Relationships between tumor grade and neurocognitive functioning in patients with glioma of the left temporal lobe prior to surgical resection

Background

Various tumor characteristics have been associated with neurocognitive functioning (NCF), though the role of tumor grade has not been adequately examined.

Methods

Seventy-two patients with histologically confirmed grade IV glioma (n = 37), grade III glioma (n = 20), and grade II glioma (n = 15) in the left temporal lobe completed preoperative neuropsychological assessment. Rates of impairment and mean test performances were compared by tumor grade with follow-up analysis of the influence of other tumor- and patient-related characteristics on NCF.

Results

NCF impairment was more frequent in patients with grade IV tumor compared with patients with lower-grade tumors in verbal learning, executive functioning, as well as language abilities. Mean performances significantly differed by tumor grade on measures of verbal learning, processing speed, executive functioning, and language, with the grade IV group exhibiting worse performances than patients with lower-grade tumors. Group differences in mean performances remained significant when controlling for T1-weighted and fluid attenuated inversion recovery MRI-based lesion volume. Performances did not differ by seizure status or antiepileptic and steroid use.

Conclusions

Compared with patients with grade II or III left temporal lobe glioma, patients with grade IV tumors exhibit greater difficulty with verbal learning, processing speed, executive functioning, and language. Differences in NCF associated with glioma grade were independent of lesion volume, seizure status, and antiepileptic or steroid use, lending support to the concept of “lesion momentum” as a primary contributor to deficits in NCF of newly diagnosed patients prior to surgery.     

Effect of sensorineural hearing loss on neurocognitive and adaptive functioning in survivors of pediatric embryonal brain tumor

Journal of Neuro-Oncology - Survivors of pediatric embryonal brain tumors (BT) are at high risk for sensorineural hearing loss (SNHL) associated with neurocognitive decline. However, previous...     

多环芳烃水平与人类直肠癌发生相关性的研究

目的:探讨多环芳烃(PAHs)在人类直肠癌发生过程中的作用。方法:直肠癌组织、癌旁组织和非直肠癌患者的直肠组织中的PAHs分别经超声提取,固相萃取净化和高效液相色谱荧光分析。结果:3组标本中共检出4种PAHs,分别是菲、芘、2-甲基蒽和苯并(a)芘。其中芘、2-甲基蒽和苯并(a)芘在直肠癌组织和癌旁组织中的含量均高于非直肠癌患者的直肠组织,差异有统计学意义,P<0.05;菲在3组标本中的含量差异无统计学意义,P>0.05;4种PAHs在直肠癌组织与癌旁组织中的含量差异均无统计学意义,P>0.05。结论:人类直肠组织中存在PAHs;人类直肠组织中PAHs的含量与直肠癌的发生有一定的相关性。     

表皮生长因子受体家族信号转导与肿瘤治疗

表皮生长因子受体(EGFR)家族属于Ⅰ型受体酪氨酸激酶家族，在特异配体的刺激下，可经多条信号通路调节细胞的生长、增殖及分化。当其异常表达时，可干扰胞外信号的正常传递而致癌。目前，已出现了多种有效措施以干扰肿瘤的信号传递。     

Fatigue,vitality, sleep,and neurocognitive functioning in adult survivors of childhood cancer

BACKGROUND:

Long‐term survivors of childhood cancer are at risk for fatigue, sleep problems, and neurocognitive impairment, although the association between these outcomes has not been previously examined.

METHODS:

Outcomes were evaluated in 1426 survivors from the Childhood Cancer Survivor Study using a validated Neurocognitive Questionnaire. Relative risks for neurocognitive impairment were calculated using demographic and treatment factors, and survivors' report on the Functional Assessment of Chronic Illness Therapy‐Fatigue, the Short Form‐36 Vitality Scale, the Pittsburgh Sleep Quality Index, and the Epworth Sleepiness Scale.

