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Sample records for cancer current modalities

  1. Current adjuvant treatment modalities for gastric cancer: From history to the future.

    Science.gov (United States)

    Kilic, Leyla; Ordu, Cetin; Yildiz, Ibrahim; Sen, Fatma; Keskin, Serkan; Ciftci, Rumeysa; Pilanci, Kezban Nur

    2016-05-15

    The discrepancy between the surgical technique and the type of adjuvant chemotherapy used in clinical trials and patient outcomes in terms of overall survival rates has led to the generation of different adjuvant treatment protocols in distinct parts of the world. The adjuvant treatment recommendation is generally chemoradiotherapy in the United States, perioperative chemotherapy in the United Kingdom and parts of Europe, and chemotherapy in Asia. These options mainly rely on the United States Intergroup-0116, United Kingdom British Medical Research Council Adjuvant Gastric Infusional Chemotherapy, and the Asian Adjuvant Chemotherapy Trial of S-1 for Gastric Cancer and Capecitabine and Oxaliplatin Adjuvant Study in Stomach Cancer trials. However, the benefits were evident for only certain patients, which were not very homogeneous regarding the type of surgery, chemotherapy regimens, and stage of disease. Whether the dissimilarities in survival are attributable to surgical technique or intrinsic biological differences is a subject of debate. Regardless of the extent of surgery, multimