共查询到20条相似文献，搜索用时 31 毫秒
1.
Susan Mercieca José S.A. Belderbos Katrien De Jaeger Dominic A.X. Schinagl Noëlle van der Voort Van Zijp Jacqueline Pomp Jacqueline Theuws Jonathan Khalifa Paul van de Vaart Marcel van Herk 《Radiotherapy and oncology》2018,126(2):325-332
Purpose
The study compared interobserver variation in the delineation of the primary tumour (GTVp) and lymph nodes (GTVln) between three different 4DCT reconstruction types; Maximum Intensity Projection (MIP), Mid-Ventilation (Mid-V) and Mid-Position (Mid-P).Material and methods
Seven radiation oncologists delineated the GTVp and GTVln on the MIP, Mid-V and Mid-P 4DCT image reconstructions of 10 lung cancer patients. The volumes, the mean standard deviation (SD) and distribution of SD (SD/area) over the median surface contour were compared for different tumour regions.Results
The overall mean delineated volume on the MIP was significantly larger (p?<?0.001) than the Mid-V and Mid-P. For the GTVp the Mid-P had the lowest interobserver variation (SD?=?0.261?cm), followed by Mid-V (SD?=?0.314?cm) and MIP (SD?=?0.330?cm) For GTVln the Mid-V had the lowest interobserver variation (SD?=?0.425?cm) followed by the MIP (SD?=?0.477?cm) and Mid-P (SD?=?0.543?cm). The SD/area distribution showed a statistically significant difference between the MIP versus Mid-P and Mid-P versus Mid-V for both GTVp and GTVln (p?<?0.001), with outliers indicating interpretation differences for GTVp located close to the mediastinum and GTVln.Conclusion
The Mid-P reduced the interobserver variation for the GTVp. Delineation protocols must be improved to benefit from the improved image quality of Mid-P for the GTVln. 相似文献2.
Marco Marcello Martin Ebert Annette Haworth Allison Steigler Angel Kennedy David Joseph James Denham 《Radiotherapy and oncology》2018,126(2):249-256
Background and purpose
To evaluate the impact of treatment planning and delivery factors on treatment outcome as measured by post-treatment disease progression.Materials and methods
Accruing 813 external beam radiotherapy participants during 2003–2007, the RADAR trial collected a comprehensive range of clinical treatment factor data for each participant. Both the Fine and Gray competing risks modelling and the Kaplan–Meier (KM) analysis were undertaken to determine the impact of these factors on local-composite progression (LCP), with 709 participants available for analysis.Results
Participants with treatments involving 7 or more beams experienced significantly higher incidence of LCP, with a sub-hazard ratio (relative to 3-beam participants) of 3.056 (CI: 1.446–6.458, p?<?0.0034). Participants treated with a more rigorous dose calculation algorithm also displayed significantly higher incidence of LCP, with a sub-hazard ratio of 1.686 (CI: 1.334–2.132, p?<?0.0001). The KM analysis resulted in the same groups showing a higher incidence of LCP, with log-rank test results of p?=?0.0005 and p?=?0.0008 respectively.Conclusions
The RADAR dataset has enabled a successful secondary analysis in which the impact of technical modifications has been assessed, challenging several established hypotheses. Increasingly precise treatments should be complemented with increasing accuracy to avoid potential geometric miss. 相似文献3.
