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Sample records for cancer clinical treatment

  1. Male breast cancer: clinical presentation, diagnosis, treatment.

    Science.gov (United States)

    Hotko, Y S

    2013-12-01

    Despite male breast cancer is rare in occurrence, it is a serious problem. In 2012, 130 men in Ukraine got breast cancer that constituted 0.74% from all patients with mentioned pathology detected in the course of year. Every year in Ukraine approximately 100 men die from breast cancer. Still many aspects of male breast cancer remain unstudied. It occurs since information about mentioned disease is mainly based on retrospective analysis of small groups. Treatment of men, who got breast cancer, is based on knowledge, which has been obtained in treatment of women with this pathology. This article is based on the results of analysis of 168 cases of breast cancer in men, who have been examined and treated in the period from 1956 to 2012. In paper the peculiarities of clinical manifestations of male breast cancer have been determined, the optimal volume of diagnostic procedures in men with suspicion of breast cancer has been established, the mammographic signs have been detected and the possible histological variants of disease have been determined, clinical course peculiarities of male breast cancer have been defined, the most essential factors of prognosis of the disease have been fixed. Furthermore, in article optimal volume of surgical treatment of male breast cancer has been substantiated, the role and place of radiotherapy in treatment of this pathology has been determined. It has been proved that adjuvant polychemotherapy should be applied to the patients with male breast cancer independently from stage of process. Also optimal schemes of this kind of treatment have been determined. The efficacy of hormonal therapy with antiestrogen in patients with positive receptors of steroid hormones and at presence of unfavorable prognostic factors of disease has been demonstrated. The inefficiency of orchiectomy as one of the widespread kinds of hormonal therapy of male breast cancer has been defined.

  2. Uncaria tomentosa—Adjuvant Treatment for Breast Cancer: Clinical Trial

    OpenAIRE

    Maria do Carmo Santos Araújo; Iria Luiza Farias; Jessie Gutierres; Dalmora, Sergio L.; Nélia Flores; Julia Farias; Ivana de Cruz; Juarez Chiesa; Vera Maria Morsch; Maria Rosa Chitolina Schetinger

    2012-01-01

    Breast cancer is the most frequent neoplasm affecting women worldwide. Some of the recommended treatments involve chemotherapy whose toxic effects include leukopenia and neutropenia. This study assessed the effectiveness of Uncaria tomentosa (Ut) in reducing the adverse effects of chemotherapy through a randomized clinical trial. Patients with Invasive Ductal Carcinoma—Stage II, who underwent a treatment regimen known as FAC (Fluorouracil, Doxorubicin, Cyclophosphamide), were divided into two...

  3. [Controversy over treatment options in clinical T3 prostate cancer].

    Science.gov (United States)

    Nishimura, Kazuo; Yamamoto, Yoshiyuki; Nakayama, Masashi; Kakimoto, Ken-ichi

    2011-12-01

    Clinical stage T3 prostate cancer is a locally advanced disease at risk of having micrometastasis.Since clinical T staging is potentially inaccurate, PSA and Gleason score are also added at biopsy for risk stratification. The recurrence rate after radical prostatectomy alone or radiotherapy alone is generally high. Therefore, multimodal treatment is required. Recent multiple randomized trials have shown survival benefits of radiotherapy combined with long-term hormonal therapy. Dose escalation utilizing intensity modulated radiotherapy (IMRT) or brachytherapy has the potential benefit of exerting local control. Since previous trials used conventional external radiotherapy, the optimal duration of hormonal therapy combined with dose escalated radiotherapy remains unknown. On the other hand, some patients can be cured by radical prostatectomy alone, and approximately half of patients with adverse features after surgery can be rescued by adjuvant radiotherapy. Primary hormonal therapy is used widely and has shown favorable results in patients with T3 prostate cancer, particularly in Japan. Based on the life expectancy and comorbidity of an individual patient, hormonal therapy can be chosen as a primary treatment. There are controversies over treatment options such as surgery, radiotherapy, and hormonal therapy in clinical T3 prostate cancer. The clinical results of these treatments are reviewed and several unresolved issues are addressed here.

  4. Uncaria tomentosa—Adjuvant Treatment for Breast Cancer: Clinical Trial

    Directory of Open Access Journals (Sweden)

    Maria do Carmo Santos Araújo

    2012-01-01

    Full Text Available Breast cancer is the most frequent neoplasm affecting women worldwide. Some of the recommended treatments involve chemotherapy whose toxic effects include leukopenia and neutropenia. This study assessed the effectiveness of Uncaria tomentosa (Ut in reducing the adverse effects of chemotherapy through a randomized clinical trial. Patients with Invasive Ductal Carcinoma—Stage II, who underwent a treatment regimen known as FAC (Fluorouracil, Doxorubicin, Cyclophosphamide, were divided into two groups: the UtCa received chemotherapy plus 300 mg dry Ut extract per day and the Ca group that only received chemotherapy and served as the control experiment. Blood samples were collected before each one of the six chemotherapy cycles and blood counts, immunological parameters, antioxidant enzymes, and oxidative stress were analyzed. Uncaria tomentosa reduced the neutropenia caused by chemotherapy and was also able to restore cellular DNA damage. We concluded that Ut is an effective adjuvant treatment for breast cancer.

  5. Uncaria tomentosa—Adjuvant Treatment for Breast Cancer: Clinical Trial

    Science.gov (United States)

    Santos Araújo, Maria do Carmo; Farias, Iria Luiza; Gutierres, Jessie; Dalmora, Sergio L.; Flores, Nélia; Farias, Julia; de Cruz, Ivana; Chiesa, Juarez; Morsch, Vera Maria; Chitolina Schetinger, Maria Rosa

    2012-01-01

    Breast cancer is the most frequent neoplasm affecting women worldwide. Some of the recommended treatments involve chemotherapy whose toxic effects include leukopenia and neutropenia. This study assessed the effectiveness of Uncaria tomentosa (Ut) in reducing the adverse effects of chemotherapy through a randomized clinical trial. Patients with Invasive Ductal Carcinoma—Stage II, who underwent a treatment regimen known as FAC (Fluorouracil, Doxorubicin, Cyclophosphamide), were divided into two groups: the UtCa received chemotherapy plus 300 mg dry Ut extract per day and the Ca group that only received chemotherapy and served as the control experiment. Blood samples were collected before each one of the six chemotherapy cycles and blood counts, immunological parameters, antioxidant enzymes, and oxidative stress were analyzed. Uncaria tomentosa reduced the neutropenia caused by chemotherapy and was also able to restore cellular DNA damage. We concluded that Ut is an effective adjuvant treatment for breast cancer. PMID:22811748

  6. Uncaria tomentosa-Adjuvant Treatment for Breast Cancer: Clinical Trial.

    Science.gov (United States)

    Santos Araújo, Maria do Carmo; Farias, Iria Luiza; Gutierres, Jessie; Dalmora, Sergio L; Flores, Nélia; Farias, Julia; de Cruz, Ivana; Chiesa, Juarez; Morsch, Vera Maria; Chitolina Schetinger, Maria Rosa

    2012-01-01

    Breast cancer is the most frequent neoplasm affecting women worldwide. Some of the recommended treatments involve chemotherapy whose toxic effects include leukopenia and neutropenia. This study assessed the effectiveness of Uncaria tomentosa (Ut) in reducing the adverse effects of chemotherapy through a randomized clinical trial. Patients with Invasive Ductal Carcinoma-Stage II, who underwent a treatment regimen known as FAC (Fluorouracil, Doxorubicin, Cyclophosphamide), were divided into two groups: the UtCa received chemotherapy plus 300 mg dry Ut extract per day and the Ca group that only received chemotherapy and served as the control experiment. Blood samples were collected before each one of the six chemotherapy cycles and blood counts, immunological parameters, antioxidant enzymes, and oxidative stress were analyzed. Uncaria tomentosa reduced the neutropenia caused by chemotherapy and was also able to restore cellular DNA damage. We concluded that Ut is an effective adjuvant treatment for breast cancer.

  7. Skin Cancer Treatment

    Science.gov (United States)

    ... of Skin Cancer Skin Cancer Screening Research Skin Cancer Treatment (PDQ®)–Patient Version General Information About Skin Cancer ... clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have ...

  8. Breast Cancer Treatment

    Science.gov (United States)

    ... Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Treatment (PDQ®)–Patient Version General Information About Breast Cancer ... clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have ...

  9. DIAGNOSIS AND TREATMENT OF METACHRONOUS TESTICULAR CANCER: A CLINICAL CASE

    Directory of Open Access Journals (Sweden)

    A. S. Kalpinsky

    2013-01-01

    Full Text Available The incidence of bilateral testicular cancer is 5% in the total cohort of patients. Synchronous and metachronous testicular cancers are detected in 1-2 and 3% of cases, respectively. The standard treatment for testicular cancer is orchifuniculectomy and that for synchronous or metachronous cancer is organ-saving treatment, testectomy.The paper describes a clinical case of multiple primary metachronous testicular cancer. A 24-year-old patient underwent surgery (orchifuniculectomy and received 4 courses of BEP polychemotherapy for embryonal carcinoma of the left testicle at the P.A. Herzen Moscow Oncology Research Institute. After 55 months, a dynamic control examination diagnosed a 9-mm tumor in his single right testis that was thereafter resected. Its histological examination revealed embryonal carcinoma with solitary structures in the immature teratoma. Following 22 months, a control examination showed a recurrence of the disease, for which orchifuniculectomy of the single right testis, followed by hormone replacement therapy, was performed. The follow-up period was 80 months; no recurrence is now observed.

  10. Surgical treatment for progressive prostate cancer: A clinical case

    Directory of Open Access Journals (Sweden)

    E. I. Veliev

    2014-01-01

    Full Text Available In spite of its existing standards, the treatment of patients with progressive prostate cancer (PC remains a matter of debate. Ensuring that the patients have good quality of life is also relevant. The paper describes a clinical case of a patient with progressive PC after hormone therapy, brachytherapy, salvage prostatectomy, enucleation of the testicular parenchyma, and salvage lymphadenectomy. A phallic prosthesis and an artificial urinary sphincter have been implanted to improve quality of life. The results of preoperative examination and the technological features of surgical interventions are given.

  11. Cancer Treatment - Cancer Currents Blog

    Science.gov (United States)

    A catalog of posts from NCI’s Cancer Currents blog on cancer treatment research. Includes posts on new treatments for cancer and their effects, clinical trial results, and overcoming treatment resistance.

  12. Enrollment and Racial Disparities in National Cancer Institute Cancer Treatment Clinical Trials in North Carolina

    Science.gov (United States)

    Zullig, Leah L.; Fortune-Britt, Alice G.; Rao, Shangbang; Tyree, Seth D.; Godley, Paul A.; Carpenter, William R.

    2015-01-01

    Background Clinical trials provide access to innovative, quality cancer treatment. Simultaneously, broad access helps ensure trial inclusion of heterogeneous patient populations, which improves generalizability of findings and development of interventions that are effective for diverse populations. We provide updated data describing enrollment into cancer treatment trials in North Carolina. Methods For 1996 to 2009, person-level data regarding cancer clinical trial enrollment and cancer incidence were obtained from the North Carolina Central Cancer Registry and the National Cancer Institute (NCI). Enrollment rates were estimated as the ratio of trial enrollment to cancer incidence for race, gender, and year for each county, Area Health Education Center (AHEC) region, and the state overall. Enrollment rates for common cancers are presented. Results From 1996 to 2009, North Carolina NCI treatment trial enrollment rate was 2.4% and 2.2% for whites and minorities, respectively. From 2007 to 2009, rates were 3.8% for white females, 3.5% for minority females, 1.3% for white men, and 1.0% for minority men, with greater enrollment among more urban populations (2.4%) than the most rural populations (1.5%). Limitations This study is limited to NCI-sponsored treatment trials in North Carolina. Policies governing collection of original data necessitate a delay in data availability. Conclusions Effort is needed to ensure trial access and enrollment among all North Carolina populations. Specifically, we identified racial and gender disparities, particularly for certain cancers (e.g., breast). Programs in North Carolina and across the nation can use the methods we employ to assess their success in broadening clinical trials enrollment for diverse populations. PMID:26763244

  13. BRIEF REVIEW ON DIAGNOSTIC TECHNIQUE AND NOVEL MOLECULES IN CLINICAL TRIALS FOR TREATMENT OF BREAST CANCER

    Directory of Open Access Journals (Sweden)

    VISHAL KUMAR S. MODI

    2015-01-01

    Full Text Available Breast cancer is the most common cancer in women in both developed and undeveloped countries, and the second most frequent cause of cancer deaths after lung cancer. Although there have been many chemotherapeutic agents like 5-fluorouracil, taxol, tamoxifen, doxorubicin, cisplatin, and camptothecin and hormones are used to treat breast cancer. This review focuses on the causes of breast cancer, latest diagnostic techniques and various molecules under clinical trials for the treatment of breast cancer.

  14. [Cancer treatment in elderly patients: evidence and clinical research].

    Science.gov (United States)

    Repetto, Lazzaro; Luciani, Andrea

    2015-01-01

    In 2020 the percentage of patients with a diagnosis of cancer in people with more than 65 years will exceed 70% and 28% in ethnic minorities. The treatment of cancer in these populations is challenging for the oncologists due to socio-economic issues such as poverty, reduced access to the hospital care, level of education. The clinical pathway "diagnosis-treatment-cure", typical of the care of young patients has to be integrated in elderly patients with a more individualized treatment by means of comprehensive geriatric assessment (CGA). IADL (Instrumental Activities of Daily Living) have the best predictive role in oncological setting and their impairment significantly correlate with overall survival, chemotherapy toxicities and thirty days postoperative morbidities. The CGA is universally accepted as the most appropriate instrument to analitically evaluate the age related problems of elderly patients. The role of CGA is crucial to identify geriatric issues not easily diagnosed, to predict treatment toxicities, functional or cognitive decline, post operative complications and to estimate life expectancy. The CGA items are predictive of severe toxicity, however it is not clearly established which are the best performers and the best cut-offs points. Today CGA is integrated with physical performance tests (the most widely used is the "time up and go" test) and laboratory assay of Interleukin 6 and D-Dimer that correlate with mortality and physical decline. There are few prospective studies that evaluated the role of CGA in treatment choice. The first is a phase II study in solid tumors, the second is a haematological trial on non Hodgkin lymphoma. The largest trial is a 571 patients observational series that confirmed the role of CGA in decision making. The administration of CGA is time consuming and consequently some screening tools were developed. VES-13 is a 13 items tool that explores prevalently the functional status and the self reported health status. VES-13

  15. Clinic application of tissue engineered bronchus for lung cancer treatment

    Science.gov (United States)

    Liu, Ruijun; Chen, Xiaoke; Wu, Jingxiang; Pan, Yinggen; Lu, Shun; Weder, Walter; Luo, Qingquan

    2017-01-01

    Background Delayed revascularization process and substitute infection remain to be key challenges in tissue engineered (TE) airway reconstruction. We propose an “in-vivo bioreactor” design, defined as an implanted TE substitutes perfused with an intra-scaffold medium flow created by an extracorporeal portable pump system for in situ organ regeneration. The perfusate keeps pre-seeded cells alive before revascularization. Meanwhile the antibiotic inside the perfusate controls topical infection. Methods A stage IIIA squamous lung cancer patient received a 5-cm TE airway substitute, bridging left basal segment bronchus to carina, with the in-vivo bioreactor design to avoid left pneumonectomy. Continuous intra-scaffold Ringer’s-gentamicin perfusion lasted for 1 month, together with orthotopic peripheral total nucleated cells (TNCs) injection twice a week. Results The patient recovered uneventfully. Bronchoscopy follow-up confirmed complete revascularization and reepithelialization four months postoperatively. Perfusate waste test demonstrated various revascularization growth factors secreted by TNCs. The patient received two cycles of chemotherapy and 30 Gy radiotherapy thereafter without complications related to the TE substitute. Conclusions In-vivo bioreactor design combines the traditionally separated in vitro 3D cell-scaffold culture system and the in vivo regenerative processes associated with TE substitutes, while treating the recipients as bioreactors for their own TE prostheses. This design can be applied clinically. We also proved for the first time that TE airway substitute is able to tolerate chemo-radiotherapy and suitable to be used in cancer treatment.

  16. Clinical report of the treatment of locally advanced lung cancer.

    Science.gov (United States)

    Petrovich, Z; Mietlowski, W; Ohanian, M; Cox, J

    1977-07-01

    This paper discusses the results of the treatment of 345 patients entered in the Veterans Administration Lung Group Protocol 13L. The study was activated March 1972, and closed for the patient accesion March 1975. All patients had a histological diagnosis of primary lung cancer considered clinically non-resectable or inoperable. Patients were equally randomized into two groups, radiotherapy alone or radiotherapy with chemotherapy. The analysis of the data included: treatment regimen, radiation dose, initial performance status, performance status change, cell type, duration of survival, quality of survival and age. The strongest influence on median survival was the level of radiation dose. The small cell carcinoma patients treated with radiotherapy and chemotherapy showed significant improvement in the median survival (38.2 weeks) over the patients treated with radiotherapy alone (20.6 weeks). The patients treated with radiotherapy and chemotherapy also showed improvement in performance status more frequently than the patients treated with radiotherapy alone. Other parameters of the analysis will be presented.

  17. Clinical Trial Design for Testing the Stem Cell Model for the Prevention and Treatment of Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Reddy, Rishindra M., E-mail: reddyrm@med.umich.edu [Medical Center, University of Michigan, 1500 E. Medical Center Drive, 2120 Taubman Center, Ann Arbor, MI 48109 (United States); Kakarala, Madhuri; Wicha, Max S. [Comprehensive Cancer Center, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109 (United States)

    2011-06-20

    The cancer stem cell model introduces new strategies for the prevention and treatment of cancers. In cancers that appear to follow the stem cell model, pathways such as Wnt, Notch and Hedgehog may be targeted with natural compounds such as curcumin or drugs to reduce the risk of initiation of new tumors. Disease progression of established tumors could also potentially be inhibited by targeting the tumorigenic stem cells alone, rather than aiming to reduce overall tumor size. These new approaches mandate a change in the design of clinical trials and biomarkers chosen for efficacy assessment for preventative, neoadjuvant, adjuvant, and palliative treatments. Cancer treatments could be evaluated by assessing stem cell markers before and after treatment. Targeted stem cell specific treatment of cancers may not result in “complete” or “partial” responses radiologically, as stem cell targeting may not reduce the tumor bulk, but eliminate further tumorigenic potential. These changes are discussed using breast, pancreatic, and lung cancer as examples.

  18. Clinical application of multimodality imaging in radiotherapy treatment planning for rectal cancer.

    Science.gov (United States)

    Wang, Yan Yang; Zhe, Hong

    2013-12-11

    Radiotherapy plays an important role in the treatment of rectal cancer. Three-dimensional conformal radiotherapy and intensity-modulated radiotherapy are mainstay techniques of radiotherapy for rectal cancer. However, the success of these techniques is heavily reliant on accurate target delineation and treatment planning. Computed tomography simulation is a cornerstone of rectal cancer radiotherapy, but there are limitations, such as poor soft-tissue contrast between pelvic structures and partial volume effects. Magnetic resonance imaging and positron emission tomography (PET) can overcome these limitations and provide additional information for rectal cancer treatment planning. PET can also reduce the interobserver variation in the definition of rectal tumor volume. However, there is a long way to go before these image modalities are routinely used in the clinical setting. This review summarizes the most promising studies on clinical applications of multimodality imaging in target delineation and treatment planning for rectal cancer radiotherapy.

  19. Types of Treatment: Clinical Trials

    Science.gov (United States)

    ... Disease Information Treatment Types of Treatment Clinical Trials Clinical Trials Clinical Trials SHARE: Print Glossary Taking part in a clinical ... for cancer are based on previous clinical trials. Clinical Trial Service: LLS provides personalized clinical trial navigation when ...

  20. Clinical evaluation of developed product for recovery of immune system in the treatment of cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Chul-Ku; Choi, Soo Yong; Rhyu, Sung Ryeol; Kim, Ki Wha; Kim, Ji Yun; Yun, Na Ra [Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)

    2006-01-15

    We evaluate the clinical efficacy of pilot product (HemoHIM) on recovery from hematopoiesis damage in cancer patients who received radiotherapy and chemotherapy. The cancer patients studied were as follows : cancer of the breast(47 intakers and 136 non-intakers), uterine cervix(38 intakers and 73 non-intakers), and head and neck(7 intakers and 15 non-intakers). The clinical efficacy of pilot product(HemoHIM) in cancer patients who received radiotherapy and chemotherapy was analyzed. In breast cancer patients, the number of leukocytes decreased according to duration of treatment in both groups. However, intakers showed a less decreasing trend compared with non-intakers. Especially, under limiting value in range of leukocyte number of intakers was significantly higher than that of non-intakers. This result incicates that HemoHIM reduce the severe leukopenia. Values of lymphocyte in both groups decreased similarly after treatment, and it was similar to that of leukocyte. Values of erythrocyte in both groups decreased similarly after treatment, but the values were within normal range. In cervix cancer patients, the results were similar to that of breast cancer patients. In cancer of head and neck, values of leukocyte slightly decreased according to duration of treatment in both group. However, it needs to collect more subjects continuously because of small number of cancer patients. No toxicological side effects of HemoHIM were observed in serological analysis, and possibility to alleviate fatigue and inflammation was investigated in some cases.

  1. Development and clinical introduction of automated radiotherapy treatment planning for prostate cancer

    Science.gov (United States)

    Winkel, D.; Bol, G. H.; van Asselen, B.; Hes, J.; Scholten, V.; Kerkmeijer, L. G. W.; Raaymakers, B. W.

    2016-12-01

    To develop an automated radiotherapy treatment planning and optimization workflow to efficiently create patient specifically optimized clinical grade treatment plans for prostate cancer and to implement it in clinical practice. A two-phased planning and optimization workflow was developed to automatically generate 77Gy 5-field simultaneously integrated boost intensity modulated radiation therapy (SIB-IMRT) plans for prostate cancer treatment. A retrospective planning study (n  =  100) was performed in which automatically and manually generated treatment plans were compared. A clinical pilot (n  =  21) was performed to investigate the usability of our method. Operator time for the planning process was reduced to  cancer.

  2. Cancer treatments

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000901.htm Cancer treatments To use the sharing features on this page, ... or IV. Immunotherapy Immunotherapy is a type of cancer treatment that relies on the body’s ability to fight ...

  3. Clinical aspects and perspectives of erlotinib in the treatment of patients with biliary tract cancer

    DEFF Research Database (Denmark)

    Jensen, Lars Henrik

    2016-01-01

    INTRODUCTION: Patients with non-resectable biliary tract cancer have a poor prognosis even if treated with systemic chemotherapy. One hope for improving treatment is through molecular biology and the characterization of specific cancer driving alterations followed by the design of targeted drugs....... The epidermal growth factor receptor system is upregulated in many cancers and can be targeted by the protein kinase inhibitor erlotinib. Erlotinib has demonstrated a clinically applicable effect in pancreatic and lung cancer Areas covered: In this review, the author presents the published clinical data about...... erlotinib in biliary tract cancer. The data is interpreted with respect to its clinical value and in regards to its future development. EXPERT OPINION: Erlotinib has low activity as a monotherapy, but has shown synergistic effects when combined with bevacizumab. The only phase III trial with erlotinib...

  4. Clinical issues in the surgical treatment of colon cancer

    NARCIS (Netherlands)

    Amri, R.

    2015-01-01

    More than half of colon cancer patients will eventually die of their disease. Early detection is crucial to maximize chances of cure, as five-year survival can range from 97% to as low as 8% depending on disease stage at diagnosis. Since colon cancer is associated with both old age and obesity,

  5. Clinical issues in the surgical treatment of colon cancer

    NARCIS (Netherlands)

    Amri, R.

    2015-01-01

    More than half of colon cancer patients will eventually die of their disease. Early detection is crucial to maximize chances of cure, as five-year survival can range from 97% to as low as 8% depending on disease stage at diagnosis. Since colon cancer is associated with both old age and obesity, near

  6. Effects of Clinical Pilates Exercises on Patients Developing Lymphedema after Breast Cancer Treatment: A Randomized Clinical Trial.

    Science.gov (United States)

    Şener, Hülya Özlem; Malkoç, Mehtap; Ergin, Gülbin; Karadibak, Didem; Yavuzşen, Tuğba

    2017-01-01

    The aim of the present study was to compare the effects of clinical Pilates exercises with those of the standard lymphedema exercises on lymphedema developing after breast cancer treatment. The study comprised 60 female patients with a mean age of 53.2±7.7 years who developed lymphedema after having breast cancer treatment. The patients were randomized into two groups: the clinical Pilates exercise group (n=30), and the control group (n=30). Before, and at the 8th week of treatment, the following parameters were measured: the severity of lymphedema, limb circumferences, body image using the Social Appearance Anxiety Scale, quality of life with the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ-BR23), and upper extremity function using the Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure. Both groups performed one-hour exercises three days a week for 8 weeks. After treatment, the symptoms recovered significantly in both groups. Reductions in the severity of lymphedema, improvements in the social appearance anxiety scale scores, quality of life scores, and upper extremity functions scores in the clinical Pilates exercise group were greater than those in the control group. Clinical Pilates exercises were determined to be more effective on the symptoms of patients with lymphedema than were standard lymphedema exercises. Clinical Pilates exercises could be considered a safe model and would contribute to treatment programs.

  7. Consensus report of the national cancer institute clinical trials planning meeting on pancreas cancer treatment.

    Science.gov (United States)

    Philip, Philip A; Mooney, Margaret; Jaffe, Deborah; Eckhardt, Gail; Moore, Malcolm; Meropol, Neal; Emens, Leisha; O'Reilly, Eileen; Korc, Murray; Ellis, Lee; Benedetti, Jacqueline; Rothenberg, Mace; Willett, Christopher; Tempero, Margaret; Lowy, Andrew; Abbruzzese, James; Simeone, Diane; Hingorani, Sunil; Berlin, Jordan; Tepper, Joel

    2009-11-20

    Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer mortality, despite significant improvements in diagnostic imaging and operative mortality rates. The 5-year survival rate remains less than 5% because of microscopic or gross metastatic disease at time of diagnosis. The Clinical Trials Planning Meeting in pancreatic cancer was convened by the National Cancer Institute's Gastrointestinal Cancer Steering Committee to discuss the integration of basic and clinical knowledge in the design of clinical trials in PDAC. Major emphasis was placed on the enhancement of research to identify and validate the relevant targets and molecular pathways in PDAC, cancer stem cells, and the microenvironment. Emphasis was also placed on developing rational combinations of targeted agents and the development of predictive biomarkers to assist selection of patient subsets. The development of preclinical tumor models that are better predictive of human PDAC must be supported with wider availability to the research community. Phase III clinical trials should be implemented only if there is a meaningful clinical signal of efficacy and safety in the phase II setting. The emphasis must therefore be on performing well-designed phase II studies with uniform sets of basic entry and evaluation criteria with survival as a primary endpoint. Patients with either metastatic or locally advanced PDAC must be studied separately.

  8. The Gap between Tobacco Treatment Guidelines, Health Service Organization, and Clinical Practice in Comprehensive Cancer Centres

    Directory of Open Access Journals (Sweden)

    R. Mazza

    2011-01-01

    Full Text Available Smoking cessation is necessary to reach a higher quality of life, and, for a cancer patient, it represents an important step in improving the outcome of both prognosis and therapy. Being a cancer patient addicted to nicotine may be a critical situation. We conducted a survey to monitor how many comprehensive cancer centres in Italy have an outpatient smoker clinic and which kinds of resources are available. We also inquired about inpatient services offering psychological and pharmacological support for smoking cessation, reduction, or care of acute nicotine withdrawal symptoms. What we have witnessed is a significant gap between guidelines and services. Oncologists and cancer nurses are overscheduled, with insufficient time to engage in discussion on a problem that they do not consider directly related to cancer treatment. Furthermore, smoking habits and limited training in tobacco dependence and treatment act as an important barrier and lead to the undervaluation of smokers' needs.

  9. Yoga for the Treatment of Insomnia among Cancer Patients: Evidence, Mechanisms of Action, and Clinical Recommendations.

    Science.gov (United States)

    Mustian, Karen M; Janelsins, Michelle; Peppone, Luke J; Kamen, Charles

    Up to 90% of cancer patients report symptoms of insomnia during and after treatment. Symptoms of insomnia include excessive daytime sleepiness, difficulty falling asleep, difficulty staying asleep, and waking up too early. Insomnia symptoms are among the most prevalent, distressing and persistent cancer- and cancer treatment-related toxicities reported by patients, and can be severe enough to increase cancer morbidity and mortality. Despite the ubiquity of insomnia symptoms, they are under-screened, under-diagnosed, and under-treated in cancer patients. When insomnia symptoms are identified, providers are hesitant to prescribe, and patients are hesitant to take pharmaceuticals due to polypharmacy concerns. In addition, sleep medications do not cure insomnia. Yoga is a well-tolerated mode of exercise with promising evidence for its efficacy in improving insomnia symptoms among cancer patients. This article reviews existing clinical research on the effectiveness of yoga for treating insomnia among cancer patients. The article also provides clinical recommendations for prescribing yoga for the treatment of insomnia in this population.

  10. Emerging treatments in management of prostate cancer: biomarker validation and endpoints for immunotherapy clinical trial design

    Directory of Open Access Journals (Sweden)

    Slovin SF

    2013-12-01

    Full Text Available Susan F SlovinGenitourinary Oncology Service, Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan-Kettering Cancer Center, New York, NY, USAAbstract: The rapidly emerging field of immunotherapy and the development of novel immunologic agents that have been approved in melanoma and successfully studied in lung cancer, kidney cancer, and prostate cancer have mandated that there be uniformity in clinical trial analysis beyond conventional survival endpoints and imaging. This includes some measure of determining whether the immunologic target is hit and how the treatment has impacted on the immune system in toto. While melanoma is leading the field towards these ends, there is some doubt that not all of the recent successes with immune therapies, for example, checkpoint inhibitors, will be effective for every cancer, and that the toxicities may also be different depending on the malignancy. This review serves to elucidate the current issues facing clinical investigators who perform immunologic trials targeted at patients with prostate cancer and discusses the challenges in assessing the right immunologic endpoints to demonstrate biologic/immunologic targeting leading to clinical benefit.Keywords: sipuleucel-T, prostate-specific antigen, prostate cancer, biomarkers, monoclonal antibodies, vaccines, cellular therapy

  11. Clinical utility of exemestane in the treatment of breast cancer 

    Directory of Open Access Journals (Sweden)

    Zucchini G

    2015-05-01

    Full Text Available Giorgia Zucchini,1 Elena Geuna,1 Andrea Milani,1 Caterina Aversa,2 Rossella Martinello,2 Filippo Montemurro1 1Investigative Clinical Oncology, Fondazione del Piemonte per l’Oncologia-Candiolo Cancer Institute (IRCCs, Candiolo, 2University of Turin Medical School, Turin, Italy Abstract: Breast cancer is the most prevalent cancer in women, causing a significant mortality worldwide. Different endocrine strategies are available for the treatment of hormone-sensitive breast cancer, including antiestrogen tamoxifen and fulvestrant, as well as third-generation aromatase inhibitors (AIs, such as letrozole, anastrozole, and exemestane. In this review, we will focus on exemestane, its clinical use, and its side effects. Exemestane is a steroidal third-generation AI now used in all treatment settings for breast cancer. In the metastatic disease, it has been extensively investigated as the first-, second-, and further-line treatment and it is now registered for the treatment of postmenopausal women with advanced estrogen-receptor-positive breast cancer whose disease has progressed following antiestrogen therapy. A potential lack of cross-resistance with nonsteroidal AIs has been described, giving additional therapeutic opportunities in sequences of endocrine agents. Exemestane is also approved for the adjuvant treatment of postmenopausal early breast cancer, either as upfront monotherapy for 5 years, as a switch following 2–3 years of tamoxifen, or as extended therapy beyond 5 years of adjuvant treatment. New promising data also showed a beneficial effect in young premenopausal early breast cancer patients, when administered together with ovarian suppression. Interesting results have also emerged when exemestane has been investigated as neodjuvant treatment as well as preventive agent in healthy women at high risk for breast cancer. Exemestane is generally well tolerated, with a side effect profile similar to that of other AIs, including menopausal

  12. Clinical Trial Design for Testing the Stem Cell Model for the Prevention and Treatment of Cancer

    Directory of Open Access Journals (Sweden)

    Max S. Wicha

    2011-06-01

    Full Text Available The cancer stem cell model introduces new strategies for the prevention and treatment of cancers. In cancers that appear to follow the stem cell model, pathways such as Wnt, Notch and Hedgehog may be targeted with natural compounds such as curcumin or drugs to reduce the risk of initiation of new tumors. Disease progression of established tumors could also potentially be inhibited by targeting the tumorigenic stem cells alone, rather than aiming to reduce overall tumor size. These new approaches mandate a change in the design of clinical trials and biomarkers chosen for efficacy assessment for preventative, neoadjuvant, adjuvant, and palliative treatments. Cancer treatments could be evaluated by assessing stem cell markers before and after treatment. Targeted stem cell specific treatment of cancers may not result in “complete” or “partial” responses radiologically, as stem cell targeting may not reduce the tumor bulk, but eliminate further tumorigenic potential. These changes are discussed using breast, pancreatic, and lung cancer as examples.

  13. SHORT OVERVIEW OF CLINICAL TRIALS WITH CURRENT IMMUNOTHERAPEUTIC TOOLS FOR CANCER TREATMENT

    Directory of Open Access Journals (Sweden)

    T. S. Nepomnyashchikh

    2017-01-01

    Full Text Available Over last decade, a substantial progress has been made, with respect to understanding of cancer biology and its interplay with the host immune system. Different immunotherapeutic drugs based on recombinant cytokines and monoclonal antibodies are widely used in cancer therapy, and a large number of experimental cancer treatments have been developed, many of which are currently undergoing various stages of clinical trials. Recent endorsement of a recombinant oncolytic herpesvirus T-VEC for the treatment of melanoma was an important step towards a more safe and efficient anticancer therapeutics. In this review, we shall mention only some of the most promising cancer immunotherapy strategies, namely, immune checkpoint inhibitors, cellular therapy and oncolytic viruses. 

  14. Testicular Cancer Treatments: After Treatment

    Science.gov (United States)

    ... to alphafetoprotein (AFP), beta-hCG (b-hCG), and lactate dehydrogenase (LDH). AFP and b-hCG are proteins ... Our recommendations are divided by type of testicular cancer, stage, and treatment given. Clinical Stage I Nonseminoma - ...

  15. Anticoagulant treatment and survival in cancer patients. The evidence from clinical studies.

    Science.gov (United States)

    Lecumberri, Ramón; Páramo, José A; Rocha, Eduardo

    2005-09-01

    The association between cancer and an increased incidence of venous thromboembolism (Trousseau syndrome) is well characterized and recent studies have shown that the hemostatic system plays a key role at different stages in the process of tumorigenesis. Anticoagulant drugs therefore appear to be an attractive strategy in cancer therapy, with an effect that would surpass the benefit of preventing thrombosis. This hypothesis was initially supported by the post-hoc analysis of clinical trials not primarily designed to evaluate the effect of anticoagulants, mainly low molecular weight heparins (LMWH), on cancer survival. Other studies regarding the addition of unfractionated heparin or oral anticoagulants to standard cancer treatment offered controversial results. However, recent investigations among cancer patients without deep venous thrombosis, with cancer-related mortality as the primary end point, suggest that at least in some patients LMWH may exert an antineoplastic effect in vivo and alter the natural history of malignant disease by increasing the response rates and, therefore, improving survival. Additional research on this field is needed to clarify the biological mechanisms involved and to answer yet unsolved questions such as the types of tumor and stages of disease most suitable for this treatment as well as how to optimize treatment regimens.

  16. Clinical implementation of a novel applicator in high-dose-rate brachytherapy treatment of esophageal cancer

    Directory of Open Access Journals (Sweden)

    Ivan M. Buzurovic

    2016-08-01

    Full Text Available Purpose : In this study, we present the clinical implementation of a novel transoral balloon centering esophageal applicator (BCEA and the initial clinical experience in high-dose-rate (HDR brachytherapy treatment of esophageal cancer, using this applicator. Material and methods: Acceptance testing and commissioning of the BCEA were performed prior to clinical use. Full performance testing was conducted including measurements of the dimensions and the catheter diameter, evaluation of the inflatable balloon consistency, visibility of the radio-opaque markers, congruence of the markers, absolute and relative accuracy of the HDR source in the applicator using the radiochromic film and source position simulator, visibility and digitization of the applicator on the computed tomography (CT images under the clinical conditions, and reproducibility of the offset. Clinical placement of the applicator, treatment planning, treatment delivery, and patient’s response to the treatment were elaborated as well. Results : The experiments showed sub-millimeter accuracy in the source positioning with distal position at 1270 mm. The digitization (catheter reconstruction was uncomplicated due to the good visibility of markers. The treatment planning resulted in a favorable dose distribution. This finding was pronounced for the treatment of the curvy anatomy of the lesion due to the improved repeatability and consistency of the delivered fractional dose to the patient, since the radioactive source was placed centrally within the lumen with respect to the clinical target due to the five inflatable balloons. Conclusions : The consistency of the BCEA positioning resulted in the possibility to deliver optimized non-uniform dose along the catheter, which resulted in an increase of the dose to the cancerous tissue and lower doses to healthy tissue. A larger number of patients and long-term follow-up will be required to investigate if the delivered optimized treatment can

  17. Clinical utility of trabectedin for the treatment of ovarian cancer: current evidence

    Directory of Open Access Journals (Sweden)

    Mascilini F

    2014-07-01

    Full Text Available Floriana Mascilini,* Giulia Amadio,* Maria Grazia Di Stefano, Manuela Ludovisi, Alessia Di Legge, Carmine Conte, Rosa De Vincenzo, Caterina Ricci, Valeria Masciullo, Vanda Salutari, Giovanni Scambia, Gabriella FerrandinaGynecologic Oncology Unit, Department of Oncology, Catholic University of Rome, Italy  *These authors contributed equally to this work Abstract: Among the pharmaceutical options available for treatment of ovarian cancer, attention has been increasingly focused on trabectedin (ET-743, a drug which displays a unique mechanism of action and has been shown to be active in several human malignancies. Currently, single agent trabectedin is approved for treatment of patients with advanced soft tissue sarcoma after failure of anthracyclines and ifosfamide, and in association with pegylated liposomal doxorubicin for treatment of patients with relapsed partially platinum-sensitive ovarian cancer. This review aims at summarizing the available evidence about the clinical role of trabectedin in the management of patients with epithelial ovarian cancer. Novel perspectives coming from a better understanding of trabectedin mechanisms of action and definition of patients subgroups likely susceptible to benefit of trabectedin treatment are also presented. Keywords: ET-743, ovarian cancer, clinical trials

  18. Choosing relevant endpoints for older breast cancer patients in clinical trials: an overview of all current clinical trials on breast cancer treatment.

    Science.gov (United States)

    de Glas, N A; Hamaker, M E; Kiderlen, M; de Craen, A J M; Mooijaart, S P; van de Velde, C J H; van Munster, B C; Portielje, J E A; Liefers, G J; Bastiaannet, E

    2014-08-01

    With the ongoing ageing of western societies, the proportion of older breast cancer patients will increase. For several years, clinicians and researchers in geriatric oncology have urged for new clinical trials that address patient-related endpoints such as functional decline after treatment of older patients. The aim of this study was to present an overview of trial characteristics and endpoints of all currently running clinical trials in breast cancer, particularly in older patients. The clinical trial register of the United States National Institutes of Health Differences was searched for all current clinical trials on breast cancer treatment. Trial characteristics and endpoints were retrieved from the register and differences in characteristics between studies in older patients specifically (defined as a lower age-limit of 60 years or older) and trials in all patients were assessed using χ(2) tests. We included 463 clinical trials. Nine trials (2 %) specifically investigated breast cancer treatment in older patients. Ninety-one breast cancer trials included any patient-related endpoint (20 %), while five trials specifically addressing older patients included any patient-related endpoint (56 %, P = 0.02). Five of the trials in older patients incorporated a geriatric assessment (56 %). Clinical trials still rarely incorporate patient-related endpoints, even in trials that specifically address older patients. Trials that are specifically designed for older patients do not often incorporate a geriatric assessment in their design. This implicates that current clinical studies are not expected to fill the gap in knowledge concerning treatment of older breast cancer patients in the next decade.

  19. SU-E-T-447: Electronic Brachytherapy (EBT) Treatment of Cervical Cancer - First Clinical Experience

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, D; Johnson, M; Thompson, J; Ahmad, S [University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma (United States); Chan, L; Hausen, H [Xoft Inc., San Jose, CA (United States)

    2014-06-01

    Purpose: To study the first trial patient in which an electronic brachytherapy (EBT) x-ray source is utilized for treatment of cervical cancer. Methods: During patient treatment, a miniaturized x-ray source was used in combination with a customized titanium tandem and ovoid applicator set. The semi-specialized source was modeled with formalisms outlined by AAMP Task Group 43. Multiple models were used to compensate for variable attenuation conditions as a function of source positions. Varian Brachyvision treatment planning software was utilized on CT data sets for dose calculations prior to treatment delivery. The dose was prescribed to “point A” as defined by American Brachytherapy society. Additional treatments plans were created from those clinically utilized in patient care and were recalculated for an existing Ir-192 source model. Dose volume histograms (DVH) and point dose calculations were compared between the modalities for the clinical condition present in patients treated with EBT. Results: Clinical treatment times, though longer than those typically experienced by Ir-192 users, were manageable. Instantaneous dose rates at personal positions within the treatment vault were lower than those measured during intra operative radiation therapy and breast EBT treatments. Due to lower average photon energy in EBT, dose gradients within the treatment plans were as expected steeper than those observed in Ir-192 based brachytherapy. DVH comparisons between Ir-192 and EBT treatments showed an expected decrease in the integral dose to normal tissues of interest for EBT. In comparing plans created for EBT delivery with those calculated for Ir-192, average dose values for EBT were more than 4%, 11%, and 9% lower at predefined bladder, rectum and “point B” positions, respectively. Conclusion: For the first time, we have demonstrated that the utilizing electronic brachytherapy system for tandem and ovoid based treatment of cancer of the cervix is feasible, and

  20. Biology and potential clinical implications of tissue inhibitor of metalloproteinases-1 in colorectal cancer treatment

    DEFF Research Database (Denmark)

    Sørensen, Nanna Møller; Sørensen, irene Vejgaard; Würtz, Sidse Ørnbjerg

    2008-01-01

    Colorectal cancer (CRC) is the second leading cause of cancer-related death in the industrialized world. About half of "curatively" resected patients develop recurrent disease within the next 3-5 years despite the lack of clinical, histological and biochemical evidence of remaining overt disease...... after resection of the primary tumour. Availability of validated biological markers for early detection, selection for adjuvant therapy, prediction of treatment efficacy and monitoring of treatment efficacy would most probably increase survival. Tissue inhibitor of metalloproteinases-1 (TIMP-1) may...... patients, suggesting that TIMP-1 could have a tumour-promoting function. Furthermore, measurement of plasma TIMP-1 has been shown to be useful for disease detection, with a high sensitivity and high specificity for early-stage colon cancer. This review describes some basic information on the current...

  1. Clinical evidence of the efficacy of everolimus and its potential in the treatment of breast cancer

    Directory of Open Access Journals (Sweden)

    Saksena R

    2013-05-01

    Full Text Available Rujuta Saksena, Serena T WongThe Cancer Institute of New Jersey, New Brunswick, NJ, USAAbstract: The PI3K/Akt/mTOR (phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin pathway regulates several key cellular functions and its dysregulation creates an environment that promotes tumorigenesis as well as resistance to therapy. The mTOR inhibitor everolimus has emerged as a promising agent in the treatment of breast cancer and was recently approved in combination with exemestane for advanced hormone receptor–positive disease after progression on a nonsteroidal aromatase inhibitor. Everolimus may also be effective in combination with cytotoxic and human epidermal growth factor receptor-2-directed therapies for the treatment of other subtypes of breast cancer. This paper highlights preclinical and clinical data that have emerged on the role of mTOR inhibition in breast cancer. Although generally well tolerated, everolimus carries a unique side effect profile of which both patients and providers should be made aware. Recommendations related to the administration of everolimus in the clinical setting are also discussed.Keywords: everolimus, breast cancer, mTOR inhibition

  2. [Clinical effectiveness of nadroparin calcium in the surgical treatment of breast cancer].

    Science.gov (United States)

    Iaremchuk, A Ia; Zotov, A S; Cheshuk, V E; Anikuc'ko, N F; Zakhartseva, L M; Diatel, M V; Kravchenko, A V; Lobanova, O E; Sidorchuk, O I

    2003-01-01

    The report deals with an assessment of frequency of fatal thromboembolic complications after surgery for breast cancer, in particular, frequency and severity of the side-effects of calcium nadroparin treatment as a component of surgical preparation. Considering the low incidence of thromboembolic complications in such patients and the side-effects of anti-coagulant therapy, it is suggested that decisions be made on a strictly individual basis under stringent clinical control.

  3. Critical appraisal of ramucirumab (IMC-1121B) for cancer treatment: from benchside to clinical use.

    Science.gov (United States)

    Aprile, Giuseppe; Bonotto, Marta; Ongaro, Elena; Pozzo, Carmelo; Giuliani, Francesco

    2013-12-01

    Although antiangiogenic treatments have produced milestone advances in the treatment of several diseases, and have significantly extended the median survival of cancer patients, these agents share some weaknesses, including a limited impact on the overall cure rate, a fleeting effect because of redundant pathways or early appearance of resistance mechanisms, and the lack of predictive factors for treatment selection. Recent data suggest that antibodies targeting the vascular endothelial growth factor axis exert their activity through the inhibition of vascular endothelial growth factor receptor-2 phosphorylation, which has a pivotal role in the neoangiogenic process. Ramucirumab, a fully humanized monoclonal antibody specifically directed against the extracellular domain of the receptor, administered intravenously every 2 or 3 weeks, is emerging as a novel antiangiogenic opportunity. Starting with preclinical data and early clinical results, this concise review focuses on the development of the novel compound across multiple cancers (including gastrointestinal malignancies, breast cancer, lung carcinoma, and genitourinary tumors), and presents available data from randomized phase II and phase III trials. REGARD was the first phase III study to report on the efficacy of single-agent ramucirumab in patients with advanced cancer. Many other ongoing phase III trials are testing the efficacy of this interesting antiangiogenic compound as a single agent or in combination with chemotherapy in different cancer types.

  4. Clinical significance of prophylactic central compartment neck dissection in the treatment of clinically node-negative papillary thyroid cancer patients.

    Science.gov (United States)

    Gambardella, Claudio; Tartaglia, Ernesto; Nunziata, Anna; Izzo, Graziella; Siciliano, Giuseppe; Cavallo, Fabio; Mauriello, Claudio; Napolitano, Salvatore; Thomas, Guglielmo; Testa, Domenico; Rossetti, Gianluca; Sanguinetti, Alessandro; Avenia, Nicola; Conzo, Giovanni

    2016-09-19

    Lymph nodal involvement is very common in differentiated thyroid cancer, and in addition, cervical lymph node micrometastases are observed in up to 80 % of papillary thyroid cancers. During the last decades, the role of routine central lymph node dissection (RCLD) in the treatment of papillary thyroid cancer (PTC) has been an object of research, and it is now still controversial. Nevertheless, many scientific societies and referral authors have definitely stated that even if in expert hands, RCLD is not associated to higher morbidity; it should be indicated only in selected cases. In order to better analyze the current role of prophylactic neck dissection in the surgical treatment of papillary thyroid cancers, an analysis of the most recent literature data was performed. Prophylactic or therapeutic lymph node dissection, selective, lateral or central lymph node dissection, modified radical neck dissection, and papillary thyroid cancer were used by the authors as keywords performing a PubMed database research. Literature reviews, PTCs large clinical series and the most recent guidelines of different referral endocrine societies, inhering neck dissection for papillary thyroid cancers, were also specifically evaluated. A higher PTC incidence was nowadays reported in differentiated thyroid cancer (DTC) clinical series. In addition, ultrasound guided fine-needle aspiration citology allowed a more precocious diagnosis in the early phases of disease. The role of prophylactic neck dissection in papillary thyroid cancer management remains controversial especially regarding indications, approach, and surgical extension. Even if morbidity rates seem to be similar to those reported after total thyroidectomy alone, RCLD impact on local recurrence and long-term survival is still a matter of research. Nevertheless, only a selective use in high-risk cases is supported by more and more scientific data. In the last years, higher papillary thyroid cancer incidence and more

  5. Clinical roundtable monograph: new and emerging treatments for advanced prostate cancer.

    Science.gov (United States)

    George, Daniel J; Kantoff, Philip W; Lin, Daniel W

    2011-06-01

    Historically, the treatment of metastatic castration-resistant prostate cancer (CRPC) has been limited to chemotherapeutic regimens that did not improve patient survival. In 2004, clinical studies began to demonstrate significant improvements in patient outcomes, including overall survival, with docetaxel versus mitoxantrone chemotherapy. Since these pivotal trials, the combination of docetaxel plus prednisone has become a standard of care for patients with metastatic CRPC. However, the limited survival benefit achieved with this regimen prompted several investigations into the development of alternative therapeutic options. Recent advances have now led to an unprecedented number of new drug approvals within the past year, providing many new treatment options for patients with metastatic CRPC. Sipuleucel-T, considered a new paradigm in cancer treatment, is the first such immunotherapeutic agent approved by the US Food and Drug Administration. Other successes include abiraterone acetate, the first androgen biosynthesis inhibitor, and cabazitaxel, a novel microtubule inhibitor, both of which have demonstrated improved survival following docetaxel failure. The bone-targeting agent denosumab, also recently approved in this setting, offers these patients significant improvement in the prevention of skeletal-related events. The data supporting the approval of each of these agents are described in this monograph, as are current approaches in the treatment of metastatic CRPC and ongoing clinical trials of novel treatments and strategies. The experts also discuss several of the issues regarding the introduction of these novel agents into clinical practice for metastatic CRPC patients.

  6. Application of next-generation sequencing in clinical oncology to advance personalized treatment of cancer

    Institute of Scientific and Technical Information of China (English)

    Yan-Fang Guan; Gai-Rui Li; Rong-Jiao Wang; Yu-Ting Yi; Ling Yang; Dan Jiang; Xiao-Ping Zhang; Yin Peng

    2012-01-01

    With the development and improvement of new sequencing technology,next-generation sequencing (NGS) has been applied increasingly in cancer genomics research over the past decade.More recently,NGS has been adopted in clinical oncology to advance personalized treatment of cancer.NGS is used to identify novel and rare cancer mutations,detect familial cancer mutation carriers,and provide molecular rationale for appropriate targeted therapy.Compared to traditional sequencing,NGS holds many advantages,such as the ability to fully sequence all types of mutations for a large number of genes (hundreds to thousands) in a single test at a relatively low cost.However,significant challenges,particularly with respect to the requirement for simpler assays,more flexible throughput,shorter turnaround time,and most importantly,easier data analysis and interpretation,will have to be overcome to translate NGS to the bedside of cancer patients.Overall,continuous dedication to apply NGS in clinical oncology practice will enable us to be one step closer to personalized medicine.

  7. Clinical Study of Docetaxel, Prednisone and Bevacizunab in the Treatment of Hormone Refractory Prostate Cancer

    Institute of Scientific and Technical Information of China (English)

    Theodore D Koreckij; Todd M Morgan

    2015-01-01

    Objective: To observe the clinical therapeutic effect of docetaxel, prednisone and bevacizunab in the treatment of hormone refractory prostate cancer. Methods:A total of 100 patients with hormone refractory prostate cancer were selected and randomly divided into 2 groups: chemotherapy group and combined group, 50 cases for each. Patients in chemotherapy group were given oral administration of hexadecadrol, 8 mg/d, intravenous drip of docetaxel, 40 mg/m2, orally taking of prednisone, 5 mg/d. Patients in combined group was added with bevacizumab, 5 mg/kg (which was diluted to 100 mL of chloride sodium injection) based on regimen of chemotherapy group. All patients were followed up every month after the end of treatment for recording reoccurrence, metastasis and deaths. Additionally, serum prostate-speciifc antigen (PSA), free prostate-speciifc antigen (fPSA)/total prostate-speciifc antigen (tPSA) before and after chemotherapy, prostate volume, maximum flow rate, the quality of life (QOL) were measured and evaluated. The progression-free survival (PFS) and the overall survival (OS) were analyzed by Kaplan-Meier method. Results: After treatment, the level of PSA in combined group was lower than that in chemotherapy group (P0.05). The median PFS and OS in combined group were 13 months and 20 months, respectively, higher than those in chemotherapy group (10 months and 17 months) (P0.05). Conclusion: Docetaxel combined with Bevacizunab can prolong the survival time of patients with hormone refractory prostate cancer, but its therapeutic effect still needs to be further veriifed. Additionally, with the in-depth of studies on hormone refractory prostate cancer in translational medicine, immunotherapy, targeted therapy, individualized treatment and multidrug therapy will surely become the research hotspot for hormone refractory prostate cancer.

  8. THE CLINICAL COURSE AND TREATMENT RESULTS OF LUNG METASTASES FROM BREAST CANCER

    Institute of Scientific and Technical Information of China (English)

    Xu Binghe; Zhou Jichang; Zhou Aiping; Wang Yan; Feng Fengyi; Sun yan

    1998-01-01

    Objective:To analyze the clinical course and treatment result of lung metastases from breast cancer. Method:122 cases with lung metastases from breast cancer were treated with chemotherapy or chemotherapy plus endocrine therapy, response was assessed according to WHO criteria and survival rate estimated using the life Table. Results: The median time from initial treatment of primary tumor to lung metastases was 22 months. Sites of common consecutive metastases were lung, liver and bone. The overall response rate was 48% with a CR rate of 15%. Compared to non- DDP- encompassing regimen, the CR rate was higher in DDP-based chemotherapy (7%versus 21%, P<0.05) with a longer median survival time (MST). The PR rate was higher in regimens containing anthracycline (48%) than in those without anthracycline (20%, P<0.01). The response rate was similar between chemotherapy and chemotherapy plus endocrine therapy (P>0.05). No difference in MST was observed between patients receiving anthracycline-and non-anthracyclineencompassing regimens. The 1-, 3-, 5-, and 10-year survival rate was 77%, 22 %, 11%, and 10%, respectively.Conclusion: Size of primary tumor, the length of diseasefree interval, the number of lung metastases may provide additional information for predicting patients survival after treatment of lung metastases. Combination chemotherapy, especially DDP-based chemotherapy may prolong survival time of patients with lung metastases from breast cancer.

  9. A Clinical Concept for Interfractional Adaptive Radiation Therapy in the Treatment of Head and Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Jensen, Alexandra D., E-mail: Alexandra.Jensen@med.uni-heidelberg.de [Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany); Nill, Simeon [Department of Medical Physics, German Cancer Research Centre (DKFZ), Heidelberg (Germany); Huber, Peter E. [Clinical Co-Operation Unit Radiation Oncology, German Cancer Research Centre (DKFZ), Heidelberg (Germany); Bendl, Rolf [Department of Medical Physics, German Cancer Research Centre (DKFZ), Heidelberg (Germany); Debus, Juergen; Muenter, Marc W. [Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany)

    2012-02-01

    Purpose: To present an approach to fast, interfractional adaptive RT in intensity-modulated radiation therapy (IMRT) of head and neck tumors in clinical routine. Ensuring adequate patient position throughout treatment proves challenging in high-precision RT despite elaborate immobilization. Because of weight loss, treatment plans must be adapted to account for requiring supportive therapy incl. feeding tube or parenteral nutrition without treatment breaks. Methods and Materials: In-room CT position checks are used to create adapted IMRT treatment plans by stereotactic correlation to the initial setup, and volumes are adapted to the new geometry. New IMRT treatment plans are prospectively created on the basis of position control scans using the initial optimization parameters in KonRad without requiring complete reoptimization and thus facilitating quick replanning in daily routine. Patients treated for squamous cell head and neck cancer (SCCHN) in 2006-2007 were evaluated as to necessity/number of replannings, weight loss, dose, and plan parameters. Results: Seventy-two patients with SCCHN received IMRT to the primary site and lymph nodes (median dose 70.4 Gy). All patients received concomitant chemotherapy requiring supportive therapy by feeding tube or parenteral nutrition. Median weight loss was 7.8 kg, median volume loss was approximately 7%. Fifteen of 72 patients required adaptation of their treatment plans at least once. Target coverage was improved by up to 10.7% (median dose). The increase of dose to spared parotid without replanning was 11.7%. Replanning including outlining and optimization was feasible within 2 hours for each patient, and treatment could be continued without any interruptions. Conclusion: To preserve high-quality dose application, treatment plans must be adapted to anatomical changes. Replanning based on position control scans therefore presents a practical approach in clinical routine. In the absence of clinically usable online

  10. [Clinical trials and licensing of monoclonal antibodies and biological medicines for cancer treatment in Brazil].

    Science.gov (United States)

    Silva, Cecilia Ferreira da; Silva, Miriam Ventura da; Osorio-de-Castro, Claudia Garcia Serpa

    2016-03-01

    Objective To analyze the pathway of clinical trials of monoclonal antibodies and biological medicines for cancer treatment involving Brazilian institutions from 2003 to 2012. Method This retrospective, descriptive study was based on review of two clinical trial registries, ClinicalTrials.gov and the Brazilian registry ReBEC. Phase II or III studies with participation from Brazilian institutions listed in at least one of the registries were included. Following selection of the trials, the pathway of monoclonal antibodies and biological medicines was investigated from the research stage until licensing by the Brazilian Agency for Sanitary Surveillance (Anvisa), Food and Drug Administration (FDA), and European Medicines Agency (EMA). Results Nine trials (eight phase III and one phase II) were selected. All had a randomized, controlled design. Two trials were double-blind and seven were open-label, and all recruited adults (≥ 18 years of age) of both sexes. The mean number of patients recruited per trial was 985.2. Seven trials had been completed and two had been terminated early. All trials were sponsored by non-Brazilian pharmaceutical companies and focused on renal, colorectal, gastric, and lung (non-small cell) cancer, non-Hodgkin lymphoma, and melanoma, and involved the use of cetuximab, figitumumab, ipilimumab, rituximab, bevacizumab and interferon alfa-2a. The FDA was the first agency to license the drugs, followed by EMA, except in the case of interferon alfa-2a, which was not approved by EMA. We were unable to determine the year of drug licensing by Anvisa in Brazil. Conclusions The participation of Brazil in clinical trials of monoclonal antibodies and biological medications for cancer treatment is insufficient. The quality of the available information on trials, history of licensing, and other relevant elements is a major weakness of the sources reviewed.

  11. Yoga for the Treatment of Insomnia among Cancer Patients: Evidence, Mechanisms of Action, and Clinical Recommendations

    OpenAIRE

    Karen M. Mustian; Janelsins, Michelle; Peppone, Luke J.; Kamen, Charles

    2014-01-01

    Up to 90% of cancer patients report symptoms of insomnia during and after treatment. Symptoms of insomnia include excessive daytime sleepiness, difficulty falling asleep, difficulty staying asleep, and waking up too early. Insomnia symptoms are among the most prevalent, distressing and persistent cancer- and cancer treatment-related toxicities reported by patients, and can be severe enough to increase cancer morbidity and mortality. Despite the ubiquity of insomnia symptoms, they are under-sc...

  12. Detection and treatment of synchronous lesions in colorectal cancer: The clinical implication of perioperative colonoscopy

    Institute of Scientific and Technical Information of China (English)

    Min Sun Kim; Young Jin Park

    2007-01-01

    AIM: To evaluate the clinical significance of pre-and intra-operative colonoscopy for the detection of synchronous lesions in colon cancer.METHODS: Two hundred and sixty-five pre-operative and 51 intra-operative colonoscopic evaluations were performed in 316 colorectal cancer patients who underwent curative resection from January 2001 to June 2006. The incidence and characteristics of synchronous lesions and their influence on surgery were evaluated.RESULTS: Two hundred and eighty-two synchronous lesions were detected in 124 (39.2%) of 316 patients including all lesions regardless of their histologic type.True adenomatous polyps were found in 91 (28.8%)of 316 patients, and 17 (5.4% of all patients) patients had synchronous colon cancers. The preoperative identification of synchronous lesions altered the planned surgery in 37 (14.0%) of 265 patients. In 18 patients among the surgically removed cases, the lesions were removed by extending the resection range.Further segmental resection or polypectomy through enterotomy was necessary in 19 patients. Nineteen (37.2%) of 51 intraoperative colonoscopy cases had synchronous lesions. Additional surgical procedures including segmental bowel resection and polypectomy with enterotomy were necessary in 7 (13.7%) of 51 intraoperative colonoscopy cases to remove the lesions.CONCLUSION: Synchronous colorectal polyps or cancer are frequent and their preoperative detection is important for optimal surgical planning and treatment.Intraoperative colonoscopy is a useful option in cases where a preoperative colonoscopy is not feasible.

  13. Clinical Study of Endostar Combined with DP Protocol in Treatment of Advanced Esophageal Cancer

    Directory of Open Access Journals (Sweden)

    Wen-ying DENG

    2015-09-01

    Full Text Available Objective: To observe the clinical outcomes of Endostar combined with DP regimen for treating advanced esophageal cancer.Methods: A total of 62 patients with advanced esophageal cancer admitted from May, 2011 to May, 2013 were enrolled for a prospective, randomized controlled trial and 2 cases were excluded from the study because of Ⅳ degree of digestive tract reaction and myelosuppression. Therefore, 60 cases could be evaluated, and then divided into combined group (given Endostar+DP plan and single chemotherapy group, 30 cases in each group. The level of VEGF, tumor size and CT perfusion (CTP parameters, including blood flow (BF, blood volume (BV, mean transit time (MTT, and permeability surface (PS before and after treatment were determined for comparison. Kaplan-Merier method was used to analyze the overall survival (OS of 2 groups.Results: The efficacy of combined group was superior to single chemotherapy group. The level of vascular endothelial growth factor (VEGF in combined group was obviously lower than that in single chemotherapy group after treatment (P<0.01. Compared with treatment before in combined group, BF, BV and PS decreased while MTT increased after treatment (P<0.05. However, there were no significant differences in single chemotherapygroup before and after treatment (P>0.05. The median OS was 30 months (95%CI: 20.935-39.065 for combined group and 21 months (95%CI: 15.109-26.591 for single chemotherapy group, respectively (P=0.048. The 1-, 2- and 3-year survival rates were 86.2%, 59.3% and 36.6% in combined group, and 70.8%, 32.1% and 17.8% in single chemotherapy group, respectively.Conclusion: Endostar can down-regulate the expression of VEGF, improve the state of hypertransfusion and high permeability of tumor vessels, has better curative effect without slighter adverse reactions, and prolong the survival time of patients with advanced esophageal cancer when combined with chemotherapy.

  14. Clinical Experiences of Korean Medicine Treatment against Urinary Bladder Cancer in General Practice

    Directory of Open Access Journals (Sweden)

    Taeyeol Park

    2016-01-01

    Full Text Available Urinary bladder cancer (UBC is one of the most common cancers, with 1 out of every 26 men and 1 out of every 80 women worldwide developing the disease during their lifetime. Moreover, it is a disease that predominantly affects the elderly and is becoming a major health problem as the elderly population continues to rapidly increase. In spite of the rapid development of medical science, the 5-year survival rate has remained around 75% since the 1990s, and the FDA has approved no new drugs for UBC over the last 10 years. In addition, most patients experience frequent recurrence and poor quality of life after diagnosis. Therefore, in order to solve unmet needs by alternative methods, we present our clinical cases of UBC where we observed outstanding results including regression and recurrence prevention exclusively through Traditional Korean Medicine such as (1 herbal therapy, (2 acupuncture, (3 pharmacopuncture and needle-embedding therapy, (4 moxibustion, and (5 cupping therapy. From our experience, it appears that multimodal strategies for synergistic efficiency are more effective than single Korean Medicine treatment. We hope this will encourage investigation of the efficacy of Korean Medicine treatment in clinical trials for UBC patients.

  15. Clinical Study of Docetaxel, Prednisone and Bevacizunab in the Treatment of Hormone Refractory Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Theodore D. Koreckij

    2015-06-01

    Full Text Available Objective: To observe the clinical therapeutic effect of docetaxel, prednisone and bevacizunab in the treatment of hormone refractory prostate cancer. Methods: A total of 100 patients with hormone refractory prostate cancer were selected and randomly divided into 2 groups: chemotherapy group and combined group, 50 cases, respectively. Patients in chemotherapy group were given oral administration of hexadecadrol, 8 mg/d, intravenous drip of docetaxel, 40 mg/m2, orally taking of prednisone, 5 mg/d. Patients in combined group was added with bevacizumab, 5 mg/kg (which was diluted to 100 mL of chloride sodium injection based on regimen of chemotherapy group. All patients were followed up every month after the end of treatment for recording reoccurrence, metastasis and deaths. Additionally, serum prostate-specific antigen (PSA, free prostate-specific antigen (fPSA/total prostate-specific antigen (tPSA before and after chemotherapy, prostate volume, maximum flow rate, the quality of life (QOL were measured and evaluated. The progression-free survival (PFS and the overall survival (OS were analyzed by Kaplan-Meier method. Results: After treatment, the level of PSA in combined group was lower than that in chemotherapy group (P<0.01 while fPSA/tPSA in combined group was higher than that in chemotherapy group after treatment (P<0.01. The prostate volume of two groups decreased, the maximum flow rate and QOL score of two groups increased, but with no difference between two groups (P>0.05. The median PFS and OS in combined group were 13 months and 20 months, respectively, higher than those in chemotherapy group (10 months and 17 months (P<0.01. The occurrence rate of adverse reactions was 66.00% in combined group and 56.00% in chemotherapy group, but with no significance between them (P>0.05. Conclusion: Docetaxel combined with Bevacizunab can prolong the survival time of patients with hormone refractory prostate cancer, but its therapeutic effect still

  16. Multiparametric magnetic resonance imaging for pre-treatment local staging of prostate cancer: A Cancer Care Ontario clinical practice guideline

    Science.gov (United States)

    Salerno, Jennifer; Finelli, Antonio; Morash, Chris; Morgan, Scott C.; Power, Nicholas; Schieda, Nichola; Haider, Masoom A.

    2016-01-01

    Introduction: The utility of T2-weighted magnetic resonance imaging (MRI) in the local staging of prostate cancer is controversial. Due to the success of multiparametric MRI in cancer localization, there is renewed interested in MRI (± functional sequences) for local staging. Guidance on pre-treatment local staging of prostate cancer by MRI was developed using systematic review methodology and expert consultation. Methods: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and other databases were searched to identify studies comparing: (1) MRI staging vs. radical prostatectomy staging on diagnostic accuracy outcomes; and (2) MRI staging vs. routine clinical staging on clinical and patient outcomes. Studies meeting inclusion criteria were synthesized by outcome and sensitivity/specificity analysis by tumour location was performed. Evidence quality of included studies was assessed and considered in recommendation formulation. Results: The literature search identified 2510 citations; 62 studies were included. Analysis of MRI ≥1.5 T plus endorectal coil (ER) (± functional sequences) in the detection of extraprostatic extension or seminal vesicle invasion showed modest sensitivities (≥50%) and excellent specificities (>85%) among patients scheduled for radical prostatectomy. MRI upstaging was shown in 20/21 studies, with large variation in correctness (11–85%). Scarcity of clinical and patient outcomes among studies limited synthesis and evaluation. Quality assessment found non-trivial biases. Conclusions: Modest imaging performance was shown for MRI (1.5 T + ER and 3 T ± ER) ± functional sequences in regards to sensitivity. Limitations in study design, reporting of clinical and patient outcomes, and the heterogeneous use of MRI tempered the strength of the recommendations.

  17. Physical and clinical implications of radiotherapy treatment of prostate cancer using a full bladder protocol

    Energy Technology Data Exchange (ETDEWEB)

    Cambria, Raffaella; Cattani, Federica; Luraschi, Rosa; Pedroli, Guido [Istituto Europeo di Oncologia, Milan (Italy). Dept. of Medical Physics; Jereczek-Fossa, Barbara A.; Orecchia, Roberto [Istituto Europeo di Oncologia, Milan (Italy). Dept. of Radiation Oncology; Univ. degli Studi of Milano, Milan (Italy); Zerini, Dario [Istituto Europeo di Oncologia, Milan (Italy). Dept. of Radiation Oncology; Serafini, Flavia [Unita operativa di radioterapia, Azienda Ospedaliera Sant' Anna, Como (Italy)

    2011-12-15

    To assess the dosimetric and clinical implication when applying the full bladder protocol for the treatment of the localized prostate cancer (PCA). A total of 26 consecutive patients were selected for the present study. Patients underwent two series of CT scans: the day of the simulation and after 40 Gy. Each series consisted of two consecutive scans: (1) full bladder (FB) and (2) empty bladder (EB). The contouring of clinical target volumes (CTVs) and organs at risk (OAR) were compared to evaluate organ motion. Treatment plans were compared by dose distribution and dose-volume histograms (DVH). CTV shifts were negligible in the laterolateral and superior-inferior directions (the maximum shift was 1.85 mm). Larger shifts were recorded in the anterior-posterior direction (95% CI, 0.83-4.41 mm). From the dosimetric point of view, shifts are negligible: the minimum dose to the CTV was 98.5% (median; 95%CI, 95-99%). The potential advantage for GU toxicity in applying the FB treatment protocol was measured: the ratio between full and empty bladder dose-volume points (selected from our protocol) is below 0.61, excluding the higher dose region where DVHs converge. Having a FB during radiotherapy does not affect treatment effectiveness, on the contrary it helps achieve a more favorable DVH and lower GU toxicities.

