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1.
T. Steinmeier S. Schulze Schleithoff B. Timmermann 《Clinical oncology (Royal College of Radiologists (Great Britain))》2019,31(3):142-150
Aims
Childhood cancer is rare and survival of childhood cancer has increased up to 80% at 5 years after diagnosis. Radiotherapy is an important element of the multimodal treatment concept. However, due to growing tissue, children are particularly sensitive to radiation-related side-effects and the induction of secondary malignancies. However, radiotherapy techniques have continuously progressed. In addition, modern treatment concepts have been improved in order to minimise long-term effects. Today, radiotherapy is used for various tumour types in childhood, such as sarcomas and tumours of the central nervous system.Materials and methods
External beam therapy with either photons or protons and brachytherapy are predominantly used for the treatment of childhood tumours. Technical developments and features, as well as clinical outcomes, for several tumour entities are presented.Results
The development of radiotherapy techniques, as well as risk-adapted therapy concepts, resulted in promising outcome regarding tumour control, survival and therapy-related side-effects. It is assumed that proton therapy will be increasingly used for treating children in the future. However, more data have to be collected through multi-institutional registries in order to strengthen the evidence.Conclusion
The development of radiotherapy techniques is beneficial for children in terms of reducing dose exposure. As compared with other modern and highly conformal techniques, particularly proton therapy may achieve high survival rates and tumour control rates while decreasing the risk for side-effects. However, clinical evidence for modern radiotherapy techniques is still limited today. An optimal patient triaging with the selection of the most appropriate radiation technique for each individual patient will be an important goal for the future. 相似文献2.
T. Saito E. Tomitaka R. Toya N. Oya 《Clinical oncology (Royal College of Radiologists (Great Britain))》2019,31(6):391-398
Aims
Total radiation dose does not predict pain response in conventionally fractionated radiotherapy for bone metastases. By contrast, in radiotherapy for solid painful tumours other than bone metastases, it is unknown whether there is a dose–response relationship. We sought to determine whether a higher total radiation dose predicted a higher pain response rate in palliative radiotherapy for non-bone painful lesions.Materials and methods
We carried out a secondary analysis of a prospective observational study. For patients scheduled for radiotherapy for painful tumours, Brief Pain Inventory data were collected at baseline and at 1, 2 and 3 months after the start of radiotherapy. The predictive value of total radiation dose was evaluated using the Fine–Gray model, in which death without a pain response was treated as a competing risk.Results
Of the 203 patients with solid painful tumours, 78 (38%) had non-bone painful lesions. There were no significant differences in pain response rate, the rate of the predominance of non-index pain or reductions in pain interference scores between the patients with non-bone lesions and those with bone metastases. Multivariable analysis showed that total radiation dose was an independent significant predictor of pain response in patients with non-bone painful lesions. This result was not robust to sensitivity analysis with Cox regression analysis.Conclusions
Higher total radiation dose seemed to be associated with a higher rate of pain response in patients with non-bone painful lesions. However, this finding was not robust to sensitivity analysis. Dose–response relationship should be investigated in clinical trials enrolling patients with these kinds of painful tumour. 相似文献3.
4.