Ahmed Mostafa Mahmoud Yahia M. Ismail Alaadin Hussien Yasser Debaky Ihab S. Ahmed Hisham S. Wahba Mikhael Manar Moneer 《Journal of the Egyptian National Cancer Institute》2018,30(4):143-150
Background
Peritoneal carcinomatosis originating from colorectal cancer (PC-CRC) carries a dismal prognosis. Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) have been offered to those patients with substantial health and economic burden, nevertheless not all patients are fitting this treatment modality and outcome is generally still poor.Objective
To elicit predictive factors associated with the success of CRS and HIPEC in PC-CRC patients.Patients and methods
This is a pilot study including 30 consecutive patients with PC-CRC; 20 of them (66.7%) presented with metachronous peritoneal disease. All patients were planned for CRS and HIPEC with Mitomycin-C after receiving preoperative systemic chemotherapy for 3?months.Results
On exploration, CRS and HIPEC were successful in 17 patients (56.6%) who had completeness of cytoreduction score 0–1 (CC-0/1), whereas failure (CC-2) was encountered in 13 patients (43.3%). The presence of ascites, extensive peritoneal disease (PCI?>?20) was significantly correlated with failure to achieve CRS and HIPEC (p?<?0.001); also, the primary rectal site showed a trend towards significance (p?=?0.08). The cumulative overall survival (OS) and progression-free survival (PFS) at 2?years were 66.6 and 62.6%, respectively. Patients who achieved CC-0/1 had significantly prolonged OS compared to CC-2 (p?<?0.001). On multivariate analysis, the CC score and the original site were independent prognostic factors for OS (p?=?0.04 and 0.02, respectively).Conclusion
In patients with PC-CRC, malignant ascites and PCI?>?20 are poor prognostic factors associated with failure to accomplish CRS with consequent poor survival. 相似文献4.
Shulian Wang Jeff Campbell Matthew H. Stenmark Paul Stanton Jing Zhao Martha M. Matuszak Randall K. Ten Haken Feng-Ming Kong 《Radiotherapy and oncology》2018,126(3):506-510
Background and purpose
To study whether cytokine markers may improve predictive accuracy of radiation esophagitis (RE) in non-small cell lung cancer (NSCLC) patients.Materials and methods
A total of 129 patients with stage I–III NSCLC treated with radiotherapy (RT) from prospective studies were included. Thirty inflammatory cytokines were measured in platelet-poor plasma samples. Logistic regression was performed to evaluate the risk factors of RE. Stepwise Akaike information criterion (AIC) and likelihood ratio test were used to assess model predictions.Results
Forty-nine of 129 patients (38.0%) developed grade ≥2 RE. Univariate analysis showed that age, stage, concurrent chemotherapy, and eight dosimetric parameters were significantly associated with grade ≥2 RE (p?<?0.05). IL-4, IL-5, IL-8, IL-13, IL-15, IL-1α, TGFα and eotaxin were also associated with grade ≥2 RE (p?<?0.1). Age, esophagus generalized equivalent uniform dose (EUD), and baseline IL-8 were independently associated grade ≥2 RE. The combination of these three factors had significantly higher predictive power than any single factor alone. Addition of IL-8 to toxicity model significantly improves RE predictive accuracy (p?=?0.019).Conclusions
Combining baseline level of IL-8, age and esophagus EUD may predict RE more accurately. Refinement of this model with larger sample sizes and validation from multicenter database are warranted. 相似文献5.
Franz Rödel Kerstin Steinhäuser Nina-Naomi Kreis Alexandra Friemel Daniel Martin Ulrike Wieland Margret Rave-Fränk Panagiotis Balermpas Emmanouil Fokas Frank Louwen Claus Rödel Juping Yuan 《Radiotherapy and oncology》2018,126(2):214-221
Background
RBP-J interacting and tubulin-associated protein (RITA) has been identified as a negative regulator of the Notch signalling pathway and its deregulation is involved in the pathogenesis of several tumour entities. RITA’s impact on the response of anal squamous cell carcinoma (SCC) to anticancer treatment, however, remains elusive.Materials and methods
In our retrospective study immunohistochemical evaluation of RITA was performed on 140 pre-treatment specimens and was correlated with clinical and histopathologic characteristics and clinical endpoints cumulative incidence of local control (LC), distant recurrence (DC), disease-free survival (DFS) and overall survival (OS).Results
We observed significant inverse correlations between RITA expression and tumour grading, the levels of HPV-16 virus DNA load, CD8 (+) tumour infiltrating lymphocytes and programmed death protein (PD-1) immunostaining. In univariate analyses, elevated levels of RITA expression were predictive for decreased local control (p?=?0.001), decreased distant control (p?=?0.040), decreased disease free survival (p?=?0.001) and overall survival (p?<?0.0001), whereas in multivariate analyses RITA expression remained significant for decreased local control (p?=?0.009), disease free survival (p?=?0.032) and overall survival (p?=?0.012).Conclusion
These data indicate that elevated levels of pretreatment RITA expression are correlated with unfavourable clinical outcome in anal carcinoma treated with concomitant chemoradiotherapy. 相似文献6.