RESULTS:

Neurocognitive impairment was identified in >20% of survivors, using sibling‐based norms for comparison. Multivariate logistic regression models revealed that fatigue (risk ratio [RR], 1.34; 95% confidence interval [CI], 1.13‐1.59), daytime sleepiness (RR, 1.68; 95% CI, 1.55‐1.83), poor sleep quality (RR, 1.23; 95% CI, 1.01‐1.49), and decreased vitality (RR, 1.75; 95% CI 1.33‐2.30) were all associated with impaired task efficiency. Likewise, fatigue (RR, 1.77; 95% CI, 1.23‐2.55), sleepiness (RR, 1.38; 95% CI, 1.14‐1.67), and decreased vitality (RR, 3.08; 95% CI, 1.98‐4.79) were predictive of emotional regulation problems. Diminished organization was associated with increased sleepiness (RR, 1.80; 95% CI, 1.31‐2.48) and decreased vitality (RR, 1.90; 95% CI, 1.37‐2.63). Impaired memory was associated with poor sleep quality (RR, 1.45; 95% CI, 1.19‐1.76), increased sleepiness (RR, 2.05; 95% CI, 1.63‐2.58), and decreased vitality (RR, 2.01; 95% CI, 1.42‐2.86). The impact of fatigue, sleepiness, sleep quality, and vitality on neurocognitive outcomes was independent of the effects of cranial radiation therapy, steroids and antimetabolite chemotherapy, sex, and current age.

CONCLUSIONS:

Neurocognitive function in long‐term survivors of childhood cancer appears particularly vulnerable to the effects of fatigue and sleep disruption. These findings suggest sleep hygiene should be emphasized among survivors, as it may provide an additional mechanism for intervention to improve neurocognitive outcomes. Cancer 2011;. © 2011 American Cancer Society.     

Association between mammographic breast density and breast cancer tumor characteristics.

OBJECTIVE: Few studies have examined the association between breast density and breast cancer tumor characteristics. We examined the association between hormonal, proliferative, and histologic tumor characteristics and mammographic breast density in women with breast cancer. METHODS: We conducted a cross-sectional analysis in 546 women diagnosed with invasive breast cancer to evaluate the associations between breast density and tumor size, lymph node status, lymphatic or vascular invasion, histologic grade, nuclear grade, tumor differentiation, mitotic index, tumor necrosis, Ki-67 proliferation, estrogen receptor, progesterone receptor, p53, p27, cyclin E, Bcl-2, and C-erb-B2 invasion. Breast density was classified as fatty (Breast Imaging Reporting and Data System code 1 or 2; n = 373) or dense (Breast Imaging Reporting and Data System code 3 or 4; n = 173) for the cancer-free breast. A single pathologist measured all tumor markers. We examined whether the relationships were modified by interval cancer or screen-detected cancer. RESULTS: Women with a tumor size >1.0 cm were more likely to have dense breasts compared with women with a tumor size < or =1.0 cm after adjusting for confounders (odds ratio, 2.0; 95% confidence interval, 1.2-3.4 for tumor sizes 1.1-2.0 cm; odds ratio, 2.3; 95% confidence interval, 1.3-4.4 for tumor sizes 2.1-10 cm). Tumor size, lymph node status, and lymphatic or vascular invasion were positively associated with breast density among screen-detected cancers. Histologic grade and mitotic index were negatively associated with breast density in women diagnosed with an interval cancer. CONCLUSIONS: These results suggest that breast density is related to tumor size, lymph node status, and lymphatic or vascular invasion in screen-detected cancers. Additional studies are needed to address whether these associations are due to density masking the detection of some tumors, a biological relationship, or both.     

Association between polycyclic aromatic hydrocarbons and human rectal tumor or liver cancer

Objective

The aim of this study was to investigate the effect of polycyclic aromatic hydrocarbons (PAHs) in rectal carcinoma and hepatocarcinoma genesis.

Methods

The PAHs in the human rectal cancer and liver cancer tissues, the adjacent tissues and homologous tissues without rectal cancer or liver cancer were extracted by ultrasonic wave. The extracts were then cleaned up and enriched by solid phase extraction, analyzed by high performance liquid chromatography (HPLC) with fluorescence spectroscopy.

Results

Four kinds of PAHs were detected in human rectal and hepatic tissues. The contents of pyrene, 2-methylanthracene and benzo (a) pyrene in both rectal cancer tissues and adjacent homologous tissues were higher than rectal tissues without rectal cancer, the differences were statistically significant (P < 0.05). The contents of phenanthrene in the three kind of tissue were not significant (P > 0.05). The differences of the content of each PAHs between rectal cancer and adjacent tissue were not significant (P > 0.05). The contents of the four PAHs in the three kinds of liver tissues were not statistically significant (P > 0.05).

Conclusion

PAHs are found in human rectal tissues or hepatic tissues. The contents of PAHs in human rectal tissue may have an effect on the occurrence of human rectal cancer while the contents of PAHs in human hepatic tissues may have not ones.     

Changes in neurocognitive functioning and quality of life in adult patients with brain tumors treated with radiotherapy

This review aims to summarize what is currently known about neurocognitive outcome and quality of life in patients with brain tumors treated with radiotherapy. Whether potential tumor-controlling benefits of radiotherapy outweigh its potential toxicity in the natural history of brain tumors is a matter of debate. This review focuses on some of the adult main brain tumors, for which the issue of neurocognitive decline has been thoroughly studied: low-grade gliomas, brain metastases, and primary central nervous system lymphomas. The aims of this review are: (1) the analysis of existing data regarding the relationship between radiotherapy and neurocognitive outcome; (2) the identification of strategies to minimize radiotherapy-related neurotoxicity by reducing the dose or the volume; (3) the evidence-based data concerning radiotherapy withdrawal; and (4) the definition of patients subgroups that could benefit from immediate radiotherapy. For high grade gliomas, the main findings from literature are summarized and some strategies to reduce the neurotoxicity of the treatment are presented. Although further prospective studies with adequate neuropsychological follow-up are needed, this article suggests that cognitive deficits in patients with brain tumor have a multifactorial genesis: radiotherapy may contribute to the neurocognitive deterioration, but the causes of this decline include the tumor itself, disease progression, other treatment modalities and comorbidities. Treatment variables, such as total and fractional dose, target volume, and irradiation technique can dramatically affect the safety of radiotherapy: optimizing radiation parameters could be an excellent approach to improve outcome and to reduce neurotoxicity. At the same time, delayed radiotherapy could be a valid option for highly selected patients.     

Relationship between tumor location and relapse in 6,781 women with early invasive breast cancer.

PURPOSE: To explore the independent prognostic impact of medial hemisphere tumor location in early breast cancer. PATIENTS AND METHODS: A comprehensive database was used to review patients referred to the British Columbia Cancer Agency from 1989 to 1995 with early breast cancer. Patients were grouped according to relapse risk (high or nonhigh) and adjuvant systemic therapy received. Multiple regression analysis was used to determine whether the significance of primary tumor location (medial v lateral hemisphere) was independent of known prognostic factors and treatment. RESULTS: In the adjuvant systemic therapy groups, medial location was associated with a 50% excess risk of systemic relapse and breast cancer death compared with lateral location. Five-year systemic disease-free survival rates were 66.3% and 74.2% for high-risk medial and lateral lesions, respectively (P <.005). Corresponding 5-year disease-specific survival rates were 75.7% and 80.8%, respectively (P <.03). No significant differences were observed between medial and lateral location for low-risk disease regardless of adjuvant therapy or for high-risk disease with no adjuvant therapy. Local recurrence rates were similar for all risk and therapy groups. CONCLUSION: The two-fold risk of relapse and breast cancer death associated with high-risk medial breast tumors may be due to occult spread to internal mammary nodes (IMNs). Enhanced local control, such as with irradiation of the IMN chain, may be one way to reduce the excess risk. Ongoing randomized controlled trials may provide prospective answers to the question of the optimal volume of radiotherapy.     

应用Alderson Rando人形体模探讨肺肿瘤位置和体积对正常肺组织剂量学参数影响

目的 探讨肺肿瘤位置、体积对正常肺组织剂量体积参数的影响.方法 将采用组织等效材料制作的模拟球形病灶分别嵌入Alderson Rando人形体模右肺3个叶和左肺下、上叶,采用6MV X线对上述各种情况进行5个野简化调强放疗计划设计,处方剂量为60 Gy(2 Gy/次共30次).所有计划都使99%靶区体积达到处方剂量要求.分析正常肺组织接受不同剂量照射的体积百分比(V_5、V_(10)、V_(20)、V_(30)、V_50)和平均肺剂量.结果 就正常肺组织的各个剂量体积参数而言,不同病灶位置和直径的差异多数是不同的,两种因素对各个参数的变化有不同程度的影响.各个参数随球形病灶直径的增大而增大(P<0.05).当病灶直径从2 cm增至3 cm、病灶位于不同位置时,各参数增幅在3.83%～125.38%范围内;当病灶直径从3 cm增至4 cm、病灶位于不同位置时,各参数增幅在10.46%～51.46%范围内.结论 肺肿瘤位置和直径变化对正常肺组织剂量体积参数多数有不同程度影响,但如何提高预测准确性尚待基础和临床实验的进一步研究.