  18. Clinical practice guidelines for the care and treatment of breast cancer: 11. Lymphedema

    Science.gov (United States)

    Harris, Susan R.; Hugi, Maria R.; Olivotto, Ivo A.; Levine, Mark; &NA;

    2001-01-01

    Objective To provide information and recommendations for women and their physicians when making decisions about the management of lymphedema related to breast cancer. Options Compression garments, pneumatic compression pumps, massage and physical therapies, other physical therapy modalities, pharmaceutical treatments. Outcomes Symptom control, quality of life, cosmetic results. Evidence Systematic review of English-language literature retrieved primarily from MEDLINE (1966 to April 2000) and CANCERLIT (1985 to April 2000). Nonsystematic review of breast cancer literature published to October 2000. Recommendations · Pre- and postoperative measurements of both arms are useful in the assessment and diagnosis of lymphedema. Circumferential measurements should be taken at 4 points: the metacarpal-phalangeal joints, the wrists, 10 cm distal to the lateral epicondyles and 15 cm proximal to the lateral epicondyles. · Clinicians should elicit symptoms of heaviness, tightness or swelling in the affected arm. A difference of more than 2.0 cm at any of the 4 measurement points may warrant treatment of the lymphedema, provided that tumour involvement of the axilla or brachial plexus, infection and axillary vein thrombosis have been ruled out. · Practitioners may want to encourage long-term and consistent use of compression garments by women with lymphedema. · One randomized trial has demonstrated a trend in favour of pneumatic compression pumps compared with no treatment. Further randomized trials are required to determine whether pneumatic compression provides additional benefit over compression garments alone. · Complex physical therapy, also called complex decongestive physiotherapy, requires further evaluation in randomized trials. In one randomized trial no difference in outcomes was detected between compression garments plus manual lymph drainage versus compression garments alone. · Clinical experience supports encouraging patients to consider some practical advice

  19. Distinct work-related, clinical and psychological factors predict return to work following treatment in four different cancer types.

    Science.gov (United States)

    Cooper, Alethea F; Hankins, Matthew; Rixon, Lorna; Eaton, Emma; Grunfeld, Elizabeth A

    2013-03-01

    Many factors influence return to work (RTW) following cancer treatment. However specific factors affecting RTW across different cancer types are unclear. This study examined the role of clinical, sociodemographic, work and psychological factors in RTW following treatment for breast, gynaecological, head and neck, and urological cancer. A 12-month prospective questionnaire study was conducted with 290 patients. Cox regression analyses were conducted to calculate hazard ratios (HR) for time to RTW. Between 89-94% of cancer survivors returned to work. Breast cancer survivors took the longest to return (median 30 weeks), and urology cancer survivors returned the soonest (median 5 weeks). Earlier return among breast cancer survivors was predicted by a greater sense of control over their cancer at work (HR 1.2; 95% CI: 1.09-1.37) and by full-time work (HR 2.1; CI: 1.24-3.4). Predictive of a longer return among gynaecological cancer survivors was a belief that cancer treatment may impair ability to work (HR 0.75; CI: 0.62-0.91). Among urological cancer survivors constipation was predictive of longer RTW (HR 0.99; CI: 0.97-1.00), whereas undertaking flexible working was predictive of returning sooner (HR 1.70; CI: 1.07-2.7). Head and neck cancer survivors who perceived greater negative consequences of their cancer took longer to return (HR 0.27; CI: 0.11-0.68). Those reporting better physical functioning returned sooner (HR1.04; CI: 1.01-1.08). A different profile of predictive factors emerged for the four cancer types. In addition to optimal symptom management and workplace adaptations, the findings suggest that eliciting and challenging specific cancer and treatment-related perceptions may facilitate RTW. Copyright © 2012 John Wiley & Sons, Ltd.

  20. Clinical and treatment factors associated with vaginal stenosis after definitive chemoradiation for anal canal cancer.

    Science.gov (United States)

    Mirabeau-Beale, Kristina; Hong, Theodore S; Niemierko, Andrzej; Ancukiewicz, Marek; Blaszkowsky, Lawrence S; Crowley, Elizabeth M; Cusack, James C; Drapek, Lorraine C; Kovalchuk, Nataliya; Markowski, Meghan; Napolitano, Brian; Nyamwanda, Jacqueline; Ryan, David P; Wolfgang, John; Kachnic, Lisa A; Wo, Jennifer Y

    2015-01-01

    We sought to evaluate the incidence of vaginal stenosis (VS) and identify clinical and treatment factors that predict for VS in female patients with anal cancer treated with definitive chemoradiation. The cohort included 95 consecutive women receiving definitive chemoradiation between 2003 and 2012. All but 1 received intensity modulated radiation therapy; median primary tumor dose 50.4 Gy (range, 41.4-60). A modified National Cancer Institute Common Terminology Criteria for Adverse Events version 4 was used to score VS based on the medical record description of dyspareunia, pain with dilator use, vaginal dryness, or difficult pelvic examination. Ordered logistic regression was performed to assess VS predictors. Median age was 60.4 years (range, 19-97). With median follow-up of 2.5 years, 70 women (74%) had adequate information to assess VS. Of these, VS grade distribution was 21.4% grade 0, 14.3% grade 1, 27.1% grade 2, and 37.1% grade 3. By multivariable ordered logistic regression, younger age (P = .02), higher tumor dose (P = .06), and earlier treatment year (P = .04) were associated with higher grade of VS. VS is a common late complication in women treated definitively with chemoradiation for anal canal cancer. Younger age, higher tumor dose, and earlier year of treatment were associated with a higher grade of stenosis. Prospective investigation into patient reported outcomes is warranted, including sexual function and VS prevention strategies to better understand its effect on long-term survivorship. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  1. Cetuximab in the treatment of head and neck cancer: preliminary results outside clinical trials

    Directory of Open Access Journals (Sweden)

    Didier Dequanter

    2010-06-01

    Full Text Available Didier Dequanter, Mohammad Shahla, Pascal Paulus, Phillippe LothaireDepartment of Head and Neck Surgery, CHU Charleroi, Montigny le Tilleul, BelgiumIntroduction: The purpose of this study was to evaluate the clinical efficacy in our daily practice, outside clinical trials, of cetuximab plus radiotherapy in a majority of treatment-naive patients with locoregionally advanced head and neck squamous cell carcinomas.Methods: A retrospective study was performed to evaluate outcomes in patients who were treated definitively with cetuximab and radiotherapy (ExRT. Patients with stage III or IV, nonmetastatic, measurable squamous cell carcinoma of the head and neck (SCCHN were eligible.Results: There were 18 males and two females. The median age was 61 years (range from 49 to 87 years old. Concurrent radiotherapy and cetuximab was used, in first line, in 17 patients with locally advanced disease; two patients with recurrent SCCHN, who were intolerant of Cisplatin-based regimens, were treated with radiotherapy combined with weekly cetuximab; and 1 patient received cetuximab and radiotherapy postoperatively. The median time of response was 10 months (range from 2 to 24 months. A partial response was observed in 11 cases; a complete response in nine cases. The occurrence of grade 2–3 skin toxicity was observed in 11 cases. Skin toxicity was clearly correlated with a better response and the duration of the response to the treatment. The use of cetuximab in combination with radiotherapy does not increase the side effects of radiotherapy. At the end of the follow-up, 17 patients died.Conclusion: Cetuximab, with its highly targeted mechanism of action and synergistic activity with current treatment modalities, is a valuable treatment option in head and neck patients. The effect of the epidermal growth factor receptor antagonist occurs without any change in the pattern and the severity of toxicity usually associated with head and neck radiation. Cetuximab seems

  2. Treatment of breast cancer with different antiprogestins: Preclinical and clinical studies

    OpenAIRE

    Bakker, Gerard; Setyono-Han, Buddy; Portengen, Henk; Jong, Frank de; Foekens, John; Klijn, Jan

    1990-01-01

    markdownabstractAbstract Treatment with antiprogestins in a new treatment modality for breast cancer. Previously, in rats with DMBA-induced mammary tumors we observed significant growth inhibitory effects of chronic treatment with the antiprogestin mifepristone (RU486). In addition, in 11 postmenopausal breast cancer patients, we observed one objective response, six instances of short-term stable disease, and four instances of progressive disease. Side-effects appeared mainly due to antigluco...

  3. Clinical Study of Endostar Combined with DP Protocol in Treatment of Advanced Esophageal Cancer

    Institute of Scientific and Technical Information of China (English)

    DENG Wen-ying; LI Ning; LUO Su-xia

    2015-01-01

    Objective: To observe the clinical outcomes of Endostar combined with DP regimen for treating advanced esophageal cancer. Methods: A total of 62 patients with advanced esophageal cancer admitted from May, 2011 to May, 2013 were enrolled for a prospective, randomized controlled trial and 2 cases were excluded from the study because ofⅣ degree of digestive tract reaction and myelosuppression. Therefore, 60 cases could be evaluated, and then divided into combined group (given Endostar+DP plan) and single chemotherapy group, 30 cases in each group. The level of VEGF, tumor size and CT perfusion (CTP) parameters, including blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface (PS) before and after treatment were determined for comparison. Kaplan-Merier method was used to analyze the overall survival (OS) of 2 groups. Results:The efifcacy of combined group was superior to single chemotherapy group. The level of vascular endothelial growth factor (VEGF) in combined group was obviously lower than that in single chemotherapy group after treatment (P0.05). The median OS was 30 months (95%CI: 20.935-39.065) for combined group and 21 months (95%CI: 15.109-26.591) for single chemotherapy group, respectively (P=0.048). The 1-, 2- and 3-year survival rates were 86.2%, 59.3% and 36.6% in combined group, and 70.8%, 32.1% and 17.8% in single chemotherapy group, respectively. Conclusion: Endostar can down-regulate the expression of VEGF, improve the state of hypertransfusion and high permeability of tumor vessels, has better curative effect without slighter adverse reactions, and prolong the survival time of patients with advanced esophageal cancer when combined with chemotherapy.

  4. International clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer

    NARCIS (Netherlands)

    Farge, D.; Debourdeau, P.; Beckers, M.; Baglin, C.; Bauersachs, R. M.; Brenner, B.; Brilhante, D.; Falanga, A.; Gerotzafias, G. T.; Haim, N.; Kakkar, A. K.; Khorana, A. A.; Lecumberri, R.; Mandala, M.; Marty, M.; Monreal, M.; Mousa, S. A.; Noble, S.; Pabinger, I.; Prandoni, P.; Prins, M. H.; Qari, M. H.; Streiff, M. B.; Syrigos, K.; Bounameaux, H.; Buller, H. R.

    2013-01-01

    . Background: Guidelines addressing the management of venous thromboembolism (VTE) in cancer patients are heterogeneous and their implementation has been suboptimal worldwide. Objectives: To establish a common international consensus addressing practical, clinically relevant questions in this settin

  5. International clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer

    NARCIS (Netherlands)

    Farge, D.; Debourdeau, P.; Beckers, M.; Baglin, C.; Bauersachs, R. M.; Brenner, B.; Brilhante, D.; Falanga, A.; Gerotzafias, G. T.; Haim, N.; Kakkar, A. K.; Khorana, A. A.; Lecumberri, R.; Mandala, M.; Marty, M.; Monreal, M.; Mousa, S. A.; Noble, S.; Pabinger, I.; Prandoni, P.; Prins, M. H.; Qari, M. H.; Streiff, M. B.; Syrigos, K.; Bounameaux, H.; Buller, H. R.

    2013-01-01

    . Background: Guidelines addressing the management of venous thromboembolism (VTE) in cancer patients are heterogeneous and their implementation has been suboptimal worldwide. Objectives: To establish a common international consensus addressing practical, clinically relevant questions in this settin

  6. Clinical use of abiraterone in the treatment of metastatic castration-resistant prostate cancer

    Directory of Open Access Journals (Sweden)

    Zobniw CM

    2014-08-01

    Full Text Available Chrystia M Zobniw,1 Alanna Causebrook,2 Mei Ka Fong1 1Department of Pharmacy, Roswell Park Cancer Institute, Buffalo, NY, USA; 2School of Pharmacy, Lake Erie College of Osteopathic Medicine, Erie, PA, USA Abstract: Prostate cancer remains the most common type of cancer among men in the United States. Treatment for metastatic prostate cancer has improved significantly over the years with more and more agents improving overall survival. This review will address the pathophysiology of prostate cancer followed by the mechanism of action and the pharmacokinetic properties of abiraterone. The review will also discuss the role of abiraterone in the treatment of metastatic castrate-resistant prostate cancer. Keywords: glucocorticoid receptor, CYP17, pipeline, enzalutamide, sipuleucel-T, drug resistance, radium-223 dichloride

  7. Clinical Trials with Pegylated Liposomal Doxorubicin in the Treatment of Ovarian Cancer

    OpenAIRE

    Carmela Pisano; Sabrina Chiara Cecere; Marilena Di Napoli; Carla Cavaliere; Rosa Tambaro; Gaetano Facchini; Cono Scaffa; Simona Losito; Antonio Pizzolorusso; Sandro Pignata

    2013-01-01

    Among the pharmaceutical options available for treatment of ovarian cancer, increasing attention has been progressively focused on pegylated liposomal doxorubicin (PLD), whose unique formulation prolongs the persistence of the drug in the circulation and potentiates intratumor accumulation. Pegylated liposomal doxorubicin (PLD) has become a major component in the routine management of epithelial ovarian cancer. In 1999 it was first approved for platinum-refractory ovarian cancer and then rece...

  8. Review of current clinical experience with prolonged (oral) etoposide in cancer treatment

    NARCIS (Netherlands)

    DeJong, RS; Mulder, NH; Dijksterhuis, D; DeVries, EGE

    1995-01-01

    Prolonged oral etoposide monotherapy is an effective treatment in patients with small cell lung cancer (SCLC) and refractory malignant lymphoma. It shows remarkable activity in relapsed or refractory breast and ovarian cancer (response rates up to 35% and 26%), and was also active in refractory germ

  9. A multidisciplinary clinical treatment of locally advanced rectal cancer complicated with rectovesical fistula: a case report

    Directory of Open Access Journals (Sweden)

    Zhan Tiancheng

    2012-10-01

    Full Text Available Abstract Introduction Rectal cancer with rectovesical fistula is a rare and difficult to treat entity. Here, we describe a case of rectal cancer with rectovesical fistula successfully managed by multimodality treatment. To the best of our knowledge, this is the first such case report in the literature. Case presentation A 51-year-old Chinese man was diagnosed as having rectal cancer accompanied by rectovesical fistula. He underwent treatment with neoadjuvant radiochemotherapy combined with total pelvic excision and adjuvant chemotherapy, as recommended by a multimodality treatment team. Post-operative pathology confirmed the achievement of pathological complete response. Conclusions This case suggests that a proactive multidisciplinary treatment is needed to achieve complete cure of locally advanced rectal cancer even in the presence of rectovesical fistula.

  10. Clinical roundtable monograph. Current treatment options for metastatic breast cancer: what now?

    Science.gov (United States)

    Rugo, Hope S; O'Shaughnessy, Joyce A; Perez, Edith A

    2011-11-01

    Approximately 30% of patients with breast cancer will develop metastatic breast disease. Metastatic breast cancer is considered an incurable disease, with complete remission rarely achieved after treatment. The goal of treatment for metastatic breast cancer patients is to increase overall survival time and delay disease progression while ameliorating symptoms and improving or maintaining quality of life. Single-agent therapeutic regimens are appropriate for most metastatic breast cancer patients. Patients with the luminal A subtype of breast cancer, which is more indolent in nature and tends to be more sensitive to treatment in general, often respond well to single-agent therapy. Several chemotherapy regimens are recommended for the treatment of metastatic breast cancer. Compared with single-agent regimens, these combination regimens often produce a greater improvement in the rate of objective response as well as a prolongation of progression-free survival. There is little evidence, however, of improvement in overall survival. Combination chemotherapy regimens are often associated with a greater degree of toxicity depending on schedules and doses used. The use of bevacizumab in metastatic breast cancer is currently a topic of controversy. It is hoped that forthcoming trial data will enable the identification of a group of patients, based on tumor biology, who could benefit from bevacizumab-based therapy.

  11. Prostate cancer - treatment

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000403.htm Prostate cancer - treatment To use the sharing features on this page, ... drugs is recommended. References National Cancer Institute. Prostate cancer treatment (PDQ): Stages of prostate cancer. Updated July 31, ...

  12. [EAU guidelines on prostate cancer. Part I: screening, diagnosis, and treatment of clinically localised disease].

    Science.gov (United States)

    Heidenreich, A; Bellmunt, J; Bolla, M; Joniau, S; Mason, M; Matveev, V; Mottet, N; Schmid, H P; van der Kwast, T; Wiegel, T; Zattoni, F

    2011-10-01

    Our aim was to present a summary of the 2010 version of the European Association of Urology (EAU) guidelines on the screening, diagnosis, and treatment of clinically localised cancer of the prostate (PCa). The working panel performed a literature review of the new data emerging from 2007 to 2010. The guidelines were updated, and level of evidence and grade of recommendation were added to the text based on a systematic review of the literature, which included a search of online databases and bibliographic reviews. A full version is available at the EAU office or Web site (www.uroweb.org). Current evidence is insufficient to warrant widespread population-based screening by prostate-specific antigen (PSA) for PCa. A systematic prostate biopsy under ultrasound guidance and local anaesthesia is the preferred diagnostic method. Active surveillance represents a viable option in men with low-risk PCa and a long life expectancy. PSA doubling time in EAU guidelines on PCa summarise the most recent findings and put them into clinical practice. Copyright © 2011 AEU. Published by Elsevier Espana. All rights reserved.

  13. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease.

    Science.gov (United States)

    Heidenreich, Axel; Bellmunt, Joaquim; Bolla, Michel; Joniau, Steven; Mason, Malcolm; Matveev, Vsevolod; Mottet, Nicolas; Schmid, Hans-Peter; van der Kwast, Theo; Wiegel, Thomas; Zattoni, Filliberto

    2011-01-01

    Our aim was to present a summary of the 2010 version of the European Association of Urology (EAU) guidelines on the screening, diagnosis, and treatment of clinically localised cancer of the prostate (PCa). The working panel performed a literature review of the new data emerging from 2007 to 2010. The guidelines were updated, and level of evidence and grade of recommendation were added to the text based on a systematic review of the literature, which included a search of online databases and bibliographic reviews. A full version is available at the EAU office or Web site (www.uroweb.org). Current evidence is insufficient to warrant widespread population-based screening by prostate-specific antigen (PSA) for PCa. A systematic prostate biopsy under ultrasound guidance and local anaesthesia is the preferred diagnostic method. Active surveillance represents a viable option in men with low-risk PCa and a long life expectancy. PSA doubling time in EAU guidelines on PCa summarise the most recent findings and put them into clinical practice. Copyright © 2010 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  14. Clinical Case Discussion: Primary Treatment for Prostate Cancer in an Elderly Man-Treatment of the Primary Tumor is Necessary.

    Science.gov (United States)

    Knipper, Sophie; Graefen, Markus

    2017-10-03

    The decision-making process for treatment of prostate cancer should not be based on a single parameter such as patient age but should account for cancer characteristics, life expectancy, comorbidities, and patient expectation. Local treatment might be beneficial in selected elderly men with aggressive disease and a long life expectancy. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  15. Children Thyroid Cancer treatment in Saint-Petersburg Endocrine SurgeryCenter and Mayo Clinic

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    Aleksandr Filippovich Romanchishen

    2015-02-01

    Full Text Available IntroductionThyroid cancer (TC is the most often malignant tumor in childhood and made 1.5 – 3.0% of all children population or 45.3% of pediatric endocrine epithelial cancers. A lot of questions concerning to volume of thyroid surgery, postoperative radio iodine therapy (RIT needs to be discussed.AimEstimation of childhood sporadic thyroid cancer specificity and comparison of children and adolescents treatment in Saint-Petersburg Endocrine Surgery Center (Russia and Mayo Clinic (USA.Material and methodsDuring 1970 –2011 in the Saint-Petersburg Center (1 group were operated 105 TC children and adolescent (up to 20 yeas and in Mayo Clinic – 188 (2 group in  1940 – 2000 period. Since of 80-s in those clinics were used the same perioperative examinations, like TSH, T4, T3 blood levels, USG, fine needles aspiration biopsy, CT and morphological examinations.Results and discussionAverage age of the Saint-Petersburg Center and Rochester patients was the same and achieve 16.3±0.3 and 16.0±0.5, accordingly. In both groups has prevailed girls: in the 1 group they made 73.3% (M:F 1:2.7 and in the 2 – 70.7% (M:F 1:2.4. Childhood differentiated TC were associated with aggressive behavior: regional metastases were found in 53.0% and 81.4%, extrathyroid TC spreading – in 9.6 and 19.7%, distant metastases - in 9.6 and 4.8%, accordingly. In our Center (1 group we have performed hemithyroidectomies and subtotal Thyroidectomies in 58.1% with ipsilateral central neck dissection (CND. In Mayo Clinic in all TC cases were performed thyroidectomy (TE since 1950. TC relapses we have no   observed in 1 group and they have place in 6.9% 2 group patients, recurring lymphatic metastases – in 8.4% and 20.7%, accordingly. Radioiodine therapy (RIT has performed in 21.1% and 25.5% operated children.In 1 group 95 (96.0 % of 99 operated were alive during 5 – 36 years, in the 2– only in two cases reason of death was TC, but in 14 – other malignant tumor

  16. Physical Activity during Cancer Treatment (PACT Study: design of a randomised clinical trial

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    de Wit G Ardine

    2010-06-01

    Full Text Available Abstract Background Fatigue is a major problem of cancer patients. Thirty percent of cancer survivors report serious fatigue three years after finishing treatment. There is evidence that physical exercise during cancer treatment reduces fatigue. This may also lead to an improvement of quality of life. Such findings may result in a decrease of healthcare related expenditures and societal costs due to sick leave. However, no studies are known that investigated these hypotheses. Therefore, the primary aim of our study is to assess the effect of exercise during cancer treatment on reducing complaints of fatigue and on reducing health service utilisation and sick leave. Methods/Design The Physical Activity during Cancer Treatment study is a multicentre randomised controlled trial in 150 breast and 150 colon cancer patients undergoing cancer treatment. Participants will be randomised to an exercise or a control group. In addition to the usual care, the exercise group will participate in an 18-week supervised group exercise programme. The control group will be asked to maintain their habitual physical activity pattern. Study endpoints will be assessed after 18 weeks (short term and after 9 months (long term. Validated questionnaires will be used. Primary outcome: fatigue (Multidimensional Fatigue Inventory and Fatigue Quality List and cost-effectiveness, health service utilisation and sick leave. Secondary outcome: health related quality of life (European Organisation Research and Treatment of Cancer-Quality of Life questionnaire-C30, Short Form 36 healthy survey, impact on functioning and autonomy (Impact on functioning and autonomy questionnaire, anxiety and depression (Hospital Anxiety and Depression Scale, physical fitness (aerobic peak capacity, muscle strength, body composition and cognitive-behavioural aspects. To register health service utilisation and sick leave, participants will keep diaries including the EuroQuol-5D. Physical activity level

  17. Working during cancer treatment

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000834.htm Working during cancer treatment To use the sharing features on this page, ... JavaScript. Many people continue to work throughout their cancer treatment. Cancer, or the side effects of treatment, may ...

  18. Salivary Gland Cancer Treatment

    Science.gov (United States)

    ... and Oropharyngeal Cancer Screening Research Salivary Gland Cancer Treatment (PDQ®)–Patient Version General Information About Salivary Gland ... in diagnosing salivary gland cancer. Certain factors affect treatment options and prognosis (chance of recovery). The treatment ...

  19. [Clinical evaluation of the effectiveness of radiation treatment for endometrial cancer].

    Science.gov (United States)

    Turkevich, V G

    2014-01-01

    The study is based on data on 306 patients with endometrial cancer treated as combined (remote + contact) and only the contact exposure with low, medium and high dose rate. For comparative radiobiological evaluation of reactions of irradiated tissues there were used the following radiobiological models: factor time-dose-fractionation, the cumulative radiation effect, linear- quadratic model in the variant of biologically effective dose. Survival of endometrial cancer patients undergone combined or only the contact radiation treatment was determined by the stage of disease. In particular, the survival of patients with Stage IB endometrial cancer (combined radiation treatment) was significantly higher than in Stage IC, while in Stage IB (contact radiation treatment) was significantly higher than in Stages IC and IIB. Long-term results of radiation treatment of patients with all Stages of endometrial cancer were significantly better by 16% when only the contact radiation treatment was performed. The most preferred component of radiotherapy in women suffering from endometrial cancer with severe comorbidities was brachytherapy with high dose rate both in the combined and only contact irradiation.

  20. Theranostic liposomes for cancer diagnosis and treatment: current development and pre-clinical success.

    Science.gov (United States)

    Muthu, Madaswamy S; Feng, Si-Shen

    2013-02-01

    Liposomes are one of the effective drug delivery systems that are developed based on the nanotechnology concept. Liposomal formulation is the first nanomedicine approved by the US FDA for clinical application. Recently, the marketed liposomes and stealth liposomes have made impact for cancer therapy. In addition, a few receptor-targeted liposome products have been in different phases of clinical trials, which are yet to be marketed. In the present editorial, the advantages of vitamin E TPGS-coated liposomes over the currently available PEG-coated liposomes will be described and their great potentials for nanotheranostics for cancer imaging and therapy will be covered.

  1. CURRENT TREATMENT POLICY FOR RECTAL CANCER WITH SYNCHRONOUS DISTANT METASTASES (A CLINICAL CASE

    Directory of Open Access Journals (Sweden)

    M. I. Davydov

    2014-01-01

    Full Text Available Treatment results of low rectal cancer patient with internal sphincter involvement and synchronous liver metastases is presented. After combined treatment including preoperative targeted therapy, chemotherapy, chemoradiotherapy a synchronous resection of primary tumour and liver metastases was carried out (R0. Synchronous right hepihepatectomy and proctectomy was performed with resection of the deep part of external sphincter, neorectum creation by transverse coloplasty, neoanal sphincter creation using colonic smooth muscle layer without preventive colostomy. A possibility of synchronous plastic sphincter-sparing surgery in metastatic rectal cancer patient with locally advanced tumour is demonstrated. Such treatment allows to remove the risk of primary tumour complications, facilitates further chemotherapy treatment and improves quality of life and long-term treatment outcome.

  2. Prevention and Treatment of Cancer-Related Infections, Version 2.2016, NCCN Clinical Practice Guidelines in Oncology.

    Science.gov (United States)

    Baden, Lindsey Robert; Swaminathan, Sankar; Angarone, Michael; Blouin, Gayle; Camins, Bernard C; Casper, Corey; Cooper, Brenda; Dubberke, Erik R; Engemann, Ashley Morris; Freifeld, Alison G; Greene, John N; Ito, James I; Kaul, Daniel R; Lustberg, Mark E; Montoya, Jose G; Rolston, Ken; Satyanarayana, Gowri; Segal, Brahm; Seo, Susan K; Shoham, Shmuel; Taplitz, Randy; Topal, Jeffrey; Wilson, John W; Hoffmann, Karin G; Smith, Courtney

    2016-07-01

    Infectious diseases are important causes of morbidity and mortality in patients with cancer. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Prevention and Treatment of Cancer-Related Infections characterize the major pathogens to which patients with cancer are susceptible, with a focus on the prevention, diagnosis, and treatment of major common and opportunistic infections. This portion of the guidelines highlights the sections on antifungal and antiviral prophylaxis. Antifungal and antiviral prophylaxis recommendations have expanded over the past few years. New agents for the treatment of fungal infections and incorporation of therapeutic drug monitoring are presented. Antiviral prophylaxis for hepatitis B and management considerations for hepatitis C and HIV have been further developed.

  3. Alternative treatment option for hypopharyngeal cancer: clinical outcomes after conservative laryngeal surgery with partial pharyngectomy.

    Science.gov (United States)

    Chung, Eun-Jae; Lee, Jong-Joo; Kim, Hyun-Sung; Lee, Dong-Jin; Jung, Chul-Hoon; Chang, Yong-Joon; Rho, Young-Soo

    2013-08-01

    The oncological and functional outcomes of hypopharyngeal cancer after conservative laryngeal surgery are fairly acceptable, making this a reasonable initial treatment option for selected patients. The purpose of this study was to assess the clinical outcomes of patients with hypopharyngeal squamous cell carcinoma (SCC) treated with conservative laryngeal surgery with partial pharyngectomy. Fifty-eight patients with hypopharyngeal SCC who underwent laryngeal preservation surgery were enrolled. The tumors were classified as cT1 in 5 (8.6%) patients, cT2 in 35 (60.3%), cT3 in 14 (24.1%), and cT4a in 4 (6.9%) patients. Surgical outcomes: 5-year overall and disease-specific survival rates were 78% and 77.6%. Recurrent disease developed in 13 patients (22.4%). Multivariate analysis revealed that level VI metastasis confirmed by histopathological analysis, close (alimentation was achieved within a mean of 26.1 days after surgery. Fifty-one patients (87.9%) could be decannulated after a mean of 43.8 days postoperatively.

  4. Management of Endometrial Cancer at Mayo Clinic: Intensive Surgical Staging and Disease-based Postoperative Treatment

    NARCIS (Netherlands)

    Mariani, A.

    2006-01-01

    Chapter 1 is a general introduction, while chapter 8 is the final discussion and conclusions. The remaining chapters (from 2 to 7) are composed by a brief introduction, followed by the published article(s) that form(s) the structure of the chapter. Management of Endometrial Cancer at Mayo Clinic: I

  5. Management of Endometrial Cancer at Mayo Clinic: Intensive Surgical Staging and Disease-based Postoperative Treatment

    NARCIS (Netherlands)

    Mariani, A.

    2006-01-01

    Chapter 1 is a general introduction, while chapter 8 is the final discussion and conclusions. The remaining chapters (from 2 to 7) are composed by a brief introduction, followed by the published article(s) that form(s) the structure of the chapter. Management of Endometrial Cancer at Mayo Clinic: I

  6. Lost in translation: animal models and clinical trials in cancer treatment.

    Science.gov (United States)

    Mak, Isabella Wy; Evaniew, Nathan; Ghert, Michelle

    2014-01-01

    Due to practical and ethical concerns associated with human experimentation, animal models have been essential in cancer research. However, the average rate of successful translation from animal models to clinical cancer trials is less than 8%. Animal models are limited in their ability to mimic the extremely complex process of human carcinogenesis, physiology and progression. Therefore the safety and efficacy identified in animal studies is generally not translated to human trials. Animal models can serve as an important source of in vivo information, but alternative translational approaches have emerged that may eventually replace the link between in vitro studies and clinical applications. This review summarizes the current state of animal model translation to clinical practice, and offers some explanations for the general lack of success in this process. In addition, some alternative strategies to the classic in vivo approach are discussed.

  7. What is a “good” treatment decision?: Decisional control, knowledge, treatment decision-making, and quality of life in men with clinically localized prostate cancer

    Science.gov (United States)

    Orom, Heather; Biddle, Caitlin; Underwood, Willie; Nelson, Christian J.; Homish, D. Lynn

    2016-01-01

    Objective We explored whether active patient involvement in decision making and greater patient knowledge are associated with better treatment decision making experiences and better quality of life (QOL) among men with clinically localized prostate cancer. Localized prostate cancer treatment decision-making is an advantageous model for studying patient treatment decision-making dynamics as there are multiple treatment options and a lack of empirical evidence to recommend one over the other; consequently, it is recommended that patients be fully involved in making the decision. Methods Men with newly diagnosed clinically localized prostate cancer (N=1529) completed measures of decisional control, prostate cancer knowledge, and their decision-making experience (decisional conflict, and decision-making satisfaction and difficulty) shortly after they made their treatment decision. Prostate cancer-specific QOL was assessed 6-months after treatment. Results More active involvement in decision making and greater knowledge were associated with lower decisional conflict and higher decision-making satisfaction, but greater decision-making difficulty. An interaction between decisional control and knowledge revealed that greater knowledge was only associated with greater difficulty for men actively involved in making the decision (67% of sample). Greater knowledge, but not decisional control predicted better QOL 6-months post-treatment. Conclusion Although men who are actively involved in decision making and more knowledgeable may make more informed decisions, they could benefit from decisional support (e.g., decision-making aids, emotional support from providers, strategies for reducing emotional distress) to make the process easier. Men who were more knowledgeable about prostate cancer and treatment side effects at the time they made their treatment decision may have appraised their QOL as higher because they had realistic expectations about side effects. PMID:26957566

  8. Clinical use of cabozantinib in the treatment of advanced kidney cancer: efficacy, safety, and patient selection

    Directory of Open Access Journals (Sweden)

    Yu SS

    2016-09-01

    Full Text Available Steven S Yu, David I Quinn, Tanya B Dorff Division of Oncology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA Abstract: Clear cell (cc renal cell carcinoma (RCC is the most common type of cancer found in the kidney accounting for ~90% of all kidney cancers. In 2012, there were ~337,000 new cases of RCC diagnosed worldwide with an estimated 143,000 deaths, with the highest incidence and mortality in Western countries. Despite improvements in cancer control achieved with VEGF- and mTOR-targeted therapy for RCC, progression remains virtually universal and additional therapies are needed. The pivotal results of the METEOR trial led to cabozantinib’s designation as a breakthrough drug by the US Food and Drug Administration and its approval for treatment of advanced RCC in 2016. Subsequent data from the CABOSUN trial, where caboxantinib is compared with sunitinib, will provide information on the relative activity of cabozantinib as first-line therapy for ccRCC. We review the development of cabozantinib in advanced RCC and its role in the treatment landscape for advanced RCC. Keywords: cabozantinib, renal cell carcinoma, kidney cancer, clear cell carcinoma, tyrosine kinase inhibitor

  9. Clinical Trials with Pegylated Liposomal Doxorubicin in the Treatment of Ovarian Cancer

    Directory of Open Access Journals (Sweden)

    Carmela Pisano

    2013-01-01

    Full Text Available Among the pharmaceutical options available for treatment of ovarian cancer, increasing attention has been progressively focused on pegylated liposomal doxorubicin (PLD, whose unique formulation prolongs the persistence of the drug in the circulation and potentiates intratumor accumulation. Pegylated liposomal doxorubicin (PLD has become a major component in the routine management of epithelial ovarian cancer. In 1999 it was first approved for platinum-refractory ovarian cancer and then received full approval for platinum-sensitive recurrent disease in 2005. PLD remains an important therapeutic tool in the management of recurrent ovarian cancer in 2012. Recent interest in PLD/carboplatin combination therapy has been the object of phase III trials in platinum-sensitive and chemonaïve ovarian cancer patients reporting response rates, progressive-free survival, and overall survival similar to other platinum-based combinations, but with a more favorable toxicity profile and convenient dosing schedule. This paper summarizes data clarifying the role of pegylated liposomal doxorubicin (PLD in ovarian cancer, as well as researches focusing on adding novel targeted drugs to this cytotoxic agent.

  10. Clinical trials with pegylated liposomal Doxorubicin in the treatment of ovarian cancer.

    Science.gov (United States)

    Pisano, Carmela; Cecere, Sabrina Chiara; Di Napoli, Marilena; Cavaliere, Carla; Tambaro, Rosa; Facchini, Gaetano; Scaffa, Cono; Losito, Simona; Pizzolorusso, Antonio; Pignata, Sandro

    2013-01-01

    Among the pharmaceutical options available for treatment of ovarian cancer, increasing attention has been progressively focused on pegylated liposomal doxorubicin (PLD), whose unique formulation prolongs the persistence of the drug in the circulation and potentiates intratumor accumulation. Pegylated liposomal doxorubicin (PLD) has become a major component in the routine management of epithelial ovarian cancer. In 1999 it was first approved for platinum-refractory ovarian cancer and then received full approval for platinum-sensitive recurrent disease in 2005. PLD remains an important therapeutic tool in the management of recurrent ovarian cancer in 2012. Recent interest in PLD/carboplatin combination therapy has been the object of phase III trials in platinum-sensitive and chemonaïve ovarian cancer patients reporting response rates, progressive-free survival, and overall survival similar to other platinum-based combinations, but with a more favorable toxicity profile and convenient dosing schedule. This paper summarizes data clarifying the role of pegylated liposomal doxorubicin (PLD) in ovarian cancer, as well as researches focusing on adding novel targeted drugs to this cytotoxic agent.

  11. Diagnosis, clinical staging, and treatment of breast cancer: a retrospective multiyear study of a large controlled population.

    Science.gov (United States)

    Legorreta, Antonio P; Chernicoff, Helen O; Trinh, Jennifer B; Parker, Robert G

    2004-04-01

    This study compares diagnosis, staging, and treatment of newly diagnosed breast cancer cases over a several-year period. The study design was a retrospective, multiyear comparison between new breast cancer cases diagnosed in 1995 (n = 827) and 1997 (n = 815). Cases were identified through claims data, and medical record abstraction was used to verify each case and to identify clinical staging and type of treatment. All medical records were reviewed by one physician to maximize internal reliability. Both cohorts were predominantly 40 and older, white, married, and postmenopausal. The latter cohort (1997) had a higher proportion of women aged 70 to 79 and a lower proportion of women aged 40 to 49. In both cohorts, women age 40 and older were likely to be diagnosed with breast cancer at the time of mammographic screening, while women younger than 40 were more likely to be diagnosed by clinical breast examination. In logistic regression analyses, controlling for confounding factors such as age, undergoing mammographic screening increased the likelihood of having a low cancer stage at diagnosis by more than three and a half times. Mammographic screening was statistically significantly positively associated with having eligibility for breast-conserving treatment (BCT); however, although an increase in BCT eligibility was observed, actual use of BCT did not change. Mammography leads to a lower clinical stage as well as a greater likelihood of BCT eligibility at time of breast cancer diagnosis, but may not have a substantial effect on treatment choice (lumpectomy vs. mastectomy). Between 1995 and 1997, a trend was observed toward downstaging of disease at diagnosis; further research is warranted to observe whether this trend continues over time.

  12. Nanotechnology in cancer treatment

    Science.gov (United States)

    Mironidou-Tzouveleki, Maria; Imprialos, Konstantinos; Kintsakis, Athanasios

    2011-10-01

    The purpose of this paper is to analyze the current evolutions on nanotechnology and its applications on cancer theragnostics.Rapid advances and emerging technologies in nanotechnology are having a profound impact on cancer treatment. Applications of nanotechnology, which include liposomes, nanoparticles, polymeric micelles, dendrimers, nanocantilever, carbon nanotubes and quantum dots have significantly revolutionized cancer theragnostics. From a pharmaceutical viewpoint, it is critical that the biodistribution of active agents has to be controlled as much as possible. This aspect is vital in order to assure the proper efficiency and safety of the anticancer agents. These biocompatible nanocomposites provide specific biochemical interactions with receptors expressed on the surface of cancer cells. With passive or active targeting strategies, an increased intracellular concentration of drugs can be achieved in cancer cells , while normal cells are being protected from the drug simultaneously. Thus, nanotechnology restricts the extent of the adverse effects of the anticancer therapy. Treatment for metastatic breast cancer, sarcoma in AIDS patients, ovarian and lung cancer is already on market or under final phases of many clinical trials, showing remarkable results. As nanotechnology is perfected, side effects due to normal cell damage will decrease, leading to better results and lengthening patient's survival.

  13. Discordance between clinical and pathological TNM classification: influence on results of treatment and prognosis in patients with laryngeal cancer.

    Science.gov (United States)

    Celakovsky, P; Kalfert, D; Smatanova, K; Kordac, P; Laco, J; Chrobok, V

    2017-01-01

    The goals of this retrospective cohort study were to compare the results of clinical and pathological TNM staging in patients with laryngeal squamous cell carcinoma and to determine the impact of the discordance on prognosis and treatment results. A total of 124 patients with laryngeal cancer, primarily indicated for surgical treatment, were enrolled. The concordance or discordance between the clinical and pathological staging was compared with the frequency of cancer relapse and disease-specific survival. Other potential prognostic factors, like age, the stage and location of the primary tumor, the status of neck lymph nodes, histological margins, and an indication for postoperative radiotherapy, were also evaluated. A disparity in at least one component of TNM staging was found in 40 patients (32%). The discordance had significant negative influence on both disease-free survival (DSF) and disease-specific survival (DSS). Other significant negative prognostic factors were the stage of the primary tumor, nodal status and postoperative radiotherapy. Our results indicate that the discordance between clinical and pathological staging affects the results of cancer treatment significantly. Some improvement can be probably achieved with higher preoperative diagnostic method accuracy.

  14. Characteristics and risk factors of major and clinically relevant non-major bleeding in cancer patients receiving anticoagulant treatment for acute venous thromboembolism-the CATCH study

    NARCIS (Netherlands)

    Kamphuisen, P.W.; Lee, A.Y.Y.; Meyer, Guy; Bauersachs, R.; Janas, M.S.; Jarner, M.F.; Khorana, A.A.

    2015-01-01

    Background: Cancer patients with acute venous thromboembolism (VTE) receiving anticoagulant treatment have a substantial risk of bleeding complications. Aims: To assess the rate, site and risk factors of clinically relevant bleeding (CRB; major or clinically relevant non-major bleeding) in cancer pa

  15. Pharmacological and clinical differences among transmucosal fentanyl formulations for the treatment of breakthrough cancer pain: a review article.

    Science.gov (United States)

    Corli, O; Roberto, A

    2014-10-01

    Breakthrough pain (BTP) is highly prevalent (59.2%) in chronic cancer patients and normally needs rescue treatments' with opioids when pain flares up. Transmucosal oral/nasal fentanyl formulations are commonly used in clinical practice. The different methods of release influence the pharmacokinetics and clinical properties of these formulations. The aim of this review was to assess and weigh these differences. Clinical trials comparing one transmucosal fentanyl with placebo or another active drug were included. We searched Medline for the last ten years and analyzed 13 studies, totaling 1447 patients. Clinical data on efficacy and safety were compared. In parallel, we report the differences in delivery systems, bioavailability, maximum plasma concentration (Cmax), plasma half-life, and time to reach Cmax (tmax). Considerable variability emerged between formulations. This suggests some considerations on the choice of the fentanyl formulation in the light of the BTP features in each clinical case.

  16. High-Dose-Rate Interstitial Brachytherapy as Monotherapy for Clinically Localized Prostate Cancer: Treatment Evolution and Mature Results

    Energy Technology Data Exchange (ETDEWEB)

    Zamboglou, Nikolaos [Department of Radiation Oncology, Klinikum Offenbach, Offenbach (Germany); Tselis, Nikolaos, E-mail: ntselis@hotmail.com [Department of Radiation Oncology, Klinikum Offenbach, Offenbach (Germany); Baltas, Dimos [Department of Medical Physics and Engineering, Klinikum Offenbach, Offenbach (Germany); Buhleier, Thomas [Department of Radiation Oncology, Klinikum Offenbach, Offenbach (Germany); Martin, Thomas [Department of Radiation Oncology, Klinikum Bremen-Mitte, Bremen (Germany); Milickovic, Natasa; Papaioannou, Sokratis [Department of Medical Physics and Engineering, Klinikum Offenbach, Offenbach (Germany); Ackermann, Hanns [Institute of Biostatistics, J.W. Goethe University of Frankfurt, Frankfurt (Germany); Tunn, Ulf W. [Department of Urology, Klinikum Offenbach, Offenbach (Germany)

    2013-03-01

    Purpose: To report the clinical outcome of high-dose-rate (HDR) interstitial (IRT) brachytherapy (BRT) as sole treatment (monotherapy) for clinically localized prostate cancer. Methods and Materials: Between January 2002 and December 2009, 718 consecutive patients with clinically localized prostate cancer were treated with transrectal ultrasound (TRUS)-guided HDR monotherapy. Three treatment protocols were applied; 141 patients received 38.0 Gy using one implant in 4 fractions of 9.5 Gy with computed tomography-based treatment planning; 351 patients received 38.0 Gy in 4 fractions of 9.5 Gy, using 2 implants (2 weeks apart) and intraoperative TRUS real-time treatment planning; and 226 patients received 34.5 Gy, using 3 single-fraction implants of 11.5 Gy (3 weeks apart) and intraoperative TRUS real-time treatment planning. Biochemical failure was defined according to the Phoenix consensus, and toxicity was evaluated using Common Toxicity Criteria for Adverse Events version 3. Results: The median follow-up time was 52.8 months. The 36-, 60-, and 96-month biochemical control and metastasis-free survival rates for the entire cohort were 97%, 94%, and 90% and 99%, 98%, and 97%, respectively. Toxicity was scored per event, with 5.4% acute grade 3 genitourinary and 0.2% acute grade 3 gastrointestinal toxicity. Late grade 3 genitourinary and gastrointestinal toxicities were 3.5% and 1.6%, respectively. Two patients developed grade 4 incontinence. No other instance of grade 4 or greater acute or late toxicity was reported. Conclusion: Our results confirm IRT-HDR-BRT is safe and effective as monotherapy for clinically localized prostate cancer.

  17. Pre-treatment clinical assessment in head and neck cancer: United Kingdom National Multidisciplinary Guidelines.

    Science.gov (United States)

    Robson, A; Sturman, J; Williamson, P; Conboy, P; Penney, S; Wood, H

    2016-05-01

    This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. This paper provides recommendations on the pre-treatment clinical assessment of patients presenting with head and neck cancer. Recommendations • Comorbidity data should be collected as it is important in the analysis of survival, quality of life and functional outcomes after treatment as well as for comparing results of different treatment regimens and different centres. (R) • Patients with hypertension of over 180/110 or associated target organ damage, should have antihypertensive medication started pre-operatively as per British Hypertension Society guidelines. (R) • Rapidly correcting pre-operative hypertension with beta blockade appears to cause higher mortality due to stroke and hypotension and should not be used. (R) • Patients with poorly controlled or unstable ischaemic heart disease should be referred for cardiology assessment pre-operatively. (G) • Patients within one year of drug eluting stents should be discussed with the cardiologist who was responsible for their percutaneous coronary intervention pre-operatively with regard to cessation of antiplatelet medication due to risk of stent thrombosis. (G) • Patients with multiple recent stents should be managed in a centre with access to interventional cardiology. (G) • Surgery after myocardial infarction should be delayed if possible to reduce mortality risk. (R) • Patients with critical aortic stenosis (AS) should be considered for pre-operative intervention. (G) • Clopidogrel should be discontinued 7 days pre-operatively; warfarin should be discontinued 5 days pre-operatively. (R) • Patients with thromboembolic disease or artificial heart valves require heparin therapy to bridge peri-operative warfarin cessation, this should start 2 days after last warfarin dose. (R) • Cardiac drugs other than angotensin-converting enzyme inhibitors and angiotensin

  18. Areva: clinical trials for a new treatment to fight cancer; Areva: essais cliniques pour un nouveau traitement contre le cancer

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    2011-01-15

    Areva Med, the branch of Areva dedicated to nuclear medicine, has been agreed by the American Food and Drug Administration to begin the validation of a new treatment to fight cancer. This treatment is called alpha radio-immunotherapy and is based on the use of Pb{sup 212}. The validation phase aims at testing its efficiency on patients and will start in 2011 and will last 2 years. Areva has developed a process to extract Pb{sup 212} from thorium coming from ancient industrial activities. (A.C.)

  19. Ayahuasca and cancer treatment.

    Science.gov (United States)

    Schenberg, Eduardo E

    2013-01-01

    Comprehensively review the evidence regarding the use of ayahuasca, an Amerindian medicine traditionally used to treat many different illnesses and diseases, to treat some types of cancer. An in-depth review of the literature was conducted using PubMed, books, institutional magazines, conferences and online texts in nonprofessional sources regarding the biomedical knowledge about ayahuasca in general with a specific focus in its possible relations to the treatment of cancer. At least nine case reports regarding the use of ayahuasca in the treatment of prostate, brain, ovarian, uterine, stomach, breast, and colon cancers were found. Several of these were considered improvements, one case was considered worse, and one case was rated as difficult to evaluate. A theoretical model is presented which explains these effects at the cellular, molecular, and psychosocial levels. Particular attention is given to ayahuasca's pharmacological effects through the activity of N,N-dimethyltryptamine at intracellular sigma-1 receptors. The effects of other components of ayahuasca, such as harmine, tetrahydroharmine, and harmaline, are also considered. The proposed model, based on the molecular and cellular biology of ayahuasca's known active components and the available clinical reports, suggests that these accounts may have consistent biological underpinnings. Further study of ayahuasca's possible antitumor effects is important because cancer patients continue to seek out this traditional medicine. Consequently, based on the social and anthropological observations of the use of this brew, suggestions are provided for further research into the safety and efficacy of ayahuasca as a possible medicinal aid in the treatment of cancer.

  20. Sipuleucel-T for the Treatment of Patients With Metastatic Castrate-resistant Prostate Cancer: Considerations for Clinical Practice.

    Science.gov (United States)

    Pieczonka, Christopher M; Telonis, Dimitrios; Mouraviev, Vladimir; Albala, David

    2015-01-01

    Sipuleucel-T treatment is associated with a significant and consistent survival benefit in patients with metastatic castrate-resistant prostate cancer. Most adverse events are infusion related, manageable, and of short duration. Early screening and diagnosis of metastatic disease is important, as the greatest survival benefit may occur in patients with a lower disease burden. The short duration of sipuleucel-T treatment facilitates the use of subsequent therapies. Sipuleucel-T is now being used in the clinic for patients with a lower disease burden. We present our own experience with the use of sipuleucel-T in the setting of a large urology practice.

  1. Relevance of health economics in breast cancer treatment: integration of economics in the management of breast cancer at the clinic level.

    Science.gov (United States)

    Jacobs, Volker R; Bogner, Gerhard; Schausberger, Christiane E; Reitsamer, Roland; Fischer, Thorsten

    2013-03-01

    Since the introduction of the diagnosis-related groups (DRG) system with cost-related and entity-specific flat-rate reimbursements for all in-patients in 2004 in Germany, economics have become an important focus in medical care, including breast centers. Since then, physicians and hospitals have had to gradually take on more and more financial responsibilities for their medical care to avoid losses for their institutions. Due to financial limitations of resources, most medical services have to be adjusted to correlating revenues, which results in the development of a variety of active measures to understand, steer, and optimize costs, resources and related processes for breast cancer treatment. In this review, the challenging task to implement microeconomic management at the clinic level for breast cancer treatment is analyzed from breast cancer-specific publications. The newly developed economic management perspective is identified for different stakeholders in the healthcare system, and successful microeconomic projects and future aspects are described.

  2. Trends of surgical treatment of hilar bile duct cancer: clinical andexperimental perspectives

    Institute of Scientific and Technical Information of China (English)

    Zhi Qiang Huang; Ning Xin Zhou; Da Dong Wang; Jian Guo Lu; Ming Yi Chen

    2000-01-01

    AIM To summarize the experience of surgical treatment of hilar cholangiocarcinoma and the results of aseries of experiments.METHODS AND RESULTS Personal perspectives of surgical treatment of hilar cholangiocarcinoma werebased on the experience of a series of patients with hilar bile duct cancer treated in the General Hospital ofPLA, Beijing from 1986 to 1999. A total of 157 cases were treated surgically, with 106 (67.5%) resections ofthe tumor , 37.6% of the resections was proved to be radical. The 1-, 2-, 3-, and 5-year survival rate of theradical resection group was 96.7%, 40.0%, 23.3% and 13.3%, respectively. No patient of the palliativeresection group lived beyond 3 years postoperatively. The recent trends of surgical management of hilar bileduct cancer were discussed. Experiments were carried out for cooperative clinicopathological study toevaluate the perineural space involvement, the neural cell adhesion molecule expression, p16 geneexpression, and the 3-dimensional reconstruction of the bile duct cancer specimens. The pathogeneticrelationship of HBV and HCV with extrahepatic cholangiocarcinoma was evaluated by histochemical and IS-PCR methods. And an inquiry into the possibility of gene therapy was made.CONCLUSION Hilar bile duct cancer rarely runs a “benign” course. It is a regional disease rather than alocal affection and may be related to HBV and HCV infection in China. It possesses the metastasing abilityalong the perineural space by a “jumping” fashion, therefore, in most cases, conventional surgical excision isbound to be unradical in the region of the porta hepatis for anatomical reasons.

  3. Clinical and Preclinical Treatment Aspects of Castration Resistant Prostate Cancer (CRPC)

    NARCIS (Netherlands)

    H.J. Meulenbeld (Hielke)

    2012-01-01

    textabstractIn the Western countries prostate cancer is the most frequently diagnosed cancer, except for skin cancer, and the second leading cause of male cancer deaths. Prostate cancer tends to develop in men over the age of fifty and although it is one of the most prevalent types of cancer in men,

  4. Early-Stage Breast Cancer in the Octogenarian: Tumor Characteristics, Treatment Choices, and Clinical Outcomes

    Science.gov (United States)

    Mamtani, Anita; Gonzalez, Julie J.; Neo, Dayna; Slanetz, Priscilla J.; Houlihan, Mary Jane; Herold, Christina I.; Recht, Abram; Hacker, Michele R.; Sharma, Ranjna

    2016-01-01

    Background Nodal staging with sentinel node biopsy (SLNB), post-lumpectomy radiotherapy (RT), and endocrine therapy (ET) for estrogen receptor-positive (ER+) tumors is valuable in the treatment of early-stage (stages 1 or 2) breast cancer but used less often for elderly women. Methods This retrospective study investigated women referred for surgical evaluation of biopsy-proven primary early-stage invasive breast cancer from January 2001 to December 2010. Clinicopathologic features, treatment course, and outcomes for women ages 80–89 years and 50–59 years were compared. Results The study identified 178 eligible women ages 80–89 years and 169 women ages 50–59 years. The elderly women more often had grade 1 or 2 disease (p = 0.003) and ER+ tumors (p = 0.007) and less frequently had undergone adjuvant therapies (all p ≤ 0.001). Lumpectomy was performed more commonly for the elderly (92 vs. 83 %, p = 0.02), and axillary surgery was less commonly performed (46 vs. 96 %; p < 0.001). Fewer elderly women had undergone post-lumpectomy RT (42 vs. 89 %; p < 0.001) and ET for ER+ tumors (72 vs. 95 %; p < 0.001). During the median follow-up period of 56 months for the 80- to 89-year old group and 98 months for the 50- to 59-year-old group, death from breast cancer was similar (4 vs. 5 %; p = 0.5). The two groups respectively experienced 7 versus 6 locoregional recurrences and 11 versus 13 distant recurrences. Conclusions The octogenarians had disease survivorship similar to that of the younger women despite less frequent use of adjuvant therapies, likely reflecting lower-risk disease features. Whether increased use of axillary surgery, post-lumpectomy RT, and/or ET for ER+ tumors would further improve outcomes is an important area for further study, but treatment should not be deferred solely on the basis of age. PMID:27364507

  5. Cancer treatment - preventing infection

    Science.gov (United States)

    ... Radiation - preventing infection; Bone marrow transplant - preventing infection; Cancer treatment - immunosuppression ... this is a short-lived side effect of cancer treatment. Your provider may give you medicines to help ...

  6. Cancer treatment -- early menopause

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000912.htm Cancer treatment - early menopause To use the sharing features on this page, please enable JavaScript. Certain types of cancer treatments can cause women to have early menopause. This ...

  7. Cancer Treatment Scams

    Science.gov (United States)

    ... Search form Search Vea esta página en español Cancer Treatment Scams Share This Page Facebook Twitter Linked-In Related Items Anatomy of a Cancer Treatment Scam Miracle Health Claims Discount Plan or Health ...

  8. Clinical utility of vandetanib in the treatment of patients with advanced medullary thyroid cancer

    Directory of Open Access Journals (Sweden)

    Deshpande H

    2011-12-01

    Full Text Available Hari Deshpande1,3, Vicky Marler3, Julie Ann Sosa2,31Department of Medicine, 2Department of Surgery, Yale University School of Medicine, 3Yale Cancer Center, New Haven, CT, USAAbstract: Vandetanib (ZD6474 became the first systemic agent to be approved for the treatment of metastatic or locally advanced medullary thyroid cancer. It was a proof of principle, because it is an orally bioavailable medication that targets the growth factors felt to be important in the pathogenesis of this disease, ie, the rearranged during transfection proto-oncogene and vascular endothelial growth factor receptor. It was tested initially in two Phase II studies at doses of 100 mg and 300 mg daily. Although activity was seen at both doses, the higher dose was chosen for a randomized, placebo-controlled Phase II study. This trial, which accrued more than 300 patients, showed a statistically significant benefit for the group taking vandetanib compared with those taking placebo medication. Progression-free survival for the vandetanib arm has not been reached, compared with 19 months for the placebo arm. The main toxicity appears to be diarrhea, although some patients experienced significant side effects, including torsades de pointes and sudden cardiac death. Therefore, it is now necessary for practitioners to enroll in a Risk Evaluation Mitigation Strategy before being allowed to prescribe this medication, to reduce the risk of serious side effects occurring.Keywords: ZD6474, medullary thyroid cancer, vandetanib

  9. Clinical effect of systemic chemotherapy combined with transcatheter arterial chemoembolization in treatment of breast cancer with liver metastases

    Directory of Open Access Journals (Sweden)

    LI Liye

    2016-01-01

    Full Text Available ObjectiveTo investigate the clinical effect of systemic chemotherapy combined with transcatheter arterial chemoembolization (TACE in the treatment of breast cancer with liver metastases. MethodsA total of 86 female breast cancer patients with liver metastases who were treated in the Affiliated Hospital of Shandong Academy of Medical Sciences from December 2012 to December 2014 were selected and equally divided into experimental group and control group. The patients in the control group received systemic chemotherapy, and those in the experimental group received systemic chemotherapy combined with TACE. The clinical effect, changes in lesions, and patients′ quality of life (QOL scores after treatment were compared between two groups. The t-test was applied for comparison of continuous data between the two groups, and the chi-square test was applied for comparison of categorical data between the two groups. ResultsThe experimental group had a significantly higher overall response rate than the control group (90.70% vs 58.14%, χ2=13.07, P=0.001. Compared with the control group, the experimental group had significantly smaller diameters of tumors and lymph nodes after treatment (t=4.26 and 4.63, both P<0.001, as well as significantly higher QOL scores at 3 and 6 months after treatment (t=6.30 and 3.89, both P<0001. ConclusionSystemic chemotherapy combined with TACE has a significant therapeutic effect in breast cancer patients with liver metastases, and can improve patients′ symptoms, reduce adverse drug reactions, and improve QOL. As a safe and reliable therapeutic method, it is worthy of clinical application.

  10. Anti-tumor immune response in ovarian cancer: clinical implications, prognostic significance and potential for novel treatment strategies

    Directory of Open Access Journals (Sweden)

    Nikos G. Gavalas

    2011-12-01

    Full Text Available Ovarian cancer is one of the leading causes of cancer-related death among women. Disease relapse occurs in a high number of cases and treatment currently involves the use of chemotherapy with the use of paclitaxel and platinum-based agents. Resistance to the disease occurs in more than 70% of the cases. The immune system is increasingly becoming a target for intense research in order to study the host’s immune response against ovarian cancer. T cell populations, including NK T cells and Tregs, have been associated with disease outcome indicating their increasing clinical significance, having been associated with positive prognosis and as markers of disease progress, respectively. Cytokines may also be associated with positive prognosis and they can have a direct or indirect effect in mobilizing relevant T cells, thus eliciting an immune response. Harnessing the immune system capacity in order to induce anti-tumor response is a major challenge. This is achieved via the use of antibodies that can elicit an immune response or via the use of direct administration of cytotoxic T cell populations (e.g., CD8?. This review examines the recent developments in our understanding of the mechanisms of development of the immune response in ovarian cancer as well as its prognostic significance and the existing experience in clinical studies using factors associated with immune response, such as monoclonal antibodies, cytokines, vaccines and activated or expanded relevant autologous populations from peripheral blood.

  11. Adjuvant treatment with concomitant radiotherapy and chemotherapy in high-risk endometrial cancer: a clinical experience.

    Science.gov (United States)

    De Marzi, Patrizia; Frigerio, Luigi; Cipriani, Sonia; Parazzini, Fabio; Busci, Luisa; Carlini, Laura; Viganò, Riccardo; Mangili, Giorgia

    2010-03-01

    The concurrent use of radiotherapy (RT) and chemotherapy (CT) as adjuvant treatment after surgery in high-risk endometrial cancer has been generally considered cautiously. Recently some of us have reported preliminary data on the efficacy and tolerability of concomitant CT and RT. In this paper, we update our experience. A total of 47 patients aged >18 years and endometrial endometrioid carcinomas entered the study. Inclusion criteria were stages IC G3, IIB, IIIA (patients with positive washing without other unfavourable prognostic factors were omitted), IIIB and IIIC. The radiation plan consisted of a total dose of 50.4 Gy, given in five fractions per week (1.8 Gy: daily dose) for 6 weeks. Paclitaxel (P) at a dose of 60 mg/m(2) was infused intravenously in 250 mL of normal saline for 1 h once weekly during RT for 5 weeks. Three further cycles of Paclitaxel, at a dose of 80 mg/m(2), have been given weekly at the end of RT. There was no life-threatening toxicity. The overall 5-year relapse-free survival was 81.8% (95% CI, 65.2-90.9). The 5-year percent overall disease-specific survival was 88.4% (95% CI, 71.1-95.6). These results, based on a larger series, support our previous data: Paclitaxel plus RT may represent an effective and well-tolerated treatment in high-risk endometrial cancer patients.

  12. Clinical potential of nintedanib for the second-line treatment of advanced non-small-cell lung cancer: current evidence

    Directory of Open Access Journals (Sweden)

    Rothschild SI

    2014-09-01

    Full Text Available Sacha I Rothschild Department of Internal Medicine, Medical Oncology, University Hospital Basel, Basel, Switzerland Abstract: The therapeutic landscape in non-small-cell lung cancer (NSCLC is changing. The description of molecular alterations leading to NSCLC carcinogenesis and progression (so-called oncogenic driver mutations and the development of targeted agents interfering with the tumor-promoting intracellular signaling pathways have improved the outcome for many patients with advanced/metastatic NSCLC. However, many patients with stage IV NSCLC do not have one of the targetable predictive biomarkers, and are therefore in need of classical chemotherapy. This especially applies to squamous cell cancer. A platinum-based doublet chemotherapy is the standard of care for patients with stage IV NSCLC. As second-line therapies, docetaxel, pemetrexed, and the EGFR tyrosine-kinase inhibitor erlotinib have demonstrated benefit in Phase III randomized trials. Recently, the addition of the angiokinase inhibitor nintedanib to docetaxel has proven efficacious, and is a new treatment option in the second-line setting. Preclinical and clinical data of nintedanib for the treatment of lung cancer patients are reviewed here. Keywords: nintedanib, lung cancer, angiokinase inhibitor, VEGFR, PDGF, FGFR

  13. Prognostic value of clinical, laboratory and molecular predictors in the formation of personalized approaches to breast cancer treatment

    Directory of Open Access Journals (Sweden)

    Phokhach A.V.

    2016-06-01

    group without Herceptin (27,4±3,4 months and higher than the HER-2 / neu-negative patients (38,1±3,0 months. The value of coefficient Spearman rank correlation to tumor response and the factor of menopause, age, general condition of the patient were - 0.174; -0.222; -0.250 (P 0.05, in accordance. In the presence of neutropenia at 1 week after treatment it has been revealed significantly better tumor response to treatment - the correlation coefficient: 0.204 (p <0.05. Conclusion. Molecular subtypes detection had shown that HER-2/neu-positive and tripple negative breast cancer demonstrated the most aggresive course of disease. It was found that a more pronounced tumor response to combination chemotherapy can be expected in young patients, pre-menopausal, high ECOG status. The presence of neutropenia has a significantly positive impact on the results of treatment of patients with metastatic breast cancer. Citation: Phokhach AV, Elhajj MH, Bondarenko IN, Zavizion VF, Hurtovyi VA. [Prognostic value of clinical, laboratory and molecular predictors in the formation of personalized approaches to breast cancer treatment]. Morphologia. 2016;10(2:53-60. Russian.

  14. Treatment Options for Recurrent Lip and Oral Cavity Cancer

    Science.gov (United States)

    ... Oropharyngeal Cancer Screening Research Lip and Oral Cavity Cancer Treatment (PDQ®)–Patient Version General Information About Lip and ... clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have ...

  15. Treatment Options by Stage (Non-Small Cell Lung Cancer)

    Science.gov (United States)

    ... Lung Cancer Screening Research Non-Small Cell Lung Cancer Treatment (PDQ®)–Patient Version General Information About Non-Small ... clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have ...

  16. Treatment Option Overview (Non-Small Cell Lung Cancer)

    Science.gov (United States)

    ... Lung Cancer Screening Research Non-Small Cell Lung Cancer Treatment (PDQ®)–Patient Version General Information About Non-Small ... clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have ...

  17. [Discordance between Clinical and Pathological TNM Classifications in Patients with Oropharyngeal Cancer - Influence on Treatment and Prognosis].

    Science.gov (United States)

    Kordač, P; Kalfeřt, D; Smatanová, K; Laco, J; Vošmik, M; Čelakovský, P; Chrobok, V

    2016-01-01

    The aim of this study was to determine the percentage of discordance between clinical (c) and pathological (p) TNM classifications in cases of oropharyngeal carcinoma and whether it influences recurrence rate and prognosis of primary disease. Fifty-one patients with oropharyngeal carcinoma who underwent primary surgical treatment were included in this retrospective study. Clinical TNM was determined on the basis of clinical examinations and imaging (US, CT, or MRI), and pathological TNM was determined by a histopathologist (analysis of the primary tumor and neck lymph nodes). Concordance and discordance were statistically evaluated. As potential prognostic factors, we statistically analyzed tumor recurrence, specific and nonspecific patient survival, patient age, extent of primary tumor, lymph node positivity, number of removed lymph nodes, and positive tumor margins. Discordance in the TNM classification was found in 27 cases. Disease-free survival was shorter in patients with discordance in T, and this was statistically significant (p = 0.034). Six patients died due to primary disease (11.8%). Disease-specific survival was at the limit of statistical significance (p = 0.069). Discordance between clinical and pathological TNM classifications was 52.9% patients with oropharyngeal carcinoma. Discordance in T is a potential prognostic factor. Improvement in cancer treatment to some extent relies on preoperative staging and should influence the decision about whether or not to administer adjuvant oncological treatment.

  18. Overview of gene therapy clinical progress including cancer treatment with gene-modified T cells.

    Science.gov (United States)

    Brenner, Malcolm K; Okur, Fatma V

    2009-01-01

    It is now twenty years since the first legal gene transfer studies were approved, and there has been considerable disappointment in the slow rate of progress that followed the initial studies. Gradually, however, as the limitations of available vectors are acknowledged and overcome, and with advances in our understanding of the molecular and cell biology of genetic diseases and of cancer, unequivocal successes are now being reported. In this paper we describe the remaining major roadblocks to successful gene therapy and outline approaches to overcome them. We also illustrate how genetically modified immune system cells are already being used for the effective treatment of hematological and other malignancies, and how these approaches are being modified so that they can be effective in treating a broader range of malignancies.

  19. Ayahuasca and cancer treatment

    Directory of Open Access Journals (Sweden)

    Eduardo E Schenberg

    2013-10-01

    Full Text Available Objectives: Comprehensively review the evidence regarding the use of ayahuasca, an Amerindian medicine traditionally used to treat many different illnesses and diseases, to treat some types of cancer. Methods: An in-depth review of the literature was conducted using PubMed, books, institutional magazines, conferences and online texts in nonprofessional sources regarding the biomedical knowledge about ayahuasca in general with a specific focus in its possible relations to the treatment of cancer. Results: At least nine case reports regarding the use of ayahuasca in the treatment of prostate, brain, ovarian, uterine, stomach, breast, and colon cancers were found. Several of these were considered improvements, one case was considered worse, and one case was rated as difficult to evaluate. A theoretical model is presented which explains these effects at the cellular, molecular, and psychosocial levels. Particular attention is given to ayahuasca’s pharmacological effects through the activity of N,N-dimethyltryptamine at intracellular sigma-1 receptors. The effects of other components of ayahuasca, such as harmine, tetrahydroharmine, and harmaline, are also considered. Conclusion: The proposed model, based on the molecular and cellular biology of ayahuasca’s known active components and the available clinical reports, suggests that these accounts may have consistent biological underpinnings. Further study of ayahuasca’s possible antitumor effects is important because cancer patients continue to seek out this traditional medicine. Consequently, based on the social and anthropological observations of the use of this brew, suggestions are provided for further research into the safety and efficacy of ayahuasca as a possible medicinal aid in the treatment of cancer.

  20. Ayahuasca and cancer treatment

    Science.gov (United States)

    2013-01-01

    Objectives: Comprehensively review the evidence regarding the use of ayahuasca, an Amerindian medicine traditionally used to treat many different illnesses and diseases, to treat some types of cancer. Methods: An in-depth review of the literature was conducted using PubMed, books, institutional magazines, conferences and online texts in nonprofessional sources regarding the biomedical knowledge about ayahuasca in general with a specific focus in its possible relations to the treatment of cancer. Results: At least nine case reports regarding the use of ayahuasca in the treatment of prostate, brain, ovarian, uterine, stomach, breast, and colon cancers were found. Several of these were considered improvements, one case was considered worse, and one case was rated as difficult to evaluate. A theoretical model is presented which explains these effects at the cellular, molecular, and psychosocial levels. Particular attention is given to ayahuasca’s pharmacological effects through the activity of N,N-dimethyltryptamine at intracellular sigma-1 receptors. The effects of other components of ayahuasca, such as harmine, tetrahydroharmine, and harmaline, are also considered. Conclusion: The proposed model, based on the molecular and cellular biology of ayahuasca’s known active components and the available clinical reports, suggests that these accounts may have consistent biological underpinnings. Further study of ayahuasca’s possible antitumor effects is important because cancer patients continue to seek out this traditional medicine. Consequently, based on the social and anthropological observations of the use of this brew, suggestions are provided for further research into the safety and efficacy of ayahuasca as a possible medicinal aid in the treatment of cancer. PMID:26770688

  1. Laetrile treatment for cancer.

    Science.gov (United States)

    Milazzo, Stefania; Horneber, Markus

    2015-04-28

    Laetrile is the name for a semi-synthetic compound which is chemically related to amygdalin, a cyanogenic glycoside from the kernels of apricots and various other species of the genus Prunus. Laetrile and amygdalin are promoted under various names for the treatment of cancer although there is no evidence for its efficacy. Due to possible cyanide poisoning, laetrile can be dangerous. To assess the alleged anti-cancer effect and possible adverse effects of laetrile and amygdalin. We searched the following databases: CENTRAL (2014, Issue 9); MEDLINE (1951-2014); EMBASE (1980-2014); AMED; Scirus; CINAHL (all from 1982-2015); CAMbase (from 1998-2015); the MetaRegister; the National Research Register; and our own files. We examined reference lists of included studies and review articles and we contacted experts in the field for knowledge of additional studies. We did not impose any restrictions of timer or language. Randomized controlled trials (RCTs) and quasi-RCTs. We searched eight databases and two registers for studies testing laetrile or amygdalin for the treatment of cancer. Two review authors screened and assessed articles for inclusion criteria. We located over 200 references, 63 were evaluated in the original review, 6 in the 2011 and none in this update. However, we did not identify any studies that met our inclusion criteria. The claims that laetrile or amygdalin have beneficial effects for cancer patients are not currently supported by sound clinical data. There is a considerable risk of serious adverse effects from cyanide poisoning after laetrile or amygdalin, especially after oral ingestion. The risk-benefit balance of laetrile or amygdalin as a treatment for cancer is therefore unambiguously negative.

  2. Maintenance treatment after induction therapy in non-small cell lung cancer: latest evidence and clinical implications

    Science.gov (United States)

    Gentzler, Ryan D.

    2014-01-01

    Non-small cell lung cancer (NSCLC) is the leading cause of cancer death in the industrialized world. Despite significant progress in early stage disease, survival rates for advanced disease remain low. Maintenance therapy is a treatment strategy that has been investigated extensively in NSCLC. Therapies that have been studied in this setting in randomized trials to date include chemotherapy and molecularly targeted agents. Following the development of multiple new agents that show activity in NSCLC and have a tolerable side-effect profile, there has been increasing interest in utilizing them to maintain response to initial therapy after treatment with platinum-based doublets. Two effective strategies have evolved: continuation and switch maintenance. Despite improvements in progression-free survival and often overall survival on multiple clinical trials, there remains considerable controversy around this treatment paradigm. Here, we briefly outline the evolution of this treatment strategy and examine the available data, including recently updated data from the PARAMOUNT, AVAPERL, and PointBreak maintenance trials. Ultimately, the decision to use maintenance chemotherapy requires a nuanced discussion between the patient and physician that adequately assesses benefits of prolonged therapy and impact in terms of toxicity, quality of life, and financial cost. PMID:24381656

  3. Immunogenicity and clinical effectiveness of the trivalent inactivated influenza vaccine in immunocompromised children undergoing treatment for cancer.

    Science.gov (United States)

    Kotecha, Rishi S; Wadia, Ushma D; Jacoby, Peter; Ryan, Anne L; Blyth, Christopher C; Keil, Anthony D; Gottardo, Nicholas G; Cole, Catherine H; Barr, Ian G; Richmond, Peter C

    2016-02-01

    Influenza is associated with significant morbidity and mortality in children receiving therapy for cancer, yet recommendation for, and uptake of the seasonal vaccine remains poor. One hundred children undergoing treatment for cancer were vaccinated with the trivalent inactivated influenza vaccine according to national guidelines in 2010 and 2011. Influenza-specific hemagglutinin inhibition antibody titers were performed on blood samples taken prior to each vaccination and 4 weeks following the final vaccination. A nasopharyngeal aspirate for influenza was performed on all children who developed an influenza-like illness. Following vaccination, seroprotection and seroconversion rates were 55 and 43% for H3N2, 61 and 43% for H1N1, and 41 and 33% for B strain, respectively. Overall, there was a significant geometric mean fold increase to H3N2 (GMFI 4.56, 95% CI 3.19-6.52, P children with solid compared with hematological malignancies and in children vaccinated study population, compared with 6.8% in unvaccinated controls, providing an adjusted estimated vaccine effectiveness of 72% (95% CI -26-94%). There were no serious adverse events and a low reactogenicity rate of 3%. The trivalent inactivated influenza vaccine is safe, immunogenic, provides clinical protection and should be administered annually to immunosuppressed children receiving treatment for cancer. All children <10 years of age should receive a two-dose schedule.

  4. Spotlight on ramucirumab in the treatment of nonsmall cell lung cancer: design, development, and clinical activity

    Science.gov (United States)

    Cobo, Manuel; Gutiérrez, Vanesa; Villatoro, Rosa; Trigo, Jose Manuel; Ramos, Inmaculada; López, Omar; Ruiz, María; Godoy, Ana; López, Irene; Arroyo, Macarena

    2017-01-01

    The vascular endothelial growth factor (VEGF) and receptor is a therapeutic target because of the importance of this pathway in carcinogenesis. This pathway regulates and promotes angiogenesis as well as increases endothelial cell proliferation, permeability, and cancer survival. Ramucirumab is a new fully human monoclonal antibody that targets the VEGF receptor-2, an important key receptor implicated in angiogenesis. Ramucirumab has been approved for the treatment of second-line advanced or metastatic non-small cell lung cancer (NSCLC) in combination with the chemotherapy agent docetaxel. This was based on the result of the randomized trial REVEL of 1,253 patients with metastatic NSCLC previously treated with a platinum-based combination therapy. The authors observed a significant improvement in overall survival (OS) with an acceptable toxicities profile. In this study, patients were randomized to receive ramucirumab plus docetaxel or placebo with docetaxel. The combination of docetaxel and ramucirumab showed an improved OS (hazard ratio [HR]: 0.86; 95% CI: 0.75, 0.98). Median OS was 10.5 months in the ramucirumab arm versus 9.1 months in the placebo arm. Regarding side effects, the toxicity described on the ramucirumab arm were principally diarrhea, fatigue, and neutropenia. The most common (5%) adverse reactions of grade 3 and 4 in the ramucirumab arm were fatigue, neutropenia, febrile neutropenia, leukopenia, and hypertension. Adding ramucirumab to docetaxel improves QoL of patients, and does not impair symptoms or functioning. There are currently several trials in progress evaluating the effects of ramucirumab in combination with other drugs in patients with advanced NSCLC. PMID:28744168

  5. A phase III clinical trial of exercise modalities on treatment side-effects in men receiving therapy for prostate cancer

    Directory of Open Access Journals (Sweden)

    Wall Bradley

    2009-06-01

    exercise in this patient population specifically targeting bone density, cardiovascular function, lean and fat mass, physical function and falls risk as primary study endpoints. In terms of advancement of prostate cancer care, we expect dissemination of the knowledge gained from this project to reduce fracture risk, improve physical and functional ability, quality of life and ultimately survival rate in this population. Clinical Trial Registry A Phase III clinical trial of exercise modalities on treatment side-effects in men receiving therapy for prostate cancer; ACTRN12609000200280

  6. Clinical Characteristics of Prostate Cancer in Advanced Stage and Its Treatment by Chinese and Western Medicine

    Institute of Scientific and Technical Information of China (English)

    张亚强; 宋竖旗

    2009-01-01

    Prostate cancer is a common malignant tumor in male seniors,with the higher rates in the Europe and America.There has been obvious increase in the incidence of prostate cancer in China recently.It has been reported that the incidence of prostate cancer was only

  7. Treatment Options for Urethral Cancer

    Science.gov (United States)

    ... Treatment Health Professional Urethral Cancer Treatment Urethral Cancer Treatment (PDQ®)–Patient Version General Information About Urethral Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment ...

  8. Treatment Option Overview (Bladder Cancer)

    Science.gov (United States)

    ... Cancer Treatment Bladder Cancer Screening Research Bladder Cancer Treatment (PDQ®)–Patient Version General Information About Bladder Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) depends on ...

  9. Vaccine Treatment for Prostate Cancer

    Science.gov (United States)

    ... Back After Treatment Prostate Cancer Treating Prostate Cancer Vaccine Treatment for Prostate Cancer Sipuleucel-T (Provenge) is ... less advanced prostate cancer. Possible side effects of vaccine treatment Side effects from the vaccine tend to ...

  10. Quantifying the aesthetic outcomes of breast cancer treatment: assessment of surgical scars from clinical photographs.

    Science.gov (United States)

    Kim, Min Soon; Rodney, William N; Reece, Gregory P; Beahm, Elisabeth K; Crosby, Melissa A; Markey, Mia K

    2011-12-01

    Accurate assessment of the degree of scaring that results from surgical intervention for breast cancer would enable more effective pre-operative counselling. The resultant scar that accompanies an open surgical intervention may be characterized by variance in thickness, colour and contour. These factors significantly impact the overall appearance of the breast. A number of studies have addressed the mechanical and pathologic aspects of scarring. The majority of these investigations have focused on the physiologic process of scar formation and means to improve the qualities of a scar. Few studies have focused on quantifying the visual impact of scars. This manuscript critically reviews current methods used to assess scars in terms of overall satisfaction after surgery. We introduce objective, quantitative measures for assessing linear breast surgical scars using digital photography. These new measurements of breast surgical scars are based on calculations of contrast and area. We demonstrate, using the intra-class correlation coefficient, that the new measures are robust to observer variability in annotating the scar region on clinical photographs. As an example of the utility of the new measures, we use them to quantify the aesthetic differences of reconstruction following skin-sparing mastectomy vs. conventional mastectomy. © 2010 Blackwell Publishing Ltd.

  11. Accrual to Cancer Clinical Trials

    LENUS (Irish Health Repository)

    Kelly, C

    2016-07-01

    Accrual to cancer clinical trials (CCT) is imperative to safeguard continued improvement in cancer outcomes. A retrospective chart review was performed of patients (n=140) starting a new anti-cancer agent in a north Dublin cancer centre. This review was performed over a four-month period, beginning in November 2015. Only 29% (n=41) had a CCT option. The overall accrual rate to CCT was 5% (n=7), which is comparable to internationally reported figures. The main reasons for failure to recruit to CCT included the lack of a CCT option for cancer type (n=30, 23%), stage (n=25, 19%), and line of treatment (n=23, 17%). Over the last decade, the rate of accrual to CCTs has in fact doubled and the number of trials open to recruitment has tripled. Ongoing governmental and philanthropic support is necessary to continue this trend to further expand CCT patient options with a target accrual rate of 10%.

  12. CLINICAL VALUE OF MULTISLICE SPIRAL X-RAY COMPUTED TOMOGRAPHY WHEN PLANNING THE TREATMENT OF PATIENTS WITH LARYNGEAL CANCER

    Directory of Open Access Journals (Sweden)

    L. G. Kozhanov

    2012-01-01

    Full Text Available Cancers remain a priority for modern society. According to the WHO estimates, global cancer morbidity  and mortality rates will triple in the period 1999 to 2030: from 10 to 30 million new cases and from 6 to 17 million deaths recorded every year, which will exceed deaths from cardiovascular diseases and injuries. The efficiency of treatment in cancer patients and their prediction are determined by timely disease diagnosis, tumor extent estimation, and adequate therapeutic measures. So search for ways to cardinally improve the early recognition of cancer is one of the major tasks in the study of the problems of cancer patients, those with throat cancer in particular.

  13. Clinical practice guidelines for the care and treatment of breast cancer: 15. Treatment for women with stage III or locally advanced breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Shenkier, T.; Weir, L.; Levine, M.; Olivotto, I.; Whelan, T.; Reyno, L. [Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast Cancer, Ontario (Canada)

    2004-03-01

    Locally advanced breast cancer (LABC) occurs relatively infrequently, but it poses a significant clinical challenge. LABC refers to large breast tumours (> 5 cm in diameter) associated with either skin or chest-wall involvement or with fixed (matted) axillary lymph nodes or with disease spread to the ipsilateral internal mammary or supraclavicular nodes. Inflammatory breast cancer, which manifests as a red swollen breast, is considered a type of LABC. The Tumour- Node-Metastasis (TNM) system is used to classify breast cancer into stages (Table 1). According to this system, LABC is stage III. During the last 60 years, the management of LABC has evolved considerably. Initially, patients with LABC were treated with radical mastectomy. Based on the disappointing results of surgery and radiotherapy in patients with LABC, and the early promising results of adjuvant systemic therapy in women with axillary node-positive breast cancer, systemic therapy was subsequently incorporated along with surgery and radiotherapy into the management of patients with LABC, termed 'combined modality therapy.' Even with such combined modality therapy, the long-term survival rate is approximately 50% among patients with LABC. The focus of this guideline is to determine the optimal therapeutic approach for patients who present with LABC. (author)

  14. Pre-treatment nomogram for biochemical control after neoadjuvant androgen deprivation and radical radiotherapy for clinically localised prostate cancer

    OpenAIRE

    Parker, C. C.; Norman, A R; Huddart, R A; Horwich, A; Dearnaley, D. P.

    2002-01-01

    Phase III studies have demonstrated the clinical benefit of adding neo-adjuvant androgen deprivation to radical radiotherapy for clinically localised prostate cancer. We have developed a nomogram to describe the probability of PSA control for patients treated in this way. Five hundred and seventeen men with clinically localised prostate cancer were treated with 3–6 months of neo-adjuvant androgen deprivation and radical radiotherapy (64 Gy in 32#) between 1988 and 1998. Median presenting PSA ...

  15. Efficacy of IP6 + inositol in the treatment of breast cancer patients receiving chemotherapy: prospective, randomized, pilot clinical study.

    Science.gov (United States)

    Bacić, Ivan; Druzijanić, Nikica; Karlo, Robert; Skifić, Ivan; Jagić, Stjepan

    2010-02-12

    Prospective, randomized, pilot clinical study was conducted to evaluate the beneficial effects of inositol hexaphosphate (IP6) + Inositol in breast cancer patients treated with adjuvant therapy. Patients with invasive ductal breast cancer where polychemotherapy was indicated were monitored in the period from 2005-2007. Fourteen patients in the same stage of ductal invasive breast cancer were involved in the study, divided in two randomized groups. One group was subjected to take IP6 + Inositol while the other group was taking placebo. In both groups of patients the same laboratory parameters were monitored. When the treatment was finished, all patients have filled questionnaires QLQ C30 and QLQ-BR23 to determine the quality of life. Patients receiving chemotherapy, along with IP6 + Inositol did not have cytopenia, drop in leukocyte and platelet counts. Red blood cell counts and tumor markers were unaltered in both groups. However, patients who took IP6 + Inositol had significantly better quality of life (p = 0.05) and functional status (p = 0.0003) and were able to perform their daily activities. IP6 + Inositol as an adjunctive therapy is valuable help in ameliorating the side effects and preserving quality of life among the patients treated with chemotherapy.

  16. Clinical utility of letrozole in the treatment of breast cancer: a Chinese perspective

    Directory of Open Access Journals (Sweden)

    He DX

    2016-03-01

    Full Text Available Dong-xu He,1 Xin Ma2 1National Engineering Laboratory for Cereal Fermentation Technology, 2School of Pharmaceutical Sciences, Jiangnan University, Wuxi, People’s Republic of China Abstract: The incidence rate of breast cancers in People’s Republic of China has increased in the last decade, and many cases are responsive to hormone therapies. The third-generation aromatase inhibitor letrozole inhibits estrogen production, and is more efficacious than the estrogen receptor inhibitor tamoxifen. In recent years, letrozole has been widely used to treat postmenopausal breast cancers in People’s Republic of China. Also, metastatic, premenopausal, and male breast cancers have been effectively treated by a combination of letrozole with cytotoxic, radiation, or other therapies. In this review, we provide a perspective and summary of recent advances in the use of letrozole for breast cancer in Chinese patients. Keywords: breast cancer, Chinese, letrozole

  17. Clinical Study on Treatment of Non-small Cell Lung Cancer by Chinese Herbal Medicine Combined with Bronchial Arterial Chemotherapy

    Institute of Scientific and Technical Information of China (English)

    刘城林; 王远东; 金学军; 刘丽萍; 喻庆薇; 蔡悦成

    2001-01-01

    To study the therapeutic effect of Chinese herbal medicine (CHM) combined with bronchial arterial chemotherapy (BAC) in treating lung cancer.Methods: Ninety patients with mid-advanced non-small cell lung cancer (NSCLC) were randomly divided into two groups. The 45 cases in Group A were treated with CHM combined with BAC and the 45 cases in Group B treated with BAC alone. The short-term and long-term effect, follow-up survival rate, quality of life, changes of clinical symptoms and peripheral blood figures in the patients were observed.Results: After treatment, the rate of CR+PR+NC in the two groups was 88.89% and 68.89% respectively, the inter-group comparison showed a significant difference (P<0.05). The 0.5-, 1- and 2-year survival rate in Group A was 75.56%, 55.56% and 48.89% respectively and in Group B 71.11%, 46.67% and 24.44% respectively. The 2-year survival rate in the former was better than that in the latter (P<0.05). Moreover, the improvement of clinical symptoms, Karnofsky scoring, body weight and peripheral blood figure in Group A was superior to those in Group B.Conclusion: Therapeutic effect of BAC could be enhanced by combining it with CHM.

  18. Targeted nanoparticles for image-guided treatment of triple-negative breast cancer: clinical significance and technological advances.

    Science.gov (United States)

    Miller-Kleinhenz, Jasmine M; Bozeman, Erica N; Yang, Lily

    2015-01-01

    Effective treatment of triple-negative breast cancer (TNBC) with its aggressive tumor biology, highly heterogeneous tumor cells, and poor prognosis requires an integrated therapeutic approach that addresses critical issues in cancer therapy. Multifunctional nanoparticles with the abilities of targeted drug delivery and noninvasive imaging for monitoring drug delivery and responses to therapy, such as theranostic nanoparticles, hold great promise toward the development of novel therapeutic approaches for the treatment of TNBC using a single therapeutic platform. The biological and pathological characteristics of TNBC provide insight into several potential molecular targets for current and future nanoparticle-based therapeutics. Extensive tumor stroma, highly proliferative cells, and a high rate of drug resistance are all barriers that must be appropriately addressed in order for these nanotherapeutic platforms to be effective. Utilization of the enhanced permeability and retention effect coupled with active targeting of cell surface receptors expressed by TNBC cells, and tumor-associated endothelial cells, stromal fibroblasts, and macrophages is likely to overcome such barriers to facilitate more effective drug delivery. An in-depth summary of current studies investigating targeted nanoparticles in preclinical TNBC mouse and human xenograft models is presented. This review aims to outline the current status of nanotherapeutic options for TNBC patients, identification of promising molecular targets, challenges associated with the development of targeted nanotherapeutics, the research done by our group as well as by others, and future perspectives on the nanomedicine field and ways to translate current preclinical studies into the clinic.

  19. A brain cancer pathway in clinical practice

    DEFF Research Database (Denmark)

    Laursen, Emilie Lund; Rasmussen, Birthe Krogh

    2012-01-01

    Danish healthcare seeks to improve cancer survival through improved diagnostics, rapid treatment and increased focus on cancer prevention and early help-seeking. In neuro-oncology, this has resulted in the Integrated Brain Cancer Pathway (IBCP). The paper explores how the pathway works...... in the initial phase in a clinical setting with emphasis on pathway criteria....

  20. Clinical commissioning of an in vivo range verification system for prostate cancer treatment with anterior and anterior oblique proton beams

    Science.gov (United States)

    Hoesl, M.; Deepak, S.; Moteabbed, M.; Jassens, G.; Orban, J.; Park, Y. K.; Parodi, K.; Bentefour, E. H.; Lu, H. M.

    2016-04-01

    The purpose of this work is the clinical commissioning of a recently developed in vivo range verification system (IRVS) for treatment of prostate cancer by anterior and anterior oblique proton beams. The IRVS is designed to perform a complete workflow for pre-treatment range verification and adjustment. It contains specifically designed dosimetry and electronic hardware and a specific software for workflow control with database connection to the treatment and imaging systems. An essential part of the IRVS system is an array of Si-diode detectors, designed to be mounted to the endorectal water balloon routinely used for prostate immobilization. The diodes can measure dose rate as function of time from which the water equivalent path length (WEPL) and the dose received are extracted. The former is used for pre-treatment beam range verification and correction, if necessary, while the latter is to monitor the dose delivered to patient rectum during the treatment and serves as an additional verification. The entire IRVS workflow was tested for anterior and 30 degree inclined proton beam in both solid water and anthropomorphic pelvic phantoms, with the measured WEPL and rectal doses compared to the treatment plan. Gafchromic films were also used for measurement of the rectal dose and compared to IRVS results. The WEPL measurement accuracy was in the order of 1 mm and after beam range correction, the dose received by the rectal wall were 1.6% and 0.4% from treatment planning, respectively, for the anterior and anterior oblique field. We believe the implementation of IRVS would make the treatment of prostate with anterior proton beams more accurate and reliable.

  1. Clinical appraisal of abiraterone in the treatment of metastatic prostatic cancer: patient considerations, novel opportunities, and future directions

    Directory of Open Access Journals (Sweden)

    Mitsiades N

    2013-01-01

    Full Text Available Diego J Bedoya,1 Nicholas Mitsiades2,31Clearview Cancer Institute, Huntsville, AL, USA; 2Department of Medicine, 3Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USAAbstract: While androgen-deprivation therapy can induce dramatic clinical responses in advanced and metastatic prostate cancer, refractory disease (castration-resistant prostate cancer [CRPC] eventually emerges. In recent years, several studies have demonstrated the importance of residual intratumoral androgens in maintaining androgen receptor (AR transcriptional activity in CRPC. The cytochrome P450 enzyme CYP17 is an obligatory step in androgen synthesis, and therefore a critical therapeutic target in CRPC. Abiraterone acetate is a selective, irreversible inhibitor of CYP17 and can suppress adrenal synthesis of androgen precursors, and possibly in situ steroidogenesis in the tumor microenvironment. In a phase III multicenter study, abiraterone in combination with prednisone improved median overall survival of men with docetaxel-refractory CRPC by 3.9 months compared to placebo plus prednisone, and also resulted in higher objective prostate-specific antigen and radiographic response rates. The study led to the FDA approval in April 2011 of abiraterone for treatment of chemotherapy-refractory CRPC patients, validating steroidogenesis and the AR axis in general as therapeutic targets in CRPC. The FDA indication for abiraterone was expanded to all CRPCs in December 2012, while evaluation in even earlier disease states is ongoing. We propose a comprehensive AR axis-targeting approach via simultaneous, frontline enzymatic blockade of several steroidogenic enzymes (eg, CYP17 and AKR1C3 in combination with gonadotropin-releasing hormone analogs and potent, second-generation AR antagonists (eg, enzalutamide in order to improve outcomes in patients with prostate cancer.Keywords: androgen synthesis, testosterone, dihydrotestosterone, CYP17, AKR1C3, MDV

  2. [Results of surgical treatment of intrathoracic recurrence after complete resection of non-small cell lung cancer: clinical significance of subsequent lesion in lung parenchyma].

    Science.gov (United States)

    Saito, Y; Takahashi, S; Sato, M; Sagawa, M; Kanma, K; Usuda, K; Endo, C; Chen, Y; Sakurada, A; Aikawa, H

    1995-01-01

    Results of surgical treatment for 33 intrathoracic recurrence after complete resection of non-small cell lung cancer were analyzed. Prognosis of the second surgical treatment were favorable in patients with subsequent cancer with in situ component and solitary lesion in lung parenchyma. Retrospective study of 53 patients who recurred and were thoroughly followed up their clinical course until lung cancer death revealed that the solitary one tends to be confined to the intrathoracic location, and the multiple one did not confined to the intrathoracic location but also extended to the extrathoracic distant metastasis or to the supraclavicular lymph nodes.

  3. Development of a real-time clinical decision support system upon the web mvc-based architecture for prostate cancer treatment

    Directory of Open Access Journals (Sweden)

    Liang Wen-Miin

    2011-03-01

    Full Text Available Abstract Background A real-time clinical decision support system (RTCDSS with interactive diagrams enables clinicians to instantly and efficiently track patients' clinical records (PCRs and improve their quality of clinical care. We propose a RTCDSS to process online clinical informatics from multiple databases for clinical decision making in the treatment of prostate cancer based on Web Model-View-Controller (MVC architecture, by which the system can easily be adapted to different diseases and applications. Methods We designed a framework upon the Web MVC-based architecture in which the reusable and extractable models can be conveniently adapted to other hospital information systems and which allows for efficient database integration. Then, we determined the clinical variables of the prostate cancer treatment based on participating clinicians' opinions and developed a computational model to determine the pretreatment parameters. Furthermore, the components of the RTCDSS integrated PCRs and decision factors for real-time analysis to provide evidence-based diagrams upon the clinician-oriented interface for visualization of treatment guidance and health risk assessment. Results The resulting system can improve quality of clinical treatment by allowing clinicians to concurrently analyze and evaluate the clinical markers of prostate cancer patients with instantaneous clinical data and evidence-based diagrams which can automatically identify pretreatment parameters. Moreover, the proposed RTCDSS can aid interactions between patients and clinicians. Conclusions Our proposed framework supports online clinical informatics, evaluates treatment risks, offers interactive guidance, and provides real-time reference for decision making in the treatment of prostate cancer. The developed clinician-oriented interface can assist clinicians in conveniently presenting evidence-based information to patients and can be readily adapted to an existing hospital

  4. Treatment of Non-Small-Cell Lung Cancer with Erlotinib following Gefitinib-Induced Hepatotoxicity: Review of 8 Clinical Cases

    Directory of Open Access Journals (Sweden)

    Yukihiro Yano

    2012-01-01

    Full Text Available Objective. Gefitinib often induces liver damage. A few reports have described that the subsequent administration of erlotinib was associated with less hepatotoxicity, but the safety and efficacy of this treatment are still not fully investigated. Therefore, we evaluated retrospectively the patients with erlotinib following gefitinib-induced hepatotoxicity. Methods and Patients. We retrospectively reviewed the medical records between December 2007 and March 2010. The patients were evaluated including the following information: age, gender, histology of lung cancer, performance status, smoking status, epidermal growth factor receptor (EGFR mutation status, liver metastasis, viral hepatitis, alcoholic liver injury, clinical response, and hepatotoxicity due to EGFR tyrosine kinase inhibitors. Results. We identified 8 patients with erlotinib following gefitinib-induced hepatotoxicity. All achieved disease control by gefitinib. Hepatotoxicity was grades 2 and 3 in 3 and 5 patients, respectively. The median duration of treatment with gefitinib was 112.5 days and the median time to gefitinib-induced hepatotoxicity was 51.5 days. The median duration of treatment with erlotinib was 171.5 days. Grade 1 and 2 erlotinib-induced hepatotoxicity was observed in 2 and 1 patient, respectively. Conclusions. Erlotinib administration with careful monitoring is thought to be a good alternative strategy for patients who respond well to gefitinib treatment but experience hepatotoxicity.

  5. Treatment Option Overview (Cervical Cancer)

    Science.gov (United States)

    ... Cancer Prevention Cervical Cancer Screening Research Cervical Cancer Treatment (PDQ®)–Patient Version General Information About Cervical Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) depends on ...

  6. Head and Neck Cancer Treatment

    Science.gov (United States)

    ... Professions Site Index A-Z Head and Neck Cancer Treatment Head and neck cancer overview What are my ... and neck cancer. For updated information on new cancer treatments that are available, you should discuss these issues ...

  7. SURGICAL TREATMENT FOR VERY HIGH-RISK LOCALLY RECURRENT PROSTATE CANCER AFTER RADICAL RETROPUBIC PROSTATECTOMY: A CLINICAL CASE

    Directory of Open Access Journals (Sweden)

    E. I. Veliyev

    2014-01-01

    Full Text Available Locally recurrent prostate cancer (PC in the bladder neck can substantially worsen quality of life in patients and hinder further treatment when castration-resistant PC develops. The paper describes a clinical case of very high-risk PC in a 55-year-old patient in whom radical cystectomy (RCE with removal of metastases in the bladder neck and the Bricker ileal conduit were performed for a local recurrence after radical retropubic prostatectomy (RPE. It gives the data of preoperative examination, the technical features of the primary operation RPE, the data of postoperative observation, the technical aspects and outcomes of еру surgery for a local recurrence, as well as the results of a 1.5-year follow-up after RCE. 

  8. Endpoint comparison for bone mineral density measurements in North Central Cancer Treatment Group cancer clinical trials N02C1 and N03CC (Alliance)

    Science.gov (United States)

    Singh, J.; Atherton, P.; Liu, H.; Novotny, P.; Hines, S.; Loprinzi, C. L.; Perez, E. A.; Tan, A.; Burger, K.; Zhao, X.; Diekmann, B.; Sloan, J. A.

    2015-01-01

    Summary Bone mineral density (BMD) measurement can vary depending upon anatomical site, machine, and normative values used. This analysis compared different BMD endpoints in two clinical trials. Trial results differed across endpoints. Future clinical trials should consider inclusion of multiple endpoints in sensitivity analysis to ensure sound overall study conclusions. Introduction Methodological issues hamper efficacy assessment of osteoporosis prevention agents in cancer survivors. Osteoporosis diagnosis can vary depending upon which bone mineral density (BMD) anatomical site and machine is used and which set of normative values are applied. This analysis compared different endpoints for osteoporosis treatment efficacy assessment in two clinical studies. Methods Data from North Central Cancer Treatment Group phase III clinical trials N02C1 and N03CC (Alliance) were employed involving 774 patients each comparing two treatments for osteoporosis prevention. Endpoints for three anatomical sites included raw BMD score (RawBMD); raw machine-based, sample-standardized, and reference population-standardized T scores (RawT, TSamp, TRef); and standard normal percentile corresponding to the reference population-standardized T score (TPerc). For each, treatment arm comparison was carried out using three statistical tests using change and percentage change from baseline (CB, %CB) at 1 year. Results Baseline correlations among endpoints ranged from 0.79 to 1.00. RawBMD and TPerc produced more statistically significant results (14 and 19 each out of 36 tests) compared to RawT (11/36), TSamp (8/36), and TRef (7/36). Spine produced the most statistically significant results (26/60) relative to femoral neck (20/60) and total hip (13/60). Lastly, CB resulted in 44 statistically significant results out of 90 tests, whereas %CB resulted in only 15 significant results. Conclusions Treatment comparisons and interpretations were different across endpoints and anatomical sites

  9. Multicenter Clinical Study for Evaluation of Efficacy and Safety of Transdermal Fentanyl Matrix Patch in Treatment of Moderate to Severe Cancer Pain in 474 Chinese Cancer Patients

    Institute of Scientific and Technical Information of China (English)

    Yu-lin Zhu; Xue-zhen Ma; Xin Ding; Bin Wang; Wei-lian Li; Zuo-wei Hu; Gang Feng; Jiang-jin Huang; Xiao Zheng; Shun-chang Jiao; Rong Wu; Guo-hong Song; Jun Ren; Duan-qi Liu; Xi Zhang; Kui-feng Liu; Ai-hua Zangs; Ying Cheng; Guo-chun Cao; Jun Liang

    2011-01-01

    Objective:Although a new matrix formulation fentanyl has been used throughout the world for cancer pain management,few data about its efficacy and clinical outcomes associated with its use in Chinese patients have been obtained.This study aimed to assess the efficacy and safety of the new system in Chinese patients with moderate to severe cancer pain.Methods:A total of 474 patients with moderate to severe cancer pain were enrolled in this study and were treated with the new transdermal fentanyl matrix patch (TDF) up to 2 weeks.All the patients were asked to record pain intensity,side effects,quality of life (QOL),adherence and global satisfaction.The initial dose of fentanyl was 25 μg/h titrated with opioid or according to National Comprehensive Cancer Network (NCCN) guidelines.Transdermal fentanyl was changed every three days.Results:After 2 weeks.The mean pain intensity of the 459 evaluated patients decreased significantly from 5.63±1.26 to 2.03±1.46 (P<0.0001).The total remission rate was 91.29%,of which moderate remission rate 53.16%,obvious remission rate 25.49% and complete remission rate 12.64%.The rate of adverse events was 33.75%,18.78% of which were moderate and 3.80% were severe.The most frequent adverse events were constipation and nausea.No fatal events were observed.The quality of life was remarkably improved after the treatment (P<0.0001).Conclusion:The new TDF is effective and safe in treating patients with moderate to severe cancer pain,and can significantly improve the quality of life.

  10. Mouth Sores Caused by Cancer Treatment: How to Cope

    Science.gov (United States)

    Diseases and Conditions Cancer Understand how to manage cancer treatment side effects, including mouth sores, so you can feel more in control as you go through cancer treatment. By Mayo Clinic Staff If you're about ...

  11. Pentoxifylline treatment in patients with cancer cachexia: A double-blind, randomized, placebo-controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Valiollah Mehrzad

    2016-01-01

    Conclusion: Results of this study demonstrated that Pentoxifylline in the treatment of cancer cachexia did not have any effect in weight gain and arm circumference in cachectic patients. But in short-term (1 month treatment, QOL was improved in these patients. And after 2 month treatment this was not effective compared to placebo.

  12. Chronic pancreatitis and pancreatic cancer; the clinical aspects and treatment of pancreatic exocrine insufficiency

    NARCIS (Netherlands)

    E.C.M. Sikkens (Edmée)

    2013-01-01

    textabstractIn exocrine pancreatic insufficiency, the pancreas is unable to deliver a sufficient quantity of pancreatic enzymes to the small intestine to digest food. It may occur in several life threatening diseases, including chronic pancreatitis and pancreatic cancer. Due to this lack or

  13. Chronic pancreatitis and pancreatic cancer; the clinical aspects and treatment of pancreatic exocrine insufficiency

    NARCIS (Netherlands)

    E.C.M. Sikkens (Edmée)

    2013-01-01

    textabstractIn exocrine pancreatic insufficiency, the pancreas is unable to deliver a sufficient quantity of pancreatic enzymes to the small intestine to digest food. It may occur in several life threatening diseases, including chronic pancreatitis and pancreatic cancer. Due to this lack or absence

  14. Genomic and clinical predictors for improving estimator precision in randomized trials of breast cancer treatments

    Directory of Open Access Journals (Sweden)

    Prasad Patil

    2016-08-01

    Conclusions: Adjusting only for clinical variables led to substantial precision gains (at least 5% in three of the four data sets, with a 1% precision loss in the remaining data set. These gains were unchanged or increased when sample sizes were doubled in our simulations. The precision gains due to incorporating genomic information, beyond the gains from adjusting for clinical variables, were not substantial.

  15. Quantifying the Aesthetic Outcomes of Breast Cancer Treatment: Assessment of Surgical Scars from Clinical Photographs

    OpenAIRE

    Kim, Min Soon; Rodney, William N.; Reece, Gregory P.; Beahm, Elisabeth K.; Crosby, Melissa A.; Markey, Mia K.

    2010-01-01

    Accurate assessment of the degree of scaring that results from surgical intervention for breast cancer would enable more effective pre-operative counseling. The resultant scar that accompanies an open surgical intervention may be characterized by variance in thickness, color, and contour. These factors significantly impact the overall appearance of the breast. A number of studies have addressed the mechanical and pathologic aspects of scarring. The majority of these investigations have focuse...

  16. Clinical impact of FDG-PET/CT on colorectal cancer staging and treatment strategy

    DEFF Research Database (Denmark)

    Petersen, Rasmus K; Hess, Søren; Alavi, Abass;

    2014-01-01

    and patients divided as follows: (A) Patients with a change in therapy following FDG-PET/CT and (B) Patients without a change following FDG-PET/CT. Sixty-two patients had colon and five had rectal cancer. Of these, 20 (30%; CI 20.2-41.7) belonged to group A, whereas 47 (70%; CI 58.3-79.8) fell in group B...

  17. Population based study on sentinel node biopsy before or after neoadjuvant chemotherapy in clinically node negative breast cancer patients : Identification rate and influence on axillary treatment

    NARCIS (Netherlands)

    van der Heiden-van der Loo, M.; de Munck, L.; Sonke, G. S.; van Dalen, T.; van Diest, P. J.; van den Bongard, H. J. G. D.; Peeters, P. H. M.; Rutgers, E. J. T.

    The timing of the sentinel lymph node biopsy (SNB) is controversial in clinically node negative patients receiving neoadjuvant chemotherapy (NAC). We studied variation in the timing of axillary staging in breast cancer patients who received NAC and the subsequent axillary treatment in The

  18. Treatment Option Overview (Colon Cancer)

    Science.gov (United States)

    ... Genetics of Colorectal Cancer Colorectal Cancer Screening Research Colon Cancer Treatment (PDQ®)–Patient Version General Information About Colon Cancer Go to Health Professional Version Key Points Colon ...

  19. Clinical study on radiotherapy combined with surgical treatment of 162 patients with cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Xiaopeng Zhong; Xukun Tong; Lingfang Yang; Donglin Yuan; Huigao Cai

    2008-01-01

    Objective: To compare the 5-year survival rates and complications of internal and external irradiation therapy combined with operation in patients with Ⅱ-Ⅲ period of cervical cancer.Methods: 162 cervical cancer patients after the whole palace resection pelvic lymphadenectomy were divided into three groups, and then accepted radiotherapy.The first group with 91 cases was accepted internal and external irradiation therapy before operation; the second group with 37 cases was given internal irradiation therapy before operation; the third group with 34 cases was given routine postoperative radiotherapy.External irradiation used 60Co irradiation or a linear accelerator, to the whole basin, and the irradiation dose of "B" point in preoperative radiotherapy was 26-30 Gy, in postoperative radiotherapy was 46-50 Gy; intraluminal brachytherapy used 192lr,the dose of "A" point was 5-15 Gy.Results: The 5-year survival rate of preoperative combined radiotherapy group was 78.0%(71/91), preoperative intracavitary radiotherapy group 64.9% (24/37), and postoperative radiotherapy group 35.3% (12/34).Comparing the 5-year survival rates of the preoperative combined and postoperative irradiation groups, there was significant difference (P<0.05).The major complications were radioactive proctitis and cystitis, the complication incidences of three groups were 35.2% (32/91), 32.4% (12/37), 38.2% (13/34), respectively, and the differences were not statistically significant (P>0.05).Conclusion: The intraluminal brachytherapy plus external irradiation can significantly increase the 5-year survival rate of patients with Ⅱa-Ⅲa stages, and the incidence of complications was not significant difference.

  20. What Happens After Treatment for Stomach Cancer?

    Science.gov (United States)

    ... Cancer After Treatment What Happens After Treatment for Stomach Cancer? For some people with stomach cancer, treatment ... Treatment for Stomach Cancer Stops Working More In Stomach Cancer About Stomach Cancer Causes, Risk Factors, and ...

  1. What Happens After Treatment for Testicular Cancer?

    Science.gov (United States)

    ... Cancer After Treatment What Happens After Treatment for Testicular Cancer? For most people with testicular cancer, treatment removes ... Treatment for Testicular Cancer Stops Working More In Testicular Cancer About Testicular Cancer Causes, Risk Factors, and Prevention ...

  2. Effect of integrated Chinese medical treatment on the survival time of patients with advanced non-small-cell lung cancer: a clinical study

    Institute of Scientific and Technical Information of China (English)

    刘苓霜

    2014-01-01

    Objective To observe clinical effect of integrated Chinese medical(CM)treatment(as maintenance therapy)on the progression-free survival(PFS)and overall survival(OS)in patients with advanced non-small-cell lung cancer(NSCLC)after first-line chemotherapy.Methods The study was a prospective,randomized,controlled clinical trial.Totally 69 non-progressive advanced NSCLC patients treated with first-line chemotherapy were

  3. Incorporation of expert variability into breast cancer treatment recommendation in designing clinical protocol guided fuzzy rule system models.

    Science.gov (United States)

    Garibaldi, Jonathan M; Zhou, Shang-Ming; Wang, Xiao-Ying; John, Robert I; Ellis, Ian O

    2012-06-01

    It has been often demonstrated that clinicians exhibit both inter-expert and intra-expert variability when making difficult decisions. In contrast, the vast majority of computerized models that aim to provide automated support for such decisions do not explicitly recognize or replicate this variability. Furthermore, the perfect consistency of computerized models is often presented as a de facto benefit. In this paper, we describe a novel approach to incorporate variability within a fuzzy inference system using non-stationary fuzzy sets in order to replicate human variability. We apply our approach to a decision problem concerning the recommendation of post-operative breast cancer treatment; specifically, whether or not to administer chemotherapy based on assessment of five clinical variables: NPI (the Nottingham Prognostic Index), estrogen receptor status, vascular invasion, age and lymph node status. In doing so, we explore whether such explicit modeling of variability provides any performance advantage over a more conventional fuzzy approach, when tested on a set of 1310 unselected cases collected over a fourteen year period at the Nottingham University Hospitals NHS Trust, UK. The experimental results show that the standard fuzzy inference system (that does not model variability) achieves overall agreement to clinical practice around 84.6% (95% CI: 84.1-84.9%), while the non-stationary fuzzy model can significantly increase performance to around 88.1% (95% CI: 88.0-88.2%), p<0.001. We conclude that non-stationary fuzzy models provide a valuable new approach that may be applied to clinical decision support systems in any application domain.

  4. Encounters in cancer treatment

    DEFF Research Database (Denmark)

    Høybye, Mette Terp; Tjørnhøj-Thomsen, Tine

    2014-01-01

    Based on extensive ethnographic material from in-depth interviews with Danish cancer patients after treatment, this study analyzes their stories to explore how interactions with the physician configures and situates a need for rehabilitation. We identify three themes in the illness stories: (1...... by this encounter. The significance of the social encounters in cancer treatment is elucidated through this analysis, and we demonstrate how the need for recognition of the complex effects of cancer on one's life is central to counter experiences of objectification and dehumanization....

  5. Integrative medicine for cancer treatment

    Science.gov (United States)

    ... gov/ency/patientinstructions/000932.htm Integrative medicine for cancer treatment To use the sharing features on this page, ... help relieve common side effects of cancer or cancer treatment, such as fatigue, anxiety, pain, and nausea. Some ...

  6. Serum cytokine levels in patients with advanced non-small cell lung cancer: correlation with clinical outcome of erlotinib treatment

    Institute of Scientific and Technical Information of China (English)

    WANG Yong-sheng; MIAO Li-yun; LIU Lu; CAI Hou-rong; DING Jing-jing; REN Sheng-xiang; ZHOU Cai-cun

    2013-01-01

    Background Serum expression of cytokines may provide information about the clinical outcome of advanced non-small cell lung cancer (NSCLC) patients.This study aimed to investigate the relationship between serum cytokine levels and the clinical outcome of erlotinib treatment in a second or third line setting in patients with advanced NSCLC.Methods A total of 162 patients with advanced NSCLC who received erlotinib as either second or third line therapy were enrolled in this study.Blood samples were collected before the initiation of erlotinib treatment,and the levels of IL-1,IL-2R,IL-6,and tumor necrosis factor (TNF)-α were assessed by enzyme-linked immunosorbent assay (ELISA).Cutoff points were defined as the median levels of IL-1 (low (≤26.5 pg/ml) and high (>26.5 pg/ml)),IL-2R (low (≤115 pmol/L) and high (>15 pmol/L)),IL-6 (low (≤49.5 pg/ml) and high (>49.5 pg/ml)),and TNF-α (low (≤48.5 pg/ml) and high (>48.5 pg/ ml)).Kaplan-Meier analysis was used to estimate the survival time,and Cox regression analyses were used to correlate cytokines and baseline clinical characteristics with clinical outcomes,including time to progression (TTP) and overall survival (OS).Results Between January 2007 and May 2011,162 patients were enrolled.Their median age was 58 years.In this group,109 were males and 53 were females,74 were former or current smokers and 88 were non-smokers.A total of 122 patients had adenocarcinoma,27 had squamous cell carcinoma,and 13 had tumors with other types of histology.And 139 patients had an Eastern cooperative oncology group (ECOG) performance status of 0-1,while 23 scored at 2-3.Expression of IL-1,IL-2R,and IL-6 was not significantly associated with age,gender,ECOG performance status,smoking status,or histology and stage of tumor.Only TNF-α was associated with smoking status (P=0.045).Survival analysis showed that patients with low levels of either IL-6 or TNF-α had a statistically longer TTp and OS than patients with high

  7. Could We Use Clinical Benefit to Evaluate the Effects of Chinese Medicine on the Treatment of Cancer?

    Institute of Scientific and Technical Information of China (English)

    LI Ping-ping

    2010-01-01

    @@ Chinese medicine (CM) exhibits special characteristics and unique superiority in the cancer treatment, mainly showing in the alleviation of the side effects of radiotherapy and chemotherapy, such as the arrest of bone marrow and gastrointestinal symptoms etc., and palliating the discomforts, such as fatigue and anorexia. CM can improve the effects when combined with chemotherapy and enhance the patients' tolerance to promote rehabilitation by regulating the whole body. The patients with cancer in the late stage usually select CM as palliative care.

  8. PRE-CLINICAL EVALUATION OF EXTRACTS AND ESSENTIAL OILS FROM BETEL-LIKE SCENT PIPER SPECIES IDENTIFIED POTENTIAL CANCER TREATMENT.

    Science.gov (United States)

    Sanubol, Arisa; Chaveerach, Arunrat; Tanee, Tawatchai; Sudmoon, Runglawan

    2017-01-01

    Nine Piper species with betel-like scents are sources of industrial and medicinal aromatic chemicals, but there is lack of information on cytotoxicity and genotoxicity for human safety, including how these plants impact human cervical cancer cell line. Plant leaves were extracted with hexane and hydro-distilled for essential oils. The extracts and oils were pre-clinically studied based on cyto - and genotoxicity using microculture tetrazolium (MTT) and comet assays. The crude extracts showed an IC50 in leukocytes and HeLa cells of 58.59-97.31 mg/ml and 34.91-101.79 mg/ml, the LD50 is higher than 5000 mg/kg. With lower values than the crude extracts, the essential oils showed an IC50 in leukocytes and HeLa cells of 0.023-0.059 μg/ml and 0.025-0.043 μg/ml the LD50 is less than 50 mg/kg. IC50 values showed that the essential oils were highly toxic than the crude extracts. At the level of human genetic materials, the crude extracts of two species, including P. betloides and P. crocatum, showed a significant toxicity (p essential oils of all studied Piper species showed insignificant toxicity in leukocytes. For HeLa cells, the eight-studied species showed significant toxicity in HeLa cells, whereas only P. submultinerve showed insignificant toxicity. The crude extracts and essential oils should be tested as putative cervical cancer treatments due to less toxicity in human normal cells.

  9. Clinical Outcomes of Image Guided Adaptive Hypofractionated Weekly Radiation Therapy for Bladder Cancer in Patients Unsuitable for Radical Treatment.

    Science.gov (United States)

    Hafeez, Shaista; McDonald, Fiona; Lalondrelle, Susan; McNair, Helen; Warren-Oseni, Karole; Jones, Kelly; Harris, Victoria; Taylor, Helen; Khoo, Vincent; Thomas, Karen; Hansen, Vibeke; Dearnaley, David; Horwich, Alan; Huddart, Robert

    2017-05-01

    We report on the clinical outcomes of a phase 2 study assessing image guided hypofractionated weekly radiation therapy in bladder cancer patients unsuitable for radical treatment. Fifty-five patients with T2-T4aNx-2M0-1 bladder cancer not suitable for cystectomy or daily radiation therapy treatment were recruited. A "plan of the day" radiation therapy approach was used, treating the whole (empty) bladder to 36 Gy in 6 weekly fractions. Acute toxicity was assessed weekly during radiation therapy, at 6 and 12 weeks using the Common Terminology Criteria for Adverse Events version 3.0. Late toxicity was assessed at 6 months and 12 months using Radiation Therapy Oncology Group grading. Cystoscopy was used to assess local control at 3 months. Cumulative incidence function was used to determine local progression at 1 at 2 years. Death without local progression was treated as a competing risk. Overall survival was estimated using the Kaplan-Meier method. Median age was 86 years (range, 68-97 years). Eighty-seven percent of patients completed their prescribed course of radiation therapy. Genitourinary and gastrointestinal grade 3 acute toxicity was seen in 18% (10/55) and 4% (2/55) of patients, respectively. No grade 4 genitourinary or gastrointestinal toxicity was seen. Grade ≥3 late toxicity (any) at 6 and 12 months was seen in 6.5% (2/31) and 4.3% (1/23) of patients, respectively. Local control after radiation therapy was 92% of assessed patients (60% total population). Cumulative incidence of local progression at 1 year and 2 years for all patients was 7% (95% confidence interval [CI] 2%-17%) and 17% (95% CI 8%-29%), respectively. Overall survival at 1 year was 63% (95% CI 48%-74%). Hypofractionated radiation therapy delivered weekly with a plan of the day approach offers good local control with acceptable toxicity in a patient population not suitable for radical bladder treatment. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights

  10. Toward Quantifying the Aesthetic Outcomes of Breast Cancer Treatment: Comparison of Clinical Photography and Colorimetry

    Science.gov (United States)

    Kim, Min Soon; Rodney, William N.; Cooper, Tara; Kite, Chris; Reece, Gregory P.; Markey, Mia K.

    2011-01-01

    Rationale, aims and objectives Scarring is a significant cause of dissatisfaction for women who undergo breast surgery. Scar tissue may be clinically distinguished from normal skin by aberrant color, rough surface texture, increased thickness (hypertrophy), and firmness. Colorimeters or spectrophotometers can be used to quantitatively assess scar color, but they require direct patient interaction and can cost thousands of dollars By comparison, digital photography is already in widespread use to document clinical outcomes and requires less patient interaction. Thus, assessment of scar coloration by digital photography is an attractive alternative. The goal of this study was to compare color measurements obtained by digital photography and colorimetry. Method Agreement between photographic and colorimetric measurements of color were evaluated. Experimental conditions were controlled by performing measurements on artificial scars created by a makeup artist. The colorimetric measurements of the artificial scars were compared to those reported in the literature for real scars in order to confirm the validity of this approach. We assessed the agreement between the colorimetric and photographic measurements of color using a hypothesis test for equivalence, the intra-class correlation coefficient (ICC), and the Bland-Altman method. Results Overall, good agreement was obtained for three parameters (L*a*b*) measured by colorimetry and photography from the results of three statistical analyses. Conclusion Color measurements obtained by digital photography were equivalent to those obtained using colorimetry. Thus, digital photography is a reliable, cost-effective measurement method of skin color and should be further investigated for quantitative analysis of surgical outcomes. PMID:19239578

  11. TREATMENT USING LAPAROSCOPIC AND THORACOSCOPIC PROCEDURES IN A PATIENT WITH SIGMOID CANCER AND SOLITARY PULMONARY METASTASIS: A CLINICAL CASE

    Directory of Open Access Journals (Sweden)

    A. O. Rasulov

    2014-01-01

    Full Text Available A clinical case of a sigmoid cancer patient with solitary lung metastasis is discussed in this article. Use of minimally invasive surgical technologies allowed to perform a simultaneous combined surgery on abdominal and thoracic cavities and improve rehabilitation time and time to systemic chemotherapy initiation. In presented clinical case patient was comorbid with stage III obesity, which was considered as a contraindication to laparoscopic surgery for a long time.

  12. Lung Cancer Clinical Trials: Advances in Immunotherapy

    Science.gov (United States)

    New treatments for lung cancer and aspects of joining a clinical trial are discussed in this 30-minute Facebook Live event, hosted by NCI’s Dr. Shakun Malik, head of thoracic oncology therapeutics, and Janet Freeman-Daily, lung cancer patient activist and founding member of #LCSM.

  13. International clinical practice guidelines for the treatment and prophylaxis of thrombosis associated with central venous catheters in patients with cancer

    NARCIS (Netherlands)

    Debourdeau, P.; Farge, D.; Beckers, M.; Baglin, C.; Bauersachs, R. M.; Brenner, B.; Brilhante, D.; Falanga, A.; Gerotzafias, G. T.; Haim, N.; Kakkar, A. K.; Khorana, A. A.; Lecumberri, R.; Mandala, M.; Marty, M.; Monreal, M.; Mousa, S. A.; Noble, S.; Pabinger, I.; Prandoni, P.; Prins, M. H.; Qari, M. H.; Streiff, M. B.; Syrigos, K.; Buller, H. R.; Bounameaux, H.

    2013-01-01

    . Background: Although long-term indwelling central venous catheters (CVCs) may lead to pulmonary embolism (PE) and loss of the CVC, there is lack of consensus on management of CVC-related thrombosis (CRT) in cancer patients and heterogeneity in clinical practices worldwide. Objectives: To establish

  14. International clinical practice guidelines for the treatment and prophylaxis of thrombosis associated with central venous catheters in patients with cancer

    NARCIS (Netherlands)

    Debourdeau, P.; Farge, D.; Beckers, M.; Baglin, C.; Bauersachs, R. M.; Brenner, B.; Brilhante, D.; Falanga, A.; Gerotzafias, G. T.; Haim, N.; Kakkar, A. K.; Khorana, A. A.; Lecumberri, R.; Mandala, M.; Marty, M.; Monreal, M.; Mousa, S. A.; Noble, S.; Pabinger, I.; Prandoni, P.; Prins, M. H.; Qari, M. H.; Streiff, M. B.; Syrigos, K.; Buller, H. R.; Bounameaux, H.

    2013-01-01

    . Background: Although long-term indwelling central venous catheters (CVCs) may lead to pulmonary embolism (PE) and loss of the CVC, there is lack of consensus on management of CVC-related thrombosis (CRT) in cancer patients and heterogeneity in clinical practices worldwide. Objectives: To establish

  15. Improved Clinical Outcomes With High-Dose Image Guided Radiotherapy Compared With Non-IGRT for the Treatment of Clinically Localized Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Zelefsky, Michael J., E-mail: Zelefskm@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Kollmeier, Marisa; Cox, Brett; Fidaleo, Anthony; Sperling, Dahlia; Pei, Xin [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Carver, Brett; Coleman, Jonathan [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Lovelock, Michael; Hunt, Margie [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

    2012-09-01

    Purpose: To compare toxicity profiles and biochemical tumor control outcomes between patients treated with high-dose image-guided radiotherapy (IGRT) and high-dose intensity-modulated radiotherapy (IMRT) for clinically localized prostate cancer. Materials and Methods: Between 2008 and 2009, 186 patients with prostate cancer were treated with IGRT to a dose of 86.4 Gy with daily correction of the target position based on kilovoltage imaging of implanted prostatic fiducial markers. This group of patients was retrospectively compared with a similar cohort of 190 patients who were treated between 2006 and 2007 with IMRT to the same prescription dose without, however, implanted fiducial markers in place (non-IGRT). The median follow-up time was 2.8 years (range, 2-6 years). Results: A significant reduction in late urinary toxicity was observed for IGRT patients compared with the non-IGRT patients. The 3-year likelihood of grade 2 and higher urinary toxicity for the IGRT and non-IGRT cohorts were 10.4% and 20.0%, respectively (p = 0.02). Multivariate analysis identifying predictors for grade 2 or higher late urinary toxicity demonstrated that, in addition to the baseline Internatinoal Prostate Symptom Score, IGRT was associated with significantly less late urinary toxicity compared with non-IGRT. The incidence of grade 2 and higher rectal toxicity was low for both treatment groups (1.0% and 1.6%, respectively; p = 0.81). No differences in prostate-specific antigen relapse-free survival outcomes were observed for low- and intermediate-risk patients when treated with IGRT and non-IGRT. For high-risk patients, a significant improvement was observed at 3 years for patients treated with IGRT compared with non-IGRT. Conclusions: IGRT is associated with an improvement in biochemical tumor control among high-risk patients and a lower rate of late urinary toxicity compared with high-dose IMRT. These data suggest that, for definitive radiotherapy, the placement of fiducial markers

  16. Triple peptide vaccination as consolidation treatment in women affected by ovarian and breast cancer: Clinical and immunological data of a phase I/II clinical trial

    Science.gov (United States)

    ANTONILLI, MORENA; RAHIMI, HASSAN; VISCONTI, VALERIA; NAPOLETANO, CHIARA; RUSCITO, ILARY; ZIZZARI, ILARIA GRAZIA; CAPONNETTO, SALVATORE; BARCHIESI, GIACOMO; IADAROLA, ROBERTA; PIERELLI, LUCA; RUGHETTI, AURELIA; BELLATI, FILIPPO; PANICI, PIERLUIGI BENEDETTI; NUTI, MARIANNA

    2016-01-01

    Vaccination with priming and expansion of tumour reacting T cells is an important therapeutic option to be used in combination with novel checkpoint inhibitors to increase the specificity of the T cell infiltrate and the efficacy of the treatment. In this phase I/II study, 14 high-risk disease-free ovarian (OC) and breast cancer (BC) patients after completion of standard therapies were vaccinated with MUC1, ErbB2 and carcinoembryonic antigen (CEA) HLA-A2+-restricted peptides and Montanide. Patients were subjected to 6 doses of vaccine every two weeks and a recall dose after 3 months. ECOG grade 2 toxicity was observed at the injection site. Eight out of 14 patients showed specific CD8+ T cells to at least one antigen. None of 4 patients vaccinated for compassionate use showed a CD8 activation. An OC patient who suffered from a lymph nodal recurrence, showed specific anti-ErbB2 CD8+ T cells in the bulky aortic lymph nodes suggesting homing of the activated T cells. Results confirm that peptide vaccination strategy is feasible, safe and well tolerated. In particular OC patients appear to show a higher response rate compared to BC patients. Vaccination generates a long-lasting immune response, which is strongly enhanced by recall administrations. The clinical outcome of patients enrolled in the trial appears favourable, having registered no deceased patients with a minimum follow-up of 8 years. These promising data, in line with the results of similar studies, the high compliance of patients observed and the favourable toxicity profile, support future trials of peptide vaccination in clinically disease-free patients who have completed standard treatments. PMID:26892612

  17. Cancer treatment: dealing with pain

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000827.htm Cancer treatment - dealing with pain To use the sharing features ... test, can cause pain. Treatment. Many types of cancer treatments can cause pain, including chemotherapy , radiation , and surgery. ...

  18. A phase I clinical study of immunotherapy for advanced colorectal cancers using carcinoembryonic antigen-pulsed dendritic cells mixed with tetanus toxoid and subsequent IL-2 treatment.

    Science.gov (United States)

    Liu, Ko-Jiunn; Chao, Tsu-Yi; Chang, Jang-Yang; Cheng, Ann-Lii; Ch'ang, Hui-Ju; Kao, Woei-Yau; Wu, Yu-Chen; Yu, Wei-Lan; Chung, Tsai-Rong; Whang-Peng, Jacqueline

    2016-08-24

    To better evaluate and improve the efficacy of dendritic cell (DC)-based cancer immunotherapy, we conducted a clinical study of patients with advanced colorectal cancer using carcinoembryonic antigen (CEA)-pulsed DCs mixed with tetanus toxoid and subsequent interleukin-2 treatment. The tetanus toxoid in the vaccine preparation serves as an adjuvant and provides a non-tumor specific immune response to enhance vaccine efficacy. The aims of this study were to (1) evaluate the toxicity of this treatment, (2) observe the clinical responses of vaccinated patients, and (3) investigate the immune responses of patients against CEA before and after treatment. Twelve patients were recruited and treated in this phase I clinical study. These patients all had metastatic colorectal cancer and failed standard chemotherapy. We first subcutaneously immunized patients with metastatic colorectal cancer with 1 × 10(6) CEA-pulsed DCs mixed with tetanus toxoid as an adjuvant. Patients received 3 successive injections with 1 × 10(6) CEA-pulsed DCs alone. Low-dose interleukin-2 was administered subcutaneously following the final DC vaccination to boost the growth of T cells. Patients were evaluated for adverse event and clinical status. Blood samples collected before, during, and after treatment were analyzed for T cell proliferation responses against CEA. No severe treatment-related side effects or toxicity was observed in patients who received the regular 4 DC vaccine injections. Two patients had stable disease and 10 patients showed disease progression. A statistically significant increase in proliferation against CEA by T cells collected after vaccination was observed in 2 of 9 patients. The results of this study indicate that it is feasible and safe to treat colorectal cancer patients using this protocol. An increase in the anti-CEA immune response and a clinical benefit was observed in a small fraction of patients. This treatment protocol should be further evaluated in

  19. Physical exercise in cancer patients during and after medical treatment: a systematic review of randomized and controlled clinical trials.

    NARCIS (Netherlands)

    Knols, R.H.; Aaronson, N.K.; Uebelhart, D.; Fransen, J.; Aufdemkampe, G.

    2005-01-01

    PURPOSE: To systematically review the methodologic quality of, and summarize the evidence from trials examining the effectiveness of physical exercise in improving the level of physical functioning and psychological well-being of cancer patients during and after medical treatment. METHODS: Thirty-fo

  20. ACR Appropriateness Criteria for external beam radiation therapy treatment planning for clinically localized prostate cancer, part II of II

    Directory of Open Access Journals (Sweden)

    Nicholas G. Zaorsky, MD

    2017-07-01

    Conclusions: External beam radiation is a key component of the curative management of T1 and T2 prostate cancer. By combining the most recent medical literature, these Appropriateness Criteria can aid clinicians in determining the appropriate treatment delivery and personalized approaches for individual patients.

  1. Clinical efficacy of recombinant human endostatin combined with FOLFOX4 in the treatment of later period episode patients of colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    Jie Zhang; Juan Wen; Yong-Gang Lu

    2015-01-01

    Objective:To observe the effects of recombinant human endostatin (recombinant human endostatin, Endostar) combined with FOLFOX4 regimen in the treatment of advanced node rectal cancer (colon and as cancer, CRC) of clinical efficacy and adverse reactions.Methods:253 patients with advanced colorectal cancer were randomly divided into observation group and control group, 126 cases in observation group and 127 cases in control group. The control group was treated with FOLFOX4, and the observation group was treated with recombinant human endostatin combined with FOLFOX4 regimen. To compare the short-term efficacy, quality of life and adverse reactions of the two groups.Results:the observation group and the control group total effective rate (ORR) were 60.32% and 43.31%, the difference was statistically significant; group two, disease control rate (DCR) were 81.75% and 70.87%, the difference was statistically significant; the first CRC patients, the observation group and the control group the PR rate was statistically significant; relapse patients, observation group and control group CR, PD, ORR and DCR rate were statistically significant;Conclusion: the use of recombinant human endostatin combined with FOLFOX4 regimen in the treatment of first-episode patients with advanced colorectal cancer, not obvious to improve curative effect; for patients with advanced relapsed, combination therapy is better than pure FOLFOX4 treatment; combination therapy in improving the quality of life and chemotherapy combined treatment had no significant difference; no serious adverse reaction, good safety, and has potential clinical application.

  2. Is social support associated with improved clinical outcomes in geriatric lung cancer patients? Observations from North Central Cancer Treatment Group Studies N9921 and N0222

    Directory of Open Access Journals (Sweden)

    Aminah Jatoi

    2009-06-01

    Full Text Available Aminah Jatoi1, Shauna L Hillman1, Katie L Allen Ziegler1, Philip J Stella2, Gamini S Soori3, Kendrith M Rowland Jr41Mayo Clinic and Mayo Foundation, Rochester, MN, USA; 2Michigan Cancer Research Consortium, Ann Arbor, MI, USA; 3Missouri Valley Cancer Consortium, Omaha, NE, USA; 4Carle Cancer Center CCOP, Urbana, IL, USABackground: Social support is defined as a network of family/friends who provide practical and emotional help. A sizable literature describes a direct relationship between social support and improved cancer clinical outcomes. This study explored the extent of social support and its potential association with survival and adverse events in geriatric lung cancer patients. Methods: One hundred thirteen patients, who were aged 65 years or older, had incurable cancer, and were enrolled in one of two chemotherapy trials, completed the Lubben Social Network Scale, a validated instrument that measures social support. All were followed for survival and chemotherapy-related adverse events.Results: The median age (range of the cohort was 74 years (65–91, and performance scores of 0, 1, or 2 were observed in 29%, 55%, and 16%, respectively. Forty-two percent were women. This cohort had a high level of social support: 81% reported they “always” had someone to take them to medical appointments. However, there were no gender-based differences in social support and no associations between social support and either survival or adverse events. Conclusion: In this cohort of geriatric lung cancer patients – all of whom were treated during a clinical trial – there was a high level of social support. However, there were no gender-based differences in extent of social support, and the latter did not predict clinical outcomes. Keywords: social support, lung cancer, elderly, adverse events, survival

  3. [Treatment of testicular cancer].

    Science.gov (United States)

    Droz, Jean-Pierre; Boyle, Helen; Culine, Stéphane; Fizazi, Karim; Fléchon, Aude; Massard, Christophe

    2013-12-01

    Germ-cell tumours (GCTs) are the most common type of cancer in young men. Since the late 1970s, disseminated GCT have been a paradigm for curable metastatic cancer and metastatic GCTs are highly curable with cisplatin-based chemotherapy followed by surgical resection of residual masses. Patients' prognosis is currently assessed using the International Germ-Cell Consensus Classification (IGCCC) and used to adapt the burden of chemotherapy. Approximately 20% of patients still do not achieve cure after first-line cisplatin-based chemotherapy, and need salvage chemotherapy (high dose or standard dose chemotherapy). Clinical stage I testicular cancer is the most common presentation and different strategies are proposed: adjuvant therapies, surgery or surveillance. During the last three decades, clinical trials and strong international collaborations lead to the development of a consensus in the management of GCTs.

  4. Overview: New Modality for Cancer Treatment.

    Science.gov (United States)

    Nishikawa, Hiroyoshi

    2015-01-01

    Cancer immunotherapy is now becoming a promising modality of cancer treatment upon the clinical successes of adoptive T-cell transfer and immune checkpoint blockade. At the 30th Nagoya International Cancer Treatment Symposium, Marcel R.M. van den Brink (Memorial Sloan Kettering Cancer Center, MSKCC, New York, N.Y., USA) showed novel strategies to control malignant relapse and graft-versus-host disease, both major obstacles for clinical benefits in allogeneic hematopoietic stem cell transplantation. Alexander M. Lesokhin (MSKCC, New York, N.Y., USA) presented an overview of immune checkpoint blockade, particularly focusing on hematologic malignancies stressing the importance of immunomonitoring to identify biomarkers.

  5. Advances in Liquid Biopsy and its Clinical Application in the Diagnosis 
and Treatment of Non-small Cell Lung Cancer

    Directory of Open Access Journals (Sweden)

    Difan ZHENG

    2016-06-01

    Full Text Available With the advances of technology, great progresses have been made in liquid biopsy in recent years. Liquid biopsy is currently playing a more and more important role in early diagnosis and treatment of cancer. Compared with traditional tissue biopsy, liquid biopsy is more popular in clinical practice due to its non-invasiveness, convenience and high repeatability. It has huge potential in the future. This review introduces circulating tumor cells (CTCs and circulating tumor DNA (ctDNA as the most important objects in liquid biopsy, mainly focusing on their history, biological characteristics, detection technologies, limitations and applications in non-small cell lung cancer.

  6. Clinical application of OxyContin hydrochloride controlled release tablets in treatment of pain suffered from advanced cancer

    Institute of Scientific and Technical Information of China (English)

    Wenwu Wang; Xuenong OuYang; Zongyang Yu; Zhangshu Chen

    2012-01-01

    Objective: The aim of this study was to evaluate the efficacy and adverse reactions of OxyContin hydrochloride controlled release tablets in the treatment of moderate or severe pain in patients with terminal cancer and to observe any improvement on the cancer patients' quality of life. Methods: Sixty-eight patients with moderate or severe cancer pain were treated with OxyContin hydrochloride controlled release tablets. The initial dose was 5 mg/12h, or 1/2 that of the standard morphine regimen. During the course of treatment, the dosage was adjusted according to the patients' condition until the pain completely disappeared or nearly did so. Each patient received a treatment for at least 15 days. At the same time, adverse reactions, the quality of life and scores for the intensity of pain were observed and recorded [1]. Results: The final titrated dosage of OxyContin was as follows: the patients in 30 cases (44.1%) received a dosage of ≤ 30 mg/d, those in 16 cases (23.5%) received a dosage of 31 to 60 mg/d, those in 18 cases (26.5%) received a dosage of 61 to 120 mg/d and those in 4 cases (5.9%) received a dosage of ≥ 120 mg/d. The overall rate of relief from pain was 95.6%, among which the rates of excellent, effective and moderate relief were respectively 39.7%, 48.5% and 7.4%. OxyContin had mild adverse reactions and patients' quality of life was markedly improved. Conclusion: OxyContin is effective in treatment of moderate and severe cancer pain. The adverse reactions of OxyContin are mild, and the drug can significantly improve the quality of life of patients with cancer pain.

  7. Defining responses to therapy and study outcomes in clinical trials of invasive fungal diseases: Mycoses Study Group and European Organization for Research and Treatment of Cancer consensus criteria.

    Science.gov (United States)

    Segal, Brahm H; Herbrecht, Raoul; Stevens, David A; Ostrosky-Zeichner, Luis; Sobel, Jack; Viscoli, Claudio; Walsh, Thomas J; Maertens, Johan; Patterson, Thomas F; Perfect, John R; Dupont, Bertrand; Wingard, John R; Calandra, Thierry; Kauffman, Carol A; Graybill, John R; Baden, Lindsey R; Pappas, Peter G; Bennett, John E; Kontoyiannis, Dimitrios P; Cordonnier, Catherine; Viviani, Maria Anna; Bille, Jacques; Almyroudis, Nikolaos G; Wheat, L Joseph; Graninger, Wolfgang; Bow, Eric J; Holland, Steven M; Kullberg, Bart-Jan; Dismukes, William E; De Pauw, Ben E

    2008-09-01

    Invasive fungal diseases (IFDs) have become major causes of morbidity and mortality among highly immunocompromised patients. Authoritative consensus criteria to diagnose IFD have been useful in establishing eligibility criteria for antifungal trials. There is an important need for generation of consensus definitions of outcomes of IFD that will form a standard for evaluating treatment success and failure in clinical trials. Therefore, an expert international panel consisting of the Mycoses Study Group and the European Organization for Research and Treatment of Cancer was convened to propose guidelines for assessing treatment responses in clinical trials of IFDs and for defining study outcomes. Major fungal diseases that are discussed include invasive disease due to Candida species, Aspergillus species and other molds, Cryptococcus neoformans, Histoplasma capsulatum, and Coccidioides immitis. We also discuss potential pitfalls in assessing outcome, such as conflicting clinical, radiological, and/or mycological data and gaps in knowledge.

  8. Population based study on sentinel node biopsy before or after neoadjuvant chemotherapy in clinically node negative breast cancer patients: Identification rate and influence on axillary treatment.

    Science.gov (United States)

    van der Heiden-van der Loo, M; de Munck, L; Sonke, G S; van Dalen, T; van Diest, P J; van den Bongard, H J G D; Peeters, P H M; Rutgers, E J T

    2015-05-01

    The timing of the sentinel lymph node biopsy (SNB) is controversial in clinically node negative patients receiving neoadjuvant chemotherapy (NAC). We studied variation in the timing of axillary staging in breast cancer patients who received NAC and the subsequent axillary treatment in The Netherlands. Patients diagnosed with clinically node negative primary breast cancer between 1st January 2010 and 30th June 2013 who received NAC and SNB were selected from the Netherlands Cancer Registry. Data on patient and tumour characteristics, axillary staging and treatment were analysed. Two groups were defined: (1) patients with SNB before NAC (N=980) and (2) patients with SNB after NAC (N=203). Eighty-three percent of patients underwent SNB before NAC, with large regional variation (35-99%). The SN identification rate differed for SNBs conducted before and after NAC (98% versus 95%; p=0.032). A lower proportion of patients had a negative SNB when assessed before NAC compared to after (54% versus 67%; p=0.001). The proportion of patients receiving any axillary treatment was higher for those with SNB before NAC than after (45% versus 33%; p=0.006). In conclusion, variation exists in the timing of SNB in clinical practice in The Netherlands for clinically node negative breast cancer patients receiving NAC. The post-NAC SN procedure is, despite some lower SN identification rate, associated with a significantly less frequent axillary treatment and thus with less expected morbidity. The effect on recurrence rate is not yet clear. Patients in this registry will be followed prospectively for long-term outcome. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Clinical and prognostic significance of pathological and inflammatory markers in the surgical treatment of locally advanced colorectal cancer

    Science.gov (United States)

    Sokolov, M; Angelov, K; Vasileva, M; Atanasova, MP; Vlahova, A; Todorov, G

    2015-01-01

    Background Locally advanced colorectal cancer (CRC) may vary in its clinical and pathological appearance. It is now accepted that progression of disease in patients with locally advanced CRC is determined not only by local tumor characteristics but also by the immune system and inflammatory response in the body. Methods We investigated patients with confirmed CRC who were treated in the surgical clinic at the University Hospital Alexandrovska over a 10-year period and retrospectively evaluated the histological features of the preoperative biopsies and operative specimens removed during radical multivisceral resections. We also collected prospective data for serum C-reactive protein levels and Jass-Klintrup score, Petersen Index score, and Glasgow Prognostic Score in patients with locally advanced CRC. Results Of 1,105 patients with CRC, 327 (29.6%) were diagnosed with locally advanced disease. In total, 108 combined multivisceral resections (79 for primary tumors and 29 for recurrent tumors) were performed. Overall survival was 34 months for pR0 cases and 12 months for pR1 cases (P<0.05). Our data confirmed that C-reactive protein is a prognostic marker of overall survival. Data for 48 patients with histologically confirmed locally advanced tumors showed significantly increased survival with a higher Jass-Klintrup score (P=0.037). In patients with node-negative disease, 5-year survival was 49%. However, where there were high-risk pathological characteristics according to the Petersen Index, survival was similar to that for node-positive disease (P=0.702). Our data also showed a significant difference in survival between groups divided according to whether they had a modified Glasgow Prognostic Score of 1 or 2 (P=0.031). Conclusion In order to maintain a reasonable balance between an aggressive approach and so-called meaningless “surgical exorbitance”, we should focus on certain histopathological and inflammatory markers that can be identified as additional

  10. Treatment of Locally Advanced Vaginal Cancer With Radiochemotherapy and Magnetic Resonance Image-Guided Adaptive Brachytherapy: Dose-Volume Parameters and First Clinical Results

    Energy Technology Data Exchange (ETDEWEB)

    Dimopoulos, Johannes C.A. [Department of Radiation Oncology, Metropolitan Hospital, Athens (Greece); Schmid, Maximilian P., E-mail: maximilian.schmid@akhwien.at [Department of Radiotherapy, Medical University of Vienna, Vienna (Austria); Fidarova, Elena; Berger, Daniel; Kirisits, Christian; Poetter, Richard [Department of Radiotherapy, Medical University of Vienna, Vienna (Austria)

    2012-04-01

    Purpose: To investigate the clinical feasibility of magnetic resonance image-guided adaptive brachytherapy (IGABT) for patients with locally advanced vaginal cancer and to report treatment outcomes. Methods and Materials: Thirteen patients with vaginal cancer were treated with external beam radiotherapy (45-50.4 Gy) plus IGABT with or without chemotherapy. Distribution of International Federation of Gynecology and Obstetrics stages among patients were as follows: 4 patients had Stage II cancer, 5 patients had Stage III cancer, and 4 patients had Stage IV cancer. The concept of IGABT as developed for cervix cancer was transferred and adapted for vaginal cancer, with corresponding treatment planning and reporting. Doses were converted to the equivalent dose in 2 Gy, applying the linear quadratic model ({alpha}/{beta} = 10 Gy for tumor; {alpha}/{beta} = 3 for organs at risk). Endpoints studied were gross tumor volume (GTV), dose-volume parameters for high-risk clinical target volume (HRCTV), and organs at risk, local control (LC), adverse side effects, and survival. Results: The mean GTV ({+-} 1 standard deviation) at diagnosis was 45.3 ({+-}30) cm{sup 3}, and the mean GTV at brachytherapy was 10 ({+-}14) cm{sup 3}. The mean D90 for the HRCTV was 86 ({+-}13) Gy. The mean D2cc for bladder, urethra, rectum, and sigmoid colon were 80 ({+-}20) Gy, 76 ({+-}16) Gy, 70 ({+-}9) Gy, and 60 ({+-}9) Gy, respectively. After a median follow-up of 43 months (range, 19-87 months), one local recurrence and two distant metastases cases were observed. Actuarial LC and overall survival rates at 3 years were 92% and 85%. One patient with Stage IVA and 1 patient with Stage III disease experienced fistulas (one vesicovaginal, one rectovaginal), and 1 patient developed periurethral necrosis. Conclusions: The concept of IGABT, originally developed for treating cervix cancer, appears to be applicable to vaginal cancer treatment with only minor adaptations. Dose-volume parameters for HRCTV and

  11. Treatment Option Overview (Gastric Cancer)

    Science.gov (United States)

    ... liver cancer . The following stages are used for gastric cancer: Stage 0 (Carcinoma in Situ) In stage 0 , abnormal cells are ... check-ups. Treatment Options by Stage Stage 0 (Carcinoma in ... Stage I Gastric Cancer Treatment of stage I gastric cancer may ...

  12. Precision Medicine in Cancer Treatment

    Science.gov (United States)

    Precision medicine helps doctors select cancer treatments that are most likely to help patients based on a genetic understanding of their disease. Learn about the promise of precision medicine and the role it plays in cancer treatment.

  13. Safe drinking during cancer treatment

    Science.gov (United States)

    ... ency/patientinstructions/000060.htm Drinking water safely during cancer treatment To use the sharing features on this page, please enable JavaScript. During and right after your cancer treatment, your body may not be able to protect ...

  14. Dry mouth during cancer treatment

    Science.gov (United States)

    ... gov/ency/patientinstructions/000032.htm Dry mouth during cancer treatment To use the sharing features on this page, please enable JavaScript. Some cancer treatments and medicines can cause dry mouth. Symptoms you ...

  15. CpG Island Methylation, Microsatellite Instability, and BRAF Mutations and Their Clinical Application in the Treatment of Colon Cancer

    Directory of Open Access Journals (Sweden)

    Christina Wu

    2012-01-01

    Full Text Available There have been significant developments in colon cancer research over the last few years, enabling us to better characterize tumors individually and classifying them according to certain molecular or genetic features. Currently, we are able to use KRAS mutational status as a guide to therapy with anti-epidermal growth factor receptor antibodies. Other molecular features under research include BRAF mutation, microsatellite instability, and CpG island methylation. These three molecular features are often associated with tumors that have overlapping phenotypes and can be present simultaneously in the same tumor. However, they carry different prognostic and predictive qualities, making analysis of their interaction relatively complex. Much research thus far has examined the clinical relevance of microsatellite instability in helping determine prognosis and the predictive value of adjuvant 5-fluorouracil chemotherapy in stages II and III colon cancers. BRAF mutation appears to be a biomarker for poor prognosis. CpG island methylation is tightly associated with microsatellite instable tumors and BRAF mutation, but its clinical utility remains uncertain. Hereby, we examine preclinical and clinical data that supports the utilization of all three phenotypes in future research applied to clinical practice.

  16. Proposed Organization of Family Cancer Clinics in Indonesia

    Directory of Open Access Journals (Sweden)

    Kunta Setiaji

    2017-02-01

    Full Text Available Abstract Around 10-15% of breast cancers are associated hereditary and/or familial predisposition. By definition familial breast occurs in two or more first degree relatives within a nuclear pedigree (first or second degree relatives. Hereditary and familial cancer displays different characteristics in the pathological features, clinical course, response to treatment, and outcomes. Therefore, specific consultation and treatment need to be addressed to patients with hereditary or familial predisposition for example the need for rigorous surveillance and preventive treatment including options for preventive surgery. Cancer clinical genetic service is not yet formally available in daily clinical practice in Indonesia. Surgeons usually become the first medical specialist to see cancer patients with familial predisposition, therefore they have to elaborate clinical cancer genetic service under Family Cancer Clinic (FCC. Clinical genetic service within FCC consists of several step-wise tasks including assessment of personal and family history of cancer, personalized cancer risk assessment, review of medical and family history, individual cancer screening and surveillance recommendations, genetic testing if necessary, discussion of benefits and limitations of genetic test, cancer risk reduction options and preventive strategies, and opportunity to participate in research as well as clinical trial. Nation-wide network for FCC is of importance to share knowledge and skill to perform cancer genetic service. Ability to perform genetic test including the interpretation in Indonesia has also been required. Keywords: familial cancer, hereditary cancer, genetic counseling, family cancer clinics

  17. A guide to clinical trials for cancer

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000823.htm A guide to clinical trials for cancer To use ... trial and where to find one. What is a Clinical Trial for Cancer? Clinical trials for cancer ...

  18. Effects of Time to Treatment on Biochemical and Clinical Outcomes for Patients With Prostate Cancer Treated With Definitive Radiation.

    Science.gov (United States)

    Dong, Yanqun; Li, Tianyu; Churilla, Thomas M; Viterbo, Rosalia; Sobczak, Mark L; Smaldone, Marc C; Chen, David Y T; Uzzo, Robert G; Hallman, Mark H; Horwitz, Eric M

    2016-10-01

    The purpose of this study was to evaluate if time to treatment (TTT) has an effect on outcomes for patients with localized prostate cancer treated with definitive external beam radiation therapy (EBRT). We included 4064 patients (1549 low-risk, 1612 intermediate-risk, and 903 high-risk) treated with EBRT. For each National Comprehensive Cancer Network (NCCN) risk group, TTT (defined as the time between initial positive prostate biopsy and start of RT) was analyzed in 4 intervals:  3.3 months were compared with those with TTT ≤ 3.3 months for each risk group. For high-risk men, 328 of 450 (72.9%) with TTT > 3.3 months were on androgen deprivation therapy (ADT) versus 299 of 453 (66%) with TTT ≤ 3.3 months. Among men with high-risk cancer treated without ADT, there remained no significant difference in outcomes between TTT > 3.3 months and TTT ≤ 3.3 months. TTT was not associated with significant differences in outcomes among each risk group of men with localized prostate cancer treated with EBRT. Among the high-risk patients, there were no observed detriments in outcomes with TTT > 3.3 months regardless of androgen deprivation therapy use. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Importance of epigenetic changes in cancer etiology, pathogenesis, clinical profiling, and treatment: what can be learned from hematologic malignancies?

    Science.gov (United States)

    Vecchio, Lorella; Seke Etet, Paul Faustin; Kipanyula, Maulilio John; Krampera, Mauro; Nwabo Kamdje, Armel Hervé

    2013-08-01

    Epigenetic alterations represent a key cancer hallmark, even in hematologic malignancies (HMs) or blood cancers, whose clinical features display a high inter-individual variability. Evidence accumulated in recent years indicates that inactivating DNA hypermethylation preferentially targets the subset of polycomb group (PcG) genes that are regulators of developmental processes. Conversely, activating DNA hypomethylation targets oncogenic signaling pathway genes, but outcomes of both events lead in the overexpression of oncogenic signaling pathways that contribute to the stem-like state of cancer cells. On the basis of recent evidence from population-based, clinical and experimental studies, we hypothesize that factors associated with risk for developing a HM, such as metabolic syndrome and chronic inflammation, trigger epigenetic mechanisms to increase the transcriptional expression of oncogenes and activate oncogenic signaling pathways. Among others, signaling pathways associated with such risk factors include pro-inflammatory nuclear factor κB (NF-κB), and mitogenic, growth, and survival Janus kinase (JAK) intracellular non-receptor tyrosine kinase-triggered pathways, which include signaling pathways such as transducer and activator of transcription (STAT), Ras GTPases/mitogen-activated protein kinases (MAPKs)/extracellular signal-related kinases (ERKs), phosphatidylinositol 3-kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR), and β-catenin pathways. Recent findings on epigenetic mechanisms at work in HMs and their importance in the etiology and pathogenesis of these diseases are herein summarized and discussed. Furthermore, the role of epigenetic processes in the determination of biological identity, the consequences for interindividual variability in disease clinical profile, and the potential of epigenetic drugs in HMs are also considered.

  20. Clinical Holistic Medicine: Metastatic Cancer

    Directory of Open Access Journals (Sweden)

    Søren Ventegodt

    2004-01-01

    Full Text Available We believe that the consciousness-based/holistic medical toolbox has a serious additional offer to cancer patients and, as a consequence, designed a treatment for the patient with metastasized cancer. From a holistic perspective, cancer can be understood as a simple disturbance of the cells, arising from the tissue holding on to a trauma with strong emotional content. This is called “a blockage”, where the function of the cells is allocated from their original function in the tissue to a function of holding emotions. We hope to be able not only to improve the quality of life, but also to improve survival and in some cases even induce spontaneous remission of the metastasized cancer. This paper describes how work with a patient with metastasized cancer can be done in the holistic clinical practice in 14 days on an individual basis, helping the patient to recover her human character, purpose of life, coherence, and will to live, thus improving quality of life and possibly also survival time. The holistic therapeutic work includes (1 teaching existential theory, (2 working with life perspective and philosophy of life, (3 helping the patient to acknowledge the state of the disease and the feelings connected to it, and finally (4 getting the patient into the holistic state of healing: (a feeling old repressed emotions, (b understanding why she got sick from a holistic point of view, and finally (c letting go of the negative beliefs and decisions that made her sick according to the holistic theory of nongenetic diseases. The theory of the human character, the quality of life theories, the holistic theory of cancer, the holistic process theory of healing, the theory of (Antonovsky coherence, and the life mission theory are the most important theories for the patient to find hope and mobilize the will to fight the cancer and survive. The patient went through the following phases: (1 finding the purpose of life and hidden resources; (2 confronting

  1. Ayahuasca and cancer treatment

    OpenAIRE

    Schenberg, Eduardo E

    2013-01-01

    Objectives: Comprehensively review the evidence regarding the use of ayahuasca, an Amerindian medicine traditionally used to treat many different illnesses and diseases, to treat some types of cancer. Methods: An in-depth review of the literature was conducted using PubMed, books, institutional magazines, conferences and online texts in nonprofessional sources regarding the biomedical knowledge about ayahuasca in general with a specific focus in its possible relations to the treatment of canc...

  2. Oral pristinamycin for the treatment of resistant Gram-positive infections in patients with cancer: Evaluation of clinical outcomes.

    Science.gov (United States)

    Teng, J C; Lingaratnam, S M; Trubiano, J A; Thursky, K A; Slavin, M A; Worth, L J

    2016-05-01

    Pristinamycin has been used to treat a range of Gram-positive infections, but reported experience in patients with malignancy is limited. This study aimed to evaluate the use of pristinamycin in patients with cancer at an Australian centre. All patients commenced on oral pristinamycin therapy at the Peter MacCallum Cancer Centre between January 2005 and December 2014 were identified using the hospital pharmacy dispensing system. Information on demographics, co-morbidities, cancer diagnosis, infection characteristics, pristinamycin regimen, pristinamycin tolerability and outcomes was collected. The median duration of follow-up was 398 days. In total, 26 patients received pristinamycin, with median age of 61 years and a male predominance (65%). Underlying diagnoses were haematological malignancies (50%) and solid tumours (50%). Pathogens included 13 meticillin-resistant Staphylococcus aureus, 6 vancomycin-resistant Enterococcus faecium, 4 meticillin-resistant Staphylococcus epidermidis, 2 meticillin-susceptible S. aureus and 1 vancomycin-susceptible E. faecium. Infection sites were osteomyelitis (6), skin and soft-tissue (4), intra-abdominal/pelvic abscess (4), bloodstream (3), empyema (3), endocarditis/endovascular (3), prosthesis-related infection (2) and epididymo-orchitis (1). One patient ceased pristinamycin due to nausea. Regarding outcome, 13 patients (50%) were cured of infection, 8 (31%) had suppression and 5 (19%) had relapse. Relapses included 1 endovascular infection, 2 episodes of osteomyelitis, 1 pelvic abscess and 1 skin and soft-tissue infection. Overall, 81% of patients achieved cure or suppression of antibiotic-resistant or complex Gram-positive infections, consistent with published experience in non-cancer populations. A favourable tolerability profile makes oral pristinamycin a viable treatment option, particularly in settings where outpatient management of cancer is the objective.

  3. Scalpel or SABR for Treatment of Early-Stage Lung Cancer: Clinical Considerations for the Multidisciplinary Team

    Directory of Open Access Journals (Sweden)

    Joe Y. Chang

    2011-09-01

    Full Text Available Treatment options for early-stage (T1-2 N0 non-small cell lung cancer are often limited by the patient’s advanced age, poor performance status, and comorbidities. Despite these challenges, stereotactic ablative radiotherapy (SABR provides a highly effective and safe therapy for intrathoracic tumors and has become the standard of care for delivering definitive treatment in medically inoperable patients. High-quality treatment, which includes reliable immobilization, accurate tumor targeting, and precise verification of dose delivery, is essential both to achieve successful cure and to avoid debilitating toxicities. Generally, SABR is well tolerated in patients with peripherally located tumors, but even centrally or superiorly located lesions can be treated if there is adequate conformal avoidance of normal structures and/or modified fractionation to meet dose constraints. While several preliminary studies suggest that SABR is as efficacious as surgery in operable patients, results of randomized data will illuminate whether the indications for SABR can be expanded to include patients who are candidates for surgical resection. Herein, we review the rationale for using SABR and its application in treating different patient populations with early-stage lung cancer.

  4. Treatment of liver cancer of middle and advanced stages using ultrasound-guided percutaneous ethanol injection combined with radiofrequency ablation: A clinical analysis

    Science.gov (United States)

    SUN, XUE; LI, RU; ZHANG, BOTAO; YANG, YUEJIE; CUI, ZHIFEI

    2016-01-01

    Liver cancer is a malignancy of the digestive system and has a high morbidity and mortality rate. Local intervention has become a viable option in identifying liver treatment. The aim of the present study was to analyze the clinical effects of treating liver cancer in middle and advanced stages using ultrasound-guided percutaneous ethanol injection (PEI) in tumors combined with radiofrequency ablation (RFA). A total of 100 patients with stage III–IV liver cancers were selected to participate in the study. Patients were divided into groups. In group A, treatment was initiated with PEI and after 1–2 weeks RFA was applied while in group B treatment was initiated with RFA and after 1–2 weeks PEI was applied. Patients in group C received PEI and RFA simultaneously. The clinical effects in the 3 groups were compared after 6-month follow ups. The volume of tumor ablation necrosis in group A was significantly greater than that in the groups B and C, while the size was significantly smaller compared to groups B and C after ablation. For group A, the complete ablation rate was significantly higher than that in groups B and C, and the differences were statistically significant (P<0.05). Liver damage indices, including raising levels of glutamic-pyruvic transaminase and total bilirubin, were significantly decreased in group A (P<0.05). The survival rate in group A was also significantly higher than in groups B and C (P<0.05). In conclusion, for patients with liver cancer in middle and advanced stages, the treatment method using PEI followed by RFA was more beneficial in terms of improving the tumor ablation rate, alleviating liver damages and increasing survival rates. PMID:26998128

  5. Lipoplatin Treatment in Lung and Breast Cancer

    OpenAIRE

    Manuela Fantini; Lorenzo Gianni; Carlotta Santelmo; Fabrizio Drudi; Cinzia Castellani; Alessandra Affatato; Mario Nicolini; Alberto Ravaioli

    2011-01-01

    The introduction of cisplatin in cancer treatment represents an important achievement in the oncologic field. Many types of cancers are now treated with this drug, and in testicular cancer patients major results are reached. Since 1965, other compounds were disovered and among them carboplatin and oxaliplatin are the main Cisplatin analogues showing similar clinical efficacy with a safer toxicity profile. Lipoplatin is a new liposomal cisplatin formulation which seems to have these cha...

  6. Clinical analysis on argon plasma coagulation (APC) under painless colonoscopy for treatment of patients with colorectal polyp canceration.

    Science.gov (United States)

    Sun, J-Y; Sun, D-J; Li, X-J; Jiao, K; Zhai, Z-W

    2016-01-01

    To investigate the clinical effects of argon plasma coagulation combined high frequency electric knife in treating patients with colorectal polyp canceration. 56 patients diagnosed with colorectal polyp canceration were divided into control group (n=23) and observation group (n=33). Patients in the control group were treated with high frequency electric band ligation electroexcision while patients in observation group were treated with argon coagulation combined high frequency electric knife therapy. The patients were followed up for 6 months and, then, compared for their clinical effects and prognosis. The average diameter of the polyp, the ratios of sessile and flat polyps in observation group were significantly higher than those in the control group with p0.05. Further, the differences in operation completion rate and polyp resection rate at one time in observation group was significantly higher than those of control group while operative complication rate and operation time was significantly lower than those in the control group with pplasma coagulation combined high frequency electric knife could extend polyp resection indication, along with improvement in the operation effect and reduction of complications.

  7. Helicobacter Pylori and Gastric Cancer: Clinical Aspects

    Directory of Open Access Journals (Sweden)

    Zhi-Qiang Song

    2015-01-01

    Full Text Available Objective: Although Helicobacter pylori (H. pylori is considered as the main etiological factor for gastric cancer, the strategy of screening and treating the oncogenic bacterium is still controversial. The objective was to evaluate the status and progress of the cognition about the relationship between H. pylori infection and gastric cancer from a clinical aspect. Data Sources: The data used in this review were mainly from the PubMed articles published in English from 1984 to 2015. Study Selection: Clinical research articles were selected mainly according to their level of relevance to this topic. Results: Gastric cancer is the fifth most common malignancy and the third leading cause of cancer deaths worldwide. The main etiological factor for gastric cancer is H. pylori infection. About 74.7-89.0% gastric cancer was related to H. pylori infection. Up to date, some regional gastric cancer prevention programs including the detection and treatment of H. pylori infection are under way. Current data obtained from the randomized controlled trials suggest that population-based H. pylori screening and treatment is feasible and cost-effective in preventing gastric cancer; however, a population-based H. pylori eradication campaign would potentially lead to bacterial resistance to the corresponding antibiotics, as well as a negative impact on the normal flora. Conclusions: The important questions of feasibility, program costs, appropriate target groups for intervention, and the potential harm of mass therapy with antibiotics must first be answered before implementing any large-scale program.

  8. 妊娠期子宫颈癌的临床治疗效果观察%Clinical treatment of cervical cancer during pregnancy Efficacy

    Institute of Scientific and Technical Information of China (English)

    罗利

    2015-01-01

    Objective:To investigate the clinical diagnosis and treatment of cervical cancer, the effects of pregnancy;Methods:A retrospective analysis of our hospital in January 2013~December 2013 admitted to the clinical data in pregnancy five cases of cervical cancer, compared to its as well as the results of surgical treatment.outcome of pregnancy in patients with cervical cancer treatment results son areas in 5 cases, 4 of 5 patients underwent radical surgery, radiotherapy and chemotherapy before surgery in 3 cases, no recurrence after surgery, with the clinical effect of surgical approach contrast was no significant difference in terms of (P <0.05);Conclusion:trimester pelvic examination and cervical cytology examination can detect cervical cancer, and treatment of cervical cancer in pregnancy needs of patients according to tumor stage and willingness and other factors considered choice of treatment.%目的:探讨妊娠期子宫颈癌的临床诊断治疗方法及其效果。方法回顾分析我院2013年1月—2013年12月收治的妊娠期子宫颈癌5例临床资料,对比其手术方式及临床疗效。结果:5例妊娠期子宫颈癌患者中4例行根治性手术,3例行术前放化疗,术后均未复发,在手术方式同临床效果方面的对比差异无统计学意义(P<0.05);结论:妊娠早期妇科检查以及宫颈细胞学方面的检查可以及时发现子宫颈癌,并且妊娠期子宫颈癌的治疗过程中需要根据肿瘤分期及患者的意愿等因素综合考虑选择治疗方式。

  9. Single High Intensity Focused Ultrasound Session as a Whole Gland Primary Treatment for Clinically Localized Prostate Cancer: 10-Year Outcomes

    Directory of Open Access Journals (Sweden)

    Ksenija Limani

    2014-01-01

    Full Text Available Objectives. To assess the treatment outcomes of a single session of whole gland high intensity focused ultrasound (HIFU for patients with localized prostate cancer (PCa. Methods. Response rates were defined using the Stuttgart and Phoenix criteria. Complications were graded according to the Clavien score. Results. At a median follow-up of 94months, 48 (44.4% and 50 (46.3% patients experienced biochemical recurrence for Phoenix and Stuttgart definition, respectively. The 5- and 10-year actuarial biochemical recurrence free survival rates were 57% and 40%, respectively. The 10-year overall survival rate, cancer specific survival rate, and metastasis free survival rate were 72%, 90%, and 70%, respectively. Preoperative high risk category, Gleason score, preoperative PSA, and postoperative nadir PSA were independent predictors of oncological failure. 24.5% of patients had self-resolving LUTS, 18.2% had urinary tract infection, and 18.2% had acute urinary retention. A grade 3b complication occurred in 27 patients. Pad-free continence rate was 87.9% and the erectile dysfunction rate was 30.8%. Conclusion. Single session HIFU can be alternative therapy for patients with low risk PCa. Patients with intermediate risk should be informed about the need of multiple sessions of HIFU and/or adjuvant treatments and HIFU performed very poorly in high risk patients.

  10. Compliance with clinical practice guidelines for breast cancer treatment: a population-based study of quality-of-care indicators in Italy

    Directory of Open Access Journals (Sweden)

    Sacerdote Carlotta

    2013-01-01

    Full Text Available Abstract Background It has been documented that variations exist in breast cancer treatment despite wide dissemination of clinical practice guidelines. The aim of this population-based study was to evaluate the impact of regional guidelines (Piedmont guidelines, PGL for breast cancer diagnosis and treatment on quality-of-care indicators in the Northwestern Italian region of Piedmont. Methods We included two samples of women aged 50–69 years with incident breast cancer treated in Piedmont before and after the introduction of PGL: 600 in 2002 (pre-PGL and 621 in 2004 (post-PGL. Patients were randomly selected among all incident breast cancer cases identified through the hospital discharge records database. We extracted clinical data on breast cancer cases from medical charts and ascertained vital status through linkage with town offices. We assessed compliance with 14 quality-of-care indicators from PGL recommendations, before and after their introduction in clinical practice. Results Among patients with invasive lesions, 77.1% (N = 368 and 77.5% (N = 383 in the pre-PGL and post-PGL groups, respectively, received breast conservative surgery (BCS as a first-line treatment. Following BCS, 87.7% received radiotherapy in 2002, compared to 87.9% in 2004. Of all patients at medium-to-high risk of distant metastasis, 65.5% (N = 268 and 63.6% (N = 252 received chemotherapy in 2002 and in 2004, respectively. Among the 117 patients with invasive lesions and negative estrogen receptor status in 2002, hormonal therapy was prescribed in 23 of them (19.6%. The incorrect prescription of hormonal therapy decreased to 10.8% (N = 10 among the 92 estrogen receptor-negative patients in 2004 (p Compliance with PGL recommendations was already high in the pre-PGL group, although some quality-of-care indicators did not reach the standard. In the pre/post analysis, 8 out of 14 quality-of-care indicators showed an improvement from 2002 to 2004, but only 4 out of 14

  11. Clinical significance of detecting CEA, CA199, AFP, HCG, CA153, CA125 in postoperative treatment of patients with ovarian cancer

    Institute of Scientific and Technical Information of China (English)

    Xue Pan; Zhen-Hua Du

    2016-01-01

    Objective:To explore the clinical significance of carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199), a tire protein (AFP), human chorionic gonadotropin (HCG), carbohydrate antigen 153 (CA153) and carbohydrate antigen 125 (CA125) in the postoperative treatment of patients with ovarian cancer.Methods:210 cases of patients with ovarian cancer after initial treatment from January 2015 to December 2015, 232 cases of patients with ovarian benign tumor and 250 cases of healthy women were selected, CEA, CA199, AFP, HCG, CA153 and CA125 levels were detected, and the levels after chemotherapy in patients with ovarian carcinoma were detected.Results:CEA, CA199, AFP, HCG, CA153 and CA125 levels in patients with ovarian cancer were (12.37±7.43) ng/mL, (84.04±26.96) U/mL, (37.46±9.47) μg/L, (110.54±35.51) IU/L, (51.23±9.20) U/mL and (64.36±42.68) U/mL, respectively, which were significantly higher than that in normal controls and patients with benign ovarian lesions, and were considered to be statistically significant. Chemotherapy after two cycles, CEA, CA199, AFP, HCG, CA153 and CA125 levels in patients with ovarian cancer were significantly lower than that before chemotherapy, and were considered to be statistically different. Chemotherapy after four cycles, CEA, CA199, AFP, HCG, CA153 and CA125 levels in patients with ovarian cancer continue to decrease, and were significantly lower than that of chemotherapy after two cycles, and had statistical differences.Conclusion:CEA, CA199, AFP, HCG, CA153 and CA125 can be used as important indicators for monitoring the chemotherapy effects, early recurrence and metastasis of ovarian cancer.

  12. Lung cancer after treatment for breast cancer.

    Science.gov (United States)

    Lorigan, Paul; Califano, Raffaele; Faivre-Finn, Corinne; Howell, Anthony; Thatcher, Nick

    2010-12-01

    Breast cancer is the most common cancer in women, and the second most common cause of cancer death after lung cancer. Improvements in the outcome of breast cancer mean that more patients are living longer and are, therefore, at risk of developing a second malignancy. The aim of this review is to present the current understanding of the risk of lung cancer arising in patients previously treated for early stage breast cancer. We review data on the effect of treatment factors (ie, surgery type, radiotherapy technique, and adjuvant chemotherapy) and patient factors (ie, age and smoking) on the risk of developing a subsequent lung cancer. The evidence suggests that older radiotherapy techniques were associated with a substantially increased risk of developing lung cancer in the ipsilateral lung, but there is no clear evidence of an increased risk with modern techniques. Smoking is an important risk factor, and increases the risk of lung cancer in those receiving radiotherapy. Adjuvant chemotherapy is not significantly associated with an increased risk. The risk of developing lung cancer increases with time elapsed since treatment, but any effect of age at treatment is unclear.

  13. DO CANCER CLINICAL TRIAL POPULATIONS TRULY REPRESENT CANCER PATIENTS? A COMPARISON OF OPEN CLINICAL TRIALS TO THE CANCER GENOME ATLAS.

    Science.gov (United States)

    Geifman, Nophar; Butte, Atul J

    2016-01-01

    Open clinical trial data offer many opportunities for the scientific community to independently verify published results, evaluate new hypotheses and conduct meta-analyses. These data provide a springboard for scientific advances in precision medicine but the question arises as to how representative clinical trials data are of cancer patients overall. Here we present the integrative analysis of data from several cancer clinical trials and compare these to patient-level data from The Cancer Genome Atlas (TCGA). Comparison of cancer type-specific survival rates reveals that these are overall lower in trial subjects. This effect, at least to some extent, can be explained by the more advanced stages of cancer of trial subjects. This analysis also reveals that for stage IV cancer, colorectal cancer patients have a better chance of survival than breast cancer patients. On the other hand, for all other stages, breast cancer patients have better survival than colorectal cancer patients. Comparison of survival in different stages of disease between the two datasets reveals that subjects with stage IV cancer from the trials dataset have a lower chance of survival than matching stage IV subjects from TCGA. One likely explanation for this observation is that stage IV trial subjects have lower survival rates since their cancer is less likely to respond to treatment. To conclude, we present here a newly available clinical trials dataset which allowed for the integration of patient-level data from many cancer clinical trials. Our comprehensive analysis reveals that cancer-related clinical trials are not representative of general cancer patient populations, mostly due to their focus on the more advanced stages of the disease. These and other limitations of clinical trials data should, perhaps, be taken into consideration in medical research and in the field of precision medicine.

  14. Colorectal Cancer: Symptoms, Diagnosis, Treatment

    Science.gov (United States)

    ... Past Issues Special Section: Colorectal Cancer Colorectal Cancer: Symptoms, Diagnosis and Treatment Past Issues / Spring 2009 Table of ... version of this page please turn Javascript on. Symptoms Check with your healthcare provider if you have ...

  15. [New frontiers in cancer treatment].

    Science.gov (United States)

    Tortora, Giampaolo; Daniele, Gennaro

    2006-12-01

    The knowledge acquired in the past few years on the regulatory mechanisms of cancer growth and spreading have started to be translated in the development of a new therapeutic modality directed against previously defined molecular targets, now defined as "target therapy", thus introducing a truly revolutionary concept in the anticancer therapeutic strategies. The novel molecular targeted drugs are usually integrated in therapeutic regimens that combine such novel agents with the conventional chemotherapy and radiotherapy, and several studies have now demonstrated their efficacy in the clinical practice. The future goal of cancer therapy will be the tailoring of treatments based on the specific molecular features of the tumor of each patient, with the aim to obtain the maximum therapeutic efficacy with the lowest toxicity.

  16. Clinical adenoviral gene therapy for prostate cancer.

    Science.gov (United States)

    Schenk, Ellen; Essand, Magnus; Bangma, Chris H; Barber, Chris; Behr, Jean-Paul; Briggs, Simon; Carlisle, Robert; Cheng, Wing-Shing; Danielsson, Angelika; Dautzenberg, Iris J C; Dzojic, Helena; Erbacher, Patrick; Fisher, Kerry; Frazier, April; Georgopoulos, Lindsay J; Hoeben, Rob; Kochanek, Stefan; Koppers-Lalic, Daniela; Kraaij, Robert; Kreppel, Florian; Lindholm, Leif; Magnusson, Maria; Maitland, Norman; Neuberg, Patrick; Nilsson, Berith; Ogris, Manfred; Remy, Jean-Serge; Scaife, Michelle; Schooten, Erik; Seymour, Len; Totterman, Thomas; Uil, Taco G; Ulbrich, Karel; Veldhoven-Zweistra, Joke L M; de Vrij, Jeroen; van Weerden, Wytske; Wagner, Ernst; Willemsen, Ralph

    2010-07-01

    Prostate cancer is at present the most common malignancy in men in the Western world. When localized to the prostate, this disease can be treated by curative therapy such as surgery and radiotherapy. However, a substantial number of patients experience a recurrence, resulting in spreading of tumor cells to other parts of the body. In this advanced stage of the disease only palliative treatment is available. Therefore, there is a clear clinical need for new treatment modalities that can, on the one hand, enhance the cure rate of primary therapy for localized prostate cancer and, on the other hand, improve the treatment of metastasized disease. Gene therapy is now being explored in the clinic as a treatment option for the various stages of prostate cancer. Current clinical experiences are based predominantly on trials with adenoviral vectors. As the first of a trilogy of reviews on the state of the art and future prospects of gene therapy in prostate cancer, this review focuses on the clinical experiences and progress of adenovirus-mediated gene therapy for this disease.

  17. The development of an ICF-based clinical guideline and screening tool for the standardized assessment and evaluation of functioning after head and neck cancer treatment.

    Science.gov (United States)

    Kisser, Ulrich; Adderson-Kisser, Christine; Coenen, Michaela; Stier-Jarmer, Marita; Becker, Sven; Sabariego, Carla; Harréus, Ulrich

    2017-02-01

    The assessment and evaluation of functioning and quality of life after tumor treatment in head and neck cancer (HNC) are considered as essential aspects of clinical routine and studies. A huge number of instruments are available that have been designed to evaluate functioning and quality of life after HNC treatment. The diversity of these instruments in terms of content, response options and administration hinders the comparability of available studies and the performance of meta-analyses. The objective of this paper is to inform about the development of a screening tool for the standardized assessment and evaluation of functioning based on the International Classification of Functioning, Disability and Health (ICF) Core Set for HNC. We followed a multi-step approach including (1) preparatory studies to identify and preselect suitable instruments for the assessment of functioning, (2) a decision-making process to agree on an ICF-based clinical guideline including instruments assessing functioning and (3) the development of a computer-based standardized screening tool to assess and evaluate functioning based on this guideline in clinical routine. Twenty-one experts participated in a consensus meeting and decided on instruments to be included in an ICF-based clinical guideline and screening tool for the assessment and evaluation of functioning in HNC patients in cancer treatment. The chosen instruments cover all aspects of the ICF Core Set for HNC addressing therapy control, pain, food intake/swallowing, voice/speech/breathing, other somatic complaints and psychosocial aspects. The screening tool contains patient-reported outcome measures and a clinician's checklist. It has to be further tested in clinical practice.

  18. Treatment Options by Stage (Esophageal Cancer)

    Science.gov (United States)

    ... Cancer Prevention Esophageal Cancer Screening Research Esophageal Cancer Treatment (PDQ®)–Patient Version General Information About Esophageal Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment ...

  19. Treatment Options by Stage (Gastric Cancer)

    Science.gov (United States)

    ... Cancer Prevention Stomach Cancer Screening Research Gastric Cancer Treatment (PDQ®)–Patient Version General Information About Gastric Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment ...

  20. Treatment Options (by Stage) for Colon Cancer

    Science.gov (United States)

    ... Colorectal Cancer Colorectal Cancer Screening Research Colon Cancer Treatment (PDQ®)–Patient Version General Information About Colon Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment ...

  1. Clinical retrospective analysis of erlotinib in the treatment of elderly patients with advanced non-small cell lung cancer.

    Science.gov (United States)

    Platania, Marco; Agustoni, Francesco; Formisano, Barbara; Vitali, Milena; Ducceschi, Monika; Pietrantonio, Filippo; Zilembo, Nicoletta; Gelsomino, Francesco; Pusceddu, Sara; Buzzoni, Roberto

    2011-09-01

    In order to evaluate the clinical efficacy and the safety profile of molecularly targeted therapies as a palliative approach in elderly populations affected by advanced thoracic neoplasms, we retrospectively studied, in terms of effectiveness and toxicities, a group of pretreated elderly metastatic non-small cell lung cancer (NSCLC) patients admitted to our institution and treated with erlotinib at standard daily/dose. Forty-three patients aged 70 years or older who had previously failed on chemotherapy or radiotherapy were treated with oral Eerlotinib (150 mg/d) until disease progression or unacceptable toxicity. Clinical data, pathological types, potential prognostic factors, efficacy and toxicity of erlotinib were included in this analysis. In our series we observed: objective responses in six patients (14%) and stable disease in 15 (35%). Skin rash was the most common side effect (67%). Grade 3-4 adverse events were observed in 16 cases (37%). The median overall survival and the median progression-free survival were 8.4 months (CI 95%: 0.7-43.6) and 3 months (CI 95%: 0.4-28.4), respectively. Patients with adenocarcinoma achieved the best disease control rate (p = 0.027), while not/former smokers showed a better response (p = 0.069). In our experience the use of erlotinib after chemotherapy failure in an unselected elderly population affected by NSCLC showed moderate efficacy and a moderate safety profile. However, erlotinib represents a valid option in this setting, but other factors such as biological information, comorbidities and concomitant medications need to be carefully take into consideration in this particular subset of cancer patients.

  2. Clinical application research on the use of the Photon Therapeutic Apparatus combined with Hops extract compound ointment in treatment for breast cancer patients

    Directory of Open Access Journals (Sweden)

    Chen Yunzhu

    2017-01-01

    Full Text Available Objective: To research Carnation-87C photon theraapeutic apparatus combine with compound hops extract ointment in the clinical effect of breast cancer patients after operation with unhealed incision of skin flap necrosis. Method: The experimental group is treated by the conventional therapy and Carnation-87C photon therapeutic apparatus combine with compound hops extract ointment, while the control group is treated by the conventional therapy only, such as regular dressing change. The other treatments for two groups of patients are the same. Through 4 weeks’ treatment, the growth of fresh granulation tissue and healing time were observed between two groups. Results: There were statistically significant differences (P<0.05 in the growth of fresh granulation tissue and healing time between two groups of patients with non-healing skin flap necrosis after the operation. Conclusion: The treatment with the Carnation-87C photon therapeutic apparatus combine with compound hops extract ointment for breast cancer patients after operation with unhealed incision of skin flap necrosis is easy to operate with good curative effect, and it is worth popularizing in clinical application.

  3. From clinical trials to the front line: Vinflunine for Treatment of UrothelialCell Carcinoma at the National Cancer Institute of Naples

    Directory of Open Access Journals (Sweden)

    GAETANO eFACCHINI

    2016-05-01

    Full Text Available BACKGROUND: the efficacy of Vinflunine, after failure of platinum-based chemotherapy in patients with metastatic or recurrent Transitional Cell Cancer of the Urothelial Tract, TCCU, has been demonstrated in an international, randomized, phase III trial comparing Vinflunine plus Best Supportive Care, BSC, with BSC alone. On the basis of that study vinflunine has been approved by the European Medicine Association, EMA, for treatment of TCCU patients after failure of a platinum treatment. However since data in clinical trials often differ from routine clinical practice due to unselected population and less strict monitoring, ‘real life’ experiences are very helpful to verify the efficacy of a new therapy. METHODS: this was a spontaneous, observational, retrospective study involving 43 patients with metastatic TCCU treated with vinflunine at our cancer center, data about demographics, disease characteristics and previous treatments were collected and outcome and toxicities of vinflunine were analyzed. RESULTS: 41 of 43 patients were eligible for RR analysis, the Overall RR was 12%, the Disease Control Rate was 29%; when including only patients treated in II line the DCR rose to 33%; the median PFS and the median OS were 2.2 and 6.9 months respectively. CONCLUSION: our findings were consistent with the outcome data emerged in the phase III randomized trial and in the other observational studies conducted all around Europe in the last 2-3 years. This experience supports the use of vinflunine in patients with advanced TTCU as effective and manageable antineoplastic drug.

  4. Clinical Observation of Erlotinib in the Treatment of Advanced Non-small Cell Lung Cancer: A Report of 92 Eases

    Directory of Open Access Journals (Sweden)

    Baohui HAN

    2009-12-01

    Full Text Available Background and objective Erlotinib, a selective inhibitor of epidermal growth factor receptor tyrosine kinase, has been approved effective in local advanced or metastatic non-small cell lung cancer (NSCLC. The aim of this study was to evaluate the efficacy and safety of erlotinib for the treatment of advanced NSCLC. Methods Ninety-two patients with advanced NSCLC who had failed or not tolerated or refused chemotherapy received 150 mg oral doses of erlotinib once daily until the disease progression or intolerable toxicity. Results Among the 92 NSCLC patients, 2 patient got complete response (2.2%, 22 partial response (23.9%, 48 stable disease (52.2% and 20 progressive disease (21.7%. The overall response rate and the disease controlled rate of erlotinib was 26.1% (24/92 and 78.3% (72/92, respectively. The response rate of erlotinib were significantly higher in rash and ECOG 0-1 than no rash and ECOG ≥ 2. The disease controlled rate of erlotinib was significantly higher in female and non-smokers than male and smokers (P < 0.05. The response rate of erlotinib did not show significant differences within pathological type or previous treatment. The most common side effects were rash and diarrhea with 84.8% and 31.5%, respectively, but usually were mild. Conclusion Erlotinib is effective and safe in the treatment of advanced NSCLC patients.

  5. Optimization and control in deep hyperthermia: Clinical implementation of hyperthermia treatment planning in cervical cancer treatment to obtain a higher treatment quality

    NARCIS (Netherlands)

    R.A.M. Canters (Richard)

    2013-01-01

    textabstractDeep hyperthermia is a treatment used in concurrence with radiation therapy or chemotherapy in the treatment of deep seated tumors. In hyperthermia, tumor temperatures are elevated 3 to 7oC above normal body temperature, up to a temperature of 44oC. In a randomized trial, the 3 year over

  6. Optimization and control in deep hyperthermia: Clinical implementation of hyperthermia treatment planning in cervical cancer treatment to obtain a higher treatment quality

    NARCIS (Netherlands)

    R.A.M. Canters (Richard)

    2013-01-01

    textabstractDeep hyperthermia is a treatment used in concurrence with radiation therapy or chemotherapy in the treatment of deep seated tumors. In hyperthermia, tumor temperatures are elevated 3 to 7oC above normal body temperature, up to a temperature of 44oC. In a randomized trial, the 3 year

  7. Long-term clinical outcome in patients with stage-i nonseminomatous germ cell cancer: a critical review of own treatment modalities in a retrospective study

    Directory of Open Access Journals (Sweden)

    Sandra Seseke

    2008-12-01

    Full Text Available PURPOSE: The optimal management of patients with clinical stage I non-seminomatous germ cell testicular cancer (NSGCT I was considered controversial until the European Germ Cell Cancer Consensus Group determined unambiguous treatment strategies. In order to assess the long-term outcome we evaluated the data of patients with NSGCT I. MATERIALS AND METHODS: In a retrospective evaluation, we included 52 patients with a mean age of 26 years (range 15-58 who were treated with different modalities at our department between 1989 and 2003. Mean follow-up was 5.9 years (range 2-14 years. After orchiectomy, 39 patients were treated with chemotherapy, 7 patients underwent retroperitoneal lymph node dissection and 6 men were managed using a surveillance strategy. Survival, recurrence rate and time of recurrence were evaluated. The histological staging and treatment modality was related to the relapse. RESULTS: Tumor specific overall mortality was 3.8%. The mortality and relapse rate of the surveillance strategy, retroperitoneal lymph node dissection and chemotherapy was 16.7% / 50%, 14.3% / 14.3% and 0% / 2.5% respectively. All relapsed patients in the surveillance group as well as in the RPLND group had at least one risk factor for developing metastatic disease. CONCLUSIONS: Following the European consensus on diagnosis and treatment of germ cell cancer in patients with NSGCT Stage I any treatment decision must be individually related to the patient according to prognostic factors and care capacity of the treating centre. In case of doubt, adjuvant chemotherapy should be the treatment of choice, as it provides the lowest risk of relapse or tumor related death.

  8. The clinical value of colostomy in the treatment of elderly patients with colorectal cancer complicated with cancerous obstruction%老年癌性结直肠梗阻患者行肠造瘘的临床价值

    Institute of Scientific and Technical Information of China (English)

    邓修民; 肖进

    2013-01-01

    Objective To investigate the clinical value of enteral colostomy in the treatment of elderly patients with unresectable colorectal cancer complicated with cancerous obstruction.Methods The clinical data of eighty-two elderly patients (from June 2006 to June 2011) who suffered from colorectal cancer complicated with cancerous obstruction were analysed retrospectively.Results The patients in colostomy group showed better effects in nutritional status,the (re-) operation rate,the time to live,the quality of life and the satisfaction rate than the patients in supporting treatment group who were given the best supporting procedures(P < 0.05).Conclusions Colostomy for the elderly patients who suffer from unresectable colorectal cancer complicated with cancerous obstruction is a simple,safe and effective treatment method.%目的 探讨老年晚期结直肠癌合并癌性梗阻患者行肠造瘘的临床价值. 方法 回顾性分析我院2006年6月至2011年6月5年间收治的82例老年癌性结肠梗阻患者的临床资料. 结果 造瘘组在营养状况、(再)手术率、生存时间、生活质量、满意度调查等方面均优于单纯最佳支持治疗组,2组比较差异有统计学意义(P<0.05). 结论 为老年癌性结肠梗阻而无法耐受肿瘤切除手术的患者施行肠造瘘术,是一种简便、安全、有效的治疗手段.

  9. SU-E-J-06: A Feasibility Study On Clinical Implementation of 4D-CBCT in Lung Cancer Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Y; Stanford, J; Duggar, W [University of Mississippi Med. Center, Jackson, MS (United States); Ruan, C [Brigham and Women' s Hospital / Harvard Medical School, Boston, MA (United States); Rajaguru, P [Univ. Mississippi Medical Center, UMC Cancer Center, Jackson, MS (United States); He, R [University of Mississippi Med. Center, Ridgeland, MS (United States); Yang, C [University of Mississippi Medical Center, Jackson, MS (United States)

    2014-06-01

    Purpose: Four-dimensional cone-beam CT (4D-CBCT) is a novel imaging technique to setup patients with pulmonary lesions in radiation therapy. This paper is to perform a feasibility study on the implementation of 4D-CBCT as image guidance for (1) SBRT and (2) Low Modulation (Low-Mod) IMRT in lung cancer treatment. Methods: Image artifacts and observers variability are evaluated by analyzing the 4D-CT QA phantom and patient 4D image data. There are two 4D-CBCT image artifacts: (1) Spatial artifact caused by the patient irregular breathing pattern will generate blurring and anatomy gap/overlap; (2) Cone beam scattering and hardening artifact will affect the image spatial and contrast resolution. The couch shift varies between 1mm to 3mm from different observers during the 4D-CBCT registration. Breath training is highly recommended to improve the respiratory regularity during CT simulation and treatment, especially for SBRT. Elekta XVI 4.5 Symmetry protocol is adopted in the patient 4DCBCT scanning and intensity-based registration. Physician adjustments on the auto-registration are involved prior to the treatment. Physician peer review on 4D-CBCT image acquisition and registration is also recommended to reduce the inter-observer variability. The average 4D-CT in reference volume coordinates is exported to MIM Vista 5.6.2 to manually fuse to the planning CT for further evaluation. Results: (1) SBRT: 4DCBCT is performed in dry-run and in each treatment fraction. Image registration and couch shift are reviewed by another physician on the 1st fraction before the treatment starts. (2) Low-Mod IMRT: 4D-CBCT is performed and peer reviewed on weekly basis. Conclusion: 4D-CBCT in SBRT dry-run can discover the ITV discrepancies caused by the low quality 4D-CT simulation. 4D-CBCT during SBRT and Low-Mod IMRT treatment provides physicians more confidence to target lung tumor and capability to evaluate inter-fractional ITV changes. More advanced 4D-CBCT scan protocol and

  10. ENDOSCOPIC TECHNOLOGIES IN EARLY RECTAL CANCER TREATMENT

    Directory of Open Access Journals (Sweden)

    D. V. Samsonov

    2015-01-01

    Full Text Available Total mesorectal excision is the “golden standard” of surgical treatment for rectal cancer. Development of endoscopic technologies allowed to implement the benefits of minimally invasive surgery in early rectal cancer treatment, decrease morbidity and mortality, improve functional outcome and quality of life. Oncological safety of this method is still a subject for discussion due to lack of lymph node harvest. Endoscopic operations for early rectal cancer are being actively implemented in daily practice, but lack of experience does not allow to include this method in national clinical prac-tice guidelines.

  11. Clinical Investigation of Efficacy of Third-line and Beyond Pemetrexed Treatment in Advanced Non-squamous Non-small Cell Lung Cancer

    Directory of Open Access Journals (Sweden)

    Fei YU

    2012-02-01

    Full Text Available Background and objective Pemetrexed in combination with platinum or a single-agent has been approved for the first- and second-line treatment of non-small cell lung cancer (NSCLC. However, the role of pemetrexed therapy in the third-line and beyond treatment of NSCLC has yet to be generally accepted. The present retrospective study reports the efficacy and safety of pemetrexed in the third-line and beyond treatment of advanced non-squamous NSCLC. Methods A total of 46 patients with advanced non-squamous NSCLC received a combination of pemetrexed plus platinum or a single-agent after multi-line treatment failed to yield positive results. Results Of the 46 patients who participated in the study, 7 achieved partial responses, 20 reached a stage of stable disease, and 19 reached a stage of progressive disease. The over-all object response rate was 15.2% and the disease control rate (DCR was 58.7%. The median progression-free survival time was 3.0 months. Pemetrexed in combination with platinum yielded a higher DCR than the pemetrexed plus single-agent treatment (P=0.043. Common adverse events included nausea, vomiting and myelosuppression. Conclusion Administration of pemetrexed after failure of multi-line treatment is clinically beneficial to patients with advanced non-squamous NSCLC. The toxic effects of the treatment appear to be tolerable.

  12. Fenretinide: a novel treatment for endometrial cancer.

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    Navdha Mittal

    Full Text Available Resistance to progestin treatment is a major hurdle in the treatment of advanced and reoccurring endometrial cancer. Fenretinide is a synthetic retinoid that has been evaluated in clinical trials as a cancer therapeutic and chemo-preventive agent. Fenretinide has been established to be cytotoxic to many kinds of cancer cells. In the present study, we demonstrate that fenretinide decreased cell viability and induced apoptosis in Ishikawa cells, which are an endometrial cancer cell line, in dose dependent manner in-vitro. This effect was found to be independent of retinoic acid nuclear receptor signaling pathway. Further, we have shown that this induction of apoptosis by fenretinide may be caused by increased retinol uptake via STRA6. Silencing of STRA6 was shown to decrease apoptosis which was inhibited by knockdown of STRA6 expression in Ishikawa cells. Results of an in-vivo study demonstrated that intraperitoneal injections of fenretinide in endometrial cancer tumors (created using Ishikawa cells in mice inhibited tumor growth effectively. Immunohistochemistry of mice tumors showed a decrease in Ki67 expression and an increase in cleaved caspase-3 staining after fenretinide treatment when compared to vehicle treated mice. Collectively, our results are the first to establish the efficacy of fenretinide as an antitumor agent for endometrial cancer both in-vitro and in-vivo, providing a valuable rationale for initiating more preclinical studies and clinical trials using fenretinide for the treatment of endometrial cancer.

  13. Clinical Application of Adjuvant Treatment after Operation in Patients with Stage IIIa Non-small Cell Lung Cancer

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    Yajie GAO

    2010-04-01

    Full Text Available Background and objective The efficacy of complete resection of the cancer for patients with stage IIIa non-small cell lung cancer (NSCLC is limited. Synthetic therapy is taken the lead in advocating at present. However, the value of post-operative radiotherapy is not still clear. The aim of this study is to evaluate the survival time and side effects of postoperative chemotherapy or chemoradiotherapy in the treatment of stage IIIa NSCLC. Methods Between December 2003 and June 2007, 52 cases that have completed followed-up data with stage IIIa of NSCLC received in the First Affiliated Hospital of Dalian Medical University. Twenty-three patients received postoperative chemoradiotherapy (group A and 29 patients received postoperative chemotherapy combined with radiotherapy (group B. Group A adopted platinum-based combination chemotherapy for 4-6 cycles. The chemotherapeutics included gemcitabine, vinorelbine and docetaxel. Group B used chemotherapy for 2-4 cycles and then received 3-dimensional conformal radiotherapy (3D-CRT. The prescribe dose of target volume was 50 Gy. The chemotherapy was same as for group A and needed 4 cycles in all. The impact of postoperative adjuvant treatment on survival and toxicity was observed in patients with stage IIIa NSCLC and the reason of disease progression was analyzed. Results The median survival was 32.5 months in group A and 31.9 months in group B (P=0.371. Progression-free survival extended about 6 months (P=0.044. The survival rate was 87% at 1 year, 0.1% at 2 year, 33% at 3 year for group A compared with 93%, 69%, 45% for group B. The major side effects were hematological and gastrointestinal toxicities, including nausea, vomiting and neutropenia. There was no significant difference in these toxicities between the two groups (P>0.05. Radioactiv esophageal infection occurred in 17.2% of the patients. Acute and late radioactive lung infection occurred in 13.8% and 27.6% of the patients. All these toxicities

  14. Targeted treatments for cervical cancer: a review

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    Peralta-Zaragoza O

    2012-11-01

    Full Text Available Oscar Peralta-Zaragoza,1 Víctor Hugo Bermúdez-Morales,1 Carlos Pérez-Plasencia,2,3 Jonathan Salazar-León,1 Claudia Gómez-Cerón,1 Vicente Madrid-Marina11Direction of Chronic Infections and Cancer, Research Center in Infection Diseases, National Institute of Public Health, Cuernavaca, Morelos, México; 2Oncogenomics Laboratory, National Cancer Institute of Mexico, Tlalpan, México; 3Biomedicine Unit, FES-Iztacala UNAM, México City, MéxicoAbstract: Cervical cancer is the second most common cause of cancer death in women worldwide and the development of new diagnosis, prognostic, and treatment strategies merits special attention. Although surgery and chemoradiotherapy can cure 80%–95% of women with early stage cancer, the recurrent and metastatic disease remains a major cause of cancer death. Many efforts have been made to design new drugs and develop gene therapies to treat cervical cancer. In recent decades, research on treatment strategies has proposed several options, including the role of HPV E6 and E7 oncogenes, which are retained and expressed in most cervical cancers and whose respective oncoproteins are critical to the induction and maintenance of the malignant phenotype. Other efforts have been focused on antitumor immunotherapy strategies. It is known that during the development of cervical cancer, a cascade of abnormal events is induced, including disruption of cellular cycle control, perturbation of antitumor immune response, alteration of gene expression, and deregulation of microRNA expression. Thus, in this review article we discuss potential targets for the treatment of cervical cancer associated with HPV infection, with special attention to immunotherapy approaches, clinical trials, siRNA molecules, and their implications as gene therapy strategies against cervical cancer development.Keywords: Cervical cancer, clinical trials, gene therapy, HPV E6 and E7 oncogenes, siRNAs

  15. Skin Cancer: Biology, Risk Factors & Treatment

    Science.gov (United States)

    ... turn Javascript on. Feature: Skin Cancer Skin Cancer: Biology, Risk Factors & Treatment Past Issues / Summer 2013 Table ... Articles Skin Cancer Can Strike Anyone / Skin Cancer: Biology, Risk Factors & Treatment / Timely Healthcare Checkup Catches Melanoma ...

  16. Treatment protocols for cervical cancer

    Directory of Open Access Journals (Sweden)

    Vujkov Tamara

    2002-01-01

    Full Text Available Introduction Cervical cancer is the second most common cancer in women worldwide and the second cause of cancer death among women. About 95% (90% in developed countries of invasive carcinomas are of sqamous types, and 5% (10% in developed countries are adenocarcinomas. FIGO classification of cervical carcinomas, based on clinical staging and prognostic factor dictate therapeutic procedures and help in designing treatment protocols. Therapeutic modalities Surgical therapy includes conization, radical hysterectomy with pelvic lymphadenectomy and palliative operation urinary diversion and colostomy. Radiotherapy, brachytherapy and teletherapy are most recently combined with chemotherapy as concurrent chemoradiation. Discussion and conclusion No change in therapeutic modalities will ever decrease mortality rate of cervical carcinoma as much as education, prevention and early screening. The 5-year survival for locally advanced disease has not improved during the last 40 years as a result of failure to deliver therapy to the paraaortic region. Paraaortic lymph nodes should be evaluated before therapy planning by different imaging procedures, or more exactly by surgical staging: laparoscopy or laparotomy. Radical operations of cervical carcinoma should be performed by experienced surgeons, educated for this type of operation, with sufficient number of cases.

  17. Lung cancer: Biology and treatment options.

    Science.gov (United States)

    Lemjabbar-Alaoui, Hassan; Hassan, Omer Ui; Yang, Yi-Wei; Buchanan, Petra

    2015-12-01

    Lung cancer remains the leading cause of cancer mortality in men and women in the U.S. and worldwide. About 90% of lung cancer cases are caused by smoking and the use of tobacco products. However, other factors such as radon gas, asbestos, air pollution exposures, and chronic infections can contribute to lung carcinogenesis. In addition, multiple inherited and acquired mechanisms of susceptibility to lung cancer have been proposed. Lung cancer is divided into two broad histologic classes, which grow and spread differently: small-cell lung carcinomas (SCLCs) and non-small cell lung carcinomas (NSCLCs). Treatment options for lung cancer include surgery, radiation therapy, chemotherapy, and targeted therapy. Therapeutic-modalities recommendations depend on several factors, including the type and stage of cancer. Despite the improvements in diagnosis and therapy made during the past 25 years, the prognosis for patients with lung cancer is still unsatisfactory. The responses to current standard therapies are poor except for the most localized cancers. However, a better understanding of the biology pertinent to these challenging malignancies, might lead to the development of more efficacious and perhaps more specific drugs. The purpose of this review is to summarize the recent developments in lung cancer biology and its therapeutic strategies, and discuss the latest treatment advances including therapies currently under clinical investigation.

  18. Adapting conventional cancer treatment for immunotherapy.

    Science.gov (United States)

    Qiao, Jian; Liu, Zhida; Fu, Yang-Xin

    2016-05-01

    The efficacy of directly killing tumors by conventional cancer therapies, such as chemotherapy and radiotherapy, has been for several decades well established. But, a suppressed immune response might become a lethal side effect after repeated cycles of intensive treatment. Recently, achievements in immune checkpoint inhibitors and adoptive T cell-mediated immunotherapies have resulted in changes in frontline management of advanced cancer diseases. However, accumulated evidence indicates that immunotherapeutic and conventional strategies alone are often ineffective to eradicate big tumors or metastasis. To improve the outcomes of treatment for advanced cancer diseases, the combination of conventional cancer treatment with various immunotherapeutic approaches has been attempted and has shown potential synergistic effects. Recent studies have unexpectedly demonstrated that some strategies of conventional cancer treatment can regulate the immune response positively, thus the understanding of how to adapt conventional treatment for immunotherapy is crucial to the design of effective combination therapy of conventional treatment with immunotherapy. Here, we review both experimental and clinical studies on the therapeutic effect and its mechanisms of combining conventional therapy with immunotherapy in treatment of cancer.

  19. Anal Cancer Treatment

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    ... outside of the body. This is called a colostomy . Lymph nodes that contain cancer may also be ... this operation. Enlarge Resection of the colon with colostomy. Part of the colon containing the cancer and ...

  20. Bronchiole tube Pulmonary Alveolus cancer 80 Example Clinical Treatment Analysis%细支气管肺泡癌80例临床治疗分析

    Institute of Scientific and Technical Information of China (English)

    王研; 仇桂龙

    2014-01-01

    Objective Bronchioloalveoar cell carcinoma(BAC)is in an adenocarcinoma of lung hypotype.This research is discussion bronchiole pulmonary alveolus cancer clinical symptom,pathology type,elephant characteristic,diagnosis treatment principle and prognosis.Method Collected from January,2000 80 example bronchiole tube bronchioloalveoar cell carcinoma(BAC)patient's clinical manifestation which admitted to January,2006,discussed the bronchial tube pulmonary alveolus cancer the treatment new pattern and the prognosis.Result Complex therapy curative effect surpasses the sole treatment result.Clinical by stages,pathology type,phantom study characteristic,treatment principle and patient lifetime close correlation.Conclusion The BAC treatment pattern should by the complex therapy primarily .Cannot the sur-gery patient be supposed to use first the chemotherapy after the later period the molecular target to continue the therapy to the treatment birthplace to be possible to obtain the good curative effect.Analyzes this group to conform to the above condition 27 example case of illness,the longest lifetime is 97 months,the position lifetime is 25 months.%目的:细支气管肺泡癌(BAC)是肺腺癌中的一个亚型。本研究探讨细支气管肺泡癌临床症状、病理类型、像特点、诊断治疗原则及预后。方法收集我院2000年1月至2006年1月收治的80例BAC患者的临床表现,探讨支气管管肺泡癌的治疗新模式及预后。结果综合治疗的疗效优于单一治疗效果。临床分期、病理类型、影像学特点、治疗原则与患者生存期密切相关。结论对BAC的治疗模式应以综合治疗为主。对晚期不能手术的患者应采用先化疗后分子靶向治疗的贯续疗法可取得较好的疗效。分析本组符合上述条件的27例病例,最长生存期为97个月,中位生存期为25个月。

  1. Progress in the clinical treatment based on breast cancer stem cells%基于乳腺癌干细胞的临床治疗进展

    Institute of Scientific and Technical Information of China (English)

    任远; 李泽桂

    2011-01-01

    背景:肿瘤干细胞在肿瘤的发生、发展、转移和复发等方面发挥着重要的作用.由于常规疗法无法消灭乳腺癌干细胞,故乳腺癌干细胞已被假定为乳腺癌治疗失败的根源.目的:阐明乳腺癌干细胞的生物学特性及一些乳腺癌靶向治疗药物的疗效,为制定提高乳腺癌患者生存率的治疗方案提供一些建议.方法:应用计算机检索PubMed数据库2000-01/2010-08有关乳腺癌干细胞的标志物与鉴定、新型药物针对乳腺癌干细胞靶向治疗方面的相关文献,检索词为"breast cancer,cancer stem cells,therapy",限定文章语言种类为English.检索文献包括临床研究、基础研究及综述类文章,初检得到文献总计203篇,排除重复性研究,保留33篇文献进一步分析.结果与结论:乳腺癌干细胞是第一个在实体瘤中被鉴定的肿瘤干细胞,人们采用多种策略成功分离出乳腺癌干细胞,对其生物学行为的认识正逐渐深入.乳腺癌干细胞的自我更新、分化等特性受到微环境和许多信号转导通路的调控.如何靶向治疗乳腺癌干细胞,最终根治乳腺癌,正逐渐成为肿瘤靶向治疗研究的一个热点.%BACKGROUND: Tumor stem cell plays an important role in the occurrence, development, metastasis and recurrence of tumor.However, due to conventional treatment cannot eliminate breast cancer stem cells, breast cancer stem cells have been assumed to be the origin of treatment failure in breast cancer.OBJECTIVE:To clarify the biological characteristics of breast cancer stem cells and the curative effects of targeted therapy for breast cancer by some drugs targeting, and then provides some advice for developing treatment strategies that may improve survival rate of breast cancer patients.METHODS: The articles related to the maker of breast cancer stem cells and identification, new drug for the targeting treatment of breast cancer stem cell from PubMed database between January 2000

  2. Image guided prostate cancer treatments

    Energy Technology Data Exchange (ETDEWEB)

    Bard, Robert L. [Bard Cancer Center, Biofoundation for Angiogenesis Research and Development, New York, NY (United States); Fuetterer, Jurgen J. [Radboud Univ. Nijmegen, Medical Centre (Netherlands). Dept. of Radiology; Sperling, Dan (ed.) [Sperling Prostate Center, Alpha 3TMRI, New York, NY (United States)

    2014-07-01

    Systematic overview of the application of ultrasound and MRI in the diagnosis and treatment of diseases of the lower urinary tract. Detailed information on image-guided therapies, including focused ultrasound, photodynamic therapy, and microwave and laser ablation. Numerous high-quality illustrations based on high-end equipment. Represents the state of the art in Non Invasive Imaging and Minimally Invasive Ablation Treatment (MIAT). Image-Guided Prostate Cancer Treatments is a comprehensive reference and practical guide on the technology and application of ultrasound and MRI in the male pelvis, with special attention to the prostate. The book is organized into three main sections, the first of which is devoted to general aspects of imaging and image-guided treatments. The second section provides a systematic overview of the application of ultrasound and MRI to the diagnosis and treatment of diseases of the lower urinary tract. Performance of the ultrasound and MRI studies is explained, and the normal and abnormal pathological anatomy is reviewed. Correlation with the ultrasound in the same plane is provided to assist in understanding the MRI sequences. Biopsy and interventional procedures, ultrasound-MRI fusion techniques, and image-guided therapies, including focused ultrasound, photodynamic therapy, microwave and laser ablation, are all fully covered. The third section focuses on securing treatment effectiveness and the use of follow-up imaging to ensure therapeutic success and detect tumor recurrence at an early stage, which is vital given that prompt focal treatment of recurrence is very successful. Here, particular attention is paid to the role of Doppler ultrasound and DCE-MRI technologies. This book, containing a wealth of high-quality illustrations based on high-end equipment, will acquaint beginners with the basics of prostate ultrasound and MRI, while more advanced practitioners will learn new skills, means of avoiding pitfalls, and ways of effectively

  3. Development and Evaluation of Evidence-Informed Clinical Nursing Protocols for Remote Assessment, Triage and Support of Cancer Treatment-Induced Symptoms

    Directory of Open Access Journals (Sweden)

    Dawn Stacey

    2013-01-01

    Full Text Available The study objective was to develop and evaluate a template for evidence-informed symptom protocols for use by nurses over the telephone for the assessment, triage, and management of patients experiencing cancer treatment-related symptoms. Guided by the CAN-IMPLEMENT© methodology, symptom protocols were developed by, conducting a systematic review of the literature to identify clinical practice guidelines and systematic reviews, appraising their quality, reaching consensus on the protocol template, and evaluating the two symptom protocols for acceptability and usability. After excluding one guideline due to poor overall quality, the symptom protocols were developed using 12 clinical practice guidelines (8 for diarrhea and 4 for fever. AGREE Instrument (Appraisal of Guidelines for Research and Evaluation rigour domain subscale ratings ranged from 8% to 86% (median 60.1 diarrhea; 40.5 fever. Included guidelines were used to inform the protocols along with the Edmonton Symptom Assessment System questionnaire to assess symptom severity. Acceptability and usability testing of the symptom populated template with 12 practicing oncology nurses revealed high readability (n=12, just the right amount of information (n=10, appropriate terms (n=10, fit with clinical work flow (n=8, and being self-evident for how to complete (n=5. Five nurses made suggestions and 11 rated patient self-management strategies the highest for usefulness. This new template for symptom protocols can be populated with symptom-specific evidence that nurses can use when assessing, triaging, documenting, and guiding patients to manage their-cancer treatment-related symptoms.

  4. Helicobacter Pylori and Gastric Cancer: Clinical Aspects

    Institute of Scientific and Technical Information of China (English)

    Zhi-Qiang Song; Li-Ya Zhou

    2015-01-01

    Objective: Although Helicobacterpylori (H.pylori) is considered as the main etiological factor for gastric cancer, the strategy of screening and treating the oncogenic bacterium is still controversial.The objective was to evaluate the status and progress of the cognition about the relationship between H.pylori infection and gastric cancer from a clinical aspect.Data Sources: The data used in this review were mainly from the PubMed articles published in English from 1984 to 2015.Study Selection: Clinical research articles were selected mainly according to their level of relevance to this topic.Results: Gastric cancer is the fifth most common malignancy and the third leading cause of cancer deaths worldwide.The main etiological factor for gastric cancer is H.pylori infection.About 74.7-89.0% gastric cancer was related to H.pylori infection.Up to date, some regional gastric cancer prevention programs including the detection and treatment of H.pylori infection are under way.Current data obtained from the randomized controlled trials suggest that population-based H.pylori screening and treatment is feasible and cost-effective in preventing gastric cancer;however, a population-based H.pylori eradication campaign would potentially lead to bacterial resistance to the corresponding antibiotics, as well as a negative impact on the normal flora.Conclusions: The important questions of feasibility, program costs, appropriate target groups for intervention, and the potential harm of mass therapy with antibiotics must first be answered before implementing any large-scale program.

  5. Nausea and Vomiting Caused by Cancer Treatment

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    ... prevent it. Risk of nausea and vomiting from cancer treatment Some drugs used for cancer treatment are more ... Options for preventing vomiting from drugs used for cancer treatment ASCO recommends the following options, based on the ...

  6. Treatment Options by Stage (Vaginal Cancer)

    Science.gov (United States)

    ... Health Professional Vaginal Cancer Treatment Research Vaginal Cancer Treatment (PDQ®)–Patient Version General Information About Vaginal Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) depends on ...

  7. Treatment Options by Stage (Salivary Gland Cancer)

    Science.gov (United States)

    ... and Oropharyngeal Cancer Screening Research Salivary Gland Cancer Treatment (PDQ®)–Patient Version General Information About Salivary Gland ... in diagnosing salivary gland cancer. Certain factors affect treatment options and prognosis (chance of recovery). The treatment ...

  8. What Happens After Treatment for Liver Cancer?

    Science.gov (United States)

    ... Support Liver Cancer After Treatment Living as a Liver Cancer Survivor Completing treatment can be both stressful and ... and treatment. Can I lower my risk of liver cancer progressing or coming back? If you have (or ...

  9. Struggling with cancer and treatment

    DEFF Research Database (Denmark)

    Adamsen, L; Andersen, C; Midtgaard, J

    2009-01-01

    Cancer and treatment can negatively affect the body's performance and appearance. Exercise has been tested in a few studies for altered body image among middle-aged women with breast cancer. The aim of the study was to explore how young pre-cancer athletes of both genders experience disease......- and treatment-related physical fitness and appearance changes while undergoing chemotherapy and participating in a 6-week group exercise intervention. A prospective, explorative study using semi-structured interviews was conducted before and at termination of the intervention. The study included 22 cancer...

  10. Identification of pre- and post-treatment markers, clinical, and laboratory parameters associated with outcome in renal cancer patients treated with MVA-5T4

    Directory of Open Access Journals (Sweden)

    Robert eAmato

    2013-07-01

    Full Text Available The recent approvals of immunotherapeutic agents (Sipuleucel-T and Ipilimumab for the treatment of different solid tumors gave a boost to the growing cancer immunotherapy field, even though few immunotherapy studies have demonstrated convincingly that there is a direct link between the predicted mode of action of an immunological compound and therapeutic benefit. MVA-5T4 (Trovax® is a novel vaccine combining the tumor-associated antigen 5T4 to an engineered vector-modified vaccinia Ankara (MVA. MVA helps to express the oncofetal 5T4 antigen and subsequently trigger a tumor-directed immune reaction. The safety and clinical benefit reported in multiple phase I and II clinical trials using MVA-5T4 were encouraging; immune responses were induced in almost all treated patients, and associations between 5T4-specific cellular or humoral responses and clinical benefit were reported in most of the nine phase II trials. In particular, clinical studies conducted in renal cell carcinoma (RCC patients have demonstrated an association between 5T4-specific (but not MVA antibody responses and enhanced survival. This review describes the clinical studies using MVA-5T4 conducted in RCC that convincingly demonstrated that an antigen-specific immune response induced by vaccination is associated with enhanced patient survival and is not simply a function of the general health of patients. We will also provide our expert opinions on possible future better-designed clinical trials based on relevant biomarkers. In addition, various combinations of MVA-5T4 and different and newer immunomodulator agents with promising clinical benefit will be discussed.

  11. Appropriateness and variation of surgical treatment of breast cancer in Italy: when excellence in clinical research does not match with generalized good quality care. Progetto Oncologia Femminile.

    Science.gov (United States)

    Scorpiglione, N; Nicolucci, A; Grilli, R; Angiolini, C; Belfiglio, M; Carinci, F; Cubasso, D; Filardo, G; Labbrozzi, D; Mainini, F

    1995-03-01

    To assess appropriateness of surgical care delivered to breast cancer patients in Italy and quantify the use of unnecessary radical procedures, a retrospective charts review of patients treated in 1988-1989 was conducted. A series of 1724 consecutive patients (median age 61 years; range 17-89) treated in 63 hospitals selected from within 8 regions with newly diagnosed operable breast carcinoma was evaluated. Overall, 541 (38%) patients had inappropriate surgery with more than two thirds of it being accounted for by the use of unnecessary mutilating Halsted mastectomy. Substantial geographic variation emerged in the overall rates of appropriateness (range 88-52%) which were not substantially affected by allowance for imbalances in patient- and hospital-related variables. Despite the important contribution given by Italian clinical researchers to the demonstration that less radical surgery can be as good as more radical procedures, still a substantial proportion of breast cancer patients are treated too aggressively. Besides pointing to the urgent need of interventions aimed at facilitating the process of technology transfer in order to promote more appropriate surgical care, these results suggest that efforts to increase patients' participation into treatment decision and awareness about alternative treatment options are warranted.

  12. Clinical photoacoustic imaging of cancer

    Science.gov (United States)

    2016-01-01

    Photoacoustic imaging is a hybrid technique that shines laser light on tissue and measures optically induced ultrasound signal. There is growing interest in the clinical community over this new technique and its possible clinical applications. One of the most prominent features of photoacoustic imaging is its ability to characterize tissue, leveraging differences in the optical absorption of underlying tissue components such as hemoglobin, lipids, melanin, collagen and water among many others. In this review, the state-of-the-art photoacoustic imaging techniques and some of the key outcomes pertaining to different cancer applications in the clinic are presented. PMID:27669961

  13. Clinical photoacoustic imaging of cancer

    Energy Technology Data Exchange (ETDEWEB)

    Valluru, Keerthi S.; Willmann, Juergen K. [Dept. of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford (United States)

    2016-08-15

    Photoacoustic imaging is a hybrid technique that shines laser light on tissue and measures optically induced ultrasound signal. There is growing interest in the clinical community over this new technique and its possible clinical applications. One of the most prominent features of photoacoustic imaging is its ability to characterize tissue, leveraging differences in the optical absorption of underlying tissue components such as hemoglobin, lipids, melanin, collagen and water among many others. In this review, the state-of-the-art photoacoustic imaging techniques and some of the key outcomes pertaining to different cancer applications in the clinic are presented.

  14. Clinical photoacoustic imaging of cancer

    Directory of Open Access Journals (Sweden)

    Keerthi S. Valluru

    2016-10-01

    Full Text Available Photoacoustic imaging is a hybrid technique that shines laser light on tissue and measures optically induced ultrasound signal. There is growing interest in the clinical community over this new technique and its possible clinical applications. One of the most prominent features of photoacoustic imaging is its ability to characterize tissue, leveraging differences in the optical absorption of underlying tissue components such as hemoglobin, lipids, melanin, collagen and water among many others. In this review, the state-of-the-art photoacoustic imaging techniques and some of the key outcomes pertaining to different cancer applications in the clinic are presented.

  15. Clinical photoacoustic imaging of cancer.

    Science.gov (United States)

    Valluru, Keerthi S; Willmann, Juergen K

    2016-10-01

    Photoacoustic imaging is a hybrid technique that shines laser light on tissue and measures optically induced ultrasound signal. There is growing interest in the clinical community over this new technique and its possible clinical applications. One of the most prominent features of photoacoustic imaging is its ability to characterize tissue, leveraging differences in the optical absorption of underlying tissue components such as hemoglobin, lipids, melanin, collagen and water among many others. In this review, the state-of-the-art photoacoustic imaging techniques and some of the key outcomes pertaining to different cancer applications in the clinic are presented.

  16. Serum tumor markers in chronic kidney disease: as clinical tool in diagnosis, treatment and prognosis of cancers.

    Science.gov (United States)

    Amiri, Fateme Shamekhi

    2016-01-01

    Cancer is singled out as the biggest cause of death in the world, predicted to reach 13.1 million cancer-related deaths by the year 2030. Although there are no specific tumor markers used in cancer screening, some markers can be used to assist in making a diagnosis and determining a prognosis. They can be used to follow in cases where the diagnosis is cancer through monitoring of the disease recurrence and/or evaluating the response to therapy. These markers are not specific as the number increases in multiple cases of cancer. Some markers are positive in a single type of cancer; others are detectable in more than one type. An ideal tumor marker should be highly sensitive, specific, and reliable with high prognostic value. Other characteristics of an ideal tumor marker are organ specificity and correlation of it with tumor stages. However, none of the tumor markers reported to date has all these characteristics. Influence of different stages of chronic kidney function on serum tumor markers is variable. Furthermore, hemodialysis, peritoneal dialysis, and kidney transplantation affect on tumor markers differently. Sometimes, no study has been found in the literature review. Combined serum tumor markers may also be valuable. This literature review points the role of serum tumor markers in screening, diagnosis, and follow-up of cancer patients in chronic kidney disease patients and renal allograft recipients. In addition, impact of chronic kidney disease and kidney transplantation on different serum tumor markers is briefly explored.

  17. Intensity-modulated arc therapy with simultaneous integrated boost in the treatment of primary irresectable cervical cancer. Treatment planning, quality control, and clinical implementation

    Energy Technology Data Exchange (ETDEWEB)

    Vandecasteele, Katrien; De Neve, Wilfried; De Gersem, Werner; Paelinck, Leen; Fonteyne, Valerie; De Wagter, Carlos; De Meerleer, Gert [Dept. of Radiotherapy, Ghent Univ. Hospital (Belgium); Delrue, Louke; Villeirs, Geert [Dept. of Radiology, Ghent Univ. Hospital (Belgium); Makar, Amin [Dept. of Gynecology, Ghent Univ. Hospital (Belgium)

    2009-12-15

    Purpose: to report on the planning procedure, quality control, and clinical implementation of intensity-modulated arc therapy (IMAT) delivering a simultaneous integrated boost (SIB) in patients with primary irresectable cervix carcinoma. Patients and methods: six patients underwent PET-CT (positron emission tomography-computed tomography) and MRI (magnetic resonance imaging) before treatment planning. Prescription (25 fractions) was (1) a median dose (D{sub 50}) of 62, 58 and 56 Gy to the primary tumor (GTVcervix), primary clinical target volume (CTVcervix) and its planning target volume (PTVcervix), respectively; (2) a D{sub 50} of 60 Gy to the PET-positive lymph nodes (GTVnodes); (3) a minimal dose (D{sub 98}) of 45 Gy to the planning target volume of the elective lymph nodes (PTVnodes). IMAT plans were generated using an anatomy-based exclusion tool with the aid of weight and leaf position optimization. The dosimetric delivery of IMAT was validated preclinically using radiochromic film dosimetry. Results: five to nine arcs were needed to create valid IMAT plans. Dose constraints on D{sub 50} were not met in two patients (both GTVcervix: 1 Gy and 3 Gy less). D{sub 98} for PTVnodes was not met in three patients (1 Gy each). Film dosimetry showed excellent gamma evaluation. There were no treatment interruptions. Conclusion: IMAT allows delivering an SIB to the macroscopic tumor without compromising the dose to the elective lymph nodes or the organs at risk. The clinical implementation is feasible. (orig.)

  18. Vitamin D and cancer: Clinical aspects

    Science.gov (United States)

    Woloszynska-Read, Anna; Johnson, Candace S.; Trump, Donald L.

    2015-01-01

    There are substantial preclinical and epidemiologic data that suggest that vitamin D plays a role in the prevention and treatment of cancer. Numerous observational studies have shown that low blood levels of 25(OH) vitamin D (cholecalciferol), estimated by geographical location, diet and activity assessment or measured serum levels are associated with a higher risk of cancer and worse cancer-specific survival as well as numerous morbidities to e.g. cardiovascular disease, stroke, infection, autoimmune disease, and neuromuscular dysfunction among large populations. A considerable number of in vitro and in vivo studies indicate that the most active metabolite of vitamin D – 1,25-dihydroxycholecalciferol or calcitriol – has anti-proliferative, pro-apoptotic, pro-differentiating, and anti-angiogenic properties. Combined treatment of calcitriol and many types of cytotoxic agents has synergistic or at least additive effects. However, clinical trials testing these hypotheses have been less encouraging, though a number of methodological, pharmacological, and pharmaceutical issues confound all trials ever conducted. In order to properly assess the clinical value of vitamin D, its metabolites and analogs in cancer prevention and treatment, more studies are needed. PMID:21872802

  19. Treatment Option Overview (Esophageal Cancer)

    Science.gov (United States)

    ... Resources Conducting Clinical Trials Statistical Tools and Data Terminology Resources NCI Data Catalog Cryo-EM NCI's Role ... Contacts Other Funding Find NCI funding for small business innovation, technology transfer, and contracts Training Cancer Training ...

  20. Treatment Option Overview (Anal Cancer)

    Science.gov (United States)

    ... Resources Conducting Clinical Trials Statistical Tools and Data Terminology Resources NCI Data Catalog Cryo-EM NCI's Role ... Contacts Other Funding Find NCI funding for small business innovation, technology transfer, and contracts Training Cancer Training ...

  1. Clinical Characteristics of Patients with Sporadic Colorectal Cancer and Primary Cancers of Other Organs

    Directory of Open Access Journals (Sweden)

    Jung-Yu Kan

    2006-11-01

    Full Text Available Most cancer patients often neglect the possibility of secondary cancer. Colorectal cancer (CRC is the third leading cause of cancer death in Taiwan. It is important to be aware of the clinical characteristics of double cancer in CRC patients for early diagnosis and treatment. We retrospectively analyzed 1,031 CRC patients who underwent surgical treatment at the Department of Surgery of Kaohsiung Medical University Hospital between January 1998 and December 2004. Among these patients, CRC was accompanied by cancer of other organs in 17 patients (1.65%, either synchronously or metachronously. Therefore, we describe our experience regarding the location of CRC, the clinical symptoms and signs of these patients, the TNM stage, histology, phase, association with other malignancies, interval between cancers and clinical outcomes. Of the 17 patients in whom CRC was accompanied by primary cancer of other organs, there were four synchronous and 13 metachronous multiple cancer patients. Our patient group comprised six men and 11 women with ages ranging from 47 to 88 years (median age, 66 years. The most common location of CRC was the sigmoid colon. Six gastric cancers (35.2% and six breast cancers (35.2% were associated with primary CRC. The remaining six second primary cancers were one lung cancer, one thyroid cancer, one cervical cancer, one ovarian cancer, one skin cancer, and one urinary bladder cancer. Of the 13 metachronous multiple cancer patients, eight patients developed subsequent CRC after primary cancers of other organs, whereas two patients developed a subsequent second primary cancer after CRC. The intervals between the development of metachronous multiple cancers ranged from 2 to 19 years. In this retrospective analysis, breast and gastric cancer patients were at increased risk of developing subsequent secondary CRC. Careful attention should always be paid to the possibility of secondary CRC in treating these cancer patients. Cancer

  2. Thermal dosimetry analysis combined with patient-specific thermal modeling of clinical interstitial ultrasound hyperthermia integrated within HDR brachytherapy for treatment of locally advanced prostate cancer

    Science.gov (United States)

    Salgaonkar, Vasant A.; Wootton, Jeff; Prakash, Punit; Scott, Serena; Hsu, I. C.; Diederich, Chris J.

    2017-03-01

    This study presents thermal dosimetry analysis from clinical treatments where ultrasound hyperthermia (HT) was administered following high-dose rate (HDR) brachytherapy treatment for locally advanced prostate cancer as part of a clinical pilot study. HT was administered using ultrasound applicators from within multiple 13-g brachytherapy catheters implanted along the posterior periphery of the prostate. The heating applicators were linear arrays of sectored tubular transducers (˜7 MHz), with independently powered array elements enabling energy deposition with 3D spatial control. Typical heat treatments employed time-averaged peak acoustic intensities of 1 - 3 W/cm2 and lasted for 60 - 70 minutes. Throughout the treatments, temperatures at multiple points were monitored using multi-junction thermocouples, placed within available brachytherapy catheters throughout mid-gland prostate and identified as the hyperthermia target volume (HTV). Clinical constraints allowed placement of 8 - 12 thermocouple sensors in the HTV and patient-specific 3D thermal modeling based on finite element methods (FEM) was used to supplement limited thermometry. Patient anatomy, heating device positions, orientations, and thermometry junction locations were obtained from patient CT scans and HDR and hyperthermia planning software. The numerical models utilized the applied power levels recorded during the treatments. Tissue properties such as perfusion and acoustic absorption were varied within physiological ranges such that squared-errors between measured and simulated temperatures were minimized. This data-fitting was utilized for 6 HT treatments to estimate volumetric temperature distributions achieved in the HTV and surrounding anatomy devoid of thermocouples. For these treatments, the measured and simulated T50 values in the hyperthermia target volume (HTV) were between 40.1 - 43.9 °C and 40.3 - 44.9 °C, respectively. Maximum temperatures between 46.8 - 49.8 °C were measured during

  3. Fully Automated Simultaneous Integrated Boosted-Intensity Modulated Radiation Therapy Treatment Planning Is Feasible for Head-and-Neck Cancer: A Prospective Clinical Study

    Energy Technology Data Exchange (ETDEWEB)

    Wu Binbin, E-mail: binbin.wu@gunet.georgetown.edu [Department of Radiation Oncology and Molecular Radiation Science, Johns Hopkins University, Baltimore, Maryland (United States); Department of Radiation Medicine, Georgetown University Hospital, Washington, DC (United States); McNutt, Todd [Department of Radiation Oncology and Molecular Radiation Science, Johns Hopkins University, Baltimore, Maryland (United States); Zahurak, Marianna [Department of Oncology Biostatistics, Johns Hopkins University, Baltimore, Maryland (United States); Simari, Patricio [Autodesk Research, Toronto, ON (Canada); Pang, Dalong [Department of Radiation Medicine, Georgetown University Hospital, Washington, DC (United States); Taylor, Russell [Department of Computer Science, Johns Hopkins University, Baltimore, Maryland (United States); Sanguineti, Giuseppe [Department of Radiation Oncology and Molecular Radiation Science, Johns Hopkins University, Baltimore, Maryland (United States)

    2012-12-01

    Purpose: To prospectively determine whether overlap volume histogram (OVH)-driven, automated simultaneous integrated boosted (SIB)-intensity-modulated radiation therapy (IMRT) treatment planning for head-and-neck cancer can be implemented in clinics. Methods and Materials: A prospective study was designed to compare fully automated plans (APs) created by an OVH-driven, automated planning application with clinical plans (CPs) created by dosimetrists in a 3-dose-level (70 Gy, 63 Gy, and 58.1 Gy), head-and-neck SIB-IMRT planning. Because primary organ sparing (cord, brain, brainstem, mandible, and optic nerve/chiasm) always received the highest priority in clinical planning, the study aimed to show the noninferiority of APs with respect to PTV coverage and secondary organ sparing (parotid, brachial plexus, esophagus, larynx, inner ear, and oral mucosa). The sample size was determined a priori by a superiority hypothesis test that had 85% power to detect a 4% dose decrease in secondary organ sparing with a 2-sided alpha level of 0.05. A generalized estimating equation (GEE) regression model was used for statistical comparison. Results: Forty consecutive patients were accrued from July to December 2010. GEE analysis indicated that in APs, overall average dose to the secondary organs was reduced by 1.16 (95% CI = 0.09-2.33) with P=.04, overall average PTV coverage was increased by 0.26% (95% CI = 0.06-0.47) with P=.02 and overall average dose to the primary organs was reduced by 1.14 Gy (95% CI = 0.45-1.8) with P=.004. A physician determined that all APs could be delivered to patients, and APs were clinically superior in 27 of 40 cases. Conclusions: The application can be implemented in clinics as a fast, reliable, and consistent way of generating plans that need only minor adjustments to meet specific clinical needs.

  4. Quantitative Imaging in Cancer Clinical Trials.

    Science.gov (United States)

    Yankeelov, Thomas E; Mankoff, David A; Schwartz, Lawrence H; Lieberman, Frank S; Buatti, John M; Mountz, James M; Erickson, Bradley J; Fennessy, Fiona M M; Huang, Wei; Kalpathy-Cramer, Jayashree; Wahl, Richard L; Linden, Hannah M; Kinahan, Paul E; Zhao, Binsheng; Hylton, Nola M; Gillies, Robert J; Clarke, Laurence; Nordstrom, Robert; Rubin, Daniel L

    2016-01-15

    As anticancer therapies designed to target specific molecular pathways have been developed, it has become critical to develop methods to assess the response induced by such agents. Although traditional, anatomic CT, and MRI examinations are useful in many settings, increasing evidence suggests that these methods cannot answer the fundamental biologic and physiologic questions essential for assessment and, eventually, prediction of treatment response in the clinical trial setting, especially in the critical period soon after treatment is initiated. To optimally apply advances in quantitative imaging methods to trials of targeted cancer therapy, new infrastructure improvements are needed that incorporate these emerging techniques into the settings where they are most likely to have impact. In this review, we first elucidate the needs for therapeutic response assessment in the era of molecularly targeted therapy and describe how quantitative imaging can most effectively provide scientifically and clinically relevant data. We then describe the tools and methods required to apply quantitative imaging and provide concrete examples of work making these advances practically available for routine application in clinical trials. We conclude by proposing strategies to surmount barriers to wider incorporation of these quantitative imaging methods into clinical trials and, eventually, clinical practice. Our goal is to encourage and guide the oncology community to deploy standardized quantitative imaging techniques in clinical trials to further personalize care for cancer patients and to provide a more efficient path for the development of improved targeted therapies.

  5. Clinical Trials Management | Division of Cancer Prevention

    Science.gov (United States)

    Information for researchers about developing, reporting, and managing NCI-funded cancer prevention clinical trials. Protocol Information Office The central clearinghouse for clinical trials management within the Division of Cancer Prevention.Read more about the Protocol Information Office. | Information for researchers about developing, reporting, and managing NCI-funded cancer prevention clinical trials.

  6. Optimisation of colorectal cancer treatment

    NARCIS (Netherlands)

    Broek, Colette Bernadine Maria-Theresia van den

    2014-01-01

    Colorectal cancer is one of the most common cancers worldwide. Although there have been several improvements in screening, staging, and treatment in the past decades, survival differences remain. For example among certain subgroups of patients, such as elderly patients and patients with comorbiditie

  7. Cancer cachexia, mechanism and treatment

    Institute of Scientific and Technical Information of China (English)

    Tomoyoshi Aoyagi; Krista P Terracina; Ali Raza; Hisahiro Matsubara; Kazuaki Takabe

    2015-01-01

    It is estimated that half of all patients with cancereventually develop a syndrome of cachexia, with anorexiaand a progressive loss of adipose tissue and skeletalmuscle mass. Cancer cachexia is characterized by systemicinflammation, negative protein and energy balance, andan involuntary loss of lean body mass. It is an insidioussyndrome that not only has a dramatic impact on patientquality of life, but also is associated with poor responsesto chemotherapy and decreased survival. Cachexia isstill largely an underestimated and untreated condition,despite the fact that multiple mechanisms are reported tobe involved in its development, with a number of cytokinespostulated to play a role in the etiology of the persistentcatabolic state. Existing therapies for cachexia, includingorexigenic appetite stimulants, focus on palliation ofsymptoms and reduction of the distress of patients andfamilies rather than prolongation of life. Recent therapiesfor the cachectic syndrome involve a multidisciplinaryapproach. Combination therapy with diet modificationand/or exercise has been added to novel pharmaceuticalagents, such as Megestrol acetate, medroxyprogesterone,ghrelin, omega-3-fatty acid among others. These agentsare reported to have improved survival rates as well asquality of life. In this review, we will discuss the emergingunderstanding of the mechanisms of cancer cachexia,the current treatment options including multidisciplinarycombination therapies, as well an update on new andongoing clinical trials.

  8. Emerging treatments for ovarian cancer.

    Science.gov (United States)

    Muggia, Franco; Lu, M Janice

    2003-05-01

    The survival at 5 years, of patients with ovarian cancer, has steadily improved since 1960, when surgery and alkylating agents were the only initial modalities employed to cope with the usual late presentation of the disease. In the 1980s, cisplatin and then carboplatin became established as the most active drugs, alone or in combination with other drugs. In the last decade, the antimicrotubulin drug paclitaxel, and the topoisomerase I inhibitor topotecan were noted to be active after failure of platinum drugs. These drugs, as well as others with known activity in the second-line setting, such as the pegylated liposomal doxorubicin, gemcitabine and oral etoposide, all play a role in the treatment of these patients and likely prolong survival without eradicating the disease. The plight of these patients has stimulated new areas of drug development. Here, the evolution of the current therapeutic strategy, the scientific rationale for cytotoxic and non-cytotoxic agents and their status at present are reviewed. 'Targeted' drug trials, in contrast to trials studying cytotoxic drug analogues, currently represent only a minor portion of clinical trials in ovarian cancer.

  9. Treatment Option Overview (Vulvar Cancer)

    Science.gov (United States)

    ... to get treatment. Having vulvar intraepithelial neoplasia or HPV infection can affect the risk of vulvar cancer. ... procedure in which a colposcope (a lighted, magnifying instrument) is used to check the vagina and cervix ...

  10. Treatment of Hormone Resistance with Docetaxel in Metastatic Prostate Cancer Patients: Results of a Clinical Experience at Omid Hospital, Isfahan, Iran

    Directory of Open Access Journals (Sweden)

    Mina Tajvidi

    2017-01-01

    Full Text Available Background: Metastatic prostate cancer is one of the most important cancers among men worldwide. Androgen ablation therapy can be used in treatment of these patients; however, most will progress to metastatic hormone-refractory prostate cancer. In this regard, docetaxel has been approved to treat metastatic hormone-refractory prostate cancer in the United States. In this study, we aimed to investigate the results of this treatment modality in metastatic prostate cancer patients from Iran. Methods:We evaluated PSA response and bone pain relief in 18 metastatic prostate cancer patients who underwent treatment with docetaxel at a dose of 75 mg/m2 intravenously on the first day of treatment. The treatment was repeated every three weeks (6 cycles along with 10 mg of prednisolone. Results: Of 18 patients, 39% had >50% decline in PSA levels.There were 16% of the patients with a PSA decline of approximately 30% to 50% of the pre-treatment levels. In addition, 29% of the patients had progressive PSA levels during chemotherapy. Among them, 55% had significant pain relief. Conclusion: This research showed the effectiveness of docetaxel to decrease PSA levels in metastatic hormone-refractory prostate cancer patients from Iran. Docetaxel was also valuable in alleviation of pain in these patients. However, prospective studies should validate this approach.

  11. Development and evaluation of a clinical model for lung cancer patients using stereotactic body radiotherapy (SBRT) within a knowledge-based algorithm for treatment planning.

    Science.gov (United States)

    Snyder, Karen Chin; Kim, Jinkoo; Reding, Anne; Fraser, Corey; Gordon, James; Ajlouni, Munther; Movsas, Benjamin; Chetty, Indrin J

    2016-11-08

    The purpose of this study was to describe the development of a clinical model for lung cancer patients treated with stereotactic body radiotherapy (SBRT) within a knowledge-based algorithm for treatment planning, and to evaluate the model performance and applicability to different planning techniques, tumor locations, and beam arrangements. 105 SBRT plans for lung cancer patients previously treated at our institution were included in the development of the knowledge-based model (KBM). The KBM was trained with a combination of IMRT, VMAT, and 3D CRT techniques. Model performance was validated with 25 cases, for both IMRT and VMAT. The full KBM encompassed lesions located centrally vs. peripherally (43:62), upper vs. lower (62:43), and anterior vs. posterior (60:45). Four separate sub-KBMs were created based on tumor location. Results were compared with the full KBM to evaluate its robustness. Beam templates were used in conjunction with the optimizer to evaluate the model's ability to handle suboptimal beam placements. Dose differences to organs-at-risk (OAR) were evaluated between the plans gener-ated by each KBM. Knowledge-based plans (KBPs) were comparable to clinical plans with respect to target conformity and OAR doses. The KBPs resulted in a lower maximum spinal cord dose by 1.0 ± 1.6 Gy compared to clinical plans, p = 0.007. Sub-KBMs split according to tumor location did not produce significantly better DVH estimates compared to the full KBM. For central lesions, compared to the full KBM, the peripheral sub-KBM resulted in lower dose to 0.035 cc and 5 cc of the esophagus, both by 0.4Gy ± 0.8Gy, p = 0.025. For all lesions, compared to the full KBM, the posterior sub-KBM resulted in higher dose to 0.035 cc, 0.35 cc, and 1.2 cc of the spinal cord by 0.2 ± 0.4Gy, p = 0.01. Plans using template beam arrangements met target and OAR criteria, with an increase noted in maximum heart dose (1.2 ± 2.2Gy, p = 0.01) and GI (0.2 ± 0.4, p = 0.01) for the nine

  12. Preoperative treatment with capecitabine, cetuximab and radiotherapy for primary locally advanced rectal cancer : A phase II clinical trial

    NARCIS (Netherlands)

    Eisterer, Wolfgang; de Vries, Alexander; Öfner, Dietmar; Rabl, Hans; Koplmüller, Renate; Greil, Richard; Tschmelitsch, Jöerg; Schmid, Rainer; Kapp, Karin; Lukas, Peter; Sedlmayer, Felix; Höfler, Gerald; Gnant, Michael; Thaler, Josef; Widder, Joachim

    2014-01-01

    BACKGROUND/AIM: To investigate the feasibility and safety of preoperative capecitabine, cetuximab and radiation in patients with MRI-defined locally advanced rectal cancer (LARC, cT3/T4). PATIENTS AND METHODS: 31 patients with LARC were treated with cetuximab and capecitabine concomitantly with 45

  13. Preoperative treatment with capecitabine, cetuximab and radiotherapy for primary locally advanced rectal cancer : A phase II clinical trial

    NARCIS (Netherlands)

    Eisterer, Wolfgang; de Vries, Alexander; Öfner, Dietmar; Rabl, Hans; Koplmüller, Renate; Greil, Richard; Tschmelitsch, Jöerg; Schmid, Rainer; Kapp, Karin; Lukas, Peter; Sedlmayer, Felix; Höfler, Gerald; Gnant, Michael; Thaler, Josef; Widder, Joachim

    2014-01-01

    BACKGROUND/AIM: To investigate the feasibility and safety of preoperative capecitabine, cetuximab and radiation in patients with MRI-defined locally advanced rectal cancer (LARC, cT3/T4). PATIENTS AND METHODS: 31 patients with LARC were treated with cetuximab and capecitabine concomitantly with 45 G

  14. Comparison of treatment outcome in metastatic colorectal cancer patients included in a clinical trial versus daily practice in The Netherlands

    NARCIS (Netherlands)

    Mol, L.; Koopman, M.; Gils, C.W. van; Ottevanger, P.B.; Punt, C.J.A.

    2013-01-01

    Abstract The external validity of trial results is a matter of debate, and no strong evidence is available to support whether a trial may have a positive or a negative effect on the outcome of patients. Methods. We compared the results of stage IV colorectal cancer patients treated within a large

  15. Curcumin nanoformulations : A review of pharmaceutical properties and preclinical studies and clinical data related to cancer treatment

    NARCIS (Netherlands)

    Naksuriya, Ornchuma; Okonogi, Siriporn; Schiffelers, Raymond M.|info:eu-repo/dai/nl/212909509; Hennink, Wim E.|info:eu-repo/dai/nl/070880409

    2014-01-01

    Curcumin, a natural yellow phenolic compound, is present in many kinds of herbs, particularly in Curcuma longa Linn. (turmeric). It is a natural antioxidant and has shown many pharmacological activities such as anti-inflammatory, anti-microbial, anti-cancer, and anti-Alzheimer in both preclinical

  16. Curcumin nanoformulations : A review of pharmaceutical properties and preclinical studies and clinical data related to cancer treatment

    NARCIS (Netherlands)

    Naksuriya, Ornchuma; Okonogi, Siriporn; Schiffelers, Raymond M.; Hennink, Wim E.

    2014-01-01

    Curcumin, a natural yellow phenolic compound, is present in many kinds of herbs, particularly in Curcuma longa Linn. (turmeric). It is a natural antioxidant and has shown many pharmacological activities such as anti-inflammatory, anti-microbial, anti-cancer, and anti-Alzheimer in both preclinical an

  17. Treatment of locally advanced prostatic cancer

    Directory of Open Access Journals (Sweden)

    Marušić Goran

    2010-01-01

    Full Text Available Introduction. A locally advanced prostate cancer is defined as a malignant process spreading beyond the prostate capsule or in seminal vesicles but without distant metastasis or regional lymph nodes invasion. Clinical classification, prediction and treatment of prostate cancer. An exact staging of clinical T3 stadium is usually difficult because of the frequent over and under staging. The risk prognostic stratification is performed through nomograms and ANN (artificial neural networks. The options for treatment are: radical prostatectomy, external radiotherapy and interstitial implantation of radioisotopes, hormonal therapy by androgen blockade. Radical prostatectomy is considered in patients with T3 stage but extensive dissection of lymph nodes, dissection of neurovascular bundle (on tumor side, total removal of seminal vesicle and sometimes resection of bladder neck are obligatory. Postoperative radiotherapy is performed in patients with invasion of seminal vesicles and capsular penetration or with prostate specific antigen value over 0.1 ng/ml, one month after the surgical treatment. Definitive radiotherapy could be used as the best treatment option considering clinical stage, Gleason score, age, starting prostate specific antigen (PSA value, concomitant diseases, life expectancy, quality of life, through multidisciplinary approach (combined with androgen deprivation. Hormonal therapy in intended for patients who are not eligible for surgical treatment or radiotherapy. Conclusion. Management of locally advanced prostate cancer is still controversial and studies for better diagnosis and new treatment modalities are ongoing.

  18. Radiation Therapy Oncology Group Consensus Panel Guidelines for the Delineation of the Clinical Target Volume in the Postoperative Treatment of Pancreatic Head Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Goodman, Karyn A., E-mail: goodmank@mskcc.org [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Regine, William F. [University of Maryland School of Medicine, Baltimore, Maryland (United States); Dawson, Laura A. [Princess Margaret Hospital, University of Toronto, Toronto, Ontario (Canada); Ben-Josef, Edgar [University of Michigan Medical School, Ann Arbor, Michigan (United States); Haustermans, Karin [University Hospital Leuven, Leuven (Belgium); Bosch, Walter R. [Image-Guided Therapy QA Center, Washington University, St. Louis, Missouri (United States); Turian, Julius; Abrams, Ross A. [Rush University Medical College, Chicago, Illinois (United States)

    2012-07-01

    Purpose: To develop contouring guidelines to be used in the Radiation Therapy Oncology Group protocol 0848, a Phase III randomized trial evaluating the benefit of adjuvant chemoradiation in patients with resected head of pancreas cancer. Methods and Materials: A consensus committee of six radiation oncologists with expertise in gastrointestinal radiotherapy developed stepwise contouring guidelines and an atlas for the delineation of the clinical target volume (CTV) in the postoperative treatment of pancreas cancer, based on identifiable regions of interest and margin expansions. Areas at risk for subclinical disease to be included in the CTV were defined, including nodal regions, anastomoses, and the preoperative primary tumor location. Regions of interest that could be reproducibly contoured on postoperative imaging after a pancreaticoduodenectomy were identified. Standardized expansion margins to encompass areas at risk were developed after multiple iterations to determine the optimal margin expansions. Results: New contouring recommendations based on CT anatomy were established. Written guidelines for the delineation of the postoperative CTV and normal tissues, as well as a Web-based atlas, were developed. Conclusions: The postoperative abdomen has been a difficult area for effective radiotherapy. These new guidelines will help physicians create fields that better encompass areas at risk and minimize dose to normal tissues.

  19. [Let Us to Know the Post-Marketing Clinical Studies and Critical Situation of Study Groups -- Now We Should Talk about How to Achieve the Safe and Most Effective Treatment for Cancer Patients].

    Science.gov (United States)

    Hamamoto, Maki

    2016-04-01

    Not to leave something to be regretted in the life of patients and their family, it is important to find the best way during and after treatment for cancer. We, cancer survivors association, propose a corporated actions among patients, administration, medical stuffs, and enterprises to solve the problems of clinical studies. And we express our opinion on the present problems and to do for patients and citizens.

  20. Small Intestine Cancer Treatment

    Science.gov (United States)

    ... intestine . The digestive system removes and processes nutrients ( vitamins , minerals , carbohydrates , fats, proteins , and water) from foods ... a microscope to see whether they contain cancer. Bypass : Surgery to allow food in the small intestine ...

  1. Ayahuasca and cancer treatment

    National Research Council Canada - National Science Library

    Schenberg, Eduardo E

    2013-01-01

    Objectives: Comprehensively review the evidence regarding the use of ayahuasca, an Amerindian medicine traditionally used to treat many different illnesses and diseases, to treat some types of cancer. Methods...

  2. Parathyroid Cancer Treatment

    Science.gov (United States)

    ... parathyroid glands. The thyroid gland lies at the base of the throat near the trachea. It is ... the neck and takes pictures. Blood flow and metabolism are higher than normal in areas where cancer ...

  3. Clinical Progress of Treatment on Recurrent Epithelial Ovarian Cancer%复发性上皮性卵巢癌临床治疗进展

    Institute of Scientific and Technical Information of China (English)

    党彩玲

    2012-01-01

    Most of patients with epithelial ovarian cancer was advanced as the initial treatment. Although cytoreductive surgery and adjuvant paclitaxel/platinum-based chemotherapy have made the most of patients in clinical remission,but there are still 80% of patients to relapse eventually. The principle of treatment for recurrent EOC is palliative rather than cure. The quality of life should be to consider once again on treatment. According to the situation in patients with initial surgery and postoperative chemotherapy and means,efficacy,toxicity,relapse types,the treatment programs was to be developed individually in order to alleviate and control symptoms of the disease,and improve quality of life and prolong progression-free survival for patient. As only a single lesion or recurrence lesion reduction by surgery effectively,the cytoreductive surgery combined with chemotherapy would be to implement. While those with large and extensive metastasis even,the only chemotherapy would be to consider. In developing the program of chemotherapy,drug-resistant,refractory and refractory patients was often considered as a group,which would be to encourage to ongoing clinical trials or receiving non-platinum chemotherapy,the patients with sensitive ovarian cancer was recommended to receive platinum or platinum plus paclitaxel-based chemotherapy. Biological treatment as an alternative cancer therapy model was more and more attended as an importance strong complement to traditional surgery and chemotherapy.%上皮性卵巢癌(epithelial ovarian cancer,EOC)患者如初次就诊时已为晚期,虽然肿瘤细胞减灭术和术后辅以紫杉醇/铂类为基础的联合化疗可使大部分患者获得临床缓解,但最终仍有80%的患者复发.复发性EOC 的治疗原则是姑息而不是治愈,生存质量是再次治疗时考虑的重要因素.可根据患者初次手术情况及术后化疗方案及途径、疗效、毒副反应、复发类型等制定个体化的治疗方

  4. Conforming to cancer staging, prognostic indicators and national treatment guidelines.

    Science.gov (United States)

    Dykstra-Long, Gwendylen R

    2011-01-01

    Clinical cancer staging and prognostic indicators guide treatment planning, and as such the American College of Surgeons Commission on Cancer Commission on Cancer (ACoS CoC) and the American Joint Committee on Cancer (AJCC) have recognized this as quality patient care. Overton Brooks Veterans Administration (OBVAMC) developed an organizational policy and procedure, flow algorithms, treatment plan templates, and education strategies in order to conform to this quality care approach. The purpose of this article is to share this systematic approach that is able to support clinical and working cancer stage and prognostic indicators which have been recognized by national standard setting organizations as quality patient care.

  5. When your cancer treatment stops working

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000851.htm When your cancer treatment stops working To use the sharing features on this page, please enable JavaScript. Cancer treatments can keep cancer from spreading and even cure ...

  6. Anatomy of a Cancer Treatment Scam

    Medline Plus

    Full Text Available ... of a Cancer Treatment Scam Anatomy of a Cancer Treatment Scam January 19, 2012 Curious about a product that claims to treat or cure cancer? According to the Federal Trade Commission, consumers should ...

  7. Anatomy of a Cancer Treatment Scam

    Medline Plus

    Full Text Available ... of a Cancer Treatment Scam Anatomy of a Cancer Treatment Scam January 19, 2012 Curious about a product that claims to treat or cure cancer? According to the Federal Trade Commission, consumers should ...

  8. Preliminary clinical evaluation of continuous infusion of 5-FU and low dose cisplatin (LFP) combined with radiation therapy for the treatment of advanced or recurrent esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Itoh, Satoshi; Morita, Soujiro; Hisa, Nobuaki; Tsuji, Akihito; Takamatsu, Masahiro; Takasaki, Motohiro; Horimi, Tadashi [Kochi Municipal Central Hospital (Japan)

    2000-11-01

    We evaluated the LFP combined with radiation therapy for the treatment of advanced or recurrent esophageal cancer. The patients consisted of 4 inoperable cases, 4 cases in combination with operation, and 5 cases with recurrent tumor. The response rate was 80% (CR2, PR6, NC1 and PD1). We conclude that the LFP combined with radiation therapy was effective and useful for the treatment of advanced or recurrent esophageal cancer. (author)

  9. Double-blind randomized placebo-controlled multicenter clinical trial (phase IIa) on diindolylmethane's efficacy and safety in the treatment of CIN: implications for cervical cancer prevention.

    Science.gov (United States)

    Ashrafian, Levon; Sukhikh, Gennady; Kiselev, Vsevolod; Paltsev, Mikhail; Drukh, Vadim; Kuznetsov, Igor; Muyzhnek, Ekaterina; Apolikhina, Inna; Andrianova, Evgeniya

    2015-01-01

    The article presents the results of a clinical trial on the efficacy and safety of a novel pharmaceutical composition in the form of vaginal suppositories containing diindolylmethane in the course of cervical intraepithelial neoplasia (CIN) I-II conservative treatment. It offers an attractive drug therapy for more personalized prevention of cervical cancer. A total of 78 women of reproductive age were included. This was a multicenter, randomized, placebo-controlled, double-blind, parallel-group trial with efficacy determined by histological evaluation of cervical biopsies. The efficacy of active drug treatment (100 and 200 mg/day) in both treatment groups was significantly higher in comparison with the placebo group, according to the primary efficacy end point (proportion of patients with complete CIN regression after 90-180 days of the study drug treatment). The efficacies were 100.0 % (confidence interval (CI) 95 %: 82.35-100.00 %), 90.5 % (CI 95 %: 69.62-98.83 %), and 61.1 % (CI 95 %: 35.75-82.70 %), for the high dose, low does, and placebo, respectively. Adverse events in the placebo group were reported in 22 % of patients (CI 95 %: 7.5-43.7 %); in the first treatment group (100 mg/day), adverse events were reported in 40.0 % of patients (CI 95 %: 21.1-61.3 %); in the second treatment group (200 mg/day), adverse events were reported in 42.0 % of patients (CI 95 %: 22.1-63.4 %). The differences in side effects between treatment groups treated with the active drug and placebo were statistically significant. No serious adverse events were reported in any of the groups. Thus, the use of diindolylmethane in the form of intravaginal suppositories can be effective in patients with CIN I-II and is not accompanied by clinically significant side effects. This approach could be a better option for young women with CIN I-II as it takes in attention their reproductive plans. ID: ChiCTR-INR-15007497 (2 December 2015).

  10. The Effects of Low to Moderate Intensity Exercise on Fatigue in Breast Cancer Patients Following Clinical Treatment

    Science.gov (United States)

    2005-09-01

    Data is being collected that suggests exercise can reduce fatigue in people surviving cancer. Little data however exists as to the appropriate...Subjects will establish a comfortable walking pace of 1.5 to 4 mph. The grade of the treadmill is increased 1% each minute and continues till the...Hypothyroid HTN DM Hyperlipidemia Osteoarthritis SLE COPD Asthma 3 3 3 1 3 3 1 0 0 2 6 3 1 3 2 0 1 0

  11. Immunological Landscape and Clinical Management of Rectal Cancer

    Directory of Open Access Journals (Sweden)

    Elísabeth ePérez-Ruiz

    2016-02-01

    Full Text Available The clinical management of rectal cancer and colon cancer differs due to increased local relapses in rectal cancer. However, the current molecular classification does not differentiate rectal cancer and colon cancer as two different entities. In recent years, the impact of the specific immune microenvironment in cancer has attracted renewed interest, and is currently recognized as one of the major determinants of clinical progression in a wide range of tumors. In colorectal cancer, the density of lymphocytic infiltration is associated with better overall survival. Due to the need for biomarkers of response to conventional treatment with chemoradiotherapy in rectal tumors, the immune status of rectal cancer emerges as a useful tool to improve the management of patients.

  12. 宫颈癌规范治疗临床进展%Clinical progress of the standard treatment of cervical cancer

    Institute of Scientific and Technical Information of China (English)

    白静

    2014-01-01

    近年来随着治疗日趋规范,宫颈癌治疗疗效总体逐步提高,但对于局部晚期和复发、转移宫颈癌的治疗还有待进一步完善.早期宫颈癌根治性手术和根治性放疗疗效相当,中晚期宫颈癌同期放化疗是标准治疗,复发和转移宫颈癌使用抗血管生成治疗联合化疗能改善生存提高疗效,是否需要新辅助治疗有待进一步研究.%In recent years,the efficacy of cervical cancer treatment has been increasing gradually.It has got a basic consensus of the standard treatment mode for most cervical cancer,but further effort should be done to improve the treatment response of locally advanced cervical cancer and recurrent or metastatic cervical cancer.The efect of redical surgery and radiotherpy is the same to early cervical cancer.Concurrent chemoradiotherapy is the standard treatment for patients with locally advanced cervical cancer.Chemotherapy combined with antiangiogenic targeted therapy can improve the survival of patients with recurrent or metastatic cervical cancer,while whether needing new adjuvant therapy or not,it asks for further investigation.

  13. Low RBM3 protein expression correlates with clinical stage, prognostic classification and increased risk of treatment failure in testicular non-seminomatous germ cell cancer.

    Directory of Open Access Journals (Sweden)

    Sven-Erik Olofsson

    Full Text Available Expression of the RNA-binding motif protein 3 (RBM3 has been shown to correlate with favourable clinicopathological parameters and prognosis in several cancer diseases. The aim of this study was to examine the expression and prognostic ability of RBM3 in patients with testicular non-seminomatous germ cell tumours (NSGCT.Immunohistochemical RBM3 expression was analysed in tissue microarrays with tumours from 206 patients. Chi-square test was applied to analyze associations between RBM3 expression and clinicopathological parameters. Kaplan-Meier analysis was used to assess the impact of RBM3 expression on cancer-specific survival (CSS and failure-free survival (FFS. Cox regression proportional hazards models were used to estimate the relative risk for failure.In the entire cohort, there was a significant association between clinical stage (p=0.044 and RBM3 expression. Weak RBM3 expression correlated with a significantly reduced FFS [79.3% versus 90.4% (p=0.019] and CSS [87.5% versus 97.3% (p=0.047]. For patients with metastatic disease (n = 88, significant associations were found between RBM3 expression and IGCCC group (p=0.007. The FFS was significantly inferior for patients with low tumour-specific RBM3 expression [59.3% versus 79.0% (p=0.013], and this association remained significant in a multivariable model for patients with metastatic disease (HR=3.67; 95% CI 1.14, 11.89.Low RBM3 expression is an independent predictor of treatment failure in metastatic NSGCT, in relation to the prognostic factors included in the International Germ Cell Consensus Classification (IGCCC. These findings suggest that RBM3 may be a potential biomarker for treatment stratification in patients with metastatic non-seminomatous germ cell tumours, and therefore merit further validation.

  14. Clinical Observation on the Combined Treatment of 57 Cases of Non-small Cell Lung Cancer Using Argon-Helium Cryosurgery and Chinese Herbal Medicine

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To observe the clinical effect of the combined therapy using argon-helium cryosurgery (Ar-He knife) and Chinese herbal medicine in treating non-small cell lung cancer (NSCLC).Methods: Fifty-seven patients of NSCLC were treated with the combined therapy and observed. Results:The treatment was successfully completed in all patients with mild adverse reactions. The effective rate was 83.8% 3 months after the operation, 79.6% 6 months after the operation, and 77.3% 12 months after the operation, with median survival of 9 months. The survival rate after 12 months was 46.67%(21/45), 34.62% (9/26) after 18 months, and 36.36% (4/11) after 24 months. Conclusion: Argon-helium cryosurgery therapy is superior in its assured orientation, quick tumor load deprivation and less postoperational reaction. Combined with Chinese herbal medication, Argon-helium cryosurgery therapy can prolong survival time, relieve clinical symptoms, and elevate the quality of life in NSCLC patients, and is thus worthy of promotion.

  15. Molecular imaging in cancer treatment

    Energy Technology Data Exchange (ETDEWEB)

    Michalski, Mark H. [Stanford University School of Medicine, Stanford, CA (United States); Chen, Xiaoyuan [National Institutes of Health (NIH), Laboratory of Molecular Imaging and Nanomedicine (LOMIN), National Institute of Biomedical Imaging and Bioengineering (NIBIB), Bethesda, MD (United States)

    2011-02-15

    The success of cancer therapy can be difficult to predict, as its efficacy is often predicated upon characteristics of the cancer, treatment, and individual that are not fully understood or are difficult to ascertain. Monitoring the response of disease to treatment is therefore essential and has traditionally been characterized by changes in tumor volume. However, in many instances, this singular measure is insufficient for predicting treatment effects on patient survival. Molecular imaging allows repeated in vivo measurement of many critical molecular features of neoplasm, such as metabolism, proliferation, angiogenesis, hypoxia, and apoptosis, which can be employed for monitoring therapeutic response. In this review, we examine the current methods for evaluating response to treatment and provide an overview of emerging PET molecular imaging methods that will help guide future cancer therapies. (orig.)

  16. Intracystic papillary breast cancer: a clinical update

    Science.gov (United States)

    Reefy, Sara Al; Kameshki, Rashid; Sada, Dhabya Al; Elewah, Abdullah Al; Awadhi, Arwa Al; Awadhi, Kamil Al

    2013-01-01

    Introduction: Intracystic (encysted) papillary cancer (IPC) is a rare entity of breast cancer accounting for approximately (1–2%) of all breast tumours [1], usually presenting in postmenopausal women and having an elusive natural history. The prediction of the biological behaviour of this rare form of breast cancer and the clinical outcome showed its overall favourable prognosis; however, its consideration as a form of ductal carcinoma in situ with non-invasive nature is to be reconsidered as it has been shown to present histologically with invasion of basement membrane and even metastasis [2]. The objective of this review is to shed some light on this rare, diagnostically challenging form of breast cancer, including its radiological, histological, and molecular characteristics and its pathological classification. The final goal is to optimize the clinical management including the role of sentinel lymph node biopsy (SLNB), general management with adjuvant radiotherapy (RT), mammary ductoscopy, and hormonal treatment. Methods: A literature review, facilitated by Medline, PubMed, and the Cochrane database, was carried out using the terms ‘Intracystic (encysted) papillary breast cancer’. Results: Intracystic papillary breast cancer (IPC) is best managed in the context of a multidisciplinary team. Surgical excision of the lump with margins in excess of 2 mm is considered satisfactory. Sentinel lymph node biopsy (SLNB) is recommended as data have shown the possibility of the presence of invasive cancer in the final histology. RT following IPC alone is of uncertain significance as this form of cancer is usually low grade and rarely recurs. However, if it is associated with DCIS or invasive cancer and found in young women, radiotherapy may be prudent to reduce local recurrence. Large tumours, centrally located or in cases where breast conserving surgery is unable to achieve a favourable aesthetic result, a skin sparing mastectomy with the opportunity for immediate

  17. Clinical Observation of Erlotinib in the Treatment of Advanced and Previously Treated Non-small Cell Lung Cancer

    Directory of Open Access Journals (Sweden)

    Liyan XU

    2009-12-01

    Full Text Available Background and objective Erlotinib is a small molecular inhibitor of tyrosine kinase. One study has confirmed that it can prolong the median progression-free survival time (PFS, and can improve the one-year survival rate of patients with advanced non-small cell lung cancer. The aim of this trial is to evaluate the response and adverse reaction of agent erlotinib in advanced and previously treated non-small-cell lung cancer. Methods The study was one part of the EAP (Expanded Access Programme study. Forty-five patients with advanced non-small cell lung cancer, which had been treated with 1-2 regimens containing platinum previously, were treated with erlotinib from Dec 2005. Erlotinib was prescribed at a dose of 150 mg daily. Results Forty-three patients were evaluated response and all patients were evaluated toxicity. Among these patients, CR 0 case, PR 19 cases (44.2%, RR (CR+PR 44.2% and SD 13 cases as their best response, disease control rate (DCR=CR+PR+SD 74.4%, PD 11cases (25.6%. The median progression-free survival time was 4.8 months; the median survival time was 15.0 months; the one-year survival rate was 68.8% (31/45. The median PFS of patients with adenocarcinoma and with non-adenocarcinoma was 7.6 months vs 2.6 months (P=0.018. The drug-related adverse reactions were skin rash (41 cases, 91.1%, billirubine increased (15 cases, 33.3%, ALT increased (9 cases, 20% and diarrhea (4 cases, 8.9%. For patients with and without skin rash, the median PFS was 7.5 months vs 1.1 months (P=0.001, and the median survival time was 15.6 months vs 5.2 months (P=0.002. Conclusion Erlotinib is effective in advanced and previously treated non-small cell lung cancer, and it is much more effective in adenocarcinoma and patients with skin rash. It is well tolerated, only with some minimal adverse reactions.

  18. Hypopharyngeal Cancer Treatment

    Science.gov (United States)

    ... of the hypopharynx . These abnormal cells may become cancer and spread into nearby normal tissue . Stage 0 is also called carcinoma in situ . Enlarge Tumor sizes. The size of a tumor may be compared to the size of a pea (1 cm), peanut (2 cm), grape (3 cm), walnut (4 cm), lime (5 cm), ...

  19. Antimatter cancer treatment

    CERN Multimedia

    Van Noorden, Richard

    2006-01-01

    "The idea that antimatter beams could treat cancer might seem ridiculous. But researchers working at Cerns particle accelerator laboratory in Geneva don't think so. They have just reported a successful first experiment into the biological effects of antiprotons radiation on living cells."

  20. Clinical Study on Treatment of Mammary Cancer by Shenqi Fuzheng Injection(参芪扶正注射液)in Cooperation with Chemotherapy

    Institute of Scientific and Technical Information of China (English)

    YANG Bo; LI Hong-sheng; QI Yan-chao; LU Min-ying

    2007-01-01

    Objective:To study the effect of Shenqi Fuzheng Injection (参芪扶正注射液,SFI) on cellular immune in patients with mammary cancer (MC) after chemotherapy.Methods:One hundred and ten patients with MC were randomly assigned to two groups.The 58 patients in the tested group were treated with SFI in cooperation with chemotherapy of CAF protocol (Cyclophosphamide,Doxorubicin and Fluorouracil),while the 52 patients in the control group were treated with chemotherapy of the same protocol alone.Changes of the patients' quality of life(QOF),adverse reaction that occurred,peripheral lymphocyte count and killing activity of single karyocyte before and after treatment between the two groups were compared.Results:Patients' QOF elevating rate after treatment in the tested group and the control group was 34.5% and 13.5% respectively;The lowering of peripheral blood cell count of WBC,platelet and lymphocyte as well as that of the killing activity of single peripheral karyocyte on various kinds of MC cells were all milder and recovery sooner than those in the control group.Conclusion:SFI in combination with chemotherapy in treating MC could reduce the occurrence of adverse reaction to chemotherapy,improve clinical symptoms,elevate QOF and enhance immunity in patients with MC.

  1. Tackling ageism in cancer treatment.

    Science.gov (United States)

    Duffin, Christian

    2013-02-01

    Evidence shows that older patients are discriminated against when it comes to cancer treatment. A pilot project was commissioned by the Department of Health in partnership with Macmillan Cancer Support and Age UK. The project involved staff, including nurses, from five cancer networks in England examining ways to improve care for this patient group. Drawing on approaches used in geriatric medicine, patients' needs in accessing treatment were explored by conducting assessments and, for example, providing taxis for hospital appointments and practical support from voluntary organisations. Challenges for nurses included lack of training in patient screening and the extra workload caused by the assessments. The report on the pilot project concluded that involving elderly care specialists and using comprehensive geriatric assessments were useful approaches in the care of older cancer patients.

  2. What's New in Thyroid Cancer Research and Treatment?

    Science.gov (United States)

    ... Thyroid Cancer About Thyroid Cancer What’s New in Thyroid Cancer Research and Treatment? Important research into thyroid cancer ... in Thyroid Cancer Research and Treatment? More In Thyroid Cancer About Thyroid Cancer Causes, Risk Factors, and Prevention ...

  3. What's New in Testicular Cancer Research and Treatment?

    Science.gov (United States)

    ... Testicular Cancer About Testicular Cancer What’s New in Testicular Cancer Research and Treatment? Important research into testicular cancer ... in Testicular Cancer Research and Treatment? More In Testicular Cancer About Testicular Cancer Causes, Risk Factors, and Prevention ...

  4. Lipoplatin treatment in lung and breast cancer.

    Science.gov (United States)

    Fantini, Manuela; Gianni, Lorenzo; Santelmo, Carlotta; Drudi, Fabrizio; Castellani, Cinzia; Affatato, Alessandra; Nicolini, Mario; Ravaioli, Alberto

    2011-01-01

    The introduction of cisplatin in cancer treatment represents an important achievement in the oncologic field. Many types of cancers are now treated with this drug, and in testicular cancer patients major results are reached. Since 1965, other compounds were disovered and among them carboplatin and oxaliplatin are the main Cisplatin analogues showing similar clinical efficacy with a safer toxicity profile. Lipoplatin is a new liposomal cisplatin formulation which seems to have these characteristics. Lipoplatin was shown to be effective in NSCLC both in phase 2 and phase 3 trials, with the same response rate of Cisplatin, a comparable overall survival but less toxicity. A new protocol aiming to elucidate the double capacity of Lipoplatin to act as a chemotherapeutic and angiogenetic agent in triple-negative breast cancer patients is upcoming.

  5. Vaccine-based clinical trials in ovarian cancer

    NARCIS (Netherlands)

    Leffers, Ninke; Daemen, Toos; Boezen, H. Marike; Melief, Kees J. M.; Nijman, Hans W.

    2011-01-01

    Ovarian cancer vaccines are one of the new treatment strategies under investigation in epithelial ovarian cancer. This article discusses the results of different immunization strategies, points out potential pitfalls in study designs and provides possible solutions for augmentation of clinical effic

  6. Breast cancer early psychological intervention in the treatment of clinical experience%早期乳腺癌保乳的心理介入治疗

    Institute of Scientific and Technical Information of China (English)

    胡军; 黄晓睿

    2009-01-01

    Objective Discussing the rationality of psychological intervening therapy in the treatment of early breast neoplasm. Methods By summarizing and reviewing 84 patients suffering from the early breast cancer between January of 2003 and December of 2005, we procured some information of their clinical manifes-tations, clinical therapy and statistic results of psychological assessment. Results By intervening the psycho-logical therapy, the patients' self-efficiency and living quality can be bettered. Conclusion Patients with early breast neoplasm need to have a comprehensive treatment with general or local therapy and individual psychologi-cal intervention. Nevertheless, it is rather practical to enhance the general level of prevention and therapy of breast neoplasm through the research of psychological problems after the operation.%目的 探讨心理介入治疗在早期乳腺癌治疗中的合理性.方法 总结回顾2003年1月至2005年12月间84例患者的临床特征、治疗方法 及心理评估统计结果 等资料.结果 心理介入治疗可以提高患者的自我效能及生存质量.结论 早期乳腺癌患者需要进行全身、局部疗法、心理个性化干预等的综合治疗.而重视乳腺癌术后心理问题的研究,对于提高乳腺癌整体防治水平具有一定的现实意义.

  7. Anatomy of a Cancer Treatment Scam

    Medline Plus

    Full Text Available ... a Cancer Treatment Scam Anatomy of a Cancer Treatment Scam January 19, 2012 Curious about a product ... and should not stop or delay their conventional treatment. Category: Scam Watch Health Download File Related Videos ...

  8. Anatomy of a Cancer Treatment Scam

    Medline Plus

    Full Text Available ... a Cancer Treatment Scam Anatomy of a Cancer Treatment Scam January 19, 2012 Curious about a product ... and should not stop or delay their conventional treatment. Category: Scam Watch Health Download File Related Videos ...

  9. Immune checkpoints in cancer clinical trials

    Institute of Scientific and Technical Information of China (English)

    Elad Sharon; Howard Streicher; Priscila Goncalves; Helen XChen

    2014-01-01

    Immunology-based therapy is rapidly developing into an effective treatment option for a surprising range of cancers. We have learned over the last decade that powerful immunologic effector cells may be blocked by inhibitory regulatory pathways controlled by specific molecules often called“immune checkpoints.” These checkpoints serve to control or turn off the immune response when it is no longer needed to prevent tissue injury and autoimmunity. Cancer cells have learned or evolved to use these mechanisms to evade immune control and elimination. The development of a new therapeutic class of drugs that inhibit these inhibitory pathways has recently emerged as a potent strategy in oncology. Three sets of agents have emerged in clinical trials exploiting this strategy. These agents are antibody-based therapies targeting cytotoxic T-lymphocyte antigen4 (CTLA4), programmed cell death1 (PD-1), and programmed cell death ligand 1 (PD-L1). These inhibitors of immune inhibition have demonstrated extensive activity as single agents and in combinations. Clinical responses have been seen in melanoma, renal cellcarcinoma, non-smal celllung cancer, and several other tumor types. Despite the autoimmune or inflammatory immune-mediated adverse effects which have been seen, the responses and overall survival benefits exhibited thus far warrant further clinical development.

  10. Microwaves for breast cancer treatments

    Directory of Open Access Journals (Sweden)

    Heba Abdelhamid Elkayal

    2015-12-01

    Full Text Available Hyperthermia is potentially an effective method for the treatment of cancer, especially breast cancer tumors. One of the most attractive attributes of hyperthermia is the possibility of providing therapeutic benefit noninvasively, minimizing side effects. To be effective, a hyperthermia treatment must selectively heat the cancerous tissue, elevating the temperature in the tumor without exposing healthy tissue to excessive temperature elevations. In this paper, a suggested simple model of Annular Phased Array (APA using eight half wavelength linear dipoles is presented. New software (COMSOL MULTIPHYSICS is used to calculate the temperature distribution inside a model of a three layered breast (skin, breast tissue, and tumor. In addition, the effect of changing the amplitude and phases of the array elements on the temperature distributions and the conditions on the values of the phases are demonstrated in order to achieve the objective of hyperthermia for breast tumor treatment.

  11. Treatment of Non-Small Cell Lung Cancer (NSCLC) Using CT in Combination with a PET Examination to Minimize the Clinical Target Volume of the Mediastinum

    Institute of Scientific and Technical Information of China (English)

    Yusheng Shi; Xiaogang Deng; Longhua Chen

    2007-01-01

    OBJECTIVE To decrease radiation injury of the esophagus and lungs by utilizing a CT scan in combination with PET tumor imaging in order to minimize the clinical target area of locally advanced non-small cell lung cancer, without preventive radiation on the lymphatic drainage area. METHODS Of 76 patients with locally advanced non-small cell lung cancer (NSCLC), 32 received a PET examination before radiotherapy. Preventive radiation was not conducted in the mediastinum area without lymphatic metastasis, which was confirmed by CT and PET. For the other 44 patients, preventive radiation was performed in the lymphatic drainage area. PET examinations showed that the clinical target volume of the patients was decreased on average to about one third. The radiation therapy for patients of the two groups was the same, I.e. The dose for accelerated fractionated irradiation was 3 Gy/time and 5 time/week. The preventive dose was 42 to 45 Gy/time, 14 to 15 time/week, with 3-week treatment, and the therapeutic dose was 60 to 63 Gy/time, 20 to 21 time/week, with a period of 4 to 5 weeks.RESULTS The rate of missed lymph nodes beyond the irradiation field was 6.3% and 4.5% respectively in the group with and without PET examination (P = 0.831). The incidence of acute radioactive esophagitis was 15.6 % and 45.5% in the two groups respectively (P = 0.006). The incidence of acute radiation pneumonia and long-term pulmonary fibrosis in the two groups was 6.3% and 9.1%, and 68.8% and 75.0%, respectively (P = 0.982 and P = 0.547).CONCLUSION The recurrence rate in the lymph nodes beyond the target area was not increased after minimizing the clinical target volume (CTV), whereas radioactive injury to the lungs and esophageal injury was reduced, and especially with a significant decrease in the rate of acute radioactive esophagitis. The method of CT in combination with PET for minimizing the mediastinal CTV is superior to the conventional preventive radiation of the mediastinum.

  12. Colorectal Cancer Molecular Biology Moves Into Clinical Practice

    Science.gov (United States)

    Pritchard, Colin C.; Grady, William M.

    2010-01-01

    The promise of personalized medicine is now a clinical reality, with colorectal cancer genetics at the forefront of this next major advance in clinical medicine. This is no more evident than in the recent advances in testing of colorectal cancers for specific molecular alterations in order to guide treatment with the monoclonal antibody therapies cetuximab and panitumumab, which target the epidermal growth factor receptor (EGFR). In this review, we examine genetic mechanisms of colorectal cancer and how these alterations relate to emerging biomarkers for early detection and risk stratification (diagnostic markers), prognosis (prognostic markers), and the prediction of treatment responses (predictive markers). PMID:20921207

  13. Cancer proteomics: developments in technology, clinical use and commercialization.

    Science.gov (United States)

    Yeat, Nai Chien; Lin, Charlotte; Sager, Monica; Lin, Jimmy

    2015-08-01

    In the last two decades, advances in genomic, transcriptomic and proteomic methods have enabled us to identify and classify cancers by their molecular profiles. Many anticipate that a molecular taxonomy of cancer will not only lead to more effective subtyping of cancers but also earlier diagnoses, more informative prognoses and more targeted treatments. This article reviews recent technological developments in the field of proteomics, recent discoveries in proteomic cancer biomarker research and trends in clinical use. Readers are also informed of examples of successful commercialization, and the future of proteomics in cancer diagnostics.

  14. Clinical Pharmacology of Chemotherapy Agents in Older People with Cancer

    Directory of Open Access Journals (Sweden)

    Xiaoye He

    2011-01-01

    Full Text Available Populations around the world are aging, and the associated increase in cancer incidence has led to the recognition of the importance of geriatric oncology. Chronological age is a poor determinant of pharmacological response to cancer chemotherapy agents. Age-associated changes in physiology and organ function have a significant impact on the clinical pharmacology of cancer chemotherapy agents used in cancer treatment. Altered response to medicines in older people is a consequence of changes in body composition, organ function, concomitant pathophysiology, multiple medications, genetic determinants of drug response, and patient's clinical status. These issues highlight the need to individualize the management of cancer in the older people with consideration of age-related changes in the clinical pharmacology of cancer drugs, analgesics, and adjunctive therapies.

  15. Treatment of colorectal cancer in the elderly

    Institute of Scientific and Technical Information of China (English)

    Monica; Millan; Sandra; Merino; Aleidis; Caro; Francesc; Feliu; Jordi; Escuder; Tani; Francesch

    2015-01-01

    Colorectal cancer has a high incidence, and approxi-mately 60% of colorectal cancer patients are older than 70, with this incidence likely increasing in the near future. Elderly patients(> 70-75 years of age) are a very heterogeneous group, ranging from the very fit to the very frail. Traditionally, these patients have often been under-treated and recruited less frequently to clinical trials than younger patients, and thus are underrepresented in publications about cancer treatment. Recent studies suggest that fit elderly patients can be treated in the same way as their younger counterparts, but the treatment of frail patients with comorbidities is still a matter of controversy. Many factors should be taken into account, including fitness for treatment, the wishes of the patient and family, and quality of life. This review will focus on the existing evidence for surgical, oncologic, and palliative treatment in patients over 70 years old with colorectal cancer. Careful patient assessment is necessary in order to individualize treatment approach, and this should rely on a multidisciplinary process. More well-designed controlled trials are needed in this patient population.

  16. Multidisciplinary treatment of patients after a surgery due to cancers in the facial area: a clinical reports.

    Science.gov (United States)

    Rolski, D; Dolegacz, A; Górska, R; Mierzwińska-Nastalska, E

    2006-01-01

    Prosthetic rehabilitation of patients after surgical removal of carcinoma in the facial skeleton is one of the most difficult problems in therapy of the stomatognathic system, due to increasing incidence of head and neck carcinoma. Significant deformations of tissues, development of dysfunctions of the stomatognathic system with concurrent biological unbalance of the oral cavity enviroment are frequently a consequence of the treatment. Cicatricial scars, contraction of the oral crevice and limitation of mobility of the tongue are noted in numerous cases. Deformations of the facial area of the skull and of structures of the temporo-mandibular joint are also the reasons of occlusion and articulation disturbances. Two cases of surgery due to carcinoma in the facial skeleton that have required combined and stepwise multispecialistic treatment performed at Department of Prosthetic Dentistry and Department of Periodontology and Oral Disease, Dental Institute, Medical University of Warsaw are presented. The therapy has involved treatment of periodontitis and applying appropriate construction of prostheses that would relieve periodontium and splinting teeth.

  17. Treatment Considerations for Cancer Pain: A Global Perspective.

    Science.gov (United States)

    Pergolizzi, Joseph V; Gharibo, Christopher; Ho, Kok-Yuen

    2015-11-01

    Cancer pain is prevalent, undertreated, and feared by patients with cancer. In April 2013, a panel of pain experts convened in Singapore to address the treatment of cancer pain. They discussed the various types of cancer pain, including breakthrough pain, which is sometimes clinically confused with analgesic gaps. Reasons for undertreating cancer pain include attitudes of patients, clinicians, and factors associated with healthcare systems. The consequences of not treating cancer pain may include reduced quality of life for patients with cancer (who now live longer than ever), functional decline, and increased psychological stress. Early analgesic intervention for cancer pain may reduce the risk of central sensitization and chronification of pain. To manage pain in oncology patients, clinicians should assess pain during regular follow-up visits using validated pain measurement tools and follow prescribing guidelines, if necessary referring patients with cancer to pain specialists. Many patients with cancer require opioids for pain relief. Pain associated with cancer may also relate to cancer treatments, such as chemotherapy-induced peripheral neuropathy. Many patients with cancer are what might be considered "special populations," in that they may be elderly, frail, comorbid, or have end-stage organ failure. Specific pain therapy guidelines for those populations are reviewed. Patients with cancer with a history of or active substance abuse disorder deserve pain control but may require close medical supervision. While much "treatment inertia" exists in cancer pain control, cancer pain can be safely and effectively managed and should be carried out to alleviate suffering and improve outcomes.

  18. What Will Happen After Treatment for Ovarian Cancer?

    Science.gov (United States)

    ... After Treatment What Will Happen After Treatment for Ovarian Cancer? For some people with ovarian cancer, treatment may ... If Ovarian Cancer Treatment Stops Working More In Ovarian Cancer About Ovarian Cancer Causes, Risk Factors, and Prevention ...

  19. Development of New Treatments for Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    DiPaola, R. S.; Abate-Shen, C.; Hait, W. N.

    2005-02-01

    The Dean and Betty Gallo Prostate Cancer Center (GPCC) was established with the goal of eradicating prostate cancer and improving the lives of men at risk for the disease through research, treatment, education and prevention. GPCC was founded in the memory of Dean Gallo, a beloved New Jersey Congressman who died tragically of prostate cancer diagnosed at an advanced stage. GPCC unites a team of outstanding researchers and clinicians who are committed to high-quality basic research, translation of innovative research to the clinic, exceptional patient care, and improving public education and awareness of prostate cancer. GPCC is a center of excellence of The Cancer Institute of New Jersey, which is the only NCI-designated comprehensive cancer center in the state. GPCC efforts are now integrated well as part of our Prostate Program at CINJ, in which Dr. Robert DiPaola and Dr. Cory Abate-Shen are co-leaders. The Prostate Program unites 19 investigators from 10 academic departments who have broad and complementary expertise in prostate cancer research. The overall goal and unifying theme is to elucidate basic mechanisms of prostate growth and oncogenesis, with the ultimate goal of promoting new and effective strategies for the eradication of prostate cancer. Members' wide range of research interests collectively optimize the chances of providing new insights into normal prostate biology and unraveling the molecular pathophysiology of prostate cancer. Cell culture and powerful animal models developed by program members recapitulate the various stages of prostate cancer progression, including prostatic intraepithelial neoplasia, adenocarcinoma, androgen-independence, invasion and metastases. These models promise to further strengthen an already robust program of investigator-initiated therapeutic clinical trials, including studies adopted by national cooperative groups. Efforts to translate laboratory results into clinical studies of early detection and

  20. Palbociclib as a first-line treatment in oestrogen receptor-positive, HER2-negative, advanced breast cancer not cost-effective with current pricing: a health economic analysis of the Swiss Group for Clinical Cancer Research (SAKK).

    Science.gov (United States)

    Matter-Walstra, K; Ruhstaller, T; Klingbiel, D; Schwenkglenks, M; Dedes, K J

    2016-07-01

    Endocrine therapy continues to be the optimal systemic treatment for metastatic ER(+)HER2(-) breast cancer. The CDK4/6 inhibitor palbociclib combined with letrozole has recently been shown to significantly improve progression-free survival. Here we examined the cost-effectiveness of this regimen for the Swiss healthcare system. A Markov cohort simulation based on the PALOMA-1 trial (Finn et al. in Lancet Oncol 16:25-35, 2015) was used as the clinical course. Input parameters were based on summary trial data. Costs were assessed from the Swiss healthcare system perspective. Adding palbociclib to letrozole (PALLET) compared to letrozole monotherapy was estimated to cost an additional CHF342,440 and gain 1.14 quality-adjusted life years, resulting in an incremental cost-effectiveness ratio (ICER) of CHF301,227/QALY gained. In univariate sensitivity analyses, no tested variation in key parameters resulted in an ICER below a willingness-to-pay threshold of CHF100,000/QALY. PALLET had a 0 % probability of being cost-effective in probabilistic sensitivity analyses. Lowering PALLET's price by 75 % resulted in an ICER of CHF73,995/QALY and a 73 % probability of being cost-effective. At current prices, PALLET would cost the Swiss healthcare system an additional CHF155 million/year. Palbociclib plus letrozole cannot be considered cost-effective for the first-line treatment of patients with metastatic breast cancer in the Swiss healthcare system.

  1. Breast cancer and depression: issues in clinical care

    Directory of Open Access Journals (Sweden)

    Thingbaijam B. Singh

    2012-11-01

    Full Text Available Many of breast-cancer patients experience distress and most of them experience depression which may lead to amplification of physical symptoms, increased functional impairment, and poor treatment adherence. We did a review on available literature from PubMed about prevalence, distress magnitudes, coping styles, and treatment methods of major depression in women with breast cancer from 1978 to 2010. Diagnosis and treatment of depressive episodes in women with breast cancer is challenging because of overlapping symptoms and co-morbid conditions. Major depression is often under-recognized and undertreated among breast cancer patients. This review highlighted the issues on identifying and managing depression in breast cancer patients in clinical settings. (Med J Indones. 2012;21:240-6Keywords: Breast cancer, coping, depression, distress

  2. Uptodate view on diagnostics and treatment of medullary thyroid cancer

    Directory of Open Access Journals (Sweden)

    D O Gazizova

    2013-09-01

    Full Text Available During last 4 years leading endocrine societies of the world published clinical recommendations on diag nostics and treatment of medullary thyroid cancer. The article covers most aspects of following patients with this pathology.

  3. Pharmacological treatment of depression in women with breast cancer

    DEFF Research Database (Denmark)

    Toftegård Andersen, Lærke; Voigt Hansen, Melissa; Rosenberg, Jacob

    2013-01-01

    that escitalopram and the norepinephrine reuptake inhibitor, reboxetine, significantly improved depression and QOL compared with baseline values. In conclusion, depression is a clinical problem in patients with breast cancer. Pharmacological treatment with antidepressants may improve depression and QOL. However...

  4. For Some Breast Cancers, New Drug May Be Treatment Option

    Science.gov (United States)

    Results from an international clinical trial suggest that women with metastatic, HER2-positive breast cancer that is no longer responding to the targeted therapy trastuzumab (Herceptin) may soon have a new treatment option.

  5. Many Patients with Cancer Need Better Treatments for Pain

    Science.gov (United States)

    Inadequate pain treatment in patients with cancer remains a significant problem and appears to be more frequent among minorities, according to a new study published online April 16, 2012, in the Journal of Clinical Oncology.

  6. The psychosocial aspects of sexual recovery after prostate cancer treatment.

    Science.gov (United States)

    Wittmann, D; Northouse, L; Foley, S; Gilbert, S; Wood, D P; Balon, R; Montie, J E

    2009-01-01

    Prostate cancer affects one in six American men. Erectile and sexual dysfunctions are long-term side effects of prostate cancer treatment. PubMed database was searched for papers on prostate cancer-related sexual recovery for men and couples. The search yielded articles on (1) the treatment of erectile dysfunction, (2) men's psychological and culturally diverse adaptation to the sexual side effects; (3) the impact of prostate cancer on couples' relationships; and (4) interventions to promote sexual function. Erectile dysfunction after prostate cancer treatment has been widely studied. Research on the sexual recovery of men and couples or understanding it in a cultural context is scarce. Greater focus on the impact of sexual sequelae of prostate cancer treatment on men as well as couples in diverse groups is needed. Clinical implications for treating sexual dysfunction and promoting sexual recovery for prostate cancer survivors and their partners are discussed. Recommendations for future research are provided.

  7. Lymphedema as a Cancer Treatment Side Effect

    Science.gov (United States)

    ... Navigating Cancer Care > Side Effects > Lymphedema Request Permissions Lymphedema Approved by the Cancer.Net Editorial Board , 05/ ... years after cancer treatment has ended. Symptoms of lymphedema People with lymphedema in their arm or leg ...

  8. Clinical outcome of patients who reduced sunitinib or pazopanib during first-line treatment for advanced kidney cancer.

    Science.gov (United States)

    Iacovelli, Roberto; Cossu Rocca, Maria; Galli, Luca; De Giorgi, Ugo; Sabbatini, Roberto; Santoni, Matteo; Mosca, Alessandra; Fornarini, Giuseppe; Massari, Francesco; Masini, Cristina; Bersanelli, Melissa; Biasco, Elisa; Lolli, Cristian; Guida, Annalisa; Berardi, Rossana; Terrone, Carlo; Pastorino, Alessandro; Ardizzoni, Andrea; Pinto, Carmine; Buti, Sebastiano; Nolè, Franco; Tortora, Giampaolo

    2017-09-01

    To investigate the different outcomes in patients with metastatic renal cell carcinoma (mRCC) who receive a reduced first-line dose of sunitinib or pazopanib compared to those who continue at the standard dose. All the patients treated in 11 oncological centers in Italy for mRCC who started first-line treatment with sunitinib or pazopanib at the standard dose. Descriptive statistical tests were used to highlight differences among groups. Survival was estimated by the Kaplan-Meier method and compared across the groups using log-rank tests, the Cox proportional hazards model adjusted for statistically significant variables was also done. A total of 591 patients were included in the study. Of these, 45.7% received a reduced dose of sunitinib or pazopanib after a median treatment time of 3.6 months at the standard dose. The median overall survival in the patients who continued to receive the standard dose was 24.0 months compared to 49.4 months for those who received a reduced dose (hazard ratio = 1.80; 95% CI: 1.42-2.29; P<0.001). Only 45% of the patients received second-line therapy: 42.5% had an mTOR and 54.1% a tyrosine kinase inhibitor. Second-line overall survival was 19.8 and 11.8 months, respectively, in the patients who received, or did not, a reduced dose during first-line therapy (P = 0.007). Toxicity-related dose reduction is a common event in mRCC patients who have started first-line therapy with either sunitinib or pazopanib. This is positively related to the outcomes of both first- and second-line therapy. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Trastuzumab in the Treatment of Breast Cancer.

    Science.gov (United States)

    Maximiano, Sofia; Magalhães, Paulo; Guerreiro, Mara Pereira; Morgado, Manuel

    2016-04-01

    Breast cancer (BC) is the most common cancer in women worldwide, and has an undeniable negative impact on public health. The advent of molecular biology and immunotherapy has made targeted therapeutic interventions possible, providing treatments tailored to the individual characteristics of the patient and the disease. The over-expression of human epidermal growth factor receptor (HER) 2 is implicated in the pathophysiology of BC and represents a clinically relevant biomarker for its treatment. Trastuzumab, a recombinant antibody targeting HER2, was the first biological drug approved for the treatment of HER2-positive BC. Although there are currently other anti-HER2 agents available (e.g. pertuzumab and lapatinib), trastuzumab remains the gold standard for treatment of this disease subtype. Nonetheless, concerns have been raised regarding potential cardiotoxicity and treatment resistance. Moreover, several other therapeutic issues remain unclear and have been addressed in an inconsistent way. The current literature lacks a comprehensive review of trastuzumab providing useful information for clinical practice, including pharmacokinetic and pharmacodynamic aspects, its clinical use, existing controversies and future advances. This detailed review of trastuzumab in the pharmacotherapy of BC attempts to fill this gap.

  10. Mechanisms and treatment of cancer cachexia.

    Science.gov (United States)

    Argilés, J M; López-Soriano, F J; Busquets, S

    2013-12-01

    According to a recent consensus, cachexia is a complex metabolic syndrome associated with underlying illness and characterised by loss of muscle with or without loss of fat mass. The prominent clinical feature of cachexia is weight loss. Cachexia occurs in the majority of terminal cancer patients and it is responsible for the deaths of 22% of cancer patients. Although body weight is, indeed, an important factor to be taken into consideration in any cachexia treatment, body composition, physical performance and quality of life should be monitored. From the results presented here, one can speculate that a single therapy may not be completely successful in the treatment of cachexia. From this point of view, treatments involving different combinations are more likely to be successful. The objectives of any therapeutical combination are two: an anticatabolic aim directed towards both fat and muscle catabolism and an anabolic objective leading to the synthesis of macromolecules such as contractile proteins.

  11. Proposed Organization of Family Cancer Clinics in Indonesia

    OpenAIRE

    Kunta Setiaji

    2017-01-01

    Abstract Around 10-15% of breast cancers are associated hereditary and/or familial predisposition. By definition familial breast occurs in two or more first degree relatives within a nuclear pedigree (first or second degree relatives). Hereditary and familial cancer displays different characteristics in the pathological features, clinical course, response to treatment, and outcomes. Therefore, specific consultation and treatment need to be addressed to patients with hereditary or familial...

  12. Delivery Parameter Variations and Early Clinical Outcomes of Volumetric Modulated Arc Therapy for 31 Prostate Cancer Patients: An Intercomparison of Three Treatment Planning Systems

    Directory of Open Access Journals (Sweden)

    Shinichi Tsutsumi

    2013-01-01

    Full Text Available We created volumetric modulated arc therapy (VMAT plans for 31 prostate cancer patients using one of three treatment planning systems (TPSs—ERGO++, Monaco, or Pinnacle—and then treated those patients. A dose of 74 Gy was prescribed to the planning target volume (PTV. The rectum, bladder, and femur were chosen as organs at risk (OARs with specified dose-volume constraints. Dose volume histograms (DVHs, the mean dose rate, the beam-on time, and early treatment outcomes were evaluated and compared. The DVHs calculated for the three TPSs were comparable. The mean dose rates and beam-on times for Ergo++, Monaco, and SmartArc were, respectively, 174.3 ± 17.7, 149.7 ± 8.4, and 185.8 ± 15.6 MU/min and 132.7 ± 8.4, 217.6 ± 13.1, and 127.5 ± 27.1 sec. During a follow-up period of 486.2 ± 289.9 days, local recurrence was not observed, but distant metastasis was observed in a single patient. Adverse events of grade 3 to grade 4 were not observed. The mean dose rate for Monaco was significantly lower than that for ERGO++ and SmartArc (P<0.0001, and the beam-on time for Monaco was significantly longer than that for ERGO++ and SmartArc (P<0.0001. Each TPS was successfully used for prostate VMAT planning without significant differences in early clinical outcomes despite significant TPS-specific delivery parameter variations.

  13. Photon iso-effective dose for cancer treatment with mixed field radiation based on dose-response assessment from human and an animal model: clinical application to boron neutron capture therapy for head and neck cancer.

    Science.gov (United States)

    Gonzalez, Sara Josefina; Pozzi, Emiliano C C; Monti Hughes, Andrea; Provenzano, Lucas; Koivunoro, Hanna; Carando, Daniel Germán; Thorp, Silvia Inés; Casal, Mariana Rosalía; Bortolussi, Silva; Trivillin, Verónica A; Garabalino, Marcela A; Curotto, Paula; Heber, Elisa M; Santa Cruz, Gustavo A; Kankaanranta, Leena; Joensuu, Heikki; Schwint, Amanda E

    2017-08-31

    Boron Neutron Capture Therapy (BNCT) is a treatment modality that combines different radiation qualities. Since the severity of biological damage following irradiation depends on the radiation type, a quantity different from absorbed dose is required to explain effects observed in the clinical BNCT in terms of outcome compared with conventional photon radiation therapy. A new approach for calculating photon iso-effective doses in BNCT was introduced previously. The present work extends this model to include information from dose-response assessments in animal models and humans. Parameters of the model were determined for tumour and precancerous tissue using dose-response curves obtained from BNCT and photon studies performed in the hamster cheek pouch in vivo models of oral cancer and/or pre-cancer, and from head and neck cancer radiotherapy data with photons. To this end, suitable expressions of the dose-limiting Normal Tissue Complication and Tumour Control Probabilities for the reference radiation and for the mixed field BNCT radiation were developed. Pearson's correlation coefficients and p-values showed that TCP and NTCP models agreed with experimental data (with r > 0.87 and p-values >0.57). The photon iso-effective dose model was applied retrospectively to evaluate the dosimetry in tumours and mucosa for head and neck cancer patients treated with BNCT in Finland. Photon iso-effective doses in tumour were lower than those obtained with the standard RBE-weighted model (between 10% to 45%). The results also suggested that the probabilities of tumour control derived from photon iso-effective doses are more adequate to explain the clinical responses than those obtained with the RBE-weighted values. The dosimetry in the mucosa revealed that the photon iso-effective doses were about 30% to 50% higher than the corresponding RBE-weighted values. While the RBE-weighted doses are unable to predict mucosa toxicity, predictions based on the proposed model are

  14. Professor ZHANG Yonghong's Clinical Experience in Treatment of Gastric Cancer%章永红治疗胃癌经验撷要

    Institute of Scientific and Technical Information of China (English)

    夏宁俊; 章永红

    2013-01-01

    Professor ZHANG Yonghong points out that Qi deficiency is the primary pathogenesis of gastric cancer, and Qi stagnation, blood stasis and phlegm retention are important pathological factors. Cancer-toxin is a particular factor causing cancer. Replenishing Qi,nourishing Yin,regulating Qi and removing toxin are basic methods in the treatment. Protecting the stomach Qi should be conducted throughout the whole process of gastric cancer treatment. It is also important to use insects drugs to promote blood circulation and remove stasis. At the same time, we must pay attention to the significant position of the adjustment in life and diets during the treatment of gastric cancer.%章永红教授指出正气不足是胃癌发生的首要病机,气滞、血瘀、痰阻是重要病理因素,癌毒是肿瘤发生的特有因素.治疗上应以补气养阴,理气解毒为基本大法,注意时时保护胃气,灵活运用虫类药物搜剔逐瘀,同时也需重视饮食生活调摄在治疗中的重要地位.

  15. Classification of treatment-related mortality in children with cancer

    DEFF Research Database (Denmark)

    Alexander, Sarah; Pole, Jason D; Gibson, Paul

    2015-01-01

    Treatment-related mortality is an important outcome in paediatric cancer clinical trials. An international group of experts in supportive care in paediatric cancer developed a consensus-based definition of treatment-related mortality and a cause-of-death attribution system. The reliability...... and validity of the system was tested in 30 deaths, which were independently assessed by two clinical research associates and two paediatric oncologists. We defined treatment-related mortality as death occurring in the absence of progressive cancer. Of the 30 reviewed deaths, the reliability of classification...

  16. Clinical Trials | Division of Cancer Prevention

    Science.gov (United States)

    Information about actively enrolling, ongoing, and completed clinical trials of cancer prevention, early detection, and supportive care, including phase I, II, and III agent and action trials and clinical trials management. |

  17. Discovery – Methotrexate: Chemotherapy Treatment for Cancer

    Science.gov (United States)

    Prior to the 1950s, treatment for the majority of cancers was limited to either surgery or the use of radiation. The discovery of the use of methotrexate in curing a rare cancer marked the first time a cancer had been cured. This led to the development of many of today’s common cancer treatments.

  18. What`s New in Cervical Cancer Research and Treatment?

    Science.gov (United States)

    ... Cervical Cancer About Cervical Cancer What's New in Cervical Cancer Research and Treatment? New ways to prevent and ... in Cervical Cancer Research and Treatment? More In Cervical Cancer About Cervical Cancer Causes, Risk Factors, and Prevention ...

  19. What's New in Stomach Cancer Research and Treatment?

    Science.gov (United States)

    ... Stomach Cancer About Stomach Cancer What’s New in Stomach Cancer Research and Treatment? Research is always being ... in Stomach Cancer Research and Treatment? More In Stomach Cancer About Stomach Cancer Causes, Risk Factors, and ...

  20. What's New in Ovarian Cancer Research and Treatment?

    Science.gov (United States)

    ... Ovarian Cancer About Ovarian Cancer What's New in Ovarian Cancer Research and Treatment? Risk factors and causes Scientists ... in Ovarian Cancer Research and Treatment? More In Ovarian Cancer About Ovarian Cancer Causes, Risk Factors, and Prevention ...

  1. What's New in Liver Cancer Research and Treatment?

    Science.gov (United States)

    ... Liver Cancer About Liver Cancer What's New in Liver Cancer Research and Treatment? Because there are only a ... in Liver Cancer Research and Treatment? More In Liver Cancer About Liver Cancer Causes, Risk Factors, and Prevention ...

  2. What Happens after Treatment for Melanoma Skin Cancer?

    Science.gov (United States)

    ... Skin Cancer After Treatment Living as a Melanoma Skin Cancer Survivor For many people with melanoma, treatment can ... Cancers After Melanoma Skin Cancer More In Melanoma Skin Cancer About Melanoma Skin Cancer Causes, Risk Factors, and ...

  3. Pancreatic cancer, treatment options, and GI-4000

    Science.gov (United States)

    Hartley, Marion L; Bade, Najeebah A; Prins, Petra A; Ampie, Leonel; Marshall, John L

    2015-01-01

    Although pancreatic cancer is but the eleventh most prevalent cancer in the US, it is predicted that of all the patients newly diagnosed with this disease in 2014, only 27% will still be alive at the end of the first year and only 6% will make it past 5 years. The choice of chemotherapy in the treatment of pancreatic cancer is dependent on disease stage and patient performance status but, in general, the most widely used approved regimens include 5-fluorouracil (5-FU) combinations and gemcitabine combinations. Recent therapeutic strategies have resulted in an improvement in survival of patients with pancreatic cancer but the magnitude of change is disappointing and vast improvements are still needed. The goal of immunotherapy is to enhance and guide the body's immune system to recognize tumor-specific antigens and mount an attack against the disease. Among newer immune therapies, GI-4000 consists of 4 different targeted molecular immunogens, each containing a different Ras protein (antigen) encoded by the most commonly found mutant RAS genes in solid tumors—RAS mutations exist in over 90% of pancreatic ductal adenocarcinomas. We will review pancreatic cancer epidemiology and its current treatment options, and consider the prospects of immunotherapy, focusing on GI-4000. We discuss the potential mechanism of action of GI-4000, and the performance of this vaccination series thus far in early phase clinical trials. PMID:25585100

  4. [A new LH-RH agonist for treatment of prostate cancer, 3-month controlled-release formulation of goserelin acetate (Zoladex LA 10.8 mg depot)--outline of pre-clinical and clinical studies].

    Science.gov (United States)

    Tsukagoshi, Shigeru

    2002-09-01

    Goserelin acetate is a LH-RH agonist developed by AstraZeneca (formerly ICI, UK), and has been used clinically for the treatment of prostate cancer as a 4-week controlled-release formulation (Zoladex 3.6 mg depot). Recently, a new drug (Zoladex LA 10.8 mg depot) with 3-month controlled-release formulation was developed and became commercially available in Japan. In the randomized comparative phase III studies carried out with global bases, single administration of the new drug yielded almost equivalent anti-testosterone effect and the same serum level of the previous 3.6 mg depot formulation in 3-times continuous administration. In these studies, adverse drug reactions, which were mainly due to pharmacological effects of the new drug and minimal, were found in 52.6% (41/78) compared with 54.8% (46/84) with the previous 3.6 mg depot formulation. In the phase III studies, there were no significant differences in average serum testosterone levels between the two formulations at 12 and 13 weeks after administration. In the Japanese late phase II study with untreated patients, castration effect was observed in all 20 cases entered in the trial. In 20 cases in which treatment was switched from 3.6 mg depot to the new formulation, there were no significant changes in serum testosterone levels at castration level of the untreated patients, 90% (18/20) responded to the treatment, and normalization of PSA level was found in 75.0% (15/20). The adverse drug reactions were mainly increased triglyceride level and hot flushes. In the retrospective evaluation of untreated patients in this trial and the post-marketing clinical trial data for 3.6 mg depot, it was concluded that the new drug had almost the same efficacy and safety profile as 3.6 mg depot in Japanese people. These results indicate that Zoladex LA 10.8 mg depot has the same efficacy and safety as 3.6 mg depot with administration every three months, the burden of injection of LH-RH agonist can be reduced. This new

  5. Cetuximab in treatment of metastatic colorectal cancer

    DEFF Research Database (Denmark)

    Guren, Tormod Kyrre; Thomsen, Maria Morandi; Kure, Elin H

    2017-01-01

    BACKGROUND: The NORDIC-VII study is a randomised phase III trial of cetuximab plus continuous or intermittent fluorouracil, folinic acid, and oxaliplatin (Nordic FLOX) vs FLOX alone in first-line treatment of metastatic colorectal cancer. The present report presents an updated and final survival......, neither on progression-free nor overall survival. However, the outcomes in a subset of patients, which, after the first eight treatment cycles, received cetuximab alone, suggested a beneficial effect of cetuximab monotherapy. CONCLUSIONS: Adding cetuximab to Nordic FLOX did not provide any clinical...

  6. CONSENSUS GUIDELINES FOR THE DELINEATION OF THE CLINICAL TARGET VOLUME FOR INTENSITY MODULATED PELVIC RADIOTHERAPY IN THE POSTOPERATIVE TREATMENT OF ENDOMETRIAL AND CERVICAL CANCER

    Science.gov (United States)

    Small, William; Mell, Loren K.; Anderson, Penny; Creutzberg, Carien; De Los Santos, Jennifer; Gaffney, David; Jhingran, Anuja; Portelance, Lorraine; Schefter, Tracey; Iyer, Revathy; Varia, Mahesh; Winter, Kathryn; Mundt, Arno J.

    2009-01-01

    PURPOSE To develop an atlas of the clinical target volumes (CTV) definitions for the post-operative radiotherapy of endometrial and cervical cancer to be utilized for planning pelvic Intensity Modulated Radiation Therapy (IMRT). METHODS AND MATERIALS The Radiation Therapy Oncology Group (RTOG) led an international collaberation of cooperative groups in development of the atlas. The groups included RTOG the Gynecologic Oncology Group (GOG), the National Cancer Institute of Canada (NCIC), the European Society of Therapeutic Radiology and Oncology (ESTRO), and the American College of Radiology Imaging Network (ACRIN). Members of the group were asked by questionnaire to define areas that were to be included in the CTV and were asked to outline theses areas on individual Computed Tomography (CT) images. The initial formulation of the group began in late 2004 and culminated with a formal consensus conference in June of 2005. RESULTS The committee achieved a consensus CTV definition for the post-operative therapy of endometrial and cervical cancer. The CTV should include the common, external, and internal iliac lymph node regions. The upper 3.0 cm of vagina and paravaginal soft tissue lateral to the vagina should also be included. For patients with cervical cancer, or endometrial cancer with cervical stromal invasion, it is also recommended that the CTV include the presacral lymph node-region. CONCLUSIONS This manuscript serves as an international template for the definition of the CTV for the post-operative IMRT of endometrial and cervical cancer. PMID:18037584

  7. Consensus guidelines for delineation of clinical target volume for intensity-modulated pelvic radiotherapy in postoperative treatment of endometrial and cervical cancer.

    Science.gov (United States)

    Small, William; Mell, Loren K; Anderson, Penny; Creutzberg, Carien; De Los Santos, Jennifer; Gaffney, David; Jhingran, Anuja; Portelance, Lorraine; Schefter, Tracey; Iyer, Revathy; Varia, Mahesh; Winter, Kathryn; Mundt, Arno J

    2008-06-01

    To develop an atlas of the clinical target volume (CTV) definitions for postoperative radiotherapy of endometrial and cervical cancer to be used for planning pelvic intensity-modulated radiotherapy. The Radiation Therapy Oncology Group led an international collaboration of cooperative groups in the development of the atlas. The groups included the Radiation Therapy Oncology Group, Gynecologic Oncology Group, National Cancer Institute of Canada, European Society of Therapeutic Radiology and Oncology, and American College of Radiology Imaging Network. The members of the group were asked by questionnaire to define the areas that were to be included in the CTV and to outline theses areas on individual computed tomography images. The initial formulation of the group began in late 2004 and culminated with a formal consensus conference in June 2005. The committee achieved a consensus CTV definition for postoperative therapy for endometrial and cervical cancer. The CTV should include the common, external, and internal iliac lymph node regions. The upper 3.0 cm of the vagina and paravaginal soft tissue lateral to the vagina should also be included. For patients with cervical cancer, or endometrial cancer with cervical stromal invasion, it is also recommended that the CTV include the presacral lymph node region. This report serves as an international template for the definition of the CTV for postoperative intensity-modulated radiotherapy for endometrial and cervical cancer.

  8. Demethylating Agents in the Treatment of Cancer

    Directory of Open Access Journals (Sweden)

    Paul M. Howell, Jr.

    2010-07-01

    Full Text Available Gene silencing resulting from aberrant DNA methylation can lead to tumorigenesis. Therefore, drugs that inhibit or interfere with DNA methylation have been used to reactivate and induce silenced gene re-expression in malignancies. Two demethylating agents, azacitidine and decitabine, are approved for the treatment of myelodysplastic syndromes (MDS by the U.S. Food and Drug Administration (FDA, and are now considered the standard of care in MDS. In this review, we discuss clinical data, including clinical benefits and toxicities, which led to the approval of azacitidine and decitabine. We also summarize findings from clinical trials that used these two demethylating agents in the treatment of solid tumors. Lastly, we discuss some limitations in the use of azacitidine and decitabine in cancer therapy.

  9. Nanoparticle therapeutics for prostate cancer treatment.

    Science.gov (United States)

    Sanna, Vanna; Sechi, Mario

    2012-09-01

    The application of nanotechnology in medicine is offering many exciting possibilities in healthcare. Engineered nanoparticles have the potential to revolutionize the diagnosis and the therapy of several diseases, particularly by targeted delivery of anticancer drugs and imaging contrast agents. Prostate cancer, the second most common cancer in men, represents one of the major epidemiological problems, especially for patients in the advanced age. There is a substantial interest in developing therapeutic options for treatment of prostate cancer based on use of nanodevices, to overcome the lack of specificity of conventional chemotherapeutic agents as well as for the early detection of precancerous and malignant lesions. Herein, we highlight on the recent development of nanotechnology strategies adopted for the management of prostate cancer. In particular, the combination of targeted and controlled-release polymer nanotechnologies has recently resulted in the clinical development of BIND-014, a promising targeted Docetaxel-loaded nanoprototype, which can be validated for use in the prostate cancer therapy. However, several limitations facing nanoparticle delivery to solid tumours, such as heterogeneity of intratumoural barriers and vasculature, cytotoxicity and/or hypersensitivity reactions to currently available cancer nanomedicines, and the difficult in developing targeted nanoparticles with optimal biophysicochemical properties, should be still addressed for a successful tumour eradication. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Clinical Outcomes of Castration-resistant Prostate Cancer Treatments Administered as Third or Fourth Line Following Failure of Docetaxel and Other Second-line Treatment: Results of an Italian Multicentre Study.

    Science.gov (United States)

    Caffo, Orazio; De Giorgi, Ugo; Fratino, Lucia; Alesini, Daniele; Zagonel, Vittorina; Facchini, Gaetano; Gasparro, Donatello; Ortega, Cinzia; Tucci, Marcello; Verderame, Francesco; Campadelli, Enrico; Lo Re, Giovanni; Procopio, Giuseppe; Sabbatini, Roberto; Donini, Maddalena; Morelli, Franco; Sartori, Donata; Zucali, Paolo; Carrozza, Francesco; D'Angelo, Alessandro; Vicario, Giovanni; Massari, Francesco; Santini, Daniele; Sava, Teodoro; Messina, Caterina; Fornarini, Giuseppe; La Torre, Leonardo; Ricotta, Riccardo; Aieta, Michele; Mucciarini, Claudia; Zustovich, Fable; Macrini, Sveva; Burgio, Salvatore Luca; Santarossa, Sandra; D'Aniello, Carmine; Basso, Umberto; Tarasconi, Sara; Cortesi, Enrico; Buttigliero, Consuelo; Ruatta, Fiorella; Veccia, Antonello; Conteduca, Vincenza; Maines, Francesca; Galligioni, Enzo

    2015-07-01

    The availability of new agents (NAs) active in patients with metastatic castration-resistant prostate cancer (mCRPC) progressing after docetaxel treatment (abiraterone acetate, cabazitaxel, and enzalutamide) has led to the possibility of using them sequentially to obtain a cumulative survival benefit. To provide clinical outcome data relating to a large cohort of mCRPC patients who received a third-line NA after the failure of docetaxel and another NA. We retrospectively reviewed the clinical records of patients who had received at least two successive NAs after the failure of docetaxel. The independent prognostic value of a series of pretreatment covariates on the primary outcome measure of overall survival was assessed using Cox regression analysis. We assessed 260 patients who received one third-line NA between January 2012 and December 2013, including 38 who received a further NA as fourth-line therapy. The median progression-free and overall survival from the start of third-line therapy was, respectively, 4 mo and 11 mo, with no significant differences between the NAs. Performance status, and haemoglobin and alkaline phosphatase levels were the only independent prognostic factors. The limitations of the study are mainly due its retrospective nature and the small number of patients treated with some of the sequences. We were unable to demonstrate a difference in the clinical outcomes of third-line NAs regardless of previous NA therapy. It is debated which sequence of treatments to adopt after docetaxel. Our data do not support the superiority of any of the three new agents in third-line treatment, regardless of the previously administered new agent. Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  11. Informed Consent (Clinical Trials)

    Science.gov (United States)

    ... Research Cancer Treatment Types of Treatment Side Effects Clinical Trials Information A to Z List of Cancer Drugs ... Staging Prognosis Treatment Types of Treatment Side Effects Clinical Trials Cancer Drugs Complementary & Alternative Medicine Coping Feelings & Cancer ...

  12. A brain cancer pathway in clinical practice

    DEFF Research Database (Denmark)

    Laursen, Emilie Lund; Rasmussen, Birthe Krogh

    2012-01-01

    Danish healthcare seeks to improve cancer survival through improved diagnostics, rapid treatment and increased focus on cancer prevention and early help-seeking. In neuro-oncology, this has resulted in the Integrated Brain Cancer Pathway (IBCP). The paper explores how the pathway works...

  13. Clinical management of gastric cancer: results of a multicentre survey

    Directory of Open Access Journals (Sweden)

    Xu Feng

    2011-08-01

    Full Text Available Abstract Background The National Comprehensive Cancer Network clinical practice guidelines in oncology-gastric cancer guidelines have been widely used to provide appropriate recommendations for the treatment of patients with gastric cancer. The aim of this study was to examine the adherence of surgical oncologists, medical oncologists, and radiation oncologists' to the recommended guidelines. Methods A questionnaire asking the treatment options for gastric cancer cases was sent to 394 Chinese oncology specialists, including surgical oncologists, medical oncologists, and radiation oncologists working in hospitals joined in The Western Cooperative Gastrointestinal Oncology Group of China. The questionnaire involved a series of clinical scenarios regarding the interpretation of surgery, neoadjuvant, adjuvant, and advanced treatment planning of gastric cancer. Results Analysis of 358 respondents (91% showed variations between each specialization and from the recommended guidelines in the management approaches to specific clinical scenarios. The majority of specialists admitted that less than 50% of patients received multidisciplinary evaluation before treatment. The participants gave different responses to questions involving adjuvant, neoadjuvant, and advanced settings, compared to the recommended guidelines. Conclusions These results highlight the heterogeneity of the treatment of gastric cancer. Surgical oncologists, medical oncologists, and radiation oncologists are not adhering to the recommended guidelines.

  14. Clinical states model for biomarkers in bladder cancer.

    Science.gov (United States)

    Apolo, Andrea B; Milowsky, Matthew; Bajorin, Dean F

    2009-09-01

    Bladder cancer is a significant healthcare problem in the USA, with a high recurrence rate, the need for expensive continuous surveillance and limited treatment options for patients with advanced disease. Research has contributed to an understanding of the molecular pathways involved in the development and progression of bladder cancer, and that understanding has led to the discovery of potentially diagnostic, predictive and prognostic biomarkers. In this review, a clinical states model of bladder cancer is introduced and integrated into a paradigm for biomarker development. Biomarkers are systematically incorporated with predefined end points to aid in clinical management.

  15. Adherence to cancer treatment guidelines: influence of general and cancer-specific guideline characteristics.

    NARCIS (Netherlands)

    Heins, M.J.; Jong, J.D. de; Spronk, I.; Ho, V.K.; Brink, M.; Korevaar, J.C.

    2016-01-01

    Background: Guideline adherence remains a challenge in clinical practice, despite guidelines’ ascribed potential to improve patient outcomes. We studied the level of adherence to recommendations from Dutch national cancer treatment guidelines, and the influence of general and

  16. Clinical outcome of salvage neck dissections in head and neck cancer in relation to initial treatment, extent of surgery and patient factors

    NARCIS (Netherlands)

    van den Bovenkamp, K.; Noordhuis, M.G.; Oosting, S.F.; van der Laan, B.F.A.M.; Roodenburg, J.L.; Bijl, H.P.; Halmos, G.B.; Plaat, B.E.C.

    ObjectiveSalvage surgery has a higher complication rate compared to primary surgical treatment. We evaluated clinical outcome of salvage neck dissections in relation to initial treatment modality, extent of surgery and patient-related factors. DesignSingle institution consecutive case series.

  17. Comparison of therapeutic efficacy and clinical parameters between recombinant human thyroid stimulating hormone and thyroid hormone withdrawal in high-dose radioiodine treatment with differentiated thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Se Hun; Na, Chang Ju; Kim, Jeong Hun; Han, Yeon Hee; KIm, Hee Kwon; Jeong, Hwan Jeong; Sohn, Myung Hee; Lim, Seok Tae [Dept. of Nuclear Medicine, Chonbuk National University Medical School and Hospital, Jeonju (Korea, Republic of)

    2015-06-15

    High-dose radioiodine treatment (HD-RIT) after injection of recombinant human thyroid stimulating hormone (rh-TSH) has become widely used. This study compared the therapeutic efficacy of HD-RIT and clinical parameters between rh-TSH supplement and thyroid hormone withdrawal (THW) after total thyroidectomy in patients with differentiated thyroid cancer. We retrospectively reviewed 266 patients (47 male and 219 female; age, 49.0 ± 10.9 years) with differentiated thyroid cancer detected from September 2011 to September 2012. Patients comprised THW (217, 81.6 %) and rh-TSH (49, 18.4 %). Inclusion criteria were: first HD-RIT; any TN stage; absence of distant metastasis. To evaluate the complete ablation of the remnant thyroid tissue or metastasis, we reviewed stimulated serum thyroglobulin (sTg), I-123 whole-body scan (RxWBS) on T4 off-state, and thyroid ultrasonography (US) or [F-18]-fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) 6–8 months after HD-RIT. We defined a complete ablation state when all three of the follow-up conditions were satisfied; <2.0 ng/ml of the sTg, I-123 RxWBS (−), and thyroid US or F-18 FDG PET/CT (−). If one of the three was positive, ablation was considered incomplete. We also compared various clinical biomarkers (body weight, body mass index, liver and kidney function) between THW and rh-TSH groups. The rates of complete ablation were 73.7 % (160/217) for the THW group and 73.5 % (36/49) for the rh-TSH group. There was no significant difference between the two groups (p = 0.970). The follow-up aspartate transaminase (p = 0.001) and alanine transaminase (p = 0.001) were significantly higher in the THW group. The renal function parameters of blood urea nitrogen (p = 0.001) and creatinine (p = 0.005) tended to increase in the THW group. The change of body weight was + Δ0.96 (±1.9) kg for the THW group and was decreased by -Δ1.39 (±1.5) kg for the rh-TSH group. The change

  18. What's New In Eye Cancer Research and Treatment?

    Science.gov (United States)

    ... try to get it to attack the cancer. Cytokines, monoclonal antibodies, cancer vaccines, and other immunotherapies are among the most promising approaches for treating melanoma and lymphoma. Although most clinical trials of these treatments include people with melanomas of the skin and ...

  19. Targeted therapy: tailoring cancer treatment

    Institute of Scientific and Technical Information of China (English)

    Min Yan; Quentin Qiang Liu

    2013-01-01

    Targeted therapies include small-molecule inhibitors and monoclonal antibodies,have made treatment more tumor-specific and less toxic,and have opened new possibilities for tailoring cancer treatment.Nevertheless,there remain several challenges to targeted therapies,including molecular identification,drug resistance,and exploring reliable biomarkers.Here,we present several selected signaling pathways and molecular targets involved in human cancers including Aurora kinases,PI3K/mTOR signaling,FOXO-FOXM1 axis,and MDM2/MDM4-p53 interaction.Understanding the molecular mechanisms for tumorigenesis and development of drug resistance will provide new insights into drug discovery and design of therapeutic strategies for targeted therapies.

  20. Patient, Physician, and Nurse Factors Associated With Entry Onto Clinical Trials and Finishing Treatment in Patients With Primary or Recurrent Uterine, Endometrial, or Cervical Cancer

    Science.gov (United States)

    2016-10-26

    Recurrent Cervical Carcinoma; Recurrent Uterine Corpus Carcinoma; Recurrent Uterine Corpus Sarcoma; Stage I Uterine Corpus Cancer; Stage I Uterine Sarcoma; Stage IA Cervical Cancer; Stage IB Cervical Cancer; Stage II Uterine Corpus Cancer; Stage II Uterine Sarcoma; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Uterine Corpus Cancer; Stage III Uterine Sarcoma; Stage IV Uterine Corpus Cancer; Stage IV Uterine Sarcoma; Stage IVA Cervical Cancer; Stage IVB Cervical Cancer

  1. Bacterial toxins for cancer treatment

    OpenAIRE

    Johansson, David

    2008-01-01

    Even though anti‐cancer chemotherapy has been continuously improved during the last decades. problems with adverse effects and drug resistance still constitutes a considerable obstacle and sets a demand for new effective treatment options. Tissue homeostasis in multi‐cellular organisms is maintained through intrinsic cell death, apoptosis, which removes unwanted or damaged cells. Disrupted apoptosis is an important factor in tumorgenesis and drug resistance, therefore induction or restoration...

  2. Treatment with Yiqi Bushen Koufuye Combined with Chemotherapy for Preventing Postoperative Metastasis of Stomach Cancer-A Clinical Observation of 28 Cases

    Institute of Scientific and Technical Information of China (English)

    LIU Yun-xia; JIANG Shen-jun; KUANG Tang-hong; YAO Yong-wei; YANG Jie-wen; WANG Yi-qing; WANG Xin-zhong

    2009-01-01

    Objective: To study the effect of Yiqi Bushen Koufuye (益气补肾口服液Oral Liquid for Invigorating Qi and Tonifying the Kidney) combined with chemotherapy on postoperative metastasis of stomach cancer. Methods: The 47 eases of postoperative stomach cancer with the syndrome of deficiency of both the spleen and kidney were divided randomly into the treatment group (28 cases), and the control group (19 cases). The control group was treated simply by chemotherapy; while the treatment group, was treated with Yiqi Bushen Koufuye in addition to chemotherapy. The effect was observed 12 months later on local relapse and distal metastasis, the life quality, peripheral hemogram, and immunologic function. Results: The rates of postoperative relapse and metastasis of the treatment group were obviously lower than those of the control group (P<0.05). The Karnofasky scores, peripheral hemogram and immunologic function of the treatment group were obviously improved in comparison with the control group (P<0.01 or P<0.05). Conclusion: Yiqi Bushen Koufuye combined with chemotherapy is effective in preventing postoperative metastasis of stomach cancer, increasing sensitivity and decreasing toxins, and improving the life quality and immunologic function of the patient.

  3. Combined androgen blockade in the treatment of advanced prostate cancer--an overview. The Scandinavian Prostatic Cancer Group

    DEFF Research Database (Denmark)

    Iversen, P

    1997-01-01

    The value of combined androgen blockade in the treatment of patients with advanced prostate cancer is still controversial. In this review by the Scandinavian Prostatic Cancer Group, the literature addressing the concept and its clinical use is critically reviewed.......The value of combined androgen blockade in the treatment of patients with advanced prostate cancer is still controversial. In this review by the Scandinavian Prostatic Cancer Group, the literature addressing the concept and its clinical use is critically reviewed....

  4. Intensity-Modulated Radiotherapy with a Simultaneous Integrated Boost Combined with Chemotherapy in Stages III-IV Hypopharynx-Larynx Cancer: Treatment Compliance and Clinical Outcomes

    Directory of Open Access Journals (Sweden)

    Giovanni Franchin

    2014-01-01

    Full Text Available Objectives. Retrospective review of our experience using intensity-modulated radiotherapy with simultaneous integrated boost (SIB-IMRT combined with chemotherapy as the primary treatment of locoregionally advanced larynx and hypopharynx cancers. Materials and Methods. Between September 2008 and June 2012, 60 patients (26 with larynx and 34 hypopharynx cancers were treated. Our policy was to offer SIB-IMRT plus concurrent cisplatin to patients affected by larynx cancer stage T3N0-N1 and NCT with TPF (docetaxel/cisplatin/fluorouracil followed by SIB-IMRT to patients with larynx cancer stage T2-4N2-3 or hypopharynx cancer T2-4N0-3. SIB-IMRT consisted in a total dose of 70.95 Gy (2.15 Gy/fraction, 5 fractions/week to the gross primary and nodal disease and differentiated dosages for high risk and low risk nodal regions. Results. Complete remission was achieved in 53/60 (88% of patients. At a median follow up of 31 months (range 9–67, the rate of overall survival and locoregional control with functional larynx at 3 years were 68% and 60%, respectively. T stage (T1–3 versus T4 resulted in being significant for predicting 3-year freedom from relapse (it was 69% and 35%, resp., for T1–T3 and T4 tumors; P=0.04, while site of primary disease (larynx versus hypopharynx was not significant (P=0.35. Conclusion. Our results indicated that combining SIB-IMRT with induction chemotherapy or concurrent chemotherapy is an effective treatment strategy for organ preservation in advanced larynx/hypopharynx cancer.

  5. Active home-based cancer treatment

    Directory of Open Access Journals (Sweden)

    Bordonaro S

    2012-06-01

    Full Text Available Sebastiano Bordonaro Fabio Raiti, Annamaria Di Mari, Calogera Lopiano, Fabrizio Romano, Vitalinda Pumo, Sebastiano Rametta Giuliano, Margherita Iacono, Eleonora Lanteri, Elena Puzzo, Sebastiano Spada, Paolo TralongoUOC Medical Oncology, RAO, ASP 8 Siracusa, ItalyBackground: Active home-based treatment represents a new model of health care. Chronic treatment requires continuous access to facilities that provide cancer care, with considerable effort, particularly economic, on the part of patients and caregivers. Oral chemotherapy could be limited as a consequence of poor compliance and adherence, especially by elderly patients.Methods: We selected 30 cancer patients referred to our department and treated with oral therapy (capecitabine, vinorelbine, imatinib, sunitinib, sorafenib, temozolomide, ibandronate. This pilot study of oral therapy in the patient’s home was undertaken by a doctor and two nurses with experience in clinical oncology. The instruments used were clinical diaries recording home visits, hospital visits, need for caregiver support, and a questionnaire specially developed by the European Organization for Research and Treatment of Cancer (EORTC, known as the QLQ-C30 version 2.0, concerning the acceptability of oral treatment from the patient’s perspective.Results: This program decreased the need to access cancer facilities by 98.1%, promoted better quality of life for patients, as reflected in increased EORTC QLQ-C30 scores over time, allowing for greater adherence to oral treatment as a result of control of drug administration outside the hospital. This model has allowed treatment of patients with difficult access to care (elderly, disabled or otherwise needed caregivers that in the project represent the majority (78% of these.Conclusions: This model of active home care improves quality of life and adherence with oral therapy, reduces the need to visit the hospital, and consequently decreases the number of lost hours of work on

  6. THE TREATMENT AND EVOLUTION OF CERVICAL CANCER

    Directory of Open Access Journals (Sweden)

    Eduard Crauciuc,

    2010-09-01

    Full Text Available The purpose of this study is to establish the evolution of cervical cancer after applying a conventional treatment. Materials and methods. The study was performed on a number of 1249 patients who were suspected of having cervical neoplasia, and who were monitored between 2006-2010 in „Elena-Doamna” Clinical Hospital of Obstetrics and Gynecology in Ia�i, the Military Hospital Gala�i, the County Hospital Gala�i and the Emergency Hospital Buzau. Results and discussions. The study proved the effectiveness of the conservative treatment for the patients who were diagnosed using cytology, colposcopy, biopsy and histopathology, with or without HPV viral infection. Conclusions. The patients with an early diagnose have a 15% higher surviving probability. The patients who responded to the conservative preoperative treatment well are more likely to survive than the patients who did not respond favourably to the conservative preoperative treatment.

  7. Clinical practice guidelines for the surgical treatment of rectal cancer: a consensus statement of the Hellenic Society of Medical Oncologists (HeSMO).

    Science.gov (United States)

    Xynos, Evaghelos; Tekkis, Paris; Gouvas, Nikolaos; Vini, Louiza; Chrysou, Evangelia; Tzardi, Maria; Vassiliou, Vassilis; Boukovinas, Ioannis; Agalianos, Christos; Androulakis, Nikolaos; Athanasiadis, Athanasios; Christodoulou, Christos; Dervenis, Christos; Emmanouilidis, Christos; Georgiou, Panagiotis; Katopodi, Ourania; Kountourakis, Panteleimon; Makatsoris, Thomas; Papakostas, Pavlos; Papamichael, Demetris; Pechlivanides, George; Pentheroudakis, Georgios; Pilpilidis, Ioannis; Sgouros, Joseph; Triantopoulou, Charina; Xynogalos, Spyridon; Karachaliou, Niki; Ziras, Nikolaos; Zoras, Odysseas; Souglakos, John

    2016-01-01

    In rectal cancer management, accurate staging by magnetic resonance imaging, neo-adjuvant treatment with the use of radiotherapy, and total mesorectal excision have resulted in remarkable improvement in the oncological outcomes. However, there is substantial discrepancy in the therapeutic approach and failure to adhere to international guidelines among different Greek-Cypriot hospitals. The present guidelines aim to aid the multidisciplinary management of rectal cancer, considering both the local special characteristics of our healthcare system and the international relevant agreements (ESMO, EURECCA). Following background discussion and online communication sessions for feedback among the members of an executive team, a consensus rectal cancer management was obtained. Statements were subjected to the Delphi methodology voting system on two rounds to achieve further consensus by invited multidisciplinary international experts on colorectal cancer. Statements were considered of high, moderate or low consensus if they were voted by ≥80%, 60-80%, or Guidelines and algorithms of diagnosis and treatment were proposed. The importance of centralization, care by a multidisciplinary team, adherence to guidelines, and personalization is emphasized.

  8. Plague: Clinics, Diagnosis and Treatment.

    Science.gov (United States)

    Nikiforov, Vladimir V; Gao, He; Zhou, Lei; Anisimov, Andrey

    2016-01-01

    Plague still poses a significant threat to human health and as a reemerging infection is unfamiliar to the majority of the modern medical doctors. In this chapter, the plague is described according to Dr. Nikiforov's experiences in the diagnosis and treatment of patients, and also a review of the relevant literature on this subject is provided. The main modern methods and criteria for laboratory diagnosis of plague are briefly described. The clinical presentations include the bubonic and pneumonic form, septicemia, rarely pharyngitis, and meningitis. Early diagnosis and the prompt initiation of treatment reduce the mortality rate associated with bubonic plague and septicemic plague to 5-50 %; although a delay of more than 24 h in the administration of antibiotics and antishock treatment can be fatal for plague patients. Most human cases can successfully be treated with antibiotics.

  9. Clinical evaluation of high dose rate intra-cavitary irradiation for treatment of uterine cervical cancer, combined with pepleomycin suppository in uterine cavity

    Energy Technology Data Exchange (ETDEWEB)

    Yamanashi, Shunji; Abe, Tatsuyuki; Mochizuki, Sachio (Jikei Univ., Tokyo (Japan). School of Medicine); Murakami, Yoshitaka; Iida, Nobuhisa

    1990-02-01

    By means of re-irradiation using pepleomycin suppository in uterine cavity, we attained local control for one patient who had local recurrence in uterine cavity and suffered from uterine fluor in which viable cancer cells were confirmed. We were enlightened by this therapeutic experience, so we attempted combination therapy using pepleomycin suppositories to supplement intra-cavitary irradiation, for the 11 selected patients who were suffering from uterine fluor. We investigated the treatment results in 7 patients of stage III out of 11 patients (of all stages), in comparison with 13 patients of stage III who were treated by irradiation alone. Consequently, these treatment results were approximately equivalent, and the incidence of sigmoid complications could be decreased. Side effects which were followed by the combination therapy were not serious, and so we believe that pepleomycin suppository is a simple method and valuable to supplement radiation therapy of uterine cervical cancer. (author).

  10. Clinical Study on Treatment of Advanced Non-small Cell Lung Cancer by Arsenious Acid Combined with Tα-1 Thymus Peptide and Megestrol Acetate

    Institute of Scientific and Technical Information of China (English)

    郭岳峰; 焦智民

    2002-01-01

    Objective:To observe the therapeutic effect of arsenious acid combined with Tα-1 thymuspeptide and megestrol acetate on advanced non-small cell lung cancer. Methods: Nintey-two patients weredivided randomly into the treated group(n= 45) and the control group(n= 47). The treated group weretreated with arsenious acid combined with Tα-1 thymus peptide and megestrol acetate, and the controlgroup were treated with chemotherapy in the NP protocol. Results: (1) Therapeutic effect: In the 36 pa-tients of the treated group, 2 were evaluated as CR, 8 as PR, 9 as MR, 8 as SD and 9 as PD, the CR+PRrate being 27.7% (10/36), while in the 40 patients of the control group, the corresponding numbers were3, 10, 11, 9, 7 and 32.5% (13/40). Comparison between the CR+PR rate between the two groupsshowed insignificant difference (P>0.05). (2)Clinical benefit rate: The positive rate of Karnofsky scoresin the treated group and the control group was 44.4 % and 20.0 % respectively; and the positive rate ofbody weight in the two groups was 33.3 % and 12.5 % respectively, the difference between the two groupswas significant ( all P<0.05). (3)Changes of T- cell subsets and NK cell activity: CD4 and CD4/CD8 ra-tio after treatment in the treated group increased significantly (P<0.05), while in the control group,CD3, CD4, CD4/CD8 ratio and NK cell activity all lowered significantly (P<0.01). Comparison betweenthe two groups after treatment showed significant difference in CD4, CD4/CD8 ratio and NK cell activity,with those in the treated group all higher than those in the control group (P<0.01). (4)Adeverse-reac-tion: No serious adverse reaction was found in both two groups. (5)Median survival period: The treatedgroup was 30 weeks and that in the control group was 28.5 weeks, and the difference between the twogroups was insignificant (P>0.05). Conclusion: Arsenious acid combined with Tα-1 thymus peptide andmegestrol acetate was a relatively effective scheme with low toxicity in

  11. Sipuleucel-T for the treatment of advanced prostate cancer.

    Science.gov (United States)

    Frohlich, Mark W

    2012-06-01

    Sipuleucel-T is an autologous cellular immunotherapy designed to stimulate an immune response to prostate cancer that prolongs the overall survival of men with asymptomatic or minimally symptomatic metastatic castrate-resistant prostate cancer (CRPC). The clinical development program and key efficacy, safety, and immune response findings from the phase III studies are presented. The integration of sipuleucel-T into the treatment paradigm of advanced prostate cancer and future directions for research are discussed.

  12. Second line treatment options for pancreatic cancer.

    Science.gov (United States)

    Passero, Frank C; Saif, Muhammad Wasif

    2017-08-18

    ABTRACT Introduction: Patients with advanced pancreatic cancer (APC) refractory to first-line therapy have a dismal prognosis and limited therapeutic options, with only one option consisting of nanoliposomal irinotecan in combination with fluorouracil and folinic acid which was approved by FDA based upon results of the phase III NAPOLI-1 study. Areas covered: We performed a literature search for relevant published clinical trials, abstracts of trials in progress and ongoing or planned trials for the second line treatment of APC using Pubmed.com, ClinicalTrials.gov and American Society of Clinical Oncology (ASCO) abstract search as sources. We present an in-depth analysis of the phase I-III clinical trials determining the role and efficacy of second-line treatment in patients with APC. We also describe ongoing studies and rationale for future investigation. Expert opinion: Despite advances in first-line therapy such as gemcitabine/nab-paclitaxel and FOLFIRINOX in APC, median overall survival remains less than 12 months, highlighting the need to develop second-line therapies. In order to establish much needed effective second-line treatment options, we need cooperative efforts among institutions and community practices in enrolling these refractory patients in clinical trials. It should be emphasized that in addition to chemotherapy options, all patients should have the opportunity to consult with nutritionist, social worker and palliative care health providers to assist with goals of care, symptom management and end of life discussions.

  13. Electrodiagnosis in cancer treatment and rehabilitation.

    Science.gov (United States)

    Custodio, Christian M

    2011-05-01

    As cancer patients are living longer and the number of cancer survivors increases, more secondary complications related to cancer and its treatments are being recognized. A large number of neuromuscular processes, stemming from cancer itself, from secondary metabolic effects, from paraneoplastic syndromes, from preexisting conditions, or from adverse effects related to cancer treatments, can affect the peripheral nervous system at any level. Electrodiagnostic tools such as nerve conduction studies and needle electromyography are uniquely suited to assess the function of the peripheral nervous system and are valuable tools in confirming and defining neuromuscular dysfunction and in helping guide oncologic and physiatric treatment and prognosis for the cancer rehabilitation patient.

  14. Cancer treatment: fertility and sexual side effects in women

    Science.gov (United States)

    ... Alternative Names Radiotherapy - fertility; Radiation - fertility; Chemotherapy - fertility; Sexual dysfunction - cancer treatment References American Cancer Society. Fertility and women with cancer. Updated November 6, 2013. www.cancer. ...

  15. The genetic epidemiology of prostate cancer and its clinical implications.

    Science.gov (United States)

    Eeles, Rosalind; Goh, Chee; Castro, Elena; Bancroft, Elizabeth; Guy, Michelle; Al Olama, Ali Amin; Easton, Douglas; Kote-Jarai, Zsofia

    2014-01-01

    Worldwide, familial and epidemiological studies have generated considerable evidence of an inherited component to prostate cancer. Indeed, rare highly penetrant genetic mutations have been implicated. Genome-wide association studies (GWAS) have also identified 76 susceptibility loci associated with prostate cancer risk, which occur commonly but are of low penetrance. However, these mutations interact multiplicatively, which can result in substantially increased risk. Currently, approximately 30% of the familial risk is due to such variants. Evaluating the functional aspects of these variants would contribute to our understanding of prostate cancer aetiology and would enable population risk stratification for screening. Furthermore, understanding the genetic risks of prostate cancer might inform predictions of treatment responses and toxicities, with the goal of personalized therapy. However, risk modelling and clinical translational research are needed before we can translate risk profiles generated from these variants into use in the clinical setting for targeted screening and treatment.

  16. Anatomy of a Cancer Treatment Scam

    Medline Plus

    Full Text Available ... Anatomy of a Cancer Treatment Scam Anatomy of a Cancer Treatment Scam January 19, 2012 Curious about a product that claims to treat or cure cancer? ... On" In Your Community December 13, 2016 Avoiding a Yo-yo Financing Scam December 13, 2016 Media ...

  17. Anatomy of a Cancer Treatment Scam

    Medline Plus

    Full Text Available ... Anatomy of a Cancer Treatment Scam Anatomy of a Cancer Treatment Scam January 19, 2012 Curious about a product that claims to treat or cure cancer? ... Center Competition Guidance I Would Like To... Submit a Consumer Complaint to the FTC Apply for a ...

  18. Brachytherapy for the treatment of prostate cancer.

    Science.gov (United States)

    Cesaretti, Jamie A; Stone, Nelson N; Skouteris, Vassilios M; Park, Janelle L; Stock, Richard G

    2007-01-01

    Low-dose rate brachytherapy has become a mainstream treatment option for men diagnosed with prostate cancer because of excellent long-term treatment outcomes in low-, intermediate-, and high-risk patients. Largely due to patient lead advocacy for minimally invasive treatment options, high-quality prostate implants have become widely available in the US, Europe, and Japan. The reason that brachytherapy results are reproducible in several different practice settings is because numerous implant quality factors have been defined over the last 20 years, which can be applied objectively to judge the success of the intervention both during and after the procedure. In addition, recent long-term follow-up studies have clarified that the secondary cancer incidence of brachytherapy is not clinically meaningful. In terms of future directions, the study of radiation repair genetics may allow for the counseling physician to better estimate any given patients risk for side effects, thereby substantially reducing the therapeutic uncertainties faced by patients choosing a prostate cancer intervention.

  19. State-of-the-art prostate cancer treatment and research. A report from the Cancer Institute of New Jersey.

    Science.gov (United States)

    DiPaola, R S; Kumar, P; Hait, W N; Weiss, R E

    2001-02-01

    Prostate cancer is a devastating disease that will be diagnosed in approximately 200,000 men in 2001. New methods for screening, prevention, and treatment are being developed. In addition, novel agents for the treatment of resistant prostate cancer are being developed in clinical trials. This review summarizes the recent efforts in diet, screening, novel systemic therapies, and alternative medicine for prostate cancer.

  20. Oncolytic Adenoviruses in Cancer Treatment

    Directory of Open Access Journals (Sweden)

    Ramon Alemany

    2014-02-01

    Full Text Available The therapeutic use of viruses against cancer has been revived during the last two decades. Oncolytic viruses replicate and spread inside tumors, amplifying their cytotoxicity and simultaneously reversing the tumor immune suppression. Among different viruses, recombinant adenoviruses designed to replicate selectively in tumor cells have been clinically tested by intratumoral or systemic administration. Limited efficacy has been associated to poor tumor targeting, intratumoral spread, and virocentric immune responses. A deeper understanding of these three barriers will be required to design more effective oncolytic adenoviruses that, alone or combined with chemotherapy or immunotherapy, may become tools for oncologists.