Jean-Pierre Bissonnette Mei Ling Yap Katy Clarke Andrea Shessel Jane Higgins Douglass Vines Eshetu G. Atenafu Nathan Becker Claudia Leavens Andrea Bezjak David A. Jaffray Alexander Sun 《Radiotherapy and oncology》2018,126(2):347-354
Background and purpose
A FDG-PET/CT image feature with optimal prognostic potential for locally-advanced non-small cell lung cancer (LA-NSCLC) patients has yet to be identified, and neither has the optimal time for FDG-PET/CT response assessment; furthermore, nodal features have been largely ignored in the literature. We propose to identify image features or imaging time point with maximal prognostic power.Materials and methods
Consecutive consenting patients with LA-NSCLC receiving curative intent CRT were enrolled. 4DPET/4DCT scans were acquired 0, 2, 4, and 7?weeks during IMRT treatment. Eleven image features and their rates of change were recorded for each time point and tested for each of the possible outcome 2?years post CRT using the Kaplan–Meier method.Results
32 consecutive patients were recruited, 27 completing all scans. Restricting analysis to 4DPET/4DCT features and rates of change with p?<?0.005, several volume-based features and their rates of change reached significance. Image features involving nodal disease were the only ones associated with overall survival.Conclusions
Several 4DPET/CT features and rates of change can reach significant association (p?<?0.005) with outcomes, including overall survival, at many time points. The optimal time for adaptive CRT is therefore not constrained uniquely on imaging. 相似文献7.
Michael Tallarico Jared C. Foster Drew Seisler Jacqueline M. Lafky Arti Hurria Aminah Jatoi Harvey J. Cohen Hyman B. Muss Nancy Bartlett Bruce D. Cheson Sin-Ho Jung John P. Leonard John C. Byrd Chadi Nabhan 《Journal of Geriatric Oncology》2018,9(4):321-328
Objective
Older patients with cancer suffer from chemotherapy-related toxicities more frequently than younger patients. As novel agents are being used more commonly in chronic lymphocytic leukemia (CLL) and non-Hodgkin lymphoma (NHL), toxicities of these agents in older patients have not been well studied. Further, impact of these toxicities on outcomes in the elderly is unknown. This study aimed to answer both questions.Patients and Methods
We reviewed 14 Alliance for Clinical Trials in Oncology trials that enrolled CLL and/or NHL patients between 2004–2014. Toxicity was assessed per the NCI-CTCAE (version 3–5). Probabilities of experiencing grade three or four hematologic and non-hematologic toxicities were modeled as a function of clinical and disease-related factors using logistic regression.Results
1199 patients (409 age?≥?65; 790 age?<?65) were analyzed; 438 received only biologic therapy (145 age?≥?65; 293 age?<?65), and 761 received biologic?+?chemotherapy (264 age?≥?65; 497 age?<?65). The odds of grade three or four hematologic [odds ratio (OR) 1.70; p?=?0.009: 95% CI (1.57–1.84)] and non-hematologic toxicities [OR 1.47; p?=?0.022; 95% CI (1.39–1.55)] were increased in older patients with CLL, as well as odds of grade three or four non-hematologic toxicities [OR 1.89; p?=?0.017; 95% CI (1.64–2.17)] in older patients with NHL. Grade three or four hematologic toxicities were associated with inferior OS and PFS in older patients with NHL [HR 3.14; p?=?0.006; 95% CI (2.25–4.39) for OS and 3.06; p?=?0.011; 95% CI (2.10–4.45) for PFS], though not in CLL. A prognostic model predicting grade three or four toxicities was also developed.Conclusions
CLL and NHL patients?≥?65 year encounter more toxicities than younger patients even when treated with novel biologic agents. Development of grade three or four hematologic toxicities lead to inferior PFS and OS in NHL but not in CLL. 相似文献8.