Marianne Grønlie Guren Bjarte Aagnes Mari Nygård Olav Dahl Bjørn Møller 《Clinical colorectal cancer》2019,18(1):e96-e103
Background
Anal squamous cell carcinoma (ASCC) is a rare, human papilloma virus-associated cancer. The purpose was to investigate the population-based incidence rates, age and gender distribution, and survival of ASCC.Materials and Methods
All primary ASCC in 1987 to 2016 were identified in the Cancer Registry of Norway (N = 1548), with information on age, gender, stage, county of residence, radiotherapy, and survival.Results
Median age was 66 years; 71% were females. World age-standardized incidence rates increased (1987-2016) from 0.79 (95% confidence interval [CI], 0.69-0.90) to 1.10 (95% CI, 1.00-1.22) per 100,000 person-years in females and, from 0.34 (95% CI, 0.28-0.42) to 0.47 (95% CI, 0.40-0.54) in males. Estimated annual percentage change was 1.7 (95% CI, 0.9-2.6) for females and 1.3 (95% CI, ?0.1 to 2.7) for males. Incidence rates increased with age; the relative risk was higher in major cities. Five-year net survival increased from 63.4% to 72.7% (1987-2016), but for age ≥ 70 years remained ～57%. Net survival was dependant on stage, age, and gender. Five-year net survival (1997-2016) was 76.4% after curative radiotherapy, and 18.0% after palliative radiotherapy.Conclusion
ASCC incidence rates increased from 1987 to 2016, and survival improved for patients < 70 years. Five-year net survival was 76% after curative radiotherapy in Norway. 相似文献5.
S. Ramasamy L.J. Murray K. Cardale K.E. Dyker P. Murray M. Sen R.J.D. Prestwich 《Clinical oncology (Royal College of Radiologists (Great Britain))》2019,31(6):344-351
Aims
To assess the impact of weekly scheduled peer review of head and neck contours for definitive and adjuvant radiotherapy cases based on rates of recommended changes.Materials and methods
Retrospective analysis of a prospective database. Recommended changes were prospectively classified as ‘major’ (change in gross tumour volume and/or high-dose clinical target volume, dose/fractionation) or ‘minor’ (change in intermediate or elective dose clinical target volumes or organs at risk). Univariate analysis to explore associations between recommended changes and tumour site/stage and radical/adjuvant indication.Results
In total, 307/375 (82%) head and neck cases treated with volumetric-modulated arc therapy were prospectively peer reviewed over a 12-month period; 195 (64%) cases received definitive and 112 (36%) received adjuvant radiotherapy. Overall, 43/307 (14.0%) changes were recommended within the peer review meetings. This comprised 27/307 (8.8%) major changes and 16/307 (5.2%) minor changes; 33/43 (77%) changes were in the clinical target volume. Rates of recommended changes were significantly higher for adjuvant versus definitive radiotherapy (odds ratio 2.26, P = 0.014) and for larynx compared with oropharynx (odds ratio 3.02, P = 0.02). There was no overall correlation between clinician experience and rates of change (P = 0.62).Conclusion
Routine weekly meeting contour-based peer review resulted in a number of major and minor changes to treatment. Compliance was high. Peer review was potentially beneficial for all tumour sites/stages/indications and any degree of clinician experience. 相似文献6.
Purpose
To assess the pharmacologic costs of second-line treatments for metastatic renal-cell cancer (mRCC).Methods
The present evaluation was restricted to pivotal phase 3 randomized controlled trials in second-line for mRCC. We calculated the pharmacologic costs necessary to get the benefit in progression-free survival and overall survival (OS) for each trial. The costs of drugs are at the pharmacy of our hospital and are expressed in euros.Results
Our analysis evaluated 5 phase 3 randomized controlled trials including 3112 patients. The lowest cost per month of progression-free survival and OS gained was associated with the use of cabozantinib (€2006 and €1473, respectively), while everolimus had the highest cost per month of OS gained (€28,590).Conclusion
Combining pharmacologic costs of drugs with the measure of efficacy represented by OS, cabozantinib is a cost-effective second-line treatments for patients with mRCC. 相似文献7.
K.A. Lee M.T.A. Sharabiani D. Tumino J. Wadsley V. Gill G. Gerrard R. Sindhu M.N. Gaze L. Moss K. Newbold 《Clinical oncology (Royal College of Radiologists (Great Britain))》2019,31(6):385-390
Aims
To obtain an overview of the management and outcomes of children aged 18 years or younger diagnosed with differentiated thyroid carcinoma of follicular cell origin across the UK, by collecting and analysing data from the limited number of centres treating these patients. This multicentre data might provide a more realistic perspective than single-institution series.Materials and methods
Six centres submitted data extracted from historical records on patients aged 18 years or younger, diagnosed between 1964 and 2017. The univariate and multivariable Cox proportional hazard model was used to identify potential predictors of progression-free survival, using national data as a control.Results
Data on 166 patients were available for analysis. Females (74%) were predominant, and the age ranged from 3 to 19 years at diagnosis, mean 14.1 years. Nodal metastases were present in 51%; 12% had distant metastases. After surgery, 95% received radioactive iodine (39% on more than one occasion) and 4% received external beam radiotherapy. With a median follow-up duration of 5 years, 69% are alive with no evidence of disease; 20% are alive with a raised thyroglobulin level as the only evidence of residual disease; 6% have residual structural disease detectable on imaging; 2% have died, from cerebral metastases.Conclusion
Despite most patients having advanced disease at presentation, outcomes are very good. A national prospective registry should allow systematic collection of good-quality data and may facilitate research to further improve outcomes. 相似文献8.
Is There a Role for an 18F-fluorodeoxyglucose-derived Biological Boost in Squamous Cell Anal Cancer?
A. Sabbagh C. Jacobs R. Cooke K.-Y. Chu S.M. Ng V.Y. Strauss P.S. Virdee M.A. Hawkins M.C. Aznar R. Muirhead 《Clinical oncology (Royal College of Radiologists (Great Britain))》2019,31(2):72-80
Aims
To investigate the potential role for a biological boost in anal cancer by assessing whether subvolumes of high 18F-fluorodeoxyglucose (FDG) avidity, identified at outset, are spatially consistent during a course of chemoradiotherapy (CRT).Materials and methods
FDG-positron emission tomography (FDG-PET) scans from 21 patients enrolled into the ART study (NCT02145416) were retrospectively analysed. In total, 29 volumes including both primary tumours and involved nodes >2 cm were identified. FDG-PET scans were carried out before treatment and on day 8 or 9 of CRT. FDG subvolumes were created using a percentage of maximum FDG avidity at thresholds of 34%, 40%, 50%, on the pre-treatment scans, and 70% and 80% on the subsequent scans. Both FDG-PET scans were deformably registered to the planning computed tomography scan. The overlap fraction and the vector distance were calculated to assess spatial consistency. FDG subvolumes for further investigation had an overlap fraction >0.7, as this has been defined in previous publications as a ‘good’ correlation.Results
The median overlap fractions between the diagnostic FDG-PET subvolumes 34%, 40% and 50% of maximum standardised uptake value (SUVmax) and subsequent FDG-PET subvolumes of 70% of SUVmax were 0.97, 0.92 and 0.81. The median overlap fraction between the diagnostic FDG-PET subvolumes 34%, 40% and 50% and subsequent FDG-PET subvolumes of 80% were 1.00, 1.00 and 0.92. The median (range) vector distance values between diagnostic FDG-PET subvolumes 34%, 40% and 50% and subsequent FDG-PET subvolumes of 80% were 0.74 mm (0.19–2.94) 0.74 mm (0.19–3.39) and 0.71 mm (0.2–3.29), respectively. Twenty of 29 volumes (69.0%) achieved a threshold > 0.7 between the FDG 50% subvolume on the diagnostic scan and the FDG 80% subvolume on the subsequent scan.Conclusion
FDG-avid subvolumes identified at baseline were spatially consistent during a course of CRT treatment. The subvolume of 50% of SUVmax on the pre-treatment scan could be considered as a potential target for dose escalation. 相似文献9.
