR/Sv 0.97, 90% CI 0.28, 1.77; 5233 deaths). Among 31 specific types of malignancies studied, a significant association was found for lung cancer (ERR/Sv 1.86, 90% CI 0.49, 3.63; 1457 deaths) and a borderline significant (P = 0.06) association for multiple myeloma (ERR/Sv 6.15, 90% CI <0, 20.6; 83 deaths) and ill-defined and secondary cancers (ERR/Sv 1.96, 90% CI -0.26, 5.90; 328 deaths). Stratification on duration of employment had a large effect on the ERR/Sv, reflecting a strong healthy worker survivor effect in these cohorts. This is the largest analytical epidemiological study of the effects of low-dose protracted exposures to ionizing radiation to date. Further studies will be important to better assess the role of tobacco and other occupational exposures in our risk estimates.
    Radiation Research 05/2007; 167(4):396-416. DOI:10.1667/RR0553.1 · 2.45 Impact Factor
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    ABSTRACT: Radiation protection standards are based mainly on risk estimates from studies of atomic bomb survivors in Japan. The validity of extrapolations from the relatively high-dose acute exposures in this population to the low-dose, protracted or fractionated environmental and occupational exposures of primary public health concern has long been the subject of controversy. A collaborative retrospective cohort study was conducted to provide direct estimates of cancer risk after low-dose protracted exposures. The study included nearly 600,000 workers employed in 154 facilities in 15 countries. This paper describes the design, methods and results of descriptive analyses of the study. The main analyses included 407,391 nuclear industry workers employed for at least 1 year in a participating facility who were monitored individually for external radiation exposure and whose doses resulted predominantly from exposure to higher-energy photon radiation. The total duration of follow-up was 5,192,710 person-years. There were 24,158 deaths from all causes, including 6,734 deaths from cancer. The total collective dose was 7,892 Sv. The overall average cumulative recorded dose was 19.4 mSv. A strong healthy worker effect was observed in most countries. This study provides the largest body of direct evidence to date on the effects of low-dose protracted exposures to external photon radiation.
    Radiation Research 05/2007; 167(4):361-79. DOI:10.1667/RR0554.1 · 2.45 Impact Factor
  • The Breast 03/2007; 16. DOI:10.1016/S0960-9776(07)70144-3 · 2.58 Impact Factor
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    ABSTRACT: The aim of our study was to investigate and evaluate the prognostic value of and correlations between preclinical and clinical factors such as the stage of the disease, blood Hb level before treatment, size of cervix and lymph nodes evaluated by CT, age, dose of irradiation and duration of radiotherapy related to overall survival, disease-free survival, local control and metastases-free survival in cervical cancer patients receiving radiotherapy alone. 162 patients with International Federation of Gynecology and Obstetrics (FIGO) stage IIA-IIIB cervical carcinoma treated with irradiation were analysed. Univariate and multivariate analyses using the Cox regression model were performed to determine statistical significance of some tumor-related factors. The Hb level before treatment showed significant influence on overall survival (p = 0.001), desease free survival (p = 0.040) and local control (p = 0.038). The lymph node status (>10 mm) assessed on CT had impact on overall survival (p = 0,030) and local control (p = 0,036). The dose at point A had impact on disease free survival (p = 0,028) and local control (p = 0,021) and the radiotherapy duration had showed significant influence on overall survival (p = 0,045), disease free survival (p = 0,006) and local control (p = 0,033). Anemia is a significant and independent prognostic factor of overall survival, disease-free survival and local control in cervical cancer patients treated with irradiation. The size of lymph nodes in CT is an independent prognostic factor for overall survival and local control in cervical cancer patients. The size of cervix uteri evaluated by CT has no prognostic significance in cervical cancer patients treated with radiotherapy. The prognostic value of FIGO stage of cervical cancer is influenced by other factors, analyzed in this study and is not an independent prognostic factor.
    BMC Cancer 02/2007; 7:234. DOI:10.1186/1471-2407-7-234 · 3.32 Impact Factor
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    ABSTRACT: A high level of chromosomal aberrations in peripheral blood lymphocytes may be an early marker of cancer risk, but data on risk of specific cancers and types of chromosomal aberrations (chromosome type and chromatid type) are limited. A total of 6,430 healthy individuals from nine laboratories in Croatia, Hungary, Lithuania, Poland, and Slovakia, included in chromosomal aberration surveys performed during 1978-2002, were followed up for cancer incidence or mortality for an average of 8.5 years; 200 cancer cases were observed. Compared with that for the low-tertile level of chromosomal aberrations, the relative risks of cancer for the medium and high tertiles were 1.78 (95% confidence interval: 1.19, 2.67) and 1.81 (95% confidence interval: 1.20, 2.73), respectively. The relative risk for chromosome-type aberrations above versus below the median was 1.50 (95% confidence interval: 1.12, 2.01), while that for chromatid-type aberrations was 0.97 (95% confidence interval: 0.72, 1.31). The analyses of risk of specific cancers were limited by small numbers, but the association was stronger for stomach cancer. This study confirms the previously reported association between level of chromosomal aberrations and cancer risk and provides novel information on the type of aberrations more strongly predictive of cancer risk and on the types of cancer more strongly predicted by chromosomal aberrations.
    American Journal of Epidemiology 02/2007; 165(1):36-43. DOI:10.1093/aje/kwj367 · 4.98 Impact Factor

Publication Stats

1k Citations
185.33 Total Impact Points


  • 2005–2010
    • Vilnius University
      • Institute of Oncology
      Vil'nyus, Vilniaus Apskritis, Lithuania
  • 2003–2010
    • Institute of Oncology Vilnius University
      Vil'nyus, Vilniaus Apskritis, Lithuania
    • University of Tampere
      Tammerfors, Pirkanmaa, Finland
  • 2007
    • Universidad Autónoma de Madrid
      Madrid, Madrid, Spain
  • 2005–2007
    • International Agency for Research on Cancer
      Lyons, Rhône-Alpes, France