Elisabeth Castel-Kremer Solene De Talhouet Anne-Laure Charlois Emmanuelle Graillot Xavier Chopin-Laly Mustapha Adham Brigitte Comte Catherine Lombard-Bohas Thomas Walter Gilles Boschetti 《Journal of Geriatric Oncology》2018,9(4):373-381
Introduction
Pancreatic adenocarcinoma affects mainly older patients. Surgery is indicated for localized tumors while chemotherapy alone is proposed in advanced or metastatic tumors.Objective
To evaluate the feasibility of standard of care oncologic treatments in this population, the accuracy of the geriatric evaluation to predict the ability of patients to tolerate the recommended treatments and to identify specific geriatric prognosis factors.Methods
We included, between 2007 and 2014, all consecutive patients over 70?years of age with a pathologically diagnosed pancreatic cancer. The patients underwent a comprehensive geriatric assessment before therapeutic decision in a multidisciplinary team meeting. We analyzed factors independently associated with all-cause mortality with Cox survival analysis.Results
Seventy-three patients (median age?=?77.9?years) were prospectively included. Among them, 42 patients underwent surgery whereas the 31 other patients not eligible for surgical treatment received chemotherapy (n?=?22) or best supportive care alone (n?=?9). Almost 62% of operated patients received adjuvant chemotherapy. In the non-surgical group, a mean of 9 cycles of palliative chemotherapy per patients were administrated. Median overall survival was 21.3?months in the surgical group and 6.1?months in the palliative group (p?=?0.0001). Most of oncologic parameters were found to be independent survival predictors. Age was not associated with the survival, but a significant impact of Lawton's Instrumental Activities of Daily Living (IADL) impairment (IADL<4) (HR?=?5.0, p?=?0.047), Cumulative Index Rating Scale-Geriatric (CIRS-G) ≥2 (HR?=?19, p?=?0.035) and weight loss >10% (HR?=?4.6, p?=?0.03) on survival was detected. Surgery was the only factor independently predictive of survival in multivariate analysis (p?<?0.001).Conclusion
Almost 90% of selected older pancreatic patients with cancer (64 out of 73 patients) may benefit from the same standard treatments as younger patients. IADL impairment of patients, CIRS-G ≥2, and weight loss >10% constitute survival prognostic factors which should be added to the oncological criteria in the therapeutic decision-making process. 相似文献9.
Alaa Mohamed Maria Mohamed El-Shebiney Ayman Mohamed El-Saka Yomna Zamzam 《Journal of the Egyptian National Cancer Institute》2018,30(2):49-55
Purpose
The purpose of this work was to assess the truncated form of human epidermal growth factor receptor 2 (HER2) such as p95-HER2 expression in HER2-positive breast cancer (BC) patients who developed metastatic disease after adjuvant treatment with a trastuzumab-containing regimen.Patients and methods
Thirty-two histologically diagnosed HER2-positive BC patients who developed distant failure after treatment with trastuzumab-based chemotherapy (CT) regimen as an adjuvant therapy were included in the study. Immunohistochemistry (IHC) method was used to analyze p95-HER2 expression in the formalin-fixed, paraffin-embedded (FFPE) blocks of the enrolled patients.Results
p95-HER2 was positive in 34.4% of the patients. The median overall survival (OS) was 22.5 and 35?months for p95-HER2 positive and negative patients, respectively (p?=?0.036) and the median time to metastases was 14 and 21?months, respectively (p?=?0.006). There was a statistically significant association between positive p95-HER2 expression and negative hormonal receptors expression (p?=?0.004), high Ki-67 expression (p?<?0.001) and development of visceral metastasis (p?=?0.034).Conclusion
Expression of p95-HER2 in HER2-positive BC patients is significantly associated with negative hormonal receptors expression, high Ki-67 expression, presence of visceral metastases and worse overall survival. A larger study is required to confirm its association with different prognostic factors and its effect on survival. 相似文献10.
11.