M.R. Ferreira K. Thomas L. Truelove A. Khan C. Parker D.P. Dearnaley S. Gulliford 《Clinical oncology (Royal College of Radiologists (Great Britain))》2019,31(6):374-384
Aims
Pelvic lymph node (PLN) radiotherapy for high-risk prostate cancer is limited by late gastrointestinal toxicity. Application of rectal and bowel constraints may reduce risks of side-effects. We evaluated associations between intensity-modulated radiotherapy (IMRT) dose-volume data and long-term gastrointestinal toxicity.Materials and methods
Data from a single-centre dose-escalation trial of PLN-IMRT were analysed, including conventionally fractionated (CFRT) and hypofractionated (HFRT) radiotherapy schedules. Associations between volumes of rectum and bowel receiving specified doses and clinician- and patient-reported toxicity outcomes were investigated independently. A metric, δ median (δM), was defined as the difference in the medians of a volume between groups with and without toxicity at a specified dose and was used to test for statistically significant differences.Results
Constraints were respected in most patients and, when exceeded, led to higher rates of gastrointestinal toxicity. Biologically relevant associations between rectum dose-points and toxicity were more numerous with both mild and moderate toxicity thresholds, but statistical significance was limited after correction for false discovery rate. Rectal V50Gy (CFRT) associated with grade 2+ bleeding; bowel V43Gy and V47 (HFRT/4 days/week schedule) associated with patient-reported loose stools and diarrhoea, respectively. Further investigation showed that CFRT patients with rectal bleeding had a mean rectal V50Gy above the treatment planning constraint.Conclusions
When dose-volume parameters are kept below tight constraints, toxicity is low. Residual dosimetry loses much of its predictive power for gastrointestinal toxicity in the setting of PLN-IMRT for prostate cancer. We have benchmarked dose-volume constraints for safely delivering PLN-IMRT using CFRT or HFRT. 相似文献10.
C.M. Jones K. Spencer C. Hitchen T. Pelly B. Wood P. Hatfield A. Crellin D. Sebag-Montefiore R. Goody T. Crosby G. Radhakrishna 《Clinical oncology (Royal College of Radiologists (Great Britain))》2019,31(6):356-364
Aims
Chemoradiotherapy (CRT) is established as a superior treatment option to definitive radiotherapy in the non-surgical management of oesophageal cancer. For patients precluded from CRT through choice or comorbidity there is little evidence to guide delivery of single-modality radiotherapy. In this study we outline outcomes for patients unfit for CRT who received a hypofractionated radiotherapy (HRT) regimen.Materials and methods
A retrospective UK single-centre analysis of 61 consecutive patients with lower- or middle-third adenocarcinoma (OAC; 61%) or squamous cell carcinoma of the oesophagus managed using HRT with radical intent between April 2009 and 2014. Treatment consisted of 50 Gy in 16 fractions (n = 49, 80.3%) or 50–52.5 Gy in 20 fractions (n = 12, 19.7%). Outcomes were referenced against a contemporaneous comparator cohort of 80 (54% OAC) consecutive patients managed with conventionally fractionated CRT within the same centre.Results
Three-year and median overall survival were, respectively, 56.9% and 29 months with HRT compared with 55.5% and 26 months for CRT; adjusted hazard ratio 0.79 (95% confidence interval 0.48–1.28). Grade 3 and 4 toxicity rates were low at 16.4% (n = 10) for those receiving HRT and 40.2% (n = 32) for the CRT group. In patients with OAC, CRT delivered superior overall survival (hazard ratio 0.46; 95% confidence interval 0.25–0.85) and progression-free survival (hazard ratio 0.45; 95% confidence interval 0.23–0.88) when compared with HRT.Conclusions
The HRT regimen described here was safe and tolerable in patients unable to receive CRT, and delivered promising survival outcomes. The use of HRT for the treatment of oesophageal cancer, both alone and as a sequential or concurrent treatment with chemotherapy, requires further study. New precision radiotherapy technologies may provide additional scope for improving outcomes in oesophageal cancer using HRT-based approaches and should be evaluated. 相似文献11.