  1. Radiation treatment of ovarian cancer

    Energy Technology Data Exchange (ETDEWEB)

    Morita, S.; Arai, T.; Kurisu, A. (National Inst. of Radiological Sciences, Chiba (Japan))

    1982-03-01

    We evaluated the clinical results obtained in 129 primary malignant ovarian cancer patients who had been treated by 4 modes of postoperative irradiation between 1961 and 1980 at NIRS. The 3- and 5-year survival rates were 52% (45/86) and 43% (32/75) in total and 71% (20/28) and 59% (10/17) in whole abdominal irradiation cases, respectively. Leucopenia (>2,000) occurred in 48%, ileus in 5.2% of the latter cases. The necessity of combining radiation therapy with surgery and chemotherapy was emphasized.

  2. What's New in Research and Treatment for Thymus Cancer?

    Science.gov (United States)

    ... Cancer What’s New in Research and Treatment for Thymus Cancer? There is always research going on in ... Research and Treatment for Thymus Cancer? More In Thymus Cancer About Thymus Cancer Causes, Risk Factors, and ...

  3. Current state of prostate cancer treatment in Jamaica.

    Science.gov (United States)

    Morrison, Belinda F; Aiken, William D; Mayhew, Richard

    2014-01-01

    Prostate cancer is the commonest cancer in Jamaica as well as the leading cause of cancer-related deaths. One report suggested that Jamaica has the highest incidence rate of prostate cancer in the world, with an age-standardised rate of 304/100,000 per year. The Caribbean region is reported to have the highest mortality rate of prostate cancer worldwide. Prostate cancer accounts for a large portion of the clinical practice for health-care practitioners in Jamaica. The Jamaica Urological Society is a professional body comprising 19 urologists in Jamaica who provide most of the care for men with prostate cancer in collaboration with medical oncologists, radiation oncologists, and a palliative care physician. The health-care system is structured in two tiers in Jamaica: public and private. The urologist-to-patient ratio is high, and this limits adequate urological care. Screening for prostate cancer is not a national policy in Jamaica. However, the Jamaica Urological Society and the Jamaica Cancer Society work synergistically to promote screening as well as to provide patient education for prostate cancer. Adequate treatment for localised prostate cancer is available in Jamaica in the forms of active surveillance, nerve-sparing radical retropubic prostatectomy, external beam radiation, and brachytherapy. However, there is a geographic maldistribution of centres that provide prostate cancer treatment, which leads to treatment delays. Also, there is difficulty in affording some treatment options in the private health-care sectors. Androgen deprivation therapy is available for treatment of locally advanced and metastatic prostate cancer and is subsidised through a programme called the National Health Fund. Second-line hormonal agents and chemotherapeutic agents are available but are costly to most of the population. The infrastructure for treatment of prostate cancer in Jamaica is good, but it requires additional technological advances as well as additional specialist

  4. Pairing smoking-cessation services with lung cancer screening: A clinical guideline from the Association for the Treatment of Tobacco Use and Dependence and the Society for Research on Nicotine and Tobacco.

    Science.gov (United States)

    Fucito, Lisa M; Czabafy, Sharon; Hendricks, Peter S; Kotsen, Chris; Richardson, Donna; Toll, Benjamin A

    2016-04-15

    Smoking cessation is crucial for reducing cancer risk and premature mortality. The US Preventive Services Task Force (USPSTF) has recommended annual lung cancer screening with low-dose computed tomography (LDCT), and the Center for Medicare and Medicaid Services recently approved lung screening as a benefit for patients ages 55 to 77 years who have a 30 pack-year history. The Society for Research on Nicotine and Tobacco (SRNT) and the Association for the Treatment of Tobacco Use and Dependence (ATTUD) developed the guideline described in this commentary based on an illustrative literature review to present the evidence for smoking-cessation health benefits in this high-risk group and to provide clinical recommendations for integrating evidence-based smoking-cessation treatment with lung cancer screening. Unfortunately, extant data on lung cancer screening participants were scarce at the time this guideline was written. However, in this review, the authors summarize the sufficient evidence on the benefits of smoking cessation and the efficacy of smoking-cessation interventions for smokers ages 55 to 77 years to provide smoking-cessation interventions for smokers who seek lung cancer screening. It is concluded that smokers who present for lung cancer screening should be encouraged to quit smoking at each visit. Access to evidence-based smoking-cessation interventions should be provided to all smokers regardless of scan results, and motivation to quit should not be a necessary precondition for treatment. Follow-up contacts to support smoking-cessation efforts should be arranged for smokers. Evidence-based behavioral strategies should be used at each visit to motivate smokers who are unwilling to try quitting/reducing smoking or to try evidence-based treatments that may lead to eventual cessation.

  5. Cancer registries in Japan: National Clinical Database and site-specific cancer registries.

    Science.gov (United States)

    Anazawa, Takayuki; Miyata, Hiroaki; Gotoh, Mitsukazu

    2015-02-01

    The cancer registry is an essential part of any rational program of evidence-based cancer control. The cancer control program is required to strategize in a systematic and impartial manner and efficiently utilize limited resources. In Japan, the National Clinical Database (NCD) was launched in 2010. It is a nationwide prospective registry linked to various types of board certification systems regarding surgery. The NCD is a nationally validated database using web-based data collection software; it is risk adjusted and outcome based to improve the quality of surgical care. The NCD generalizes site-specific cancer registries by taking advantage of their excellent organizing ability. Some site-specific cancer registries, including pancreatic, breast, and liver cancer registries have already been combined with the NCD. Cooperation between the NCD and site-specific cancer registries can establish a valuable platform to develop a cancer care plan in Japan. Furthermore, the prognosis information of cancer patients arranged using population-based and hospital-based cancer registries can help in efficient data accumulation on the NCD. International collaboration between Japan and the USA has recently started and is expected to provide global benchmarking and to allow a valuable comparison of cancer treatment practices between countries using nationwide cancer registries in the future. Clinical research and evidence-based policy recommendation based on accurate data from the nationwide database may positively impact the public.

  6. Ovarian Cancer Treatment | Cancer Trends Progress Report

    Science.gov (United States)

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  7. Magnetic resonance imaging for prostate cancer clinical application

    Institute of Scientific and Technical Information of China (English)

    Bing Li; Yong Du; Hanfeng Yang; Yayong Huang; Jun Meng; Dongmei Xiao

    2013-01-01

    As prostate cancer is a biologically heterogeneous disease for which a variety of treatment options are available,the major objective of prostate cancer imaging is to achieve more precise disease characterization.In clinical practice,magnetic resonance imaging (MRI) is one of the imaging tools for the evaluation of prostate cancer,the fusion of MRI or dynamic contrast-enhanced MRI (DCE-MRI) with magnetic resonance spectroscopic imaging (MRSI) is improving the evaluation of cancer location,size,and extent,while providing an indication of tumor aggressiveness.This review summarizes the role of MRI in the application of prostate cancer and describes molecular MRI techniques (including MRSI and DCE-MRI)for aiding prostate cancer management.

  8. Integrating epothilones into the treatment of patients with metastatic breast cancer: clinical perspectives on incorporating recent data in the practice setting.

    Science.gov (United States)

    Cigler, Tessa; Vahdat, Linda

    2008-12-01

    The introduction of modern chemotherapy agents, including the taxanes, has improved the prognosis of women with metastatic breast cancer (MBC). Ultimately, however, inevitable intrinsic or acquired resistance to chemotherapy limits treatment options. The epothilones, a novel class of microtubule-stabilizing agents that have incomplete cross-resistance with taxanes and are less susceptible to common mechanisms of resistance, have demonstrated activity in breast cancer. Ixabepilone, the best studied epothilone to date, has been approved for use as a single agent or in combination with capecitabine in anthracycline- and taxanepretreated or refractory MBC. Ixabepilone is relatively well tolerated, with the most common side effects being peripheral neuropathy and neutropenia. Other epothilones such as KOS-862, patupilone, ZK-EPO, BMS-310705, and KOS-1584 are being evaluated as therapy for patients with breast cancer, with promising preliminary data. Ongoing research aims to define and optimize the efficacy of the epothilones in an attempt to improve the quality of life and overall survival of individuals with breast cancer.

  9. Anal cancer: French Intergroup Clinical Practice Guidelines for diagnosis, treatment and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, SNFCP).

    Science.gov (United States)

    Moureau-Zabotto, Laurence; Vendrely, Veronique; Abramowitz, Laurent; Borg, Christophe; Francois, Eric; Goere, Diane; Huguet, Florence; Peiffert, Didier; Siproudhis, Laurent; Ducreux, Michel; Bouché, Olivier

    2017-08-01

    This document is a summary of the French Intergroup guidelines regarding the management of anal carcinomas, published in November 2016. It is a collaborative work produced under the auspices of the majority of the French medical societies involved in the management of anal cancer. It is based on the previous guidelines published in 2010. Recommendations are graded in three categories, according to the amount of evidence found in the literature. Non-metastatic anal carcinomas can be divided into two risk groups, according to magnetic resonance imaging (MRI) or endorectal-ultrasonograpy. Localized small cancers (T1N0) are mainly treated by exclusive radiation therapy in the case of cancers of the anal canal, or by surgery in the case of cancers of the anal margin. The recommended treatment of locally advanced tumours (T2-T4, N0-N2) is definitive concomitant radio-chemotherapy. Salvage surgery should be reserved for patients with poor response, tumour progression or local relapse after radio-chemotherapy, or in cases of persistent vaginal fistula or total anal incontinence after the cessation of radio-chemotherapy. In the case of metastatic tumours, current therapeutic recommendations are based on less robust evidence; with chemotherapy playing a major role. These recommendations are permanently being reviewed, and each individual case must be discussed inside a multidisciplinary team. Copyright © 2017. Published by Elsevier Ltd.

  10. [Kleptomania: clinical characteristics and treatment].

    Science.gov (United States)

    Grant, Jon E; Odlaug, Brian L

    2008-05-01

    Kleptomania, a disabling impulse control disorder, is characterized by the repetitive and uncontrollable theft of items that are of little use to the afflicted person. Despite its relatively long history, kleptomania remains poorly understood to the general public, clinicians, and sufferers. This article reviews the literature for what is known about the clinical characteristics, family history, neurobiology, and treatment options for individuals with kleptomania. Kleptomania generally has its onset in late adolescence or early adulthood and appears to be more common among women. Lifetime psychiatric comorbidity is frequent, mainly with other impulse control (20-46%), substance use (23-50%) and mood disorders (45-100%). Individuals with kleptomania suffer significant impairment in their ability to function socially and occupationally. Kleptomania may respond to cognitive behavioral therapy and various pharmacotherapies (lithium, anti-epileptics, and opioid antagonists). Kleptomania is a disabling disorder that results in intense shame, as well as legal, social, family, and occupational problems. Large scale treatment studies are needed.

  11. Carboplatin treatment of antiestrogen-resistant breast cancer cells

    DEFF Research Database (Denmark)

    Larsen, Mathilde S; Yde, Christina Westmose; Christensen, Ib J

    2012-01-01

    Antiestrogen resistance is a major clinical problem in current breast cancer treatment. Therefore, biomarkers and new treatment options for antiestrogen-resistant breast cancer are needed. In this study, we investigated whether antiestrogen‑resistant breast cancer cell lines have increased...... to the antiestrogen tamoxifen, were more sensitive to carboplatin treatment compared to the parental MCF-7 cell line. This indicates that carboplatin may be an advantageous treatment in antiestrogen‑resistant breast cancer; however, a marker for increased sensitivity would be needed. Low Bcl-2 expression...... sensitivity to carboplatin, as it was previously shown with cisplatin, and whether low Bcl-2 expression levels have a potential value as marker for increased carboplatin sensitivity. Breast cancer cells resistant to the pure antiestrogen fulvestrant, and two out of four cell lines resistant...

  12. Clinical observation of three-dimensional conformal radiotherapy(3D-CRT)with concurrent chemotherapy in treatment of recurrent cervical cancers

    Institute of Scientific and Technical Information of China (English)

    Hongbing Ma; Minghua Bai; Xijing Wang; Hongtao Ren

    2010-01-01

    Objective:The aim of the study was to explore the efficacy of three-dimensional conformal radiotherapy(3DCRT)combined with TP concurrent chemotherapy in treatment of recurrent cervical cancers.Methods:From May 2005 to May 2009,36 patients with recurrent cervical cancer were treated by 3D-CRT of 60-66 Gy and TP(docetaxel 70 mg/m2,d1;cisplatin 20 mg/m2,d1-d3;21 days per cycle,totally 2 cycles)concurrent chemotherapy.Results:All of the patients had finished the 3D-CRT,the total response rate,complete response rate and partial response rate were 80.0%(28/35),45.7%(16/35),and 34.3%(12/35),respectively.The pain-alleviation rate was 91.4%(32/35).The hemorrhage control rate was 94.3%(33/35).The median overall survival was 21.2 months.The 1-,2- and 3-year survival rates were 54.3%,37.1% and 22.8%,respectively.The life qualities of the patients were improved,without any treatment related death.Conclusion:Radiotherapy is effective and well-tolerated for recurrent cervical cancers,and it can promote regional control of the disease and prolong survival time.

  13. Treatment of locally advanced rectal cancer

    NARCIS (Netherlands)

    Klaassen, RA; Nieuwenhuijzen, GAP; Martijn, H; Rutten, HJT; Hospers, GAP; Wiggers, T

    2004-01-01

    Historically, locally advanced rectal cancer is known for its dismal prognosis. The treatment of locally advanced rectal cancer is subject to continuous change due to development of new and better diagnostic tools, radiotherapeutic techniques, chemotherapeutic agents and understanding of the

  14. Immunotherapy: Disrupting the Cancer Treatment World

    Science.gov (United States)

    ... to create the best and most far-reaching cancer immunotherapy treatments. THE BASICS : The human immune system is ... none, abound these days – and point to why cancer immunotherapies matter. Immunotherapy is “providing options for people out ...

  15. New treatment modalities in advanced thyroid cancer.

    NARCIS (Netherlands)

    Kapiteijn, E.; Schneider, T.C.; Morreau, H.; Gelderblom, H.; Nortier, J.W.; Smit, J.W.A.

    2012-01-01

    BACKGROUND: Thyroid cancer is a heterogeneous disease that is classified into differentiated thyroid carcinoma (DTC), undifferentiated/anaplastic thyroid carcinoma (ATC) and medullary thyroid carcinoma. Results of conventional treatment modalities in advanced thyroid cancer have been disappointing a

  16. Evolution of surgical treatment for breast cancer

    Directory of Open Access Journals (Sweden)

    V. P. Letyagin

    2012-01-01

    Full Text Available The paper considers main surgical interventions used to treat breast cancer. It defines the role and place of conservative surgery and describes current procedures for the organ-saving treatment of cancer at this site.

  17. International Partnerships for Clinical Cancer Research

    Science.gov (United States)

    CGH co-sponsors the 2015 International Symposium on Cancer Clinical Trials and related meetings held in partnership with the Japanese National Cancer Center (JNCC) and Embassies of France, Korea, United Kingdom (UK), and United States (US) in Tokyo on May 14 - 15, 2015.

  18. Risk of skin cancer following tamoxifen treatment in more than 16,000 breast cancer patients

    DEFF Research Database (Denmark)

    Præstegaard, Camilla; Kjaer, Susanne K.; Andersson, Michael

    2016-01-01

    Background: Women with breast cancer are at increased risk of developing skin cancer. Little is known about how tamoxifen affects this risk. We aimed to investigate whether tamoxifen treatment following breast cancer is associated with skin cancer. Methods: A cohort consisting of 44,589 women...... diagnosed with breast cancer during 1977–2007 from the nationwide clinical database of the Danish Breast Cancer Cooperative Group, was followed for a primary skin cancer [basal cell carcinoma (BCC), squamous cell carcinoma (SCC) or melanoma] in the Danish Cancer Registry supplemented by data on BCC and SCC...... from the Danish Pathology Register. We investigated incidence of skin cancer among 16,214 women treated with tamoxifen compared to 28,375 women not treated with tamoxifen by calculating incidence rate ratios (IRRs) in Cox regression models. Results: Tamoxifen users were followed for a median of 2...

  19. Polymer nanoassemblies for cancer treatment and imaging.

    Science.gov (United States)

    Lee, Hyun Jin; Ponta, Andrei; Bae, Younsoo

    2010-12-01

    Amphiphilic polymers represented by block copolymers self-assemble into well-defined nanostructures capable of incorporating therapeutics. Polymer nanoassemblies currently developed for cancer treatment and imaging are reviewed in this article. Particular attention is paid to three representative polymer nanoassemblies: polymer micelles, polymer micellar aggregates and polymer vesicles. Rationales, design and performance of these polymer nanoassemblies are addressed, focusing on increasing the solubility and chemical stability of drugs. Also discussed are polymer nanoassembly formation, the distribution of polymer materials in the human body and applications of polymer nanoassemblies for combined therapy and imaging of cancer. Updates on tumor-targeting approaches, based on preclinical and clinical results are provided, as well as solutions for current issues that drug-delivery systems have, such as in vivo stability, tissue penetration and therapeutic efficacy. These are discussed to provide insights on the future development of more effective polymer nanoassemblies for the delivery of therapeutics in the body.

  20. Clinical significance of MET in gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Mikito; Inokuchi; Sho; Otsuki; Yoshitaka; Fujimori; Yuya; Sato; Masatoshi; Nakagawa; Kazuyuki; Kojima

    2015-01-01

    Chemotherapy has become the global standard treatment for patients with metastatic or unresectable gastric cancer(GC),although outcomes remain unfavorable.Many molecular-targeted therapies inhibiting signaling pathways of various tyrosine kinase receptors have been developed,and monoclonal antibodies targeting human epidermal growth factor receptor 2 or vascular endothelial growth factor receptor 2 have become standard therapy for GC.Hepatocyte growth factor and its receptor,c-MET(MET),play key roles in tumor growth through activated signaling pathways from receptor in GC cells.Genomic amplification of MET leads to the aberrant activation found in GC tumors and is related to survival in patients with GC.This review discusses the clinical significance of MET in GC and examines MET as a potential therapeutic target in patients with GC.Preclinical studies in animal models have shown that MET antibodies or smallmolecule MET inhibitors suppress tumor-cell proliferation and tumor progression in MET-amplified GC cells.These drugs are now being evaluated in clinical trials as treatments for metastatic or unresectable GC.

  1. [New antibodies in cancer treatment].

    Science.gov (United States)

    Pestalozzi, B C; Knuth, A

    2004-09-22

    Since the development of hybridoma technology in 1975 monoclonal antibodies with pre-defined specificity can be produced. Only twenty years later did it become possible to make therapeutic use of monoclonal antibodies in oncology. To this end it was necessary to attach the antigen-binding site of a mouse antibody onto the scaffold of a human antibody molecule. Such chimeric or "humanized" antibodies may be used in passive immunotherapy without eliciting an immune response. Rituximab and trastuzumab are such humanized antibodies. They are used today routinely in the treatment of malignant lymphoma and breast cancer, respectively. These antibodies are usually used in combination with conventional cytostatic anticancer drugs.

  2. Current Status of Immunotherapy Treatments for Pancreatic Cancer.

    Science.gov (United States)

    Jimenez-Luna, Cristina; Prados, Jose; Ortiz, Raul; Melguizo, Consolacion; Torres, Carolina; Caba, Octavio

    Pancreatic cancer (PC) is a lethal disease representing the seventh most frequent cause of death from cancer worldwide. Resistance of pancreatic tumors to current treatments leads to disappointing survival rates, and more specific and effective therapies are urgently needed. In recent years, immunotherapy has been proposed as a promising approach to the treatment of PC, and encouraging results have been published by various preclinical and clinical studies. This review provides an overview of the latest developments in the immunotherapeutic treatment of PC and summarizes the most recent and important clinical trials.

  3. miRNA Expression Analyses in Prostate Cancer Clinical Tissues.

    Science.gov (United States)

    Bucay, Nathan; Shahryari, Varahram; Majid, Shahana; Yamamura, Soichiro; Mitsui, Yozo; Tabatabai, Z Laura; Greene, Kirsten; Deng, Guoren; Dahiya, Rajvir; Tanaka, Yuichiro; Saini, Sharanjot

    2015-09-08

    A critical challenge in prostate cancer (PCa) clinical management is posed by the inadequacy of currently used biomarkers for disease screening, diagnosis, prognosis and treatment. In recent years, microRNAs (miRNAs) have emerged as promising alternate biomarkers for prostate cancer diagnosis and prognosis. However, the development of miRNAs as effective biomarkers for prostate cancer heavily relies on their accurate detection in clinical tissues. miRNA analyses in prostate cancer clinical specimens is often challenging owing to tumor heterogeneity, sampling errors, stromal contamination etc. The goal of this article is to describe a simplified workflow for miRNA analyses in archived FFPE or fresh frozen prostate cancer clinical specimens using a combination of quantitative real-time PCR (RT-PCR) and in situ hybridization (ISH). Within this workflow, we optimize the existing methodologies for miRNA extraction from FFPE and frozen prostate tissues and expression analyses by Taqman-probe based miRNA RT-PCR. In addition, we describe an optimized method for ISH analyses formiRNA detection in prostate tissues using locked nucleic acid (LNA)- based probes. Our optimized miRNA ISH protocol can be applied to prostate cancer tissue slides or prostate cancer tissue microarrays (TMA).

  4. Preclinical and clinical development of DNA vaccines for prostate cancer.

    Science.gov (United States)

    Colluru, V T; Johnson, Laura E; Olson, Brian M; McNeel, Douglas G

    2016-04-01

    Prostate cancer is the most commonly diagnosed cancer in the United States. It is also the second leading cause of cancer-related death in men, making it one of the largest public health concerns today. Prostate cancer is an ideal disease for immunotherapies because of the generally slow progression, the dispensability of the target organ in the patient population, and the availability of several tissue-specific antigens. As such, several therapeutic vaccines have entered clinical trials, with one autologous cellular vaccine (sipuleucel-T) recently gaining Food and Drug Administration approval after demonstrating overall survival benefit in randomized phase III clinical trials. DNA-based vaccines are safe, economical, alternative "off-the-shelf" approaches that have undergone extensive evaluation in preclinical models. In fact, the first vaccine approved in the United States for the treatment of cancer was a DNA vaccine for canine melanoma. Several prostate cancer-specific DNA vaccines have been developed in the last decade and have shown promising results in early phase clinical trials. This review summarizes anticancer human DNA vaccine trials, with a focus on those conducted for prostate cancer. We conclude with an outline of special considerations important for the development and successful translation of DNA vaccines from the laboratory to the clinic.

  5. Clinical statistics of gynecologic cancers in Japan

    Science.gov (United States)

    Nagase, Satoru

    2017-01-01

    Cervical, endometrial, and ovarian cancers, have both high morbidity and mortality among the gynecologic malignant tumors in Japan. The present study was conducted using both the population-based cancer registry and the gynecologic cancer registry to elucidate the characteristics of gynecologic malignant tumors in Japan. Based on nationwide estimates from the population-based cancer registry in Japan, the morbidities and mortality of cervical, endometrial, and ovarian cancers were obtained and used for analysis. Clinicopathologic factors for cervical cancer, endometrial cancer, ovarian cancer, including age, clinical stage, postsurgical stage, histological type, therapeutic strategy, and prognosis were retrieved from the gynecologic cancer registry published by the Japan Society of Obstetrics and Gynecology and used for analysis. The morbidities of cervical, endometrial, and ovarian cancers were 10,908, 13,606, and 9,384 women in 2012, respectively. The prevalence of endometrial cancer has significantly and consistently been increasing and represents the most common gynecologic malignant tumor in Japan. The mortalities of cervical, endometrial, and ovarian cancers were 2.1, 1.3, and 3.2 per 100,000 in 2012, respectively. In 2014, 52.2% of cervical cancer patients were classified as stage I, 22.5% as stage II, 10.2% as stage III, and 11.2% as stage IV. In addition, 71.9% of endometrial cancer patients were classified as stage I, 6.0% as stage II, 13.3% as stage III, and 7.5% as stage IV. Finally, 43.2% of ovarian cancer patients were classified as stage I, 9.1% as stage II, 27.6% as stage III, and 7.2% as stage IV. Twelve point five percent of ovarian cancer patients received neoadjuvant chemotherapy. PMID:28198168

  6. Clinical statistics of gynecologic cancers in Japan.

    Science.gov (United States)

    Yamagami, Wataru; Nagase, Satoru; Takahashi, Fumiaki; Ino, Kazuhiko; Hachisuga, Toru; Aoki, Daisuke; Katabuchi, Hidetaka

    2017-03-01

    Cervical, endometrial, and ovarian cancers, have both high morbidity and mortality among the gynecologic malignant tumors in Japan. The present study was conducted using both the population-based cancer registry and the gynecologic cancer registry to elucidate the characteristics of gynecologic malignant tumors in Japan. Based on nationwide estimates from the population-based cancer registry in Japan, the morbidities and mortality of cervical, endometrial, and ovarian cancers were obtained and used for analysis. Clinicopathologic factors for cervical cancer, endometrial cancer, ovarian cancer, including age, clinical stage, postsurgical stage, histological type, therapeutic strategy, and prognosis were retrieved from the gynecologic cancer registry published by the Japan Society of Obstetrics and Gynecology and used for analysis. The morbidities of cervical, endometrial, and ovarian cancers were 10,908, 13,606, and 9,384 women in 2012, respectively. The prevalence of endometrial cancer has significantly and consistently been increasing and represents the most common gynecologic malignant tumor in Japan. The mortalities of cervical, endometrial, and ovarian cancers were 2.1, 1.3, and 3.2 per 100,000 in 2012, respectively. In 2014, 52.2% of cervical cancer patients were classified as stage I, 22.5% as stage II, 10.2% as stage III, and 11.2% as stage IV. In addition, 71.9% of endometrial cancer patients were classified as stage I, 6.0% as stage II, 13.3% as stage III, and 7.5% as stage IV. Finally, 43.2% of ovarian cancer patients were classified as stage I, 9.1% as stage II, 27.6% as stage III, and 7.2% as stage IV. Twelve-point six percent of ovarian cancer patients received neoadjuvant chemotherapy. Copyright © 2017. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.

  7. Gastrointestinal cancers in India: Treatment perspective

    Directory of Open Access Journals (Sweden)

    Nikhil Suresh Ghadyalpatil

    2016-01-01

    Full Text Available GI cancer is not one cancer but is a term for the group of cancers that affect the digestive system including gastric cancer (GC, colorectal cancer (CRC, hepatocellular carcinoma (HCC, esophageal cancer (EC, and pancreatic cancer (PC. Overall, the GI cancers are responsible for more cancers and more deaths from cancer than any other organ. 5 year survival of these cancers remains low compared to western world. Unlike the rest of the world where organ based specialities hepatobiliary, pancreatic, colorectal and esophagogastric exist , these cancers are managed in India by either a gastrointestinal surgeons, surgical oncologist, or a general surgeon with varying outcomes.The aim of this review was to collate data on GI cancers in indian continent. In colorectal cancers, data from tertiary care centres identifies the unique problem of mucinous and signet colorectal cancer. Results of rectal cancer resection in terms of technique (intersphincteric resection, extralevator aper, minimal invasive approach to be comparable with world literature. However long term outcome and data regarding colon cancers and nationally is needed. Gastric cancer at presentation are advanced and in surgically resected patients, there is need for a trial to compare chemoradiation vs chemotherapy alone to prevent loco regional recurrence. Data on minimal invasive gastric cancer surgery may be sparse for the same reason. Theree is a lot of data on surgical techniques and perioperatve outcomes in pancreatic cancer. There is a high volume of locally advanced gallbladder cancers with efforts on to decide whether neoadjuvant chemotherapy or neoadjuvant chemoradiotherapy is better for down staging. Considering GI cancers, a heterogeneous disease with site specific treatment options and variable outcomes, the overall data and outcomes are extremely variable. Young patients with pathology unique to the Indian subcontinent (for example, signet ring rectal cancer, GBCs need focussed

  8. Clinical cancer advances 2011: Annual Report on Progress Against Cancer from the American Society of Clinical Oncology.

    Science.gov (United States)

    Vogelzang, Nicholas J; Benowitz, Steven I; Adams, Sylvia; Aghajanian, Carol; Chang, Susan Marina; Dreyer, Zoann Eckert; Janne, Pasi A; Ko, Andrew H; Masters, Greg A; Odenike, Olatoyosi; Patel, Jyoti D; Roth, Bruce J; Samlowski, Wolfram E; Seidman, Andrew D; Tap, William D; Temel, Jennifer S; Von Roenn, Jamie H; Kris, Mark G

    2012-01-01

    A message from ASCO'S President. It has been forty years since President Richard Nixon signed the National Cancer Act of 1971, which many view as the nation's declaration of the "War on Cancer." The bill has led to major investments in cancer research and significant increases in cancer survival. Today, two-thirds of patients survive at least five years after being diagnosed with cancer compared with just half of all diagnosed patients surviving five years after diagnosis in 1975. The research advances detailed in this year's Clinical Cancer Advances demonstrate that improvements in cancer screening, treatment, and prevention save and improve lives. But although much progress has been made, cancer remains one of the world's most serious health problems. In the United States, the disease is expected to become the nation's leading cause of death in the years ahead as our population ages. I believe we can accelerate the pace of progress, provided that everyone involved in cancer care works together to achieve this goal. It is this viewpoint that has shaped the theme for my presidential term: Collaborating to Conquer Cancer. In practice, this means that physicians and researchers must learn from every patient's experience, ensure greater collaboration between members of a patient's medical team, and involve more patients in the search for cures through clinical trials. Cancer advocates, insurers, and government agencies also have important roles to play. Today, we have an incredible opportunity to improve the quality of cancer care by drawing lessons from the real-world experiences of patients. The American Society of Clinical Oncology (ASCO) is taking the lead in this area, in part through innovative use of health information technology. In addition to our existing quality initiatives, ASCO is working with partners to develop a comprehensive rapid-learning system for cancer care. When complete, this system will provide physicians with personalized, real

  9. Modeling precision treatment of breast cancer.

    Science.gov (United States)

    Daemen, Anneleen; Griffith, Obi L; Heiser, Laura M; Wang, Nicholas J; Enache, Oana M; Sanborn, Zachary; Pepin, Francois; Durinck, Steffen; Korkola, James E; Griffith, Malachi; Hur, Joe S; Huh, Nam; Chung, Jongsuk; Cope, Leslie; Fackler, Mary Jo; Umbricht, Christopher; Sukumar, Saraswati; Seth, Pankaj; Sukhatme, Vikas P; Jakkula, Lakshmi R; Lu, Yiling; Mills, Gordon B; Cho, Raymond J; Collisson, Eric A; van't Veer, Laura J; Spellman, Paul T; Gray, Joe W

    2013-01-01

    First-generation molecular profiles for human breast cancers have enabled the identification of features that can predict therapeutic response; however, little is known about how the various data types can best be combined to yield optimal predictors. Collections of breast cancer cell lines mirror many aspects of breast cancer molecular pathobiology, and measurements of their omic and biological therapeutic responses are well-suited for development of strategies to identify the most predictive molecular feature sets. We used least squares-support vector machines and random forest algorithms to identify molecular features associated with responses of a collection of 70 breast cancer cell lines to 90 experimental or approved therapeutic agents. The datasets analyzed included measurements of copy number aberrations, mutations, gene and isoform expression, promoter methylation and protein expression. Transcriptional subtype contributed strongly to response predictors for 25% of compounds, and adding other molecular data types improved prediction for 65%. No single molecular dataset consistently out-performed the others, suggesting that therapeutic response is mediated at multiple levels in the genome. Response predictors were developed and applied to TCGA data, and were found to be present in subsets of those patient samples. These results suggest that matching patients to treatments based on transcriptional subtype will improve response rates, and inclusion of additional features from other profiling data types may provide additional benefit. Further, we suggest a systems biology strategy for guiding clinical trials so that patient cohorts most likely to respond to new therapies may be more efficiently identified.

  10. Changing paradigm in treatment of lung cancer

    Institute of Scientific and Technical Information of China (English)

    Sundaram Viswanath; Abhishek Pathak; Amul Kapoor; Anvesh Rathore; Bhupendra Nath Kapur

    2016-01-01

    Lung cancer is one of the most common and deadliest forms of cancer. It accounts for 13% of all new cancer cases and 19% of cancer-related deaths. In India, lung cancer constitutes 6.9% of all new cancer cases and 9.3% of all cancer cases. There has also been a dramatic rise worldwide in both the absolute and relative frequencies of lung cancer occurrence. In 1953 it became the most common cause of cancer mortality in men. By 1985, it became the leading cause of cancer deaths in women, causing almost twice as many deaths as breast cancer. The demographic proifle of lung cancer has changed greatly over the years; however, methods for diagnosing, screening, and managing lung cancer patients have improved. This is due to our growing understanding of the biology of lung cancer. It is now possible to further deifne lung cancer types beyond small cell lung carcinoma and non-small cell lung carcinoma. Moreover, new histology-based therapeutic modalities have been developed, and more new lung cancer biomarkers have been uncovered. Therefore, more detailed histological characterization of lung cancer samples is warranted in order to determine the best course of treatment for speciifc patients. This review article describes how these new molecular technologies are shaping the way lung cancer can be treated in future.

  11. Biomolecular features of clinical relevance in breast cancer

    NARCIS (Netherlands)

    Daidone, M.G.; Paradiso, A.; Gion, M.; Harbeck, N.; Sweep, C.G.J.; Schmitt, M.

    2004-01-01

    Breast cancer is a heterogeneous disease and its consequent complexity is a major challenge for physicians and biologists. Notwithstanding its potential curability due to the availability of treatment modalities which are effective in the presence of favourable clinical or pathobiological features,

  12. Gene expression profiling predicts clinical outcome of breast cancer

    NARCIS (Netherlands)

    Veer, L.J. van 't; Dai, H.; Vijver, H. van de; He, Y.D.; Hart, A.A.M.; Mao, M.; Peterse, H.L.; Kooy, K. van der; Marton, M.J.; Witteveen, A.T.; Schreiber, G.J.; Kerkhoven, R.M.; Roberts, C.; Linsley, P.S.; Bernards, R.A.; Friend, S.H.

    2002-01-01

    Breast cancer patients with the same stage of disease can have markedly different treatment responses and overall outcome. The strongest predictors for metastases (for example, lymph node status and histological grade) fail to classify accurately breast tumours according to their clinical behaviour.

  13. The impact of nutritional status, nutritional risk, and nutritional treatment on clinical outcome of 2248 hospitalized cancer patients: a multi-center, prospective cohort study in Chinese teaching hospitals.

    Science.gov (United States)

    Pan, Hongming; Cai, Sanjun; Ji, Jiafu; Jiang, Zhiwei; Liang, Houjie; Lin, Feng; Liu, Xiyong

    2013-01-01

    To better understand the impact of undernutrition, nutritional risk, and nutritional treatment on the clinical outcomes of hospitalized cancer patients in China, the authors conducted a multicenter, cross-sectional study with 2248 cancer patients from 20 hospitals from January to June 2010. The authors defined 19.7% and 26.8% patients as undernourished at baseline and reassessment, respectively. Patients with gastrointestinal malignancies had a higher rate of undernutrition than other patients. The nutritional risk rate was 24.6% and 40.2% at baseline and reassessment, respectively. For patients with nutritional risk, the relative risk (RR) of adverse events (AEs) significantly increased with and without nutritional treatment. In comparison with the nonnutritional treatment subgroup, patients who received enteral nutrition (EN) or total parenteral nutrition (TPN) significantly reduced the RR of AE development. The RR of AEs for EN and TPN were 0.08 (95% CI: 0.01-0.62) and 0.56 (95% CI: 0.33-0.96), respectively. Separated nutrient infusion increased the risk of AEs. The authors concluded that undernutrition and nutritional risk are general problems that impact the outcomes of hospitalized cancer patients in China. Higher NRS2002 scores are related to AE risk but not weight loss. In nutritional treatment, EN and TPN can significantly reduce the risk of AEs.

  14. Treatment Option Overview (Endometrial Cancer)

    Science.gov (United States)

    ... of endometrial cancer. Signs and symptoms of endometrial cancer include unusual vaginal bleeding or pain in the pelvis. These and other signs and symptoms may be caused by endometrial cancer or by other conditions. Check with your doctor ...

  15. Translational potential of cancer stem cells: A review of the detection of cancer stem cells and their roles in cancer recurrence and cancer treatment.

    Science.gov (United States)

    Islam, Farhadul; Gopalan, Vinod; Smith, Robert A; Lam, Alfred K-Y

    2015-07-01

    Cancer stem cells (CSCs) are a subpopulation of cancer cells with many clinical implications in most cancer types. One important clinical implication of CSCs is their role in cancer metastases, as reflected by their ability to initiate and drive micro and macro-metastases. The other important contributing factor for CSCs in cancer management is their function in causing treatment resistance and recurrence in cancer via their activation of different signalling pathways such as Notch, Wnt/β-catenin, TGF-β, Hedgehog, PI3K/Akt/mTOR and JAK/STAT pathways. Thus, many different therapeutic approaches are being tested for prevention and treatment of cancer recurrence. These may include treatment strategies targeting altered genetic signalling pathways by blocking specific cell surface molecules, altering the cancer microenvironments that nurture cancer stem cells, inducing differentiation of CSCs, immunotherapy based on CSCs associated antigens, exploiting metabolites to kill CSCs, and designing small interfering RNA/DNA molecules that especially target CSCs. Because of the huge potential of these approaches to improve cancer management, it is important to identify and isolate cancer stem cells for precise study and application of prior the research on their role in cancer. Commonly used methodologies for detection and isolation of CSCs include functional, image-based, molecular, cytological sorting and filtration approaches, the use of different surface markers and xenotransplantation. Overall, given their significance in cancer biology, refining the isolation and targeting of CSCs will play an important role in future management of cancer.

  16. Are erlotinib and gefitinib interchangeable, opposite or complementary for non-small cell lung cancer treatment? Biological, pharmacological and clinical aspects.

    Science.gov (United States)

    Bronte, Giuseppe; Rolfo, Christian; Giovannetti, Elisa; Cicero, Giuseppe; Pauwels, Patrick; Passiglia, Francesco; Castiglia, Marta; Rizzo, Sergio; Vullo, Francesca Lo; Fiorentino, Eugenio; Van Meerbeeck, Jan; Russo, Antonio

    2014-02-01

    Gefitinib and erlotinib are the two anti-epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) approved for treatment of advanced NSCLC patients. These drugs target one of the most important pathways in lung carcinogenesis and are able to exploit the phenomenon of 'oncogene addiction', with different efficacy according to EGFR gene mutational status in tumor samples. Gefitinib has been approved only for EGFR mutation bearing patients regardless the line of treatment, while erlotinib is also indicated in patients without EGFR mutation who undergo second- or third-line treatment. Some studies evaluated the main differences between these drugs both for direct comparison and to improve their sequential use. In particular, toxicity profile resulted partially different, and these observations may be explained by several molecular and pharmacokinetic features. Therefore, this review integrates preclinical data with clinical evidences of TKIs to guide the optimization of currently available treatments in advanced NSCLC patients.

  17. Formalized prediction of clinically significant prostate cancer: is it possible?

    Institute of Scientific and Technical Information of China (English)

    Carvell T Nguyen; Michael W Kattan

    2012-01-01

    Greater understanding of the biology and epidemiology of prostate cancer in the last several decades have led to significant advances in its management.Prostate cancer is now detected in greater numbers at lower stages of disease and is amenable to multiple forms of efficacious treatment.However,there is a lack of conclusive data demonstrating a definitive mortality benefit from this earlier diagnosis and treatment of prostate cancer.It is likely due to the treatment of a large proportion of indolent cancers that would have had little adverse impact on health or lifespan if left alone.Due to this overtreatment phenomenon,active surveillance with delayed intervention is gaining traction as a viable management approach in contemporary practice.The ability to distinguish clinically insignificant cancers from those with a high risk of progression and/or lethality is critical to the appropriate selection of patients for surveillance protocols versus immediate intervention.This chapter will review the ability of various prediction models,including risk groupings and nomograms,to predict indolent disease and determine their role in the contemporary management of clinically localized prostate cancer.

  18. Acute onset of ovarian dysfunction in young females after start of cancer treatment

    DEFF Research Database (Denmark)

    Mörse, Helena; Elfving, Maria; Lindgren, Anna

    2013-01-01

    Female childhood cancer survivors are at risk of ovarian failure and premature ovarian insufficiency. We hereby present an interim analysis of a prospective observational study of ovarian function during cancer treatment of young females in relation to clinical factors.......Female childhood cancer survivors are at risk of ovarian failure and premature ovarian insufficiency. We hereby present an interim analysis of a prospective observational study of ovarian function during cancer treatment of young females in relation to clinical factors....

  19. Unique perception of clinical trials by Korean cancer patients

    Directory of Open Access Journals (Sweden)

    Lee Su Jin

    2012-12-01

    Full Text Available Abstract Background In the past few years, the number of clinical trials has increased rapidly in East Asia, especially for gastric and hepatobiliary cancer that are prevalent in Asian populations. However, the actual degree of understanding or perceptions of clinical trials by cancer patients in East Asian countries have seldom been studied. Methods Between July 1st and November 30th of 2011, we conducted a prospective study to survey cancer patients regarding their awareness of, and willingness to participate in, a clinical trial. Patients with gastrointestinal/hepatobiliary cancer who visited the Hematology-Oncology outpatient clinic at Samsung Medical Center (SMC were enrolled. A total of 21 questions were asked including four questions which used the Visual analogue scale (VAS score. Results In this survey study, 1,000 patients were asked to participate and 675 patients consented to participate (67.5%. The awareness of clinical trials was substantially higher in patients who had a higher level of education (pp=0.004, and had a higher economic status (p=0.001. However, the willingness to participate in a clinical trial was not affected by the level of education or economic status of patients. The most influential factors for patient willingness to participate were a physician recommendation (n=181, 26.8%, limited treatment options (n=178, 26.4%, and expectations of effectiveness of new anti-cancer drugs (n=142, 21.0%. Patients with previous experience in clinical trials had a greater willingness to participate in clinical trials compared to patients without previous experience (p Conclusions This large patient cohort survey study showed that Korean cancer patients are more aware of clinical trials, but awareness did not translate into willingness to participate.

  20. 奥施康定治疗中重度癌痛疗效观察%Clinical efficacy of OxyContin in the treatment of cancer pain

    Institute of Scientific and Technical Information of China (English)

    Xiaomei Li; Duanqi Liu

    2007-01-01

    Objective:To evaluate the analgesic efficacy as well as adverse effects of OxyContin for the treatment of moderate to severe cancer pain.Methods:OxyContin was administered at an initial dose of 10 ma every 12 h and titrated upwards according to the extent of pain relief.The analgesic effect,Karnofsky performance status(KPS)scale as well as adverse effects were investigated.Results:The mean onset time and duration of analgesic effect was 41 min and 12.6 h.respectively.with the daily average dose of 69.03mg.Among all the 31 patients who had suffered moderate to severe pain.slight pain relief was achieved in one patient(3.23%).Moderate,obvious and complete pain relief were achieved in 4(12.90%),20 (64.52%)and 6 (19.53%),respectively.KPS was elevated in 19 (61.29%) and stable in 9 (29.03%)patients after administration of OxyContin.3(9.68%)patients were died of disease deterioration.Main adverse effect was constipation in 10 cases(32.26%).Conclusio:OxyContin was effective in the treatment of moderate to severe cancer pain.with rapid onset,good analgesic performance,mild adverse effect and safety profile.

  1. 青年女性乳腺癌的临床治疗和病理特征分析%Analysis of Clinical Treatment and Pathological Characteristics of Breast Cancer of Young Women

    Institute of Scientific and Technical Information of China (English)

    王辉

    2015-01-01

    Objective To analyze the clinical treatment of breast cancer in young women, and to explore the pathological features. Methods 68 cases of young breast cancer patients in our hospital (observation group), and at the same time select reference object as 68 patients (control group). Results The misdiagnosis rate of observation group are high, the clinical symptoms of occult, invasive cancer was the main pathological types, and the histological grade, pathological stage and lymph node metastasis rate index compared with the control group there are differences.Conclusion Breast cancer in young and aggressive, early diagnosis is helpful for clinical treatment.%目的:探讨、分析青年女性乳腺癌的临床治疗以及病理特征。方法选取我院收治的68例青年乳腺癌患者(观察组),并同期选取68例中老年患者作为参照对象(对照组)。结果观察组存在较高的误诊率,临床症状隐匿,浸润性癌是其主要病理类型,且其组织分级、病理分期以及淋巴转移率等指标与对照组相比存在差异。结论青年乳腺癌侵袭性强,早期诊断有利于临床的治疗。

  2. Clinical Implications of Sarcopenic Obesity in Cancer.

    Science.gov (United States)

    Carneiro, Isabella P; Mazurak, Vera C; Prado, Carla M

    2016-10-01

    Sarcopenia has been associated with several negative clinical outcomes in cancer. However, the consequences of sarcopenic obesity, a condition of combined sarcopenia and obesity burden, have been less extensively investigated. The aim of this paper was to review the current evidence on the prevalence and clinical implications of sarcopenic obesity in cancer. A total of 14 studies linking sarcopenic obesity to a clinical outcome in cancer were included. There is considerable inconsistency in methods used to evaluate body composition as well as in the criteria used to define sarcopenic obesity, which limits comparison among studies. Therefore, the prevalence of sarcopenic obesity varied substantially: between 1 and 29 % in studies including individuals from all body mass index categories and between 15 and 36 % for those including obese individuals only. Negative clinical outcomes reported to be associated with sarcopenic obesity included higher risk of dose-limiting toxicity, surgical complications, physical disability, and shorter survival.

  3. Profiling critical cancer gene mutations in clinical tumor samples.

    Directory of Open Access Journals (Sweden)

    Laura E MacConaill

    Full Text Available BACKGROUND: Detection of critical cancer gene mutations in clinical tumor specimens may predict patient outcomes and inform treatment options; however, high-throughput mutation profiling remains underdeveloped as a diagnostic approach. We report the implementation of a genotyping and validation algorithm that enables robust tumor mutation profiling in the clinical setting. METHODOLOGY: We developed and implemented an optimized mutation profiling platform ("OncoMap" to interrogate approximately 400 mutations in 33 known oncogenes and tumor suppressors, many of which are known to predict response or resistance to targeted therapies. The performance of OncoMap was analyzed using DNA derived from both frozen and FFPE clinical material in a diverse set of cancer types. A subsequent in-depth analysis was conducted on histologically and clinically annotated pediatric gliomas. The sensitivity and specificity of OncoMap were 93.8% and 100% in fresh frozen tissue; and 89.3% and 99.4% in FFPE-derived DNA. We detected known mutations at the expected frequencies in common cancers, as well as novel mutations in adult and pediatric cancers that are likely to predict heightened response or resistance to existing or developmental cancer therapies. OncoMap profiles also support a new molecular stratification of pediatric low-grade gliomas based on BRAF mutations that may have immediate clinical impact. CONCLUSIONS: Our results demonstrate the clinical feasibility of high-throughput mutation profiling to query a large panel of "actionable" cancer gene mutations. In the future, this type of approach may be incorporated into both cancer epidemiologic studies and clinical decision making to specify the use of many targeted anticancer agents.

  4. Targeting hedgehog signaling in cancer: research and clinical developments

    Directory of Open Access Journals (Sweden)

    Xie J

    2013-10-01

    Full Text Available Jingwu Xie, Christopher M Bartels, Scott W Barton, Dongsheng GuWells Center for Pediatric Research, Division of Hematology and Oncology, Department of Pediatrics, Indiana University Simon Cancer Center, Indiana University, Indianapolis, IN, USAAbstract: Since its first description in Drosophila by Drs Nusslein-Volhard and Wieschaus in 1980, hedgehog (Hh signaling has been implicated in regulation of cell differentiation, proliferation, tissue polarity, stem cell maintenance, and carcinogenesis. The first link of Hh signaling to cancer was established through studies of Gorlin syndrome in 1996 by two independent teams. Later, it was shown that Hh signaling may be involved in many types of cancer, including skin, leukemia, lung, brain, and gastrointestinal cancers. In early 2012, the US Food and Drug Administration approved the clinical use of Hh inhibitor Erivedge/vismodegib for treatment of locally advanced and metastatic basal cell carcinomas. With further investigation, it is possible to see more clinical applications of Hh signaling inhibitors. In this review, we will summarize major advances in the last 3 years in our understanding of Hh signaling activation in human cancer, and recent developments in preclinical and clinical studies using Hh signaling inhibitors.Keywords: hedgehog, smoothened, PTCH1, cancer, signal transduction, clinical trials, animal model

  5. Targeting cancer epigenetics: Linking basic biology to clinical medicine.

    Science.gov (United States)

    Shinjo, Keiko; Kondo, Yutaka

    2015-12-01

    Recent studies provide compelling evidence that epigenetic dysregulation is involved in almost every step of tumor development and progression. Differences in tumor behavior, which ultimately reflects clinical outcome, can be explained by variations in gene expression patterns generated by epigenetic mechanisms, such as DNA methylation. Therefore, epigenetic abnormalities are considered potential biomarkers and therapeutic targets. DNA methylation is stable at certain specific loci in cancer cells and predominantly reflects the characteristic clinicopathological features. Thus, it is an ideal biomarker for cancer screening, classification and prognostic purposes. Epigenetic treatment for cancers is based on the pharmacologic targeting of various core transcriptional programs that sustains cancer cell identity. Therefore, targeting aberrant epigenetic modifiers may be effective for multiple processes compared with using a selective inhibitor of aberrant single signaling pathway. This review provides an overview of the epigenetic alterations in human cancers and discusses about novel therapeutic strategies targeting epigenetic alterations.

  6. Models for prevention and treatment of cancer: problems vs promises.

    Science.gov (United States)

    Aggarwal, Bharat B; Danda, Divya; Gupta, Shan; Gehlot, Prashasnika

    2009-11-01

    Current estimates from the American Cancer Society and from the International Union Against Cancer indicate that 12 million cases of cancer were diagnosed last year, with 7 million deaths worldwide; these numbers are expected to double by 2030 (27 million cases with 17 million deaths). Despite tremendous technological developments in all areas, and President Richard Nixon's initiative in the 1974 "War against Cancer", the US cancer incidence is the highest in the world and the cancer death rate has not significantly changed in the last 50 years (193.9 per 100,000 in 1950 vs 193.4 per 100,000 in 2002). Extensive research during the same time, however, has revealed that cancer is a preventable disease that requires major changes in life style; with one third of all cancers assigned to Tobacco, one third to diet, and remaining one third to the environment. Approximately 20 billion dollars are spent annually to find a cure for cancer. We propose that our inability to find a cure to cancer lies in the models used. Whether cell culture or animal studies, no model has yet been found that can reproduce the pathogenesis of the disease in the laboratory. Mono-targeted therapies, till know in most cases, have done a little to make a difference in cancer treatment. Similarly, molecular signatures/predictors of the diagnosis of the disease and response are also lacking. This review discusses the pros and cons of current cancer models based on cancer genetics, cell culture, animal models, cancer biomarkers/signature, cancer stem cells, cancer cell signaling, targeted therapies, therapeutic targets, clinical trials, cancer prevention, personalized medicine, and off-label uses to find a cure for cancer and demonstrates an urgent need for "out of the box" approaches.

  7. Clinical management of hereditary colorectal cancer syndromes.

    Science.gov (United States)

    Vasen, Hans F A; Tomlinson, Ian; Castells, Antoni

    2015-02-01

    Hereditary factors are involved in the development of a substantial proportion of all cases of colorectal cancer. Inherited forms of colorectal cancer are usually subdivided into polyposis syndromes characterized by the development of multiple colorectal polyps and nonpolyposis syndromes characterized by the development of few or no polyps. Timely identification of hereditary colorectal cancer syndromes is vital because patient participation in early detection programmes prevents premature death due to cancer. Polyposis syndromes are fairly easy to recognize, but some patients might have characteristics that overlap with other clinically defined syndromes. Comprehensive analysis of the genes known to be associated with polyposis syndromes helps to establish the final diagnosis in these patients. Recognizing Lynch syndrome is more difficult than other polyposis syndromes owing to the absence of pathognomonic features. Most investigators therefore recommend performing systematic molecular analysis of all newly diagnosed colorectal cancer using immunohistochemical methods. The implementation in clinical practice of new high-throughput methods for molecular analysis might further increase the identification of individuals at risk of hereditary colorectal cancer. This Review describes the clinical management of the various hereditary colorectal cancer syndromes and demonstrates the advantage of using a classification based on the underlying gene defects.

  8. Pregnancy associated breast cancer and pregnancy after breast cancer treatment

    OpenAIRE

    Doğer, Emek; Çalışkan, Eray; Mallmann, Peter

    2011-01-01

    Breast cancer is one of the most common cancers diagnosed during pregnancy and its frequency is increasing as more women postpone their pregnancies to their thirties and forties. Breast cancer diagnosis during pregnancy and lactation is difficult and complex both for the patient and doctors. Delay in diagnosis is frequent and treatment modalities are difficult to accept for the pregnant women. The common treatment approach is surgery after diagnosis, chemotherapy after the first trimester and...

  9. Clinical evaluation of the efficacy of external therapies of traditional Chinese medicine in treatment of cancer pain%中医外治癌性疼痛的临床评价

    Institute of Scientific and Technical Information of China (English)

    朱世杰; 贾立群; 李佩文

    2011-01-01

    中医外治癌性疼痛缺少科学的评价方法,临床研究水平有待提高.本文作者认为中医外治癌性疼痛应分清癌痛的不同类型,审因辨治,科学评价,指出了随机、双盲和对照设计的注意事项,并将吗啡滴定引入到中医外治癌性疼痛的临床研究中,既遵循了世界卫生组织三阶梯止痛原则,又不影响中医外治止痛的疗效评价.在观察指标方面,作者修订了患者疼痛日记表格,将疼痛强度评分作为中医外治癌痛的主要疗效指标,将等效吗啡用量和疼痛缓解率作为次要疗效指标.止痛起效时间、缓解持续时间和疼痛影响的评估都能反映中医外治癌痛的疗效特点.%There lack scientific methods for evaluating the treatment of cancer pain with external therapies of traditional Chinese medicine (TCM). The level of clinical study in this field needs to be improved. The authors assert that when external therapies of TCM are applied to treat cancer pain, different types of cancer pain should be distinguished and treatment should be applied according to such a differentiation. Under this framework scientific evaluation can be conducted. The authors also assert that the findings of randomized,blinded and controlled trials should be given particular attention, and it is necessary to include titration of morphine into clinical trails of external therapies for the treatment of cancer pain, not only complying with the three-ladder principle for treating cancer pain suggested by the World Health Organization, but also not influencing the effect evaluation of external therapies of TCM on cancer pain. Patient diaries recording pain were revised as observation indexes. The primary indicator of efficacy was the pain intensity score and the secondary indicators were the equivalent of morphine and the remission rate of pain. The time to onset,remission duration and comparison of assessment of pain influence can mirror the characteristics of external

  10. The benchmark analysis of gastric, colorectal and rectal cancer pathways: toward establishing standardized clinical pathway in the cancer care.

    Science.gov (United States)

    Ryu, Munemasa; Hamano, Masaaki; Nakagawara, Akira; Shinoda, Masayuki; Shimizu, Hideaki; Miura, Takeshi; Yoshida, Isao; Nemoto, Atsushi; Yoshikawa, Aki

    2011-01-01

    Most clinical pathways in treating cancers in Japan are based on individual physician's personal experiences rather than on an empirical analysis of clinical data such as benchmark comparison with other hospitals. Therefore, these pathways are far from being standardized. By comparing detailed clinical data from five cancer centers, we have observed various differences among hospitals. By conducting benchmark analyses, providing detailed feedback to the participating hospitals and by repeating the benchmark a year later, we strive to develop more standardized clinical pathways for the treatment of cancers. The Cancer Quality Initiative was launched in 2007 by five cancer centers. Using diagnosis procedure combination data, the member hospitals benchmarked their pre-operative and post-operative length of stays, the duration of antibiotics administrations and the post-operative fasting duration for gastric, colon and rectal cancers. The benchmark was conducted by disclosing hospital identities and performed using 2007 and 2008 data. In the 2007 benchmark, substantial differences were shown among five hospitals in the treatment of gastric, colon and rectal cancers. After providing the 2007 results to the participating hospitals and organizing several brainstorming discussions, significant improvements were observed in the 2008 data study. The benchmark analysis of clinical data is extremely useful in promoting more standardized care and, thus in improving the quality of cancer treatment in Japan. By repeating the benchmark analyses, we can offer truly clinical evidence-based higher quality standardized cancer treatment to our patients.

  11. Safe eating during cancer treatment

    Science.gov (United States)

    ... to 165°F (73.9°C). Warm hot dogs and lunch meats to steaming before you eat ... National Cancer Institute: PDQ Nutrition in cancer care. Bethesda, MD: National Cancer Institute. Updated January 8, 2016. www.cancer. ...

  12. [Borderline resectable pancreatic cancer - a definition and effective treatment strategy].

    Science.gov (United States)

    Yokoyama, Yukihiro; Ebata, Tomoki; Igami, Tsuyoshi; Sugawara, Gen; Takahashi, Yuh; Kokuryo, Toshio; Tsunoda, Nobuyuki; Fukaya, Masahide; Uehara, Keisuke; Itatsu, Keita; Yoshioka, Yuichiro; Nagino, Masato

    2012-03-01

    The survival benefit of extended surgery for advanced pancreatic cancer has been denied by four randomized controlled trials. However, there still is confusion and conflict over the definition and effective treatment strategy for so-called locally advanced or borderline resectable pancreatic cancer. Although there are a number of reports that showed outcomes of preoperative chemotherapy or chemoradiotherapy for this disease, the definitions and treatment regimens described in these studies vary. Moreover, all of the studies were Phase I / II trials or retrospective analysis, and there is no Phase III trial currently focused on this issue. It is urgently necessary to establish an international consensus on the definition of borderline resectable pancreatic cancer. The usefulness of neoadjuvant treatment for this disease should also be elucidated in future clinical trials. In this review article, we discuss the current understanding and definition of borderline resectable pancreatic cancer, and the value of neoadjuvant treatment strategy for treating it.

  13. Depression Treatment Patterns among Elderly with Cancer

    Directory of Open Access Journals (Sweden)

    Patricia A. Findley

    2012-01-01

    Full Text Available Little is known about cancer treatment patterns among the elderly as depression and cancer in this older population have not been well explored. This study seeks to fill a gap in the literature by using data from the Medicare Current Beneficiary Survey from years 2000–2005 to examine depression treatment patterns among elderly diagnosed with both cancer and depression. Depression treatments examined include antidepressants with and without psychotherapy. We found that of those with both cancer and depression, 57.7% reported antidepressant use only, 19.7% received psychotherapy with or without antidepressants, and 22.6% had no depression treatment. We found those with greater comorbidity, of a minority race, with lower levels of education, and living in rural areas were less likely to receive treatment for depression. These findings highlight the need to address disparities in the treatment of depression in the elderly population with cancer.

  14. Gastric Cancer: Current Status of Diagnosis and Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Tsunehiro; Saikawa, Yoshiro, E-mail: saiky@z8.keio.jp; Kitagawa, Yuko [Department of Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo 1608582 (Japan)

    2013-01-16

    Gastric cancer is the second leading cause of death from malignant disease worldwide and most frequently discovered in advanced stages. Because curative surgery is regarded as the only option for cure, early detection of resectable gastric cancer is extremely important for good patient outcomes. Therefore, noninvasive diagnostic modalities such as evolutionary endoscopy and positron emission tomography are utilized as screening tools for gastric cancer. To date, early gastric cancer is being treated using minimally invasive methods such as endoscopic treatment and laparoscopic surgery, while in advanced cancer it is necessary to consider multimodality treatment including chemotherapy, radiotherapy, and surgery. Because of the results of large clinical trials, surgery with extended lymphadenectomy could not be recommended as a standard therapy for advanced gastric cancer. Recent clinical trials had shown survival benefits of adjuvant chemotherapy after curative resection compared with surgery alone. In addition, recent advances of molecular targeted agents would play an important role as one of the modalities for advanced gastric cancer. In this review, we summarize the current status of diagnostic technology and treatment for gastric cancer.

  15. Clinical Cancer Advances 2017: Annual Report on Progress Against Cancer From the American Society of Clinical Oncology.

    Science.gov (United States)

    Burstein, Harold J; Krilov, Lada; Aragon-Ching, Jeanny B; Baxter, Nancy N; Chiorean, E Gabriela; Chow, Warren Allen; De Groot, John Frederick; Devine, Steven Michael; DuBois, Steven G; El-Deiry, Wafik S; Epstein, Andrew S; Heymach, John; Jones, Joshua Adam; Mayer, Deborah K; Miksad, Rebecca A; Pennell, Nathan A; Sabel, Michael S; Schilsky, Richard L; Schuchter, Lynn Mara; Tung, Nadine; Winkfield, Karen Marie; Wirth, Lori J; Dizon, Don S

    2017-02-01

    A MESSAGE FROM ASCO'S PRESIDENT I am pleased to present Clinical Cancer Advances 2017, which highlights the most promising advances in patient-oriented cancer research over the past year. The report gives us an opportunity to reflect on what an exciting time it is for cancer research and how swiftly our understanding of cancer has improved. One year ago, the White House announced the national Cancer Moonshot program to accelerate progress against cancer. This shared vision of progress has reinvigorated the research community, identified new areas of scientific collaboration, and raised our ambitions regarding what may be possible beyond the progress we have already made. When I entered the field 35 years ago, I could not have imagined where we would be today. We can now detect cancer earlier, target treatments more effectively, and manage adverse effects more effectively to enable patients to live better, more fulfilling lives. Today, two of three people with cancer live at least 5 years after diagnosis, up from roughly one of two in the 1970s. This progress has resulted from decades of incremental advances that have collectively expanded our understanding of the molecular underpinnings of cancer. There is no better current example of this than ASCO's 2017 Advance of the Year: Immunotherapy 2.0. Over the last year, there has been a wave of new successes with immunotherapy. Research has proven this approach can be effective against a wide range of hard-to-treat advanced cancers previously considered intractable. Researchers are now working to identify biologic markers that can help increase the effectiveness of treatment and determine who is most likely to benefit from immunotherapy. This knowledge will enable oncologists to make evidence-based decisions so as many patients as possible might benefit from this new type of treatment. Each successive advance builds on the previous hard work of generations of basic, translational, and clinical cancer researchers

  16. Lung Cancer Gene Signatures and Clinical Perspectives

    Directory of Open Access Journals (Sweden)

    Ruprecht Kuner

    2013-12-01

    Full Text Available Microarrays have been used for more than two decades in preclinical research. The tumor transcriptional profiles were analyzed to select cancer-associated genes for in-deep functional characterization, to stratify tumor subgroups according to the histopathology or diverse clinical courses, and to assess biological and cellular functions behind these gene sets. In lung cancer—the main type of cancer causing mortality worldwide—biomarker research focuses on different objectives: the early diagnosis of curable tumor diseases, the stratification of patients with prognostic unfavorable operable tumors to assess the need for further therapy regimens, or the selection of patients for the most efficient therapies at early and late stages. In non-small cell lung cancer, gene and miRNA signatures are valuable to differentiate between the two main subtypes’ squamous and non-squamous tumors, a discrimination which has further implications for therapeutic schemes. Further subclassification within adenocarcinoma and squamous cell carcinoma has been done to correlate histopathological phenotype with disease outcome. Those tumor subgroups were assigned by diverse transcriptional patterns including potential biomarkers and therapy targets for future diagnostic and clinical applications. In lung cancer, none of these signatures have entered clinical routine for testing so far. In this review, the status quo of lung cancer gene signatures in preclinical and clinical research will be presented in the context of future clinical perspectives.

  17. CLINICAL CASE OF A MASSIVE ISOLA TED METASTATIC ADRENAL LESION IN COLORECT AL CANCER

    Directory of Open Access Journals (Sweden)

    I. P. Moshurov

    2015-01-01

    Full Text Available AbstractThe liver, lungs, parietal and visceral peritoneum have traditionally been considered to be the main target organs of metastatic colorectal cancer. The isolated adrenal metastasis in colorectal cancer is rare, in the literature there are single observations of clinical cases of successful surgical treatment of such patients. This article presents the clinical observation of successful surgical treatment of patients with colorectal cancer with massive isolated adrenal metastases.

  18. [Rectal cancer: diagnosis, screening and treatment].

    Science.gov (United States)

    Decanini-Terán, César Oscar; González-Acosta, Jorge; Obregón-Méndez, Jorge; Vega-de Jesús, Martín

    2011-01-01

    Rectal cancer is one of the primary malignant neoplasms occurring in Mexican patients of reproductive age. Unfortunately, randomized studies in rectal cancer do not exist as they do with well-recognized colon cancer. We must individualize the epidemiology, risk factors, diagnostic approach, staging and treatment because management is different in rectal cancers affecting the mid- and lower third of the rectum than in the upper third and in colon cancers. Histological staging is the primary prognostic factor. TNM staging (tumor, node, and metastasis) is used internationally by the American Joint Committee on Cancer (AJCC). Staging is done with the assistance of endorectal ultrasound, which is best used in early-stage cancer; however, there are certain disadvantages in detecting node involvement. Magnetic resonance, on the other hand, allows for the evaluation of stenotic tumors and node involvement. Once the correct diagnosis and staging have been made, the next step is correct treatment. Neoadjuvant treatment has demonstrated to be better than adjuvant treatment. Abdominoperineal resection is rarely practiced currently, with sphincter preservation being the preferred procedure. Laparoscopic approach has conferred the advantages of the approach itself when performed by experts in the procedure but there is insufficient evidence to make it the "gold standard." Rectal cancer is a complex pathology that must be considered totally different from colon cancer for diagnosis and treatment. The patient must be staged completely and appropriately for individualizing correct treatment. More long-term studies are needed for optimizing treatment modalities.

  19. Cervical cancer screening and treatment in Uganda

    Directory of Open Access Journals (Sweden)

    Carolyn Nakisige

    2017-05-01

    Training of health professionals, ongoing construction of new radiotherapy bunkers, and opening of regional centers are all geared towards improving cervical cancer care in Uganda. The Uganda Cancer Institute Bill establishes the Institute as a semi-autonomous agency mandated to undertake and coordinate the prevention and treatment of cancer. Its implementation will be a milestone in cervical cancer prevention and control. However, execution will require political will and an increase in domestic and international investment.

  20. ERS/ESTS clinical guidelines on the fitness of patients for radical treatment of lung cancer (surgery and chemo-radiotherapy

    Directory of Open Access Journals (Sweden)

    Vlasis Polychronopoulos

    2010-01-01

    Full Text Available SUMMARY. Collaboration of a multidisciplinary team of experts on the functional evaluation of patients with lung cancer was facilitated by the European Respiratory Society (ERS and the European Society of Thoracic Surgery (ESTS, in order to draw up recommendations and provide clinicians with clear, up-to-date guidelines on their fitness for surgery and chemo-radiotherapy. The subject was divided into various different topics, each of which was then assigned to at least two experts. The authors searched the literature according to their own strategies, with no central literature Review and compiled draft reports on each topic, which were then reviewed, discussed and voted on by the entire expert panel. The evidence supporting each recommendation was summarized, and graded as described by the Scottish Intercollegiate Guidelines Network Grading Review Group. Clinical practice guidelines were generated and finalized in a functional algorithm for risk stratification of the lung resection candidates, with emphasis on the cardiological evaluation, forced expiratory volume in 1 s (FEV1, systematic carbon monoxide lung diffusion capacity (DLCO and exercise testing. In contrast to lung resection, for which the scientific evidence is more robust, it was not possible to recommend any specific test, cut-off value, or algorithm for chemo-radiotherapy, due to the lack of data. It is highly recommended that patients with lung cancer should be managed in specialized units by experienced multidisciplinary teams. Pneumon 2010, 23(1:80-102.

  1. Professor SUN Gui-zhi's Clinical Experience of Using Herbal Medicine for Testicular Cancer Treatment%孙桂芝教授治疗睾丸癌经验

    Institute of Scientific and Technical Information of China (English)

    王辉; 孙桂芝

    2011-01-01

    Testicular cancer is one of the most common male reproductive system tumors. Professor SUN Gui-zhi who has been treating this disease for several years in Guang1 anmen hospital affiliated to China Academy of Chinese Medical Sciences sums up her experience and raises an Chinese medicine theory that the function of liver, spleen and kidney is the spindle in testicular cancer treting. And she always uses Chinese medicine methods called "yipishen" , "wenxiaojiao" , "sanhanshi" , "pojiqi" , 'heqixue" , "tongxuemai" , "chu'edu" and so on to adjust this spindle under the principle of differentiation symptoms and differentiation deseases. As results, her patients always access good clinical effects.%睾丸肿瘤是男性生殖系统最常见的肿瘤.中国中医科学院广安门医院肿瘤科孙桂芝教授从中医脏象理论的肝、脾、肾三脏功能为主轴,通过补肝肾、温下焦、散寒湿、破积气、和气血、通血脉、除恶毒等治法,辨证与辨病相结合,临床获得良好疗效.