Keiko Nemoto Murofushi Masaru Nakajima Tetsuya Tomita Minako Sumi Yasuo Yoshioka Masahiko Oguchi Hideyuki Sakurai 《Breast cancer (Tokyo, Japan)》2018,25(6):656-662
Background
We evaluated the effectiveness of visual feedback (VF) on radiotherapy with deep inspiration breath-holding (DIBH), and reviewed the dose for organs at risk (OARs).Methods
Respiratory motions during DIBH for 15 s were monitored during planning computed tomography (CT)-scanning and simulation for 40 patients after breast-conserving surgery from June 2007 to February 2008. For 22 of 40 patients, a goggle-type liquid crystal display monitor was used for VF. The opposing tangential field was planned. The prescribed dose was 50.0 Gy in 25 fractions.Results
The mean differences of the chest wall respiratory movement in DIBH between planning CT-scanning and simulation were 4.7?±?2.6 mm for the patients without VF and 1.0?±?0.9 mm for those with VF (p?<?0.01). The mean chest wall excursion as a whole in DIBH using VF (2.0?±?1.0 mm) was smaller than in those without VF (4.1?±?2.4 mm) (p?<?0.01). According to reproducibility and stability parameters, 4 mm was added as a posterior margin to the clinical target volume for RT with VF, and 10 mm for those without VF. The mean heart doses were 1.3?±?0.5 Gy with VF and 2.4?±?1.1 Gy without VF (p?<?0.01). Mean dose and max dose of right breast were significantly reduced in procedures with VF use vs. in those without VF (p?<?0.01 and <?0.01, respectively).Conclusions
VF increases the accuracy of postoperative radiotherapy with DIBH, and also helps reduce the dose for OARs.12.
Kim I. Cao Flore Salviat Fatima Laki Marie-Christine Falcou Matthieu Carton Philip Poortmans Alain Fourquet Youlia M. Kirova 《Journal of Geriatric Oncology》2018,9(6):600-605
Objectives
The aim of this study was to assess efficacy, tolerability, and the impact of comorbidities on outcomes in older women treated by radiation therapy (RT) for non-metastatic breast cancer.Materials and Methods
Women aged ≥70?years at diagnosis who received postoperative RT for primary non-metastatic BC between 2003 and 2009 were retrieved from the Institut Curie registry. We calculated the Charlson Comorbidity Index (CCI) for each patient. We analyzed overall survival (OS), progression free survival (PFS), and acute and late toxicities according to the Common Terminology Criteria for Adverse Events (CTCAE) v3.0.Results
A total of 752 patients were included in this study. Median age at diagnosis was 75?years [70–93.3]. With a median follow-up of 7.3?years [0.4–12.9], OS and PFS at 5?years were 87.2% CI95%[84.8–89.8] and 85.7% CI95%[83.1–88.3], respectively. OS at 5?years was statistically different according to the CCI: 90.7% CI95%[87.6–93.9] for a CCI of 0, 85.8% CI95%[81.8–90.1] for a CCI of 1, and 79.1% CI95%[71.1–87.9] for a CCI?≥?2 (p?<?0.01, log-rank test), respectively. Similar results were found for PFS (p?<?0.05, log-rank test). Most (23.3%) of the patients had no toxicities; of those who experienced side-effects, the majority were grade I or II (96.9%).Conclusion
Postoperative RT for non-metastatic BC in older women is effective and well-tolerated. Outcome is impacted by age and comorbidities, which are clear independent prognostic factors. 相似文献13.
Cristina Stephens J. Lee Westmaas Jihye Kim Rachel Cannady Kevin Stein 《Journal of cancer survivorship》2016,10(5):865-873
Purpose
Research suggests that a cancer diagnosis predicts marital dissolution more strongly for women survivors than men, but there is a paucity of research on potential processes underlying this vulnerability. The present cross-sectional study examined whether specific cancer-related problems were associated with the odds of relationship breakup following diagnosis and whether these relationships differed between male and female cancer survivors.Methods
A national cross-sectional quality of life study assessed self-reported cancer-related problems and relationship change among survivors who were either 2, 6, or 10 years post-diagnosis (n?=?6099).Results
Bivariate analyses indicated that cancer-related problems (e.g., emotional distress) were greater for divorced/separated survivors compared to those with intact relationships and were greater for women versus men. Logistic regressions indicated that for both male and female survivors, lower income, younger age, and longer time since diagnosis were associated with greater odds of divorce or separation after diagnosis (ORs?>?2.14, p?<?.01). For women only, greater emotional distress (OR?=?1.14, p?<?0.01) and employment and financial problems (OR?=?1.23, p?<?0.0001) were associated with greater odds of post-diagnosis divorce or separation. For men only, fear of cancer recurrence was associated with greater odds of divorce or separation (OR?=?1.32, p?<?0.001).Conclusion
Female and male survivors differed in the extent to which emotional or financial/employment problems attributed to the cancer diagnosis were associated with the likelihood of reporting relationship dissolution.Implications for cancer survivors
Although directions of causality could not be ascertained, results suggest the possibility that helping male and female cancer survivors cope with specific cancer-related problems may benefit the quality and stability of their relationships with significant others following diagnosis.14.