S. Bergamin T. Eade A. Kneebone J.G. Kench P. Sved J.-F. Biset G. Hruby 《Clinical oncology (Royal College of Radiologists (Great Britain))》2019,31(2):108-114
Aims
Ductal adenocarcinoma is a rare variant of prostate cancer, and as such clinical outcomes and best management are not well defined. This series demonstrates the atypical presentation and unusual clinical behaviour of ductal adenocarcinoma and proposes management guidelines to assist clinicians.Materials and methods
A retrospective review of pure (nine patients) and mixed (18 patients) ductal adenocarcinoma of the prostate referred to the Departments of Radiation Oncology of the Sydney Cancer Centre, Royal Prince Alfred Hospital and Northern Sydney Cancer Centre, Royal North Shore Hospital, between 2000 and 2015.Results
Twenty-seven patients were treated with definitive radiotherapy, nine patients (33%) with pure ductal and 18 (67%) with mixed ductal-acinar adenocarcinoma. The median follow-up was 38 months. Four patients (15%) failed locally, all of whom received less than 80 Gy, or no brachytherapy boost. Five patients (19%) failed distantly, four with biopsy-proven lung metastases. All distant failures occurred with a prostate-specific antigen (PSA) < 3 ng/ml.Conclusion
This series shows the atypical clinical presentation of this entity, as well as its propensity to metastasise to unusual sites. Relapse may occur at low absolute PSA values and is often asymptomatic. Ductal cancer should not simply be regarded as a high Gleason grade cancer. We propose management guidelines, including regular computed tomography examinations (rather than relying solely on PSA levels) as part of the follow-up for patients with any component of ductal adenocarcinoma. 相似文献12.
I. Mallick A. Das M. Arunsingh 《Clinical oncology (Royal College of Radiologists (Great Britain))》2019,31(4):260-264
Aims
Node-positive prostate cancer is a unique subgroup, with varied practice on locoregional treatment. Definitive treatment with hypofractionated radiotherapy has not been widely reported. We have routinely used standard regimens of hypofractionated radiotherapy for node-positive disease and report our results of toxicity, biochemical control and survival.Materials and methods
Medical records of patients diagnosed with prostate cancer between February 2011 and April 2016 with radiologically involved pelvic nodes on magnetic resonance imaging/computed tomography without distant metastases were analysed. All patients were treated with long-term androgen deprivation therapy (ADT) and hypofractionated radiotherapy. Acute and late toxicities were assessed using Radiation Therapy Oncology Group acute and late morbidity scoring criteria. Biochemical control and survival were computed using Kaplan–Meier survival statistics.Results
In total, 61 patients were identified with node-positive disease, with a median age of 68 years and a median initial prostate-specific antigen level of 40.1 ng/ml. Most, 50 (81.9%), had T3 disease; 47.6% had Gleason 8–10 disease. All were treated with hypofractionated intensity-modulated radiotherapy, predominantly 60 Gy/20 fractions/4 weeks, with a dose of 44 Gy/20 fractions to the pelvic nodes. Twenty-five patients (41%) who had residual radiologically enlarged nodes after 3–6 months of ADT received nodal boost to the involved nodes, to a dose of 54–60 Gy as simultaneous boost. Incidences of late grade 2 + gastrointestinal and genitourinary toxicities were 13.1 and 18%, respectively, with no grade 4 toxicities. With a median follow-up of 48 months, 15 (24.6%) patients developed biochemical failure, with only four locoregional failures. The 4-year biochemical control rate was 77.5% and overall survival was 91%. Patients who had residual enlarged nodes after initial ADT had worse biochemical control (53.9% versus 93.1% at 4 years, P < 0.001).Conclusion
Moderately hypofractionated radiotherapy using an established fractionation schedule with long-term ADT for node-positive prostate cancer patients is feasible and results in excellent biochemical control rates at 4 years, with acceptable late toxicity rates. The response to initial ADT predicts outcomes. 相似文献13.