  2. Guipi decoction combined with clinical observation of moxibustion for treatment of cancer cachexia%归脾汤加减配合艾灸治疗癌性恶病质的临床观察

    Institute of Scientific and Technical Information of China (English)

    孙素芹; 高磊; 常丽

    2014-01-01

    To observe the clinical therapeutic effect of Guipi Decoction Combined with moxibustion for treatment of cancer cachexia .Methods:All the 30 patients with Guipi Decoction Combined with moxibustion ,and observing the recent curative effect .Results:Some clinical symptoms relieved or disappeared , The majority of the patients appetite improved .Conclusion:Guipi Decoction Combined with moxibustion for treatment of cancer cachexia could receive good clinical results .%目的:观察归脾汤加减配合艾灸治疗癌性恶病质的临床疗效。方法:30例患者均用归脾汤加减内服,同时配合艾灸,观察近期疗效。结果:患者的临床症状部分缓解或消失,多数患者食欲得到改善。结论:归脾汤加减配合艾灸治疗癌性恶病质收到较好的临床效果。

  3. Prostate cancer epigenetics and its clinical implications

    Directory of Open Access Journals (Sweden)

    Srinivasan Yegnasubramanian

    2016-01-01

    Full Text Available Normal cells have a level of epigenetic programming that is superimposed on the genetic code to establish and maintain their cell identity and phenotypes. This epigenetic programming can be thought as the architecture, a sort of cityscape, that is built upon the underlying genetic landscape. The epigenetic programming is encoded by a complex set of chemical marks on DNA, on histone proteins in nucleosomes, and by numerous context-specific DNA, RNA, protein interactions that all regulate the structure, organization, and function of the genome in a given cell. It is becoming increasingly evident that abnormalities in both the genetic landscape and epigenetic cityscape can cooperate to drive carcinogenesis and disease progression. Large-scale cancer genome sequencing studies have revealed that mutations in genes encoding the enzymatic machinery for shaping the epigenetic cityscape are among the most common mutations observed in human cancers, including prostate cancer. Interestingly, although the constellation of genetic mutations in a given cancer can be quite heterogeneous from person to person, there are numerous epigenetic alterations that appear to be highly recurrent, and nearly universal in a given cancer type, including in prostate cancer. The highly recurrent nature of these alterations can be exploited for development of biomarkers for cancer detection and risk stratification and as targets for therapeutic intervention. Here, we explore the basic principles of epigenetic processes in normal cells and prostate cancer cells and discuss the potential clinical implications with regards to prostate cancer biomarker development and therapy.

  4. Prostate cancer epigenetics and its clinical implications.

    Science.gov (United States)

    Yegnasubramanian, Srinivasan

    2016-01-01

    Normal cells have a level of epigenetic programming that is superimposed on the genetic code to establish and maintain their cell identity and phenotypes. This epigenetic programming can be thought as the architecture, a sort of cityscape, that is built upon the underlying genetic landscape. The epigenetic programming is encoded by a complex set of chemical marks on DNA, on histone proteins in nucleosomes, and by numerous context-specific DNA, RNA, protein interactions that all regulate the structure, organization, and function of the genome in a given cell. It is becoming increasingly evident that abnormalities in both the genetic landscape and epigenetic cityscape can cooperate to drive carcinogenesis and disease progression. Large-scale cancer genome sequencing studies have revealed that mutations in genes encoding the enzymatic machinery for shaping the epigenetic cityscape are among the most common mutations observed in human cancers, including prostate cancer. Interestingly, although the constellation of genetic mutations in a given cancer can be quite heterogeneous from person to person, there are numerous epigenetic alterations that appear to be highly recurrent, and nearly universal in a given cancer type, including in prostate cancer. The highly recurrent nature of these alterations can be exploited for development of biomarkers for cancer detection and risk stratification and as targets for therapeutic intervention. Here, we explore the basic principles of epigenetic processes in normal cells and prostate cancer cells and discuss the potential clinical implications with regards to prostate cancer biomarker development and therapy.

  5. Future directions in the treatment of neuroendocrine tumors: consensus report of the National Cancer Institute Neuroendocrine Tumor clinical trials planning meeting.

    Science.gov (United States)

    Kulke, Matthew H; Siu, Lillian L; Tepper, Joel E; Fisher, George; Jaffe, Deborah; Haller, Daniel G; Ellis, Lee M; Benedetti, Jacqueline K; Bergsland, Emily K; Hobday, Timothy J; Van Cutsem, Eric; Pingpank, James; Oberg, Kjell; Cohen, Steven J; Posner, Mitchell C; Yao, James C

    2011-03-01

    Neuroendocrine tumors (NETs) arise from a variety of anatomic sites and share the capacity for production of hormones and vasoactive peptides. Because of their perceived rarity, NETs have not historically been a focus of rigorous clinical research. However, the diagnosed incidence of NETs has been increasing, and the estimated prevalence in the United States exceeds 100,000 individuals. The recent completion of several phase III studies, including those evaluating octreotide, sunitinib, and everolimus, has demonstrated that rigorous evaluation of novel agents in this disease is both feasible and can lead to practice-changing outcomes. The NET Task Force of the National Cancer Institute GI Steering Committee convened a clinical trials planning meeting to identify key unmet needs, develop appropriate study end points, standardize clinical trial inclusion criteria, and formulate priorities for future NET studies for the US cooperative group program. Emphasis was placed on the development of well-designed clinical trials with clearly defined efficacy criteria. Key recommendations include the evaluation of pancreatic NET separately from NETs of other sites and the exclusion of patients with poorly differentiated histologies from trials focused on low-grade histologies. Studies evaluating novel agents for the control of hormonal syndromes should avoid somatostatin analog washout periods when possible and should include quality-of-life end points. Because of the observed long survival after progression of many patients, progression-free survival is recommended as a feasible and relevant primary end point for both phase III studies and phase II studies where a delay in progression is expected in the absence of radiologic responses.

  6. Pulmonary Complications of Childhood Cancer Treatment

    NARCIS (Netherlands)

    Versluijs, AB; Bresters, Dorine

    2016-01-01

    Pulmonary complications of childhood cancer treatment are frequently seen. These can lead to adverse sequelae many years after treatment, with important impact on morbidity, quality of life and mortality in childhood cancer survivors. This review addresses the effects of chemotherapy, radiotherapy,

  7. Hopes Dashed for Rare Bone Cancer Treatment

    Science.gov (United States)

    ... news/fullstory_160652.html Hopes Dashed for Rare Bone Cancer Treatment Extra chemo drugs failed to change course of ... t benefit patients with a rare type of bone cancer, according to a new ... teenagers. With current treatments, only 65 to 70 percent of patients live ...

  8. Molecular and Clinical Markers of Pancreas Cancer

    OpenAIRE

    James L Buxbaum; Eloubeidi, Mohamad A

    2010-01-01

    Pancreas cancer has the worst prognosis of any solid tumor but is potentially treatable if it is diagnosed at an early stage. Thus there is critical interest in delineating clinical and molecular markers of incipient disease. The currently available biomarker, CA 19-9, has an inadequate sensitivity and specificity to achieve this objective. Diabetes mellitus, tobacco use, and chronic pancreatitis are associated with pancreas cancer. However, screening is currently only recommended in those wi...

  9. Molecular and Clinical Markers of Pancreas Cancer

    Directory of Open Access Journals (Sweden)

    James L Buxbaum

    2010-11-01

    Full Text Available Pancreas cancer has the worst prognosis of any solid tumor but is potentially treatable if it is diagnosed at an early stage. Thus there is critical interest in delineating clinical and molecular markers of incipient disease. The currently available biomarker, CA 19-9, has an inadequate sensitivity and specificity to achieve this objective. Diabetes mellitus, tobacco use, and chronic pancreatitis are associated with pancreas cancer. However, screening is currently only recommended in those with hereditary pancreatitis and genetic syndromes which predispose to cancer. Ongoing work to identify early markers of pancreas cancer consists of high throughput discovery methods including gene arrays and proteomics as well as hypothesis driven methods. While several promising candidates have been identified none has yet been convincingly proven to be better than CA 19-9. New methods including endoscopic ultrasound are improving detection of pancreas cancer and are being used to acquire tissue for biomarker discovery.

  10. The Brustkrebs-Studien.de website for breast cancer patients: User acceptance of a German internet portal offering information on the disease and treatment options, and a clinical trials matching service

    Directory of Open Access Journals (Sweden)

    Hartkopf Andreas D

    2010-12-01

    Full Text Available Abstract Background The internet portal http://www.brustkrebs-studien.de (BKS was launched in 2000 by the German Society of Senology (DGS and the Baden-Württemberg Institute for Women's Health (IFG to provide expert-written information on breast cancer online and to encourage and facilitate the participation of breast cancer patients in clinical trials. We describe the development of BKS and its applications, and report on website statistics and user acceptance. Methods Existing registries, including ClinicalTrials.gov, were analysed before we designed BKS, which combines a trial registry, a knowledge portal, and an online second opinion service. An advisory board guided the process. Log files and patient enquiries for trial participation and second opinions were analysed. A two-week user satisfaction survey was conducted online. Results During 10/2005-06/2010, the portal attracted 702,655 visitors, generating 15,507,454 page views. By 06/2010, the website's active scientific community consisted of 189 investigators and physicians, and the registry covered 163 clinical trial protocols. In 2009, 143 patients requested trial enrolment and 119 sought second opinions or individual treatment advice from the expert panel. During the two-week survey in 2008, 5,702 BKS visitors submitted 507 evaluable questionnaires. Portal acceptance was high. Respondents trusted information correctness (80%, welcomed self-matching to clinical trials (79% and planned to use the portal in the future (76% and recommend it to others (81%. Conclusions BKS is an established and trusted breast cancer information platform offering up-to-date resources and protocols to the growing physician and patient community to encourage participation in clinical trials. Further studies are needed to assess potential increases in trial enrolment by eligibility matching services.

  11. The Brustkrebs-Studien.de website for breast cancer patients: User acceptance of a German internet portal offering information on the disease and treatment options, and a clinical trials matching service

    Science.gov (United States)

    2010-01-01

    Background The internet portal http://www.brustkrebs-studien.de (BKS) was launched in 2000 by the German Society of Senology (DGS) and the Baden-Württemberg Institute for Women's Health (IFG) to provide expert-written information on breast cancer online and to encourage and facilitate the participation of breast cancer patients in clinical trials. We describe the development of BKS and its applications, and report on website statistics and user acceptance. Methods Existing registries, including ClinicalTrials.gov, were analysed before we designed BKS, which combines a trial registry, a knowledge portal, and an online second opinion service. An advisory board guided the process. Log files and patient enquiries for trial participation and second opinions were analysed. A two-week user satisfaction survey was conducted online. Results During 10/2005-06/2010, the portal attracted 702,655 visitors, generating 15,507,454 page views. By 06/2010, the website's active scientific community consisted of 189 investigators and physicians, and the registry covered 163 clinical trial protocols. In 2009, 143 patients requested trial enrolment and 119 sought second opinions or individual treatment advice from the expert panel. During the two-week survey in 2008, 5,702 BKS visitors submitted 507 evaluable questionnaires. Portal acceptance was high. Respondents trusted information correctness (80%), welcomed self-matching to clinical trials (79%) and planned to use the portal in the future (76%) and recommend it to others (81%). Conclusions BKS is an established and trusted breast cancer information platform offering up-to-date resources and protocols to the growing physician and patient community to encourage participation in clinical trials. Further studies are needed to assess potential increases in trial enrolment by eligibility matching services. PMID:21126358

  12. 67 INVITED Personalized surgical treatment for early breast cancer

    National Research Council Canada - National Science Library

    Rutgers, E

    2007-01-01

    ... belongtothemodernsurgicalapproachinthebattleagainstlocalisedand locallyadvancedprostatecancer. 67 INVITED Personalized surgical treatment for early breast cancer E.Rutgers. The Netherlands Cancer Institute, Department...

  13. Systemic treatment for hereditary cancers: a 2012 update

    OpenAIRE

    Imyanitov, Evgeny N; Byrski, Tomasz

    2013-01-01

    The history of specific therapy for hereditary tumors dates back to mid 1980s and involves a number of reports demonstrating regression of familial colon polyps upon administration of sulindac. Virtually no clinical studies on other hereditary cancer types were available until the year 2009, when Byrski et al. presented the data on unprecedented sensitivity of BRCA1-associated breast malignancies to cisplatin. This breakthrough has revived interest to the treatment of cancer in germ-line muta...

  14. Potential utility of cancer-specific biomarkers for assessing response to hormonal treatments in metastatic prostate cancer

    NARCIS (Netherlands)

    Schalken, J.; Dijkstra, S.; Baskin-Bey, E.; Oort, I. van

    2014-01-01

    Prostate cancer is the second leading cause of cancer death in men and there is an urgent clinical need to improve its detection and treatment. The introduction of prostate-specific antigen (PSA) as a biomarker for prostate cancer several decades ago represented an important step forward in our abil

  15. Clinical Study of S-1 Plus Oxaliplatin Versus S-1 Plus Cisplatin as First-Line Treatment for Elderly Patients with Advanced Gastric Cancer

    Directory of Open Access Journals (Sweden)

    Deng-feng BO

    2015-12-01

    Full Text Available Abstract Objective: To explore the efficacy and safety of S-1 plus oxaliplatin versus S-1 plus cisplatin as the first-line treatment for elderly patients with advanced gastric cancer. Methods: A total of 60 patients with advanced gastric cancer admitted in Xi’an Yanliang Railway Hospital from Jan., 2011 to Oct., 2013 were selected as study objects and randomly divided into 2 groups: S1 plus oxaliplatin group (SOX group, 30 cases and S1 plus cisplatin group (SP group, 30 cases. SOX group were given intravenous drip of 130 mg/m2 oxaliplatin for 2 h on d1. And S-1 was also given according to body surface area: body surface area <1.25 m2, 40 mg once; 1.25-1.5 m2, 60 mg once; >1.5, 28 d as 1 cycle. SP group was administered with intravenous drip of 25 mg/m2 cisplatin during d1-d3. Treatment was discontinued until the occurrence of disease progression or patients’ intolerance to chemotherapy. Results: SOX group was non-inferior to SP group in overall response rate (ORR (53.3% vs. 43.3%, disease control rate (DCR (83.3% vs. 80.0%, median progression-free survival (PFS (7.0 vs. 6.0 months and median overall survival (OS (11.0 vs. 10.5 months. However, the difference was statistical significant in the rate of increased KPS score (86.7% vs. 46.7%, χ2=10.800, P=0.001 and the rate of increased FACT-G score (73.3% vs. 36.7%, χ2=8.148, P=0.004. The main toxic and side effects of two groups was hematological toxicity. There was no degree III-IV toxic and side effects occurring in non hematological toxicity in two groups. The main toxic effect was peripheral neuritis in SOX group, and nausea and vomiting and renal dysfunction in SP group, and there were statistical differences in the above toxic and side effects between two groups (P<0.05. Conclusion: SOX regimen is as safe and effective as SP regimen for elderly patients with advanced gastric cancer, with better quality of life and less toxic and side effects.

  16. New Prostate Cancer Treatment Target

    Science.gov (United States)

    Researchers have identified a potential alternative approach to blocking a key molecular driver of an advanced form of prostate cancer, called androgen-independent or castration-resistant prostate cancer.

  17. Current treatment options for colon cancer peritoneal carcinomatosis.

    Science.gov (United States)

    Aoyagi, Tomoyoshi; Terracina, Krista P; Raza, Ali; Takabe, Kazuaki

    2014-09-21

    Peritoneal carcinomatosis (PC), the dissemination of cancer cells throughout the lining of the abdominal cavity, is the second most common presentation of colon cancer distant metastasis. Despite remarkable advances in cytotoxic chemotherapy and targeted therapy for colon cancer over the last 15 years, it has been repeatedly shown that these therapies remain ineffective for colon cancer PC. Recently, there has been a rapid accumulation of reports that cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) prolongs the life of colon cancer PC patients. Here, we will review the clinical presentation, the mechanisms of disease progression, and current treatment options for colon cancer PC, with a focus on the benefits and limitations of CRS-HIPEC.

  18. Clinical Study of Pemetrexed as the First-line Treatment in Elderly Patients with Advanced Non-squamous Non-small Cell Lung Cancer

    Directory of Open Access Journals (Sweden)

    Xiaolin Pu

    2013-12-01

    Full Text Available Objective: To evaluate the efficacy and adverse reactions of pemetrexed as the first-line treatment in elderly patients with advanced non-squamous non-small-cell lung cancer (NSCLC. Methods: The elderly patients with advanced non-squamous NSCLC received pemetrexed as the first-line treatment were retrospectively analyzed. All of them were intravenously injected 500 mg/ m2 pemetrexed, and 21 days were as one cycle. The efficiency was evaluated every two cycles till the disease progressed or sever adverse reactions occurred. The condition of adverse reactions as well as final outcome were observed. Results: Eighty-seven patients were enrolled in the research, totally receiving 392 cycles of chemotherapy, and the mean for 1 patient being 4.5 cycles. After 2 cycles of chemotherapy, partial response (PR and stable disease (SD were respectively 39 and 18 cases. The response rate and disease control rate were 44.8% and 65.5%, respectively. The median overall survival (OS of all patients was 16.1 months, and median progression-free survival (PFS was 3.2 months. Twenty-five patients completed 4 cycles of chemotherapy, and 32 patients completed 6 cycles of chemotherapy at least. The median OS of patients > 4 cycles of chemotherapy was 17.4 months, while those ≤ 4 cycles was 13.6 months, and the difference had statistical significance (χ2 = 4.374, P = 0.036. The major adverse reactions included myelosuppression, fatigue and gastrointestinal reactions, mainly at grades 1 - 2. No treatment-related deaths occurred. Conclusion: The efficiency of pemetrexed is definite as the first-line treatment in elderly patients with advanced non-squamous NSCLC, and the incidence of adverse reactions is low. The prognosis of patients is associated with cycles of pemetrexed chemotherapy.

  19. Diagnosis and Treatment of Multiple Primary Lung Cancer

    Directory of Open Access Journals (Sweden)

    Jingjing HOU

    2015-12-01

    Full Text Available Multiple primary lung cancer (MPLC is an uncommon entity of the primary lung cancer. With the widespread use of early detection tools such as multislice spiral computed tomography (CT, positron emission tomography (PET, and the better survival results after resection of primary lung cancer, more and more MPLC have been detected. However, the current diagnostic and therapeutic methods cannot meet the needs of MPLC individualized demand of diagnosis and treatment. At present, diagnostic criteria of MPLC are based on histological types, genetic characteristics, image features, tumor locations and clinical manifestation. On the treatment of MPLC, Surgery-based multi-discipline comprehensive treatment is regarded as the treatment of choice. In this paper, we make a review through summarizing the latest literature progress on the epidemiology, etiology, diagnostic criteria, treatment options and prognosis of MPLC.

  20. CANCER PAIN ASSESSMENT AND TREATMENT

    African Journals Online (AJOL)

    their management of a hypothetical patient who had severe cancer pain and also asked questions on other issues ... hypothetical patient with terminal pelvic cancer presenting in the .... one of the impediments to adequate analgesic therapy f 'or cancer ... physician attitude and the prevailing culture of the institute where.

  1. Molecular biology of breast cancer stem cells: potential clinical applications.

    Science.gov (United States)

    Nguyen, Nam P; Almeida, Fabio S; Chi, Alex; Nguyen, Ly M; Cohen, Deirdre; Karlsson, Ulf; Vinh-Hung, Vincent

    2010-10-01

    Breast cancer stem cells (CSC) have been postulated recently as responsible for failure of breast cancer treatment. The purpose of this study is to review breast CSCs molecular biology with respect to their mechanism of resistance to conventional therapy, and to develop treatment strategies that may improve survival of breast cancer patients. A literature search has identified in vitro and in vivo studies of breast CSCs. Breast CSCs overexpress breast cancer resistance protein (BCRP) which allows cancer cells to transport actively chemotherapy agents out of the cells. Radioresistance is modulated through activation of Wnt signaling pathway and overexpression of genes coding for glutathione. Lapatinib can selectively target HER-2 positive breast CSCs and improves disease-free survival in these patients. Metformin may target basal type breast CSCs. Parthenolide and oncolytic viruses are promising targeting agents for breast CSCs. Future clinical trials for breast cancer should include anti-cancer stem cells targeting agents in addition to conventional chemotherapy. Hypofractionation radiotherapy may be indicated for residual disease post chemotherapy.

  2. [Hyperandrogenism: clinical aspects, investigation and treatment].

    Science.gov (United States)

    Beckers, A; Parotte, M C; Gaspard, U; Khalife, A

    1999-04-01

    Androgen excess (AE) is one of the most common endocrine disorders, affecting 10% of adult women before the menopause. The clinical picture varies widely depending on the etiology of AE. Most of these women are suffering from hirsutism, acne, menstrual disturbances, anovulation and obesity. Virilization is unusual, except in patients with ovary or adrenal cancer. Polycystic ovary syndrome (PCOS) and idiopathic hirsutism (IH) are the most frequent causes of androgen excess, accounting for more than 90% of the cases. The pathogenesis of PCOS is still an unresolved problem. A hereditary predisposition has been suggested. Enzymatic deficiency is a less frequent cause of AE, the most common deficiency being the non classic 21-OH deficiency (NCAH). AE has been implicated as a side effect of many drugs. Ovary and adrenal tumours are unusual, however, they must be considered especially in case of severe hirsutism or virilization. Complementary investigations are selected based on the result of clinical examination. Pharmacologic therapy, usually with anti-androgens, is the most widely used treatment for PCOS, IH and NCAH. Surgical therapy should be considered only when there is a particular indication such as Cushing's syndrome, ovary or adrenal tumours.

  3. Three Good Reasons to See a Dentist Before Cancer Treatment

    Science.gov (United States)

    ... Three Good Reasons to See a Dentist BEFORE Cancer Treatment Main Content Protect Your Mouth During Cancer Treatment ... should include a dentist. Protect Your Mouth During Cancer Treatment Brush gently, brush often Brush your teeth—and ...

  4. Clinical roundtable monograph: Recent advances in taxanes for the first-line treatment of advanced non-small cell lung cancer.

    Science.gov (United States)

    Socinski, Mark A; Govindan, Ramaswamy; Spigel, David

    2012-10-01

    Treatments for non-small cell lung cancer (NSCLC) are based on the broad categories of squamous or non-squamous histology. Frontline treatment options include pemetrexed and cisplatin, pemetrexed and a taxane, gemcitabine with cisplatin, and the addition of bevacizumab to a taxane and carboplatin. Pemetrexed is used for maintenance therapy for non-squamous NSCLC, whereas patients with squamous NSCLC lack easy options for maintenance therapy. nab-Paclitaxel overcomes the solubility and toxicity issues of solvent-based paclitaxel, and the albumin in nab-paclitaxel improves the concentration of the drug in the tumor. A recent phase III trial in NSCLC compared nab-paclitaxel with carboplatin versus solvent-based paclitaxel with carboplatin, and found improved overall response rates (ORRs) in the nab-paclitaxel arm (33% vs 25%; P=.005). In a subset analysis, NSCLC patients with squamous histology had a higher ORR (41%) with nab-paclitaxel than with solvent-based paclitaxel (24%; P<.001). Another subset analysis found that patients ages 70 years and older had improved overall survival (median 19.9 months) with nab-paclitaxel compared with solvent-based paclitaxel (median 10.4 months; P=.009). Patients in the nab-paclitaxel arm had less neuropathy, less hearing loss, and fewer interruptions in daily living than patients in the solvent-based paclitaxel arm.

  5. Cancer Treatment for Women: Possible Sexual Side Effects

    Science.gov (United States)

    ... Endometrial cancer Ovarian cancer Rectal cancer Uterine cancer Vaginal cancer Vulvar cancer Treatment for any cancer carries the ... you experience. Topical estrogen creams applied to the vaginal area also can ... or ovarian cancer should carefully discuss any type of hormone therapy ...

  6. A Web application for the management of clinical workflow in image-guided and adaptive proton therapy for prostate cancer treatments.

    Science.gov (United States)

    Yeung, Daniel; Boes, Peter; Ho, Meng Wei; Li, Zuofeng

    2015-05-08

    Image-guided radiotherapy (IGRT), based on radiopaque markers placed in the prostate gland, was used for proton therapy of prostate patients. Orthogonal X-rays and the IBA Digital Image Positioning System (DIPS) were used for setup correction prior to treatment and were repeated after treatment delivery. Following a rationale for margin estimates similar to that of van Herk,(1) the daily post-treatment DIPS data were analyzed to determine if an adaptive radiotherapy plan was necessary. A Web application using ASP.NET MVC5, Entity Framework, and an SQL database was designed to automate this process. The designed features included state-of-the-art Web technologies, a domain model closely matching the workflow, a database-supporting concurrency and data mining, access to the DIPS database, secured user access and roles management, and graphing and analysis tools. The Model-View-Controller (MVC) paradigm allowed clean domain logic, unit testing, and extensibility. Client-side technologies, such as jQuery, jQuery Plug-ins, and Ajax, were adopted to achieve a rich user environment and fast response. Data models included patients, staff, treatment fields and records, correction vectors, DIPS images, and association logics. Data entry, analysis, workflow logics, and notifications were implemented. The system effectively modeled the clinical workflow and IGRT process.

  7. Clinical significance of plasma metastin level in pancreatic cancer patients.

    Science.gov (United States)

    Katagiri, Fumihiko; Nagai, Kazuyuki; Kida, Atsushi; Tomita, Kenji; Oishi, Shinya; Takeyama, Masaharu; Doi, Ryuichiro; Fujii, Nobutaka

    2009-03-01

    Metastin, which is a 54-residue peptide coded by KiSS-1 gene, is an endogenous ligand to a G-protein-coupled receptor GPR54. Metastin suppresses a malignant tumor to metastasize and regulates secretion of gonadotropine releasing hormone. Physiological action of metastin has been focused on in oncology. It is reported that less KiSS-1 gene and more hOT7T175 gene which codes GPR54 are expressed in pancreatic cancers than in normal pancreatic tissues; however, there is no study that investigates the relationship between clinicopathological characteristics and plasma metastin concentration in pancreatic cancer patients. The purpose of this study was to investigate the relationship between plasma metastin-like immunoreactive substance (LI) levels and clinical characteristics in pancreatic cancer patients. Thirty-three patients with pathologically confirmed pancreatic cancer before or just after treatments and 24 healthy volunteers were included in the study. Patients were grouped according to the International Union Against Cancer TNM classification. Plasma metastin-LI was measured by enzyme immunoassay. The plasma metastin-LI levels of cancer patients were significantly higher when compared with healthy volunteers. Significant relationship was not found between the plasma metastin-LI levels and the clinicopathological factors such as tumor size, invasion, lymph node metastasis and distant metastasis. The plasma metastin levels may be a significant biomarker to predict the presence of pancreatic cancer and could be used in pancreatic cancer screening.

  8. Study Design and Rationale for the Phase 3 Clinical Development Program of Enobosarm, a Selective Androgen Receptor Modulator, for the Prevention and Treatment of Muscle Wasting in Cancer Patients (POWER Trials).

    Science.gov (United States)

    Crawford, Jeffrey; Prado, Carla M M; Johnston, Mary Ann; Gralla, Richard J; Taylor, Ryan P; Hancock, Michael L; Dalton, James T

    2016-06-01

    Muscle wasting in cancer is a common and often occult condition that can occur prior to overt signs of weight loss and before a clinical diagnosis of cachexia can be made. Muscle wasting in cancer is an important and independent predictor of progressive functional impairment, decreased quality of life, and increased mortality. Although several therapeutic agents are currently in development for the treatment of muscle wasting or cachexia in cancer, the majority of these agents do not directly inhibit muscle loss. Selective androgen receptor modulators (SARMs) have the potential to increase lean body mass (LBM) and hence muscle mass, without the untoward side effects seen with traditional anabolic agents. Enobosarm, a nonsteroidal SARM, is an agent in clinical development for prevention and treatment of muscle wasting in patients with cancer (POWER 1 and 2 trials). The POWER trials are two identically designed randomized, double-blind, placebo-controlled, multicenter, and multinational phase 3 trials to assess the efficacy of enobosarm for the prevention and treatment of muscle wasting in subjects initiating first-line chemotherapy for non-small-cell lung cancer (NSCLC). To assess enobosarm's effect on both prevention and treatment of muscle wasting, no minimum weight loss is required. These pivotal trials have pioneered the methodological and regulatory fields exploring a therapeutic agent for cancer-associated muscle wasting, a process hereby described. In each POWER trial, subjects will receive placebo (n = 150) or enobosarm 3 mg (n = 150) orally once daily for 147 days. Physical function, assessed as stair climb power (SCP), and LBM, assessed by dual-energy X-ray absorptiometry (DXA), are the co-primary efficacy endpoints in both trials assessed at day 84. Based on extensive feedback from the US Food and Drug Administration (FDA), the co-primary endpoints will be analyzed as a responder analysis. To be considered a physical function responder, a

  9. Integration of Translational Research in the European Organization for Research and Treatment of Cancer Research (EORTC) Clinical Trial Cooperative Group Mechanisms.

    NARCIS (Netherlands)

    F. Lehmann (Frederick); D. Lacombe (Denis); A.M.M. Eggermont (Alexander)

    2003-01-01

    textabstractThe landscape for cancer research is profoundly different today from that only one decade ago. Basic science is moving rapidly and biotechnological revolutions in molecular targeting and immunology have completely modified the opportunities and concepts for cancer treat

  10. Treatment modalities for early gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Jesús; Espinel; Eugenia; Pinedo; Vanesa; Ojeda; Maria; Guerra; del; Rio

    2015-01-01

    Different treatment modalities have been proposed in the treatment of early gastric cancer(EGC). Endoscopic resection(ER) is an established treatment that allows curative treatment, in selected cases. In addition, ER allows for an accurate histological staging, which is crucial when deciding on the best treatment option for EGC. Recently, endoscopic mucosal resection(EMR) and endoscopic submucosal dissection(ESD) have become alternatives to surgery in early gastric cancer, mainly in Asian countries. Patients with "standard" criteria can be successfully treated by EMR techniques. Those who meet "expanded" criteria may benefit from treatment by ESD, reducing the need for surgery. Standardized ESD training system is imperative to promulgate effective and safe ESD technique to practices with limited expertise. Although endoscopic resection is an option in patients with EGC, surgical treatment continues to be a widespread therapeutic option worldwide. In this review we tried to point out the treatment modalities for early gastric cancer.

  11. American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline.

    Science.gov (United States)

    Runowicz, Carolyn D; Leach, Corinne R; Henry, N Lynn; Henry, Karen S; Mackey, Heather T; Cowens-Alvarado, Rebecca L; Cannady, Rachel S; Pratt-Chapman, Mandi L; Edge, Stephen B; Jacobs, Linda A; Hurria, Arti; Marks, Lawrence B; LaMonte, Samuel J; Warner, Ellen; Lyman, Gary H; Ganz, Patricia A

    2016-02-20

    The purpose of the American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline is to provide recommendations to assist primary care and other clinicians in the care of female adult survivors of breast cancer. A systematic review of the literature was conducted using PubMed through April 2015. A multidisciplinary expert workgroup with expertise in primary care, gynecology, surgical oncology, medical oncology, radiation oncology, and nursing was formed and tasked with drafting the Breast Cancer Survivorship Care Guideline. A total of 1,073 articles met inclusion criteria; and, after full text review, 237 were included as the evidence base. Patients should undergo regular surveillance for breast cancer recurrence, including evaluation with a cancer-related history and physical examination, and should be screened for new primary breast cancer. Data do not support performing routine laboratory tests or imaging tests in asymptomatic patients to evaluate for breast cancer recurrence. Primary care clinicians should counsel patients about the importance of maintaining a healthy lifestyle, monitor for post-treatment symptoms that can adversely affect quality of life, and monitor for adherence to endocrine therapy. Recommendations provided in this guideline are based on current evidence in the literature and expert consensus opinion. Most of the evidence is not sufficient to warrant a strong evidence-based recommendation. Recommendations on surveillance for breast cancer recurrence, screening for second primary cancers, assessment and management of physical and psychosocial long-term and late effects of breast cancer and its treatment, health promotion, and care coordination/practice implications are made.This guideline was developed through a collaboration between the American Cancer Society and the American Society of Clinical Oncology and has been published jointly by invitation and consent in both CA: A Cancer Journal for

  12. New generation of breast cancer clinical trials implementing molecular profiling

    Institute of Scientific and Technical Information of China (English)

    Dimitrios Zardavas; Martine Piccart-Gebhart

    2016-01-01

    The implementation of molecular profiling technologies in oncology deepens our knowledge for the molecular landscapes of cancer diagnoses, identifying aberrations that could be linked with specific therapeutic vulnerabilities. In particular, there is an increasing list of molecularly targeted anticancer agents undergoing clinical development that aim to block specific molecular aberrations. This leads to a paradigm shift, with an increasing list of specific aberrations dictating the treatment of patients with cancer. This paradigm shift impacts the field of clinical trials, since the classical approach of having clinico-pathological disease characteristics dictating the patients' enrolment in oncology trials shifts towards the implementation of molecular profiling as pre-screening step. In order to facilitate the successful clinical development of these new anticancer drugs within specific molecular niches of cancer diagnoses, there have been developed new, innovative trial designs that could be classified as follows: i) longitudinal cohort studies that implement (or not) "nested" downstream trials, 2) studies that assess the clinical utility of molecular profiling, 3) "master" protocol trials, iv) "basket" trials, v) trials following an adaptive design. In the present article, we review these innovative study designs, providing representative examples from each category and we discuss the challenges that still need to be addressed in this era of new generation oncology trials implementing molecular profiling. Emphasis is put on the field of breast cancer clinical trials.

  13. The biology and clinical development of MEK inhibitors for cancer.

    Science.gov (United States)

    Luke, Jason J; Ott, Patrick A; Shapiro, Geoffrey I

    2014-12-01

    The mitogen-activated protein kinase kinases (MAPKK) MEK1 and MEK2 are integral members of the MAPK/ERK signaling pathway and are of interest in the development of anti-cancer therapeutics. The MAPK/ERK pathway is dysregulated in more than 30 % of cancers, predominately by mutations in RAS and BRAF proteins, and MEK serves as a potential downstream target for both of these. The biology of MEK inhibition is complex, as the molecule is differentially regulated by upstream RAS or RAF. This has impacted on the past development of MEK inhibitors as treatments for cancer and may be exploited in more rational, molecularly selected drug development plans in the future. The role of MEK in cancer and the mechanism of action of MEK inhibitors is reviewed. Furthermore, MEK inhibitors that are available in standard practice, as well as those most advanced in clinical development, are discussed. Finally, next steps in the development of MEK inhibitors are considered.

  14. Pancreatic cancer in obesity: epidemiology, clinical observations, and basic mechanisms.

    Science.gov (United States)

    Zyromski, Nicholas J; White, Patrick B

    2011-06-01

    Obesity, now a worldwide epidemic, causes myriad medical problems. One of the most significant obesity-related problems is the well-recognized relationship between obesity and various malignancies, including pancreatic cancer. Pancreatic cancer is a devastating disease--the annual death rate nearly approximates its incidence. While surgical extirpation provides the best chance at long term survival, systemic therapy is largely ineffective: even those patients undergoing successful operative resection have only approximately 20% 5-year survival. These poor outcomes are largely a consequence of poor understanding of tumor biology. Clearly, identification of novel treatment strategies is of paramount importance; investigation of pancreatic cancer biology from the novel aspect of obesity offers the potential to identify unique therapeutic targets. This manuscript reviews the epidemiology, clinical findings, and putative basic science mechanisms underlying obesity-related pancreatic cancer.

  15. Active surveillance for clinically localized prostate cancer

    DEFF Research Database (Denmark)

    Thomsen, Frederik B; Brasso, Klaus; Klotz, Laurence H

    2014-01-01

    Active surveillance (AS) has been introduced as an observational strategy to delay or avoid curative treatment without compromising long-term cancer-specific survival. The 10 studies included in this review, published between 2008 and 2013, generally agreed upon patients selection for the AS stra......Active surveillance (AS) has been introduced as an observational strategy to delay or avoid curative treatment without compromising long-term cancer-specific survival. The 10 studies included in this review, published between 2008 and 2013, generally agreed upon patients selection...

  16. Neoadjuvant Treatment for Esophageal Cancer

    Institute of Scientific and Technical Information of China (English)

    PaulM.Schneider; HuanXi; StephanE.Baldus; JanBrabender; RalfMetzger

    2004-01-01

    Because the conflicting data currently available from the performed randomized trials it is very difficult to provide strict guidelines for the treatment of patients with locoregional advanced esophageal cancers. Surgery however, remains the standard of care for potentially resectable disease. Preoperative chemotherapy is still controversial with two large randomized trials resulting in two different conclusions regarding the survival benefit. Preoperative chemoradiation is also controversial since only one randomized trial showed a clear survival benefit however, the patients treated with surgery alone in this trial had an unusually poor outcome. And the study by Urba et al was not powered enough to show a clear survival benefit for patients treated with neoadjuvant chemoradiation. The results of three metaanalysis of these randomized studies show lower rate of resection, higher rate of R0-resection, more often postoperative mortality and better prognosis for patients with neoadjuvant radiochemotherapy. As a consequence one may consider offering neoadjuvant chemotherapy or neoadjuvant radiochemotherapy to patients with locallyadvanced disease under the premise that patients have a good performance status and understand the controversies about this therapeutic option. Larger trials with sufficient power to clearly detect survival benefits for patients treated with neoadjuvant chemotherapy or radiochemotherapy are necessary before this therapeutic option will be the standard of care.

  17. Treatment Options by Stage (Thyroid Cancer)

    Science.gov (United States)

    ... Resources Conducting Clinical Trials Statistical Tools and Data Terminology Resources NCI Data Catalog Cryo-EM NCI's Role ... Contacts Other Funding Find NCI funding for small business innovation, technology transfer, and contracts Training Cancer Training ...

  18. Lentiviral Vectors for Cancer Immunotherapy and Clinical Applications

    Directory of Open Access Journals (Sweden)

    David Escors

    2013-07-01

    Full Text Available The success of immunotherapy against infectious diseases has shown us the powerful potential that such a treatment offers, and substantial work has been done to apply this strategy in the fight against cancer. Cancer is however a fiercer opponent than pathogen-caused diseases due to natural tolerance towards tumour associated antigens and tumour-induced immunosuppression. Recent gene therapy clinical trials with viral vectors have shown clinical efficacy in the correction of genetic diseases, HIV and cancer. The first successful gene therapy clinical trials were carried out with onco(g-retroviral vectors but oncogenesis by insertional mutagenesis appeared as a serious complication. Lentiviral vectors have emerged as a potentially safer strategy, and recently the first clinical trial of patients with advanced leukemia using lentiviral vectors has proven successful. Additionally, therapeutic lentivectors have shown clinical efficacy for the treatment of HIV, X-linked adrenoleukodystrophy, and b-thalassaemia. This review aims at describing lentivectors and how they can be utilized to boost anti-tumour immune responses by manipulating the effector immune cells.

  19. Lentiviral Vectors for Cancer Immunotherapy and Clinical Applications

    Energy Technology Data Exchange (ETDEWEB)

    Liechtenstein, Therese, E-mail: t.liechtenstein.12@ucl.ac.uk [University College London, 5 University Street, London, WC1E 6JF (United Kingdom); Perez-Janices, Noemi; Escors, David [University College London, 5 University Street, London, WC1E 6JF (United Kingdom); Navarrabiomed Fundacion Miguel Servet, 3 Irunlarrea St., Hospital Complex of Navarra, 31008 Pamplona, Navarra (Spain)

    2013-07-02

    The success of immunotherapy against infectious diseases has shown us the powerful potential that such a treatment offers, and substantial work has been done to apply this strategy in the fight against cancer. Cancer is however a fiercer opponent than pathogen-caused diseases due to natural tolerance towards tumour associated antigens and tumour-induced immunosuppression. Recent gene therapy clinical trials with viral vectors have shown clinical efficacy in the correction of genetic diseases, HIV and cancer. The first successful gene therapy clinical trials were carried out with onco(γ-)retroviral vectors but oncogenesis by insertional mutagenesis appeared as a serious complication. Lentiviral vectors have emerged as a potentially safer strategy, and recently the first clinical trial of patients with advanced leukemia using lentiviral vectors has proven successful. Additionally, therapeutic lentivectors have shown clinical efficacy for the treatment of HIV, X-linked adrenoleukodystrophy, and β-thalassaemia. This review aims at describing lentivectors and how they can be utilized to boost anti-tumour immune responses by manipulating the effector immune cells.

  20. Lung cancer: current diagnosis and treatment.

    Science.gov (United States)

    Hammerschmidt, Stefan; Wirtz, Hubert

    2009-12-01

    Much progress has been made in the treatment of lung cancer in the last ten years (adjuvant chemotherapy, targeted therapy, individualized therapy). Nonetheless, lung cancer is still the leading cause of death due to cancer and thus remains a major medical, scientific, and social problem. This review is based on national and international recommendations and selected articles from the literature. Cigarette smoking is the major pathogenic factor for lung cancer. Lung cancer can be divided into two major types that differ in their biological behavior, small cell lung cancer and non-small cell lung cancer. Whenever possible, the diagnosis should be confirmed by biopsy, the extent of disease should be documented in detail (international TNM classification/staging), and the patient's functional level should be assessed with a view toward treatment planning. Surgery for non-small cell lung cancer with curative intent is possible up to stage IIIA, while stage IIIB is the domain of radiotherapy. Surgery for small cell lung cancer with curative intent is possible for rare cases in early stages (T1N0 and T2N0, i.e., stage IA and IB). As long as small cell lung cancer is restricted to one side of the chest, simultaneous radiation therapy and chemotherapy are indicated. If a malignant pleural effusion or distant metastases are present, both lung cancers are treated palliatively with platinum-based chemotherapy.

  1. Potentials of interferon therapy in the treatment of pancreatic cancer.

    Science.gov (United States)

    Booy, Stephanie; Hofland, Leo; van Eijck, Casper

    2015-05-01

    Pancreatic cancer is a highly aggressive malignancy with limited treatment options. To improve survival for patients with pancreatic cancer, research has focused on other treatment modalities like adding biological modulators such as type-I interferons (IFNs). Type I IFNs (ie, IFN-α/IFN-β) have antiproliferative, antiviral, and immunoregulatory activities. Furthermore, they are able to induce apoptosis, exert cell cycle blocking, and sensitize tumor cells for chemo- and radiotherapy. A few years ago in vitro, in vivo, and several clinical trials have been described regarding adjuvant IFN-α therapy in the treatment of pancreatic cancer. Some studies reported a remarkable increase in the 2- and 5-year survival. Unfortunately, the only randomized clinical trial did not show a significant increase in overall survival, although the increased median survival implicated that some patients in the experimental group benefited from the adjuvant IFN-α therapy. Furthermore, encouraging in vitro and in vivo data points to a possible role for adjuvant IFN therapy. However, up till now, the use of IFNs in the treatment of pancreatic cancer remains controversial. This review, therefore, aims to describe, based on the available data, whether there is a distinct role for IFN therapy in the treatment of pancreatic cancer.

  2. Long-Term Outcome and Morbidity After Treatment With Accelerated Radiotherapy and Weekly Cisplatin for Locally Advanced Head-and-Neck Cancer: Results of a Multidisciplinary Late Morbidity Clinic

    Energy Technology Data Exchange (ETDEWEB)

    Ruetten, Heidi, E-mail: h.rutten@rther.umcn.nl [Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Pop, Lucas A.M.; Janssens, Geert O.R.J. [Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Takes, Robert P. [Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Knuijt, Simone [Department of Rehabilitation/Speech Pathology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Rooijakkers, Antoinette F. [Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Berg, Manon van den [Department of Gastroenterology-Dietetics, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Merkx, Matthias A. [Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Herpen, Carla M.L. van [Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Kaanders, Johannes H.A.M. [Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands)

    2011-11-15

    Purpose: To evaluate the long-term outcome and morbidity after intensified treatment for locally advanced head-and-neck cancer. Methods and Materials: Between May 2003 and December 2007, 77 patients with Stage III to IV head-and-neck cancer were treated with curative intent. Treatment consisted of accelerated radiotherapy to a dose of 68 Gy and concurrent cisplatin. Long-term survivors were invited to a multidisciplinary outpatient clinic for a comprehensive assessment of late morbidity with special emphasis on dysphagia, including radiological evaluation of swallowing function in all patients. Results: Compliance with the treatment protocol was high, with 87% of the patients receiving at least five cycles of cisplatin and all but 1 patient completing the radiotherapy as planned. The 5-year actuarial disease-free survival and overall survival rates were 40% and 47%, respectively. Locoregional recurrence-free survival at 5 years was 61%. The 5-year actuarial rates of overall late Radiation Therapy Oncology Group (RTOG)/European Organization for Research and Treatment of Cancer (EORTC) Grade 3 and Grade 4 toxicity were 52% and 25% respectively. Radiologic evaluation after a median follow-up of 44 months demonstrated impaired swallowing in 57% of the patients, including 23% with silent aspiration. Subjective assessment using a systematic scoring system indicated normalcy of diet in only 15.6% of the patients. Conclusion: This regimen of accelerated radiotherapy with weekly cisplatin produced favorable tumor control rates and survival rates while compliance was high. However, comprehensive assessment by a multidisciplinary team of medical and paramedical specialists revealed significant long-term morbidity in the majority of the patients, with dysphagia being a major concern.

  3. MicroRNA signatures as clinical biomarkers in lung cancer

    Directory of Open Access Journals (Sweden)

    Markou A

    2015-05-01

    Full Text Available Athina Markou, Martha Zavridou, Evi S Lianidou Analysis of Circulating Tumor Cells, Lab of Analytical Chemistry, Department of Chemistry, University of Athens, Athens, Greece Abstract: Even if early lung cancer detection has been recently significantly improved, the invasive nature of current diagnostic procedures, and a relatively high percentage of false positives, is limiting the application of modern detection tools. The discovery and clinical evaluation of novel specific and robust non-invasive biomarkers for diagnosis of lung cancer at an early stage, as well as for better prognosis and prediction of therapy response, is very challenging. MicroRNAs (miRNAs can play an important role in the diagnosis and management of lung cancer patients, as important and reliable biomarkers for cancer detection and prognostic prediction, and even as promising as novel targets for cancer therapy. miRNAs are important in cancer pathogenesis, and deregulation of their expression levels has been detected not only in lung cancer but in many other human tumor types. Numerous studies strongly support the potential of miRNAs as biomarkers in non-small-cell lung cancer, and there is increasing evidence that altered miRNA expression is associated with tumor progression and survival. It is worth mentioning also that detection of miRNAs circulating in plasma or serum has enormous potential, because miRNAs serve as non-invasive biomarkers not only for the diagnosis and prognosis of the disease, but also as novel response and sensitivity predictors for cancer treatment. In this review, we summarize the current findings on the critical role of miRNAs in lung cancer tumorigenesis and highlight their potential as circulating biomarkers in lung cancer. Our review is based on papers that have been published after 2011, and includes the key words “miRNAs” and “lung cancer”. Keywords: non-small-cell lung carcinoma, miRNAs, tumor biomarkers, circulating miRNAs, liquid

  4. Maximizing outcomes in genitourinary cancers across the treatment continuum.

    LENUS (Irish Health Repository)

    Fitzpatrick, John M

    2011-04-01

    Key controversies concerning the management of genitourinary cancers across the treatment continua were discussed at the second annual Interactive Genitourinary Cancer Conference (IGUCC) held in February 2010 in Athens, Greece. Prostate cancer is the most common form of cancer among western men and prevention strategies are needed. Trials evaluating 5α-reductase inhibitors have reported beneficial and clinically meaningful results, but uptake remains low for primary prostate cancer prevention. Prostate cancer detection programmes are also important as curative treatments for advanced disease are unavailable. Two large landmark randomized controlled trials reported conflicting results concerning screening efficacy and uncovered high levels of over-diagnosis and potential over-treatment. Tailored management strategies after diagnosis are important and predictive markers that distinguish between aggressive and indolent tumours are needed. The majority of newly diagnosed cases of prostate cancer are clinically localized. Active surveillance of favourable risk patients may be beneficial in the intermediate term, while an integrated approach of multi-modality therapy in patients with adverse features is recommended. The benefits of new technologies such as high-intensity focused ultrasound (HIFU) and robotic prostatectomy have not been established in prospective randomized trials vs current standards of care. A multidisciplinary approach is essential to evolving the management of advanced prostate cancer into a chronic disease paradigm. Docetaxel plus prednisone is the standard first-line chemotherapy for patients with metastatic castration-resistant prostate cancer (mCRPC), but the optimal timing of chemotherapy initiation has not been addressed in randomized clinical trials. Retrospective analyses suggest that asymptomatic patients with adverse prognostic factors for survival may also benefit from receiving chemotherapy. Bladder cancer is a common malignancy and the

  5. Diagnosis and Treatment of Testicular Cancer: A Clinician's Perspective.

    Science.gov (United States)

    Bernard, Brandon; Sweeney, Christopher J

    2015-12-01

    Testicular germ cell tumors (GCTs) include seminoma and nonseminoma. Chance of cure is excellent for clinical stage I disease regardless of whether adjuvant treatment or a surveillance strategy with treatment only for those who relapse is used. Risk of recurrence is greater in nonseminoma with evidence of lymphovascular invasion, but most can be salvaged with chemotherapy and survival rates remain high. This article outlines key pathologic and clinical considerations in clinical stage I seminoma, nonseminoma, advanced disease, and assessment of cancer of unknown primary as a potential GCT.

  6. Are breast cancer stem cells the key to resolving clinical issues in breast cancer therapy?

    Science.gov (United States)

    Shima, Hidetaka; Ishikawa, Takashi; Endo, Itaru

    2017-01-01

    Despite the dramatic advances in breast cancer treatment over the past two decades, it is still the most common malignancies in women. One of the reasons patients succumb to breast cancer is treatment resistance leading to metastasis and recurrence. Recently, cancer stem cells (CSCs) have been suggested as a cause of metastasis and recurrence in several cancers because of their unique characteristics, including self-renewal, pluripotency, and high proliferative ability. Increasing evidence has implicated breast cancer stem cells (BCSCs) as essential for tumor development, progression, recurrence, and treatment resistance. BCSCs exhibit resistance to treatment owing to several inter-related factors, including overexpression of ATP-binding cassette (ABC) transporters and increased aldehyde dehydrogenase (ALDH) activity, DNA repair, and reactive oxygen species (ROS) scavenging. In addition, the Notch, Hedgehog, and Wnt signaling pathways have been suggested as the major pathways involved in the self-renewal and differentiation of BCSCs. Despite growing evidence suggesting the importance of BCSCs in progression and metastasis, clear criteria for the identification of BCSCs in clinical practice have yet to be established. Several potential markers have been suggested, including CD44+/CD24−/low, ALDH1, EpCAM/ESA, and nestin; however, there is no standard method to detect BCSCs. Triple-negative breast cancer, which shows initial chemosensitivity, demonstrates worsened prognosis due to therapy resistance, which might be related to the presence of BCSCs. Several clinical trials aimed at the identification of BCSCs or the development of BCSC-targeted therapy are in progress. Determining the clinical relevance of BCSCs may provide clues for overcoming therapy resistance in breast cancer. PMID:28210556

  7. Cancer treatment-induced diarrhea: interventions to minimize the roller coaster ride.

    Science.gov (United States)

    2004-01-01

    This program used a case-study approach to discuss interventions that nurses can implement in their daily clinical environment to minimize cancer treatment-induced diarrhea. Manifestations of cancer treatment-induced diarrhea, medical treatment options, and nutritional interventions were covered.

  8. Cancer cachexia update in head and neck cancer: Pathophysiology and treatment.

    Science.gov (United States)

    Couch, Marion E; Dittus, Kim; Toth, Michael J; Willis, Monte S; Guttridge, Denis C; George, Jonathan R; Chang, Eric Y; Gourin, Christine G; Der-Torossian, Hirak

    2015-07-01

    The pathophysiology of cancer cachexia remains complex. A comprehensive literature search was performed up to April 2013 using PubMed, the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, and the Google search engine. In this review, we focus on the different mediators of impaired anabolism and upregulated catabolism that alter the skeletal muscle homeostasis resulting in the wasting of cancer cachexia. We present recent evidence of targeted treatment modalities from clinical trials along with their potential mechanisms of action. We also report on the most current evidence from randomized clinical trials using multimodal treatments in patients with cancer cachexia, but also the evidence from head and neck cancer-specific trials. A more complete understanding of the pathophysiology of the syndrome may lead to more effective targeted therapies and improved outcomes for patients.

  9. Early breast cancer: diagnosis, treatment and survivorship.

    LENUS (Irish Health Repository)

    Meade, Elizabeth

    2013-01-11

    Breast cancer is the most common female cancer and globally remains a major public health concern. The diagnosis and treatment of breast cancer continues to develop. Diagnosis is now more precise, surgery is less mutilating and women now have the option of breast conserving therapy with better cosmesis, and without sacrificing survival. Radiotherapy is more targeted and the selection of patients for adjuvant chemotherapy is based not only on prognostic and predictive factors, but also on newer molecular profiling that will ensure that chemotherapy is given to the patients who need and respond to it. These developments all provide a more tailored approach to the treatment of breast cancer. Management now involves a multidisciplinary team approach in order to provide the highest standard of care for patients throughout their cancer journey from diagnosis through treatment and into follow-up care.

  10. Anterior urethral recurrence of superficial bladder cancer: its clinical significance.

    Directory of Open Access Journals (Sweden)

    Saika T

    2003-12-01

    Full Text Available The aim of this study was to reveal the clinical features of anterior urethral recurrence in patients with superficial bladder cancer, and to determine the appropriate treatment. Three hundred and three patients with superficial bladder cancer, who were newly diagnosed and initially treated conservatively in our hospital between 1965 and 1990, were followed for at least 5 years and their clinical outcomes were analyzed. Clinical factors, including anterior urethral recurrence, were evaluated statistically regarding tumor progression. Eight patients (2.6% had anterior urethral recurrence following superficial bladder cancer. Twenty-four patients (7.9% had tumor progression and 149 (49.2% had tumor recurrence. In a multivariate analysis using a logistic model, anterior urethral recurrence was the most important factor, followed by histological grade. Four of 5 patients who were treated for anterior urethral recurrent tumors by transurethral resection showed progression and died of the cancer within one year. Two of the remaining three patients who underwent radical cysto-urethrectomy at the time of anterior urethral recurrence survived. Anterior urethral recurrence following superficial bladder cancer is a predictor for rapid subsequent malignant progression. Once there is anterior urethral recurrence, radical intensive therapy, including radical cysto-urethrectomy, should be carried out immediately.

  11. CT引导下射频消融术治疗肝癌的临床效果评价%The Clinical Effect Assessment of CT-guided Radiofrequency Ablation(RFA)in Treatment of Liver Cancer

    Institute of Scientific and Technical Information of China (English)

    曾智明; 朱广志

    2014-01-01

    Objective:To explore and evaluate the clinical effect of CT-guided radiofrequency ablation(RFA) in treatment of liver cancer.Method:60 patients who were treated by CT-guided radiofrequency ablation(RFA)in our hospital from April 2012 to April 2013 were selected,and the clinical efficacy and prognosis of CT-guided radiofrequency ablation(RFA)in treatment of 60 liver cancer patients were explored and analyzed.Result:There had no significant differences in blood pressure,pulse and blood oxygen saturation between preoperative and intraoperative (P>0.05).After treatment,the average value of AFP and CEA were significantly lower than before treatment,the differences were statistically significant(P0.05),而治疗后平均AFP和CEA检测值均明显低于治疗前,差异均有统计学意义(P<0.05)。60例患者肿瘤完全坏死56例,占93.3%;不完全坏死3例,占5.0%;部分坏死1例,占1.7%。60例患者在1年内复发16例,占26.7%;1年内死亡患者1例,存活59例,1年生存率为98.3%。结论:CT引导下射频消融术(RFA)治疗肝癌的临床效果良好,值得在临床上推广。

  12. Monitoring cancer stem cells: insights into clinical oncology

    Directory of Open Access Journals (Sweden)

    Lin SC

    2016-02-01

    Full Text Available ShuChen Lin,1,* YingChun Xu,2,* ZhiHua Gan,1 Kun Han,1 HaiYan Hu,3 Yang Yao,3 MingZhu Huang,4 DaLiu Min1 1Department of Oncology, Shanghai Sixth People’s Hospital East Campus, Shanghai Jiao Tong University, 2Department of Oncology, Renji Hospital, Shanghai Jiao Tong University, 3Department of Oncology, The Sixth People’s Hospital, Shanghai Jiao Tong University, 4Department of Medical Oncology, Cancer Hospital of Fudan University, Shanghai, People’s Republic of China *These authors contributed equally to this work Abstract: Cancer stem cells (CSCs are a small, characteristically distinctive subset of tumor cells responsible for tumor initiation and progression. Several treatment modalities, such as surgery, glycolytic inhibition, driving CSC proliferation, immunotherapy, and hypofractionated radiotherapy, may have the potential to eradicate CSCs. We propose that monitoring CSCs is important in clinical oncology as CSC populations may reflect true treatment response and assist with managing treatment strategies, such as defining optimal chemotherapy cycles, permitting pretreatment cancer surveillance, conducting a comprehensive treatment plan, modifying radiation treatment, and deploying rechallenge chemotherapy. Then, we describe methods for monitoring CSCs. Keywords: cancer stem cells, glycolytic inhibition, watchful waiting, rechallenge, immunotherapy

  13. The clinical observation of Yanshu Injection in treatment of advanced liver cancer%岩舒注射液治疗中晚期肝癌的临床观察

    Institute of Scientific and Technical Information of China (English)

    雷小林; 张敬卫; 杨蕾; 李铁连

    2011-01-01

    Objective To investigate the clinical efficacy of Yanshu Injection in treatment of advanced liver cancer. Methods Treatment of 84 advanced liver cancer patients with intravenous infusion of Yanshu Injection and supporting therapy was compared with simple supporting therapy. The neoplasm size,physical status, survival rate and so on were evaluated for the 2 groups. Results Tumor control rate: the control group and treatment group were 9.6% and 32. 6% respectively; AFP decrease comparison: the control group and treatment group were 0% and 40.9% respectively, among which rate of 50% decrease accounted for 18.2%; increased and stable Karnofsky Score: the control group and treatment group were 21.9% and 41.9% respectively; survival rate in the treatment group was higher than in the control group significantly(P < 0.05). Conclusions Yanshu Injection can improve life quality, prolong live time and control tumor growth in advanced liver cancer patients and deserves further clinical applications.%目的 观察岩舒注射液治疗中晚期肝癌的临床疗效.方法 84例中晚期肝癌分为两组,分别采用静脉点滴岩舒注射液加支持治疗和单纯支持治疗.对两组肿瘤大小、体力状况、生存率等进行评价.结果 肿瘤控制率:对照组9.6%,治疗组32.6%;血AFP值下降比较:对照组0;治疗组40.9%,其中下降50%占18.2%.Karnofsky评分上升加稳定,对照组为21.9%,治疗组为41.9%.治疗组生存率也明显高于对照组,两组差异有显著性(P<0.05).结论 岩舒注射液治疗中晚期肝癌,在改善生活质量、延长生存时间、控制肿瘤生长等方面明显好于对照组,值得在临床推广.

  14. Identifying and targeting cancer stem cells in the treatment of gastric cancer.

    Science.gov (United States)

    Bekaii-Saab, Tanios; El-Rayes, Bassel

    2017-04-15

    Current treatment regimens for gastric cancer are not adequate. Cancer stem cells (CSCs) may be a key driving factor for growth and metastasis of this tumor type. In contrast to the conventional clonal evolution hypothesis, CSCs can initiate tumor formation, self-renew, and differentiate into tumor-propagating cells. Because gastric cancer can originate from CSCs, it is necessary to review current targets of signaling pathways for CSCs in gastric cancer that are being studied in clinical trials. These pathways are known to regulate the self-renewal and differentiation process in gastric CSCs. A better understanding of the clinical results of trials that target gastric CSCs will lead to better outcomes for patients with gastric cancer. Cancer 2017;123:1303-1312. © 2017 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons Attribution NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2017 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

  15. [Selenium and cancer: from prevention to treatment].

    Science.gov (United States)

    Brozmanová, J

    2011-01-01

    Selenium (Se) is an essential dietary component for all animals, including human beings, that is regarded as a protective agent against cancer. Although the mode of its anticancer action is not yet fully understood, several mechanisms, such as antioxidant protection through selenoenzymes, stimulation of DNA repair, and apoptosis in tumor prestages have all been proposed. Despite the unsupported results of the last "SELECT" trial, the cancer-preventing activity of Se has been demonstrated in a majority of epidemiological studies. Moreover, recent studies suggest that Se has a potential to be used not only in cancer prevention but also in cancer treatment, where in combination with other anticancer drugs or radiation it may increase the efficacy of cancer therapy. In combating cancer cells, Se acts as a prooxidant rather than an antioxidant, inducing apoptosis through the generation of oxidative stress. Thus, inorganic Se compounds, having high redox potency, represent a promising option in cancer therapy.

  16. Resveratrol and cancer: Challenges for clinical translation

    Science.gov (United States)

    Singh, Chandra K.; Ndiaye, Mary A.; Ahmad, Nihal

    2014-01-01

    Significant work has been done towards identifying the health-beneficial effects of the grape antioxidant resveratrol in a variety of bioassay- and disease- models, with much research being focused on its possible application to cancer management. Despite the large number of preclinical studies dealing with different aspects of the biological effects of resveratrol, it’s translation to clinics is far from reality due to a variety of challenges. In this review, we discuss the issues and questions associated with resveratrol becoming an effective in vivo anticancer drug, from basic metabolic issues to the problems faced by incomplete understanding of the mechanism(s) of action in the body. We also explore efforts taken by researchers, both public and private, to contend with some of these issues. By examining the published data and previous clinical trials, we have attempted to identify the problems and issues that hinder the clinical translation of resveratrol for cancer management. PMID:25446990

  17. Nedaplatin/Gemcitabine Versus Carboplatin/Gemcitabine in Treatment of Advanced Non-small Cell Lung Cancer: A Randomized Clinical Trial

    Institute of Scientific and Technical Information of China (English)

    Jin-ji Yang; Qing Zhou; Ri-qiang Liao; Yi-sheng Huang; Chong-rui Xu; Zhen Wang; Bin-chao Wang; Hua-jun Chen; Yi-long Wu

    2012-01-01

    Objective:To evaluate the efficacy and safety of nedaplatin/gemcitabine (NG) and carboplatin/gemcitabine (CG) in the management of untreated advanced non-small cell lung cancer (NSCLC).Methods:Sixty-two patients with previously untreated advanced NSCIC were recruited between June 2006 and November 2007.Subjects were randomly assigned to the NG arm (n=30) and the CG arm (n=32).Only patients (24 and 25 in the NG and CG arms,respectively) who completed ≥2 chemotherapy cycles were included in the data analysis.The primary outcome measure was the objective response rate (ORR).The secondary outcome measures included progression-free survival (PFS),overall survival (OS) and adverse events.Results:There were no statistically significant differences in the efficacy measures (ORR,P=0.305; median PFS,P=0.198; median OS,P=0.961) or in the major adverse events (grade 3/4 neutropenia,P=0.666; grade 3/4 anemia,P=0.263; grade 3/4 thrombocytopenia,P=0.212) between the two treatment arms.However,there was a trend towards higher ORR (37.5% vs.24.0%),longer PFS (6.0 vs.5.0 months),and less adverse events in the NG arm.Conclusion:NG regimen seems to be superior over CG regimen for advance NSCLS,but further investigation is needed to validate this superiority.

  18. Clinical introduction of Monte Carlo treatment planning: a different prescription dose for non-small cell lung cancer according to tumor location and size.

    Science.gov (United States)

    van der Voort van Zyp, Noëlle C; Hoogeman, Mischa S; van de Water, Steven; Levendag, Peter C; van der Holt, Bronno; Heijmen, Ben J M; Nuyttens, Joost J

    2010-07-01

    To provide a prescription dose for Monte Carlo (MC) treatment planning in patients with non-small-cell lung cancer according to tumor size and location. Fifty-three stereotactic radiotherapy plans designed using the equivalent path-length (EPL) algorithm were re-calculated using MC. Plans were compared by the minimum dose to 95% of the PTV (D95), the heterogeneity index (HI) and the mean dose to organs at risk (OARs). Based on changes in D95, the prescription dose was converted from EPL to MC. Based on changes in HI, we examined the feasibility of MC prescription to plans re-calculated but not re-optimized with MC. The MC fraction dose for peripheral tumors is 16-18 Gy depending on tumor size. For central tumors the MC dose was reduced less than for peripheral tumors. The HI decreased on average by 4-9% in peripheral tumors and 3-5% in central tumors. The mean dose to OARs was lower for MC than EPL, and correlated strongly (R(2)=0.98-0.99). For the conversion from EPL to MC we recommend a separate prescription dose according to tumor size. MC optimization is not required if a HI > or = 70% is accepted. Dose constraints to OARs can be easily converted due to the high EPL-MC correlation. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  19. Persistent Neutrophil to Lymphocyte Ratio >3 during Treatment with Enzalutamide and Clinical Outcome in Patients with Castration-Resistant Prostate Cancer.

    Directory of Open Access Journals (Sweden)

    Vincenza Conteduca

    Full Text Available The baseline value of neutrophil to lymphocyte ratio (NLR has been found to be prognostic in patients with metastatic castration resistant prostate cancer (CRPC. We evaluated the impact of baseline NLR and its change in patients receiving enzalutamide. We included consecutive metastatic CRPC patients treated with enzalutamide after docetaxel and studies the change of NLR (>3 vs ≤3 after week 4 and 12 weeks. Progression-free survival (PFS, overall survival (OS and their 95% Confidence Intervals (95% CI were estimated by the Kaplan-Meier method and compared with the log-rank test. The impact of NLR on PFS and OS was evaluated by Cox regression analyses and on prostate-specific antigen response rates (PSA RR; PSA decline >50% were evaluated by binary logistic regression. Data collected on 193 patients from 9 centers were evaluated. Median age was 73.1 years (range, 42.8-90.7. The median baseline NLR was 3.2. The median PFS was 3.2 months (95% CI = 2.7-4.2 in patients with baseline NLR >3 and 7.4 months (95% CI = 5.5-9.7 in those with NLR ≤3, p 3 and 16.9 months (95% CI = 11.2-20.9 in those with baseline NLR ≤3, p 3 during treatment with enzalutamide seems to have both prognostic and predictive value in CRPC patients.

  20. Clinical diagnosis and treatment of fungal infections in gastric cancer patients after chemotherapy%胃癌患者化疗后真菌感染的临床诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    李刚; 段玉霞; 吴芳

    2015-01-01

    目的:探讨胃癌患者化疗后侵入性真菌感染的临床诊治情况,以期更好治疗真菌感染。方法选取2008年1月-2013年4月105例胃癌化疗后患者为研究对象,对其中出现侵入性真菌感染的37例患者从临床表现、危险因素和治疗方法等方面进行分析。结果胃癌化疗后侵入性真菌感染常见咯血、咳嗽、咳痰;骨髓像增生活跃,真菌G试验阳性,影像学为肺部大片实变影,双肺感染;病原菌主要分布在痰液和尿液中,常见病原菌为白色假丝酵母菌、光滑假丝酵母菌,占63.27%;APACHⅡ评分≥20分、年龄≥60岁、侵入性操作时间≥2周、化疗和放疗、全胃肠外营养、基础疾病等是胃癌化疗后侵入性真菌感染的危险因素(P<0.05);治疗后总有效率为45.95%,病死率为32.43%。结论胃癌化疗后侵入性真菌感染临床表现较明显,结合影像学和实验室检查可明确诊断,病原菌较为集中,采用卡泊芬净联合两性霉素B进行治疗临床效果显著。%OBJECTIVE To investigate the clinical diagnosis and treatment of invasive fungal infections in the gastric cancer patients after chemotherapy so as to facilitate the clinical treatment of the fungal infections .METHODS A total of 105 gastric cancer patients who underwent the chemotherapy from Jan 2008 to Apr 2013 were recruited as the study objects ,then the clinical manifestations of 37 patients with the invasive fungal infections ,risk factors , and treatment measures were observed .RESULTS Hemoptysis ,cough ,and expectoration were common in the gas‐tric cancer patients with invasive fungal infections after the chemotherapy ;the bone marrow like hyperplasia was active ,the fungal G test was positive ,the imaging showed lar