Ryoko Suzuki Steven H. Lin Xiong Wei Pamela K. Allen James W. Welsh Lauren A. Byers Ritsuko Komaki 《Radiotherapy and oncology》2018,126(3):499-505
Background
We evaluated pretreatment total lymphocyte count (TLC, marker of immunosuppression), neutrophil-to-lymphocyte ratio (NLR, marker of inflammation), and overall survival (OS) in patients with extensive-stage small-cell lung cancer (ES-SCLC).Methods
Pretreatment blood characteristics, age, sex, performance status, race, stage (M1a vs. M1b), number and location of metastases, weight loss, smoking status, chemotherapy cycles (<4 vs. ≥4), thoracic radiotherapy dose (<45 vs. ≥45?Gy), and receipt of prophylactic cranial irradiation (PCI) were evaluated in 252 patients with ES-SCLC treated in 1998–2015. Factors significant in univariate analysis were selected as covariates for a multivariate Cox model.Results
Pretreatment TLC was below normal (<1.0?×?103/µL) in 58 patients (23%). Median OS time was 11.0?months and was worse for those with TLC?≤?1.5?×?103/µL (9.8 vs. 12.0?months) and pretreatment NLR?>?4.0 (9.4 vs. 13.9?months). Multivariate analysis identified low TLC (hazard ratio [HR] 0.734, 95% confidence interval [CI] 0.565–0.955, P?=?0.021) and high NLR (HR 1.521, 95% CI 1.172–1.976, P?=?0.002) as predicting inferior survival. Age (>63?y), sex (male), performance status (≥2), chemotherapy cycles (<4), radiation dose (<45?Gy), and no PCI also predicted worse OS (P?<?0.05).Conclusions
Pretreatment TLC and NLR may be useful for stratifying patients with ES-SCLC for treatment approaches. 相似文献15.
James L. Devin Andrew T. Sax Gareth I. Hughes David G. Jenkins Joanne F. Aitken Suzanne K. Chambers Kate A. Bolam Tina L. Skinner 《Journal of cancer survivorship》2016,10(3):467-479
Purpose
Following colorectal cancer diagnosis and anti-cancer therapy, declines in cardiorespiratory fitness and body composition lead to significant increases in morbidity and mortality. There is increasing interest within the field of exercise oncology surrounding potential strategies to remediate these adverse outcomes. This study compared 4 weeks of moderate-intensity exercise (MIE) and high-intensity exercise (HIE) training on peak oxygen consumption (V?O2peak) and body composition in colorectal cancer survivors.Methods
Forty seven post-treatment colorectal cancer survivors (HIE?=?27 months post-treatment; MIE?=?38 months post-treatment) were randomised to either HIE [85–95 % peak heart rate (HRpeak)] or MIE (70 % HRpeak) in equivalence with current physical activity guidelines and completed 12 training sessions over 4 weeks.Results
HIE was superior to MIE in improving absolute (p?=?0.016) and relative (p?=?0.021) V?O2peak. Absolute (+0.28 L.min?1, p?<?0.001) and relative (+3.5 ml.kg?1.min?1, p?<?0.001) V?O2 peak were increased in the HIE group but not the MIE group following training. HIE led to significant increases in lean mass (+0.72 kg, p?=?0.002) and decreases in fat mass (?0.74 kg, p?<?0.001) and fat percentage (?1.0 %, p?<?0.001), whereas no changes were observed for the MIE group. There were no severe adverse events.Conclusions
In response to short-term training, HIE is a safe, feasible and efficacious intervention that offers clinically meaningful improvements in cardiorespiratory fitness and body composition for colorectal cancer survivors.Implications for Cancer Survivors
HIE appears to offer superior improvements in cardiorespiratory fitness and body composition in comparison to current physical activity recommendations for colorectal cancer survivors and therefore may be an effective clinical utility following treatment.16.