Aabra Ahmed Ahmed Tahseen Elizabeth England Katrine Wolfe Michael Simhachalam Travis Homan Jenna Sitenga Ryan W. Walters Peter T. Silberstein 《Clinical colorectal cancer》2019,18(1):e1-e7
Background
Colon cancer is the third most frequent cancer diagnosis, and primary payer status has been shown to be associated with treatment modalities and survival in cancer patients. The goal of our study was to determine the between-insurance differences in survival in patients with clinical stage III colon cancer using data from the National Cancer Database (NCDB).Materials and Methods
We identified 130,998 patients with clinical stage III colon cancer in the NCDB diagnosed from 2004 to 2012. Kaplan-Meier curves and multivariable Cox regression models were used to determine the association between insurance status and survival.Results
Patients with private insurance plans were 28%, 30%, and 16% less likely to die than were uninsured patients, Medicaid recipients, and Medicare beneficiaries, respectively. Medicare patients were 14% were less likely to die compared with uninsured patients. Patients receiving chemotherapy were, on average, 65% less likely to die compared with the patients not receiving chemotherapy.Conclusion
Private insurance and a greater socioeconomic status were associated with increased patient survival compared with other insurance plans or the lack of insurance. Future research should continue to unravel how socioeconomic status and insurance status contribute to the quality of care and survival of oncologic patients. 相似文献14.
Uday Yanamandra Prateek Deo Kamal Kant Sahu Ram Vasudevan Nampoothiri Nalini Gupta Anusree Prabhakaran Deb Prasad Dhibhar Alka Khadwal Gaurav Prakash Man Upadesh Singh Sachdeva Deepesh Lad Neelam Varma Subhash Varma Pankaj Malhotra 《Clinical Lymphoma, Myeloma & Leukemia》2019,19(3):183-189.e1
Background
Multiple myeloma (MM) is a hematologic malignancy of plasma cell origin. MM primarily affects bone marrow, but extramedullary sites can also be involved. Myelomatous pleural effusion (MPE) is an atypical and rare complication of MM. We aimed to systematically study the incidence and clinicopathologic profile of patients with MPE in a real-world setting.Patients and Methods
In this retrospective study, 415 consecutive patients with MM managed at a tertiary care center in North India during a study period of January 1, 2010 to December 31, 2015 were evaluated for MPE. The patients with MPE were analyzed for their clinical profile, diagnosis, treatment, and outcomes.Results
Of these 415 patients, 11 (2.65%) patients had MPE. The median age of the study population was 50 years with male preponderance. The majority of these patients had immunoglobin (Ig)G Kappa disease. All patients had higher than International Staging System stage I disease. MPE was a presenting feature at MM diagnosis in 45.45% (n = 5) of the patients, whereas the rest developed MPE during follow-up. MPE presented predominantly (81.8%) as a unilateral effusion. Concurrent extramedullary involvement at other site was seen in 45.45% (n = 5), with 3 (27%) patients having concurrent myelomatous ascites. Six of these were managed aggressively, whereas 5 patients opted for palliation. The outcomes were dismal (90.9% mortality), with a median survival of 2.47 months.Conclusion
MPE is a rare entity, and positive outcomes of therapy remain low with dismal prognosis. 相似文献15.
Seán Fitzgerald Julie-Ann O&#x;Reilly Erin Wilson Ann Joyce Richard Farrell Dermot Kenny Elaine Williamson Kay Jenny Fitzgerald Barry Byrne Gregor Stefan Kijanka Richard O&#x;Kennedy 《Clinical colorectal cancer》2019,18(1):e53-e60
Introduction
Colorectal cancer is a major public health issue, with incidences continuing to rise owing to the growing and aging world population. Current screening strategies for colorectal cancer diagnosis suffer from various limitations, including invasiveness and poor uptake. Consequently, there is an unmet clinical need for a minimally invasive, sensitive, and specific method for detecting the presence of colorectal cancer and pre-malignant lesions.Patients and Methods
An indirect enzyme-linked immunosorbent assay was used to measure the primary (IgM) and secondary (IgG) adaptive humoral immune responses to a panel of previously identified cancer antigens in the sera of normal and adenoma samples, and sera from patients with colorectal cancer.Results
An optimal panel of 7 biomarkers capable of identifying patients with colorectal cancer as distinct from both normal and adenoma samples is identified. The cumulative sensitivity and specificity of the assay are 70.8% and 86.5%, respectively. The positive and negative predictive values of the cohort are 77.3% and 82.1%. This assay was not able to accurately discriminate between normal and adenoma samples. Patients whose serum was positive for the presence of anti-ICLN IgM autoantibodies had a significantly poorer 5-year survival than patients whose serum was negative (P = .004).Conclusion
This study describes a novel minimally invasive enzyme-linked immunosorbent assay-based method, capable of identifying patients with colorectal cancer as distinct from both normal and adenoma samples. Patients are likely to be far more amenable to a blood-based test such as the one described herein, rather than a fecal-based test, likely leading to increased patient uptake. 相似文献16.
Irina Druzhkova Nadezhda Ignatova Natalia Prodanets Nikolay Kiselev Iliya Zhukov Marina Shirmanova Vladimir Zagainov Elena Zagaynova 《Clinical colorectal cancer》2019,18(1):e74-e86
Background
The conventional chemotherapy of colorectal cancer with irinotecan, 5-fluorouracil, and oxaliplatin remains one of the front-line treatments worldwide. However, its efficacy is quite low. Recently studies of the epithelial–mesenchymal transition (EMT) have become the focus of investigations into the cause of chemoresistance in several types of cancer, including colorectal cancer. The data about the role of EMT in chemosensitivity are controversial.Materials and Methods
Human colon adenocarcinoma cell lines HT29 and HCT116 and 14 primary short-term cultures established from patient tumors were used. The chemosensitivity to irinotecan, 5-fluorouracil, and oxaliplatin was assessed using the (4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) test. Immunocytochemistry, immunohistochemistry, and Western blot test were used to investigate the E-cadherin expression, the loss of which is a major hallmark of EMT.Results
Elevated chemosensitivity of the cell line with EMT phenotype, HCT116, was demonstrated. Increased chemosensitivity was revealed in HT29 cell line upon EMT induction. E-cadherin–positive short-term cultures were more resistant to all the drugs tested, whereas each of E-cadherin–negative cultures showed sensitivity to at least one drug. The statistically significant dependency of cells viability on the E-cadherin expression (P < .04) was demonstrated on the short-term cultures using 2 concentrations of each drug.Conclusion
The data obtained may serve as a basis for the analysis of colon cancer chemosensitivity using short-term cultures and the assay of E-cadherin expression. 相似文献17.
Bernardo Cacho-Díaz Héctor Spínola-Maroño Nancy Reynoso Alberto González-Aguilar Alejandro Mohar-Betancourt 《Clinical breast cancer》2019,19(2):e394-e398
Introduction
Breast cancer (BC) is the most common cancer in women, and the incidence of brain metastasis (BM) from BC ranges from 20% to 30%, with a median survival of 10 to 15 months. Previous reports have shown that the presence of obesity or diabetes negatively impacts survival. The present study investigates the association between obesity or diabetes mellitus (DM) and overall survival of patients with BC with BM.Materials and Methods
A database from 2 referral centers for the period of July 2014 to February 2018 was analyzed. The inclusion criteria were as follows: patients who had a confirmed diagnosis of BC with BM were followed and treated at these centers. Demographic data, body weight and height, clinical and oncologic history, functional status, prognostic scales, and prognoses were examined.Results
A total of 228 patients were included. The median age at BM was 50 years; the median survival after diagnosis was 12.1 months; 108 patients had a body mass index (BMI) ≥ 25, and 40 (17%) patients had DM. The association between survival and the presence of BMI > 25 exhibited a P value of 0.3.Discussion
We found no association between overweight, obesity, or DM and survival in patients with BC with BM. The role of obesity in cancer is a robust research topic, as there are many questions to be answered.Conclusion
Obesity as a prognostic indicator should be further studied, because we found no association between overall survival and either patients with BM from BC with a BMI > 25 or those with normal weight. 相似文献18.