Hiroki Ishihara Toshio Takagi Tsunenori Kondo Hironori Fukuda Kazuhiko Yoshida Junpei Iizuka Kazunari Tanabe 《Targeted oncology》2018,13(6):745-755
Background
Sarcopenia is a state of degenerative skeletal muscle wasting induced by cancer cachexia.Objective
To evaluate the prognostic impact of changes in skeletal muscle mass (SMM) during first-line sunitinib therapy on oncological outcomes in metastatic renal cell carcinoma (mRCC).Patients and Methods
Sixty-nine patients were evaluated retrospectively. The skeletal muscle index (SMI) was calculated based on computed tomography images obtained before the initiation (pre-treatment SMI) and after two cycles of sunitinib treatment (post-treatment SMI). The change in SMM was evaluated based on the value of ΔSMI, which was calculated as [(posttreatment SMI – pretreatment SMI)/ pretreatment SMI]?×?100. Oncological outcomes were compared between patients with ΔSMI <0 (SMM decrease) and ΔSMI ≥0 (SMM maintenance).Results
A decrease in SMM was observed in 38 patients (55.1%). Progression-free survival (PFS) and overall survival (OS) after sunitinib therapy initiation were significantly shorter in patients with ΔSMI <0 than in those with ΔSMI ≥0 (median PFS: 9.53 vs. 28.4 months, p?<?0.0001; OS: 19.8 vs. 52.6 months, p?=?0.0001). ΔSMI was an independent predictive factor for PFS (HR 3.25, 95% CI 1.74–6.29, p?=?0.0002) and OS (HR 4.53, 95% CI 2.15–10.5, p?<?0.0001). The objective response rate was significantly lower in patients with ΔSMI <0 than in those with ΔSMI ≥0 (23.7% vs. 51.6%, p?=?0.0164).Conclusion
Decreased SMM during first-line sunitinib therapy can be an effective marker of outcome prediction for mRCC.17.
Masoumeh Mehdipour Minoo Shahidi Soheila Manifar Soudeh Jafari Fatemeh Mashhadi Abbas Mahmood Barati Hamed Mortazavi Mohammad Shirkhoda Amir Farzanegan Zahra Elmi Rankohi 《Cellular oncology (Dordrecht)》2018,41(3):329-334
Background
Oral lichen planus (OLP), a relatively common chronic inflammatory disease of the oral mucosa, is considered to be a premalignant disorder of the oral cavity. Previously, several biomarkers have been tested for their diagnostic potential. Here, we aimed to investigate the diagnostic potential of four miRNAs, miR-21, -125a, -31 and -200a, known to be involved in oral squamous cell carcinoma (OSCC) development, in the saliva of OLP patients as also their putative relation to OSCC development in these patients.Materials and methods
Saliva samples from 30 patients with OLP were collected, 15 of whom were diagnosed with dysplasia upon histopathologic examination. In addition, 15 saliva samples from patients with OSCC and 15 saliva samples from healthy donors were collected. After RNA extraction, the respective miRNA levels were assessed by quantitative RT-PCR.Results
We found that the miR-21 levels were significantly increased in saliva samples derived from patients with OLP, dysplastic OLP and OSCC, compared to those from healthy controls (p?=?0.012, p?=?0.0017 and p?<?0.0001, respectively). Conversely, significant decreases in miR-125a levels were found in the OLP, dysplastic OLP and OSCC samples, compared to those from healthy controls (p?<?0.0014, p?<?0.0001 and p?<?0.0001, respectively). In addition, significant increases in miR-31 levels were found in samples derived from dysplastic OLP and OSCC patients, but not in those from nondysplastic OLP patients, compared to those in healthy controls (p?=?0.01 and p?=?0.004, respectively). Finally, we found that the miR-200a levels were significantly decreased only in samples derived from OSCC patients (p?<?0.0001).Conclusions
From our data we conclude that increased miR-21 levels in conjunction with decreased miR-125a levels in saliva of OLP patients may be indicative for a poor prognosis. Conversely, we conclude that lack of significant alterations in miR-31 and miR-200a levels in saliva of OLP patients may be indicative for absence of malignant transformation.18.
Nicholas G. Zaorsky Charles T. Lee Eddie Zhang Thomas J. Galloway 《Radiotherapy and oncology》2018,126(3):386-393
Background and purpose
To compare cosmesis and local recurrence (LR) of definitive external beam radiation therapy (EBRT) vs brachytherapy (BT) for indolent basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) of the skin.Materials and methods
Studies including patients with T1-2?N0 SCCs/BCCs treated with definitive EBRT/BT and ≥10?months follow-up were analyzed. The primary endpoint was post-treatment cosmesis, categorized as “good,” “fair,” or “poor.” The secondary endpoint was LR. Mixed effects regression models were used to estimate weighted linear relationships between biologically equivalent doses with α/β?=?3 (BED3) and cosmetic outcomes.Results
A total of 9965 patients received EBRT and 553 received BT across 24 studies. Mean age was 73?years, median follow-up was 36?months, and median dose was 45?Gy/10 fractions at 4.4?Gy/fraction. At BED3 of 100?Gy, “good” cosmesis was more frequently observed in patients receiving BT, 95% (95% CI: 88–100%) vs 79% (95% CI: 60–82%), p?<?0.05. Similar results were found for “good” cosmesis at BED3 >100?Gy. No difference in “poor” cosmesis was noted at any BED3. LR was?<7% for both at one year.Conclusion
BT has favorable cosmesis over EBRT for skin SCCs/BCCs at common fractionation regimens. Prospective studies comparing EBRT vs BT are warranted. 相似文献19.
Alberto Farolfi Micaela Petrone Emanuela Scarpi Valentina Gallà Filippo Greco Claudia Casanova Lucia Longo Gennaro Cormio Michele Orditura Alessandra Bologna Laura Zavallone Jole Ventriglia Elisena Franzese Vera Loizzi Donatella Giardina Eva Pigozzi Raffaella Cioffi Sandro Pignata Giorgio Giorda Ugo De Giorgi 《Targeted oncology》2018,13(4):469-479
Background
The variability in progression-free survival (PFS) and overall survival (OS) among patients with epithelial ovarian cancer (EOC) makes it difficult to reliably predict outcomes. A predictive biomarker of bevacizumab efficacy as first-line therapy in EOC is still lacking.Objective
The MITO group conducted a multicenter, retrospective study (MITO 24) to investigate the role of inflammatory indexes as prognostic factors and predictors of treatment efficacy in FIGO stage III–IV EOC patients treated with first-line chemotherapy alone or in combination with bevacizumab.Patients and Methods
Of the 375 patients recruited, 301 received chemotherapy alone and 74 received chemotherapy with bevacizumab. The pre-treatment neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune inflammation index (SII) were evaluated to identify a potential correlation with PFS and OS in both the overall population and the two treatment arms.Results
In the overall population, the PFS and OS were significantly longer in patients with low inflammatory indexes (p?<?0.0001). In multivariate analyses, the NLR was significantly associated with OS (p?=?0.016), and the PLR was significantly associated with PFS (p?=?0.024). Inflammatory indexes were significantly correlated with patient prognosis in the chemotherapy-alone group (p?<?0.0001). Patients in the chemotherapy with bevacizumab group with a high NLR had a higher PFS and OS (p?=?0.026 and p?=?0.029, respectively) than those in the chemotherapy-alone group. Conversely, PFS and OS were significantly poorer in patients with a high SII (p?=?0.024 and p?=?0.017, respectively).Conclusion
Our results suggest that bevacizumab improves clinical outcome in patients with a high NLR but may be detrimental in those with a high SII.20.
Dan Ou Ingrid Garberis Julien Adam Pierre Blanchard France Nguyen Antonin Levy Odile Casiraghi Philippe Gorphe Ingrid Breuskin François Janot Stephane Temam Jean-Yves Scoazec Eric Deutsch Yungan Tao 《Radiotherapy and oncology》2018,126(1):116-124