Clark Howell Gregg Tracton Alison Amos Bhishamjit Chera Lawrence B. Marks Lukasz M. Mazur 《Practical radiation oncology》2019,9(2):e210-e217
Purpose
This study aimed to present an innovative approach to quantify, visualize, and predict radiation therapy (RT) process reliability using data captured from a voluntary incident learning system, with an overall aim to improve patient safety outcomes.Methods and Materials
We analyzed 111 reported deviations that were tripped and caught within 159 mapped RT process steps included within 7 major stages of RT delivery, 94 of which were any type of quality assurance (QA) controls. This allowed for us to compute the trip rate and fail-to-catch-rate (FCR) per each QA control with the available data. Next, we used a logistic regression model to identify significant variables predictive of FCRs, predicted FCRs for each QA control without available data, and thus, attempted to quantify RT process reliability expressed as percentage of patients with uncaught deviations after treatment planning, before their first treatment, and during treatment delivery.Results
Using the predicted FCRs, we computed the upper 95% likelihood that a deviation remains uncaught in a patient's course of treatment at the following RT process stages: immediately after treatment planning at 10.26%; before the first treatment at 0.0052%; and throughout treatment delivery at 0.0276%.Conclusions
The results suggest that RT process reliability can be predicted and visualized using data from incident learning systems. If implemented and used as a safety metric, this could help RT clinics to proactively maintain their preoccupation with patient safety. RT process reliability may also help guide future work on standardization and continuous improvement of the design of RT QA programs. 相似文献19.
Baoan Hong Lin Cai Jiangyi Wang Shengjie Liu Jingcheng Zhou Kaifang Ma Jiufeng Zhang Bowen Zhou Xiang Peng Ning Zhang Kan Gong 《Clinical genitourinary cancer》2019,17(2):97-104.e1
Background
Programmed death ligand-1 (PD-L1) is a potential predictive biomarker for immunotherapy in several malignancies. However, the expression level and clinical significance of PD-L1 in von Hippel–Lindau (VHL)-associated hereditary clear-cell renal cell carcinoma (ccRCC) remain unclear.Patients and Methods
Surgical specimens were recruited from 129 patients with sporadic ccRCC and 26 patients with VHL-associated hereditary ccRCC. The PD-L1 expression level was assessed using immunohistochemistry. Correlations between PD-L1 expression and clinicopathological features were analyzed.Results
In sporadic ccRCC, the positive expression rate of PD-L1 was 47.3% (61/129). Positive PD-L1 expression was correlated with advanced tumor T stage (P = .011), higher Fuhrman nuclear grade (P = .022), poor disease-free survival (P = .037), and sex (P = .025). In the VHL-associated hereditary ccRCC, positive PD-L1 expression rate was 34.6% (9/26), lower than that in sporadic ccRCC. Positive PD-L1 was correlated with higher Fuhrman nuclear grade (P = .008), but not with sex, age, tumor stage, or the onset age of VHL-associated tumors.Conclusion
Positive PD-L1 expression was correlated with the aggressive clinicopathological features in sporadic and VHL-associated hereditary ccRCC. Whether PD-L1 expression level in ccRCC is related to the effectiveness of programmed death-1/PD-L1 checkpoint inhibitor immunotherapy needs to be further investigated. 相似文献20.
Bruce D. Cheson Susan O’Brien Michael S. Ewer Marcus D. Goncalves Azeez Farooki Georg Lenz Anthony Yu Richard I. Fisher Pierre L. Zinzani Martin Dreyling 《Clinical Lymphoma, Myeloma & Leukemia》2019,19(3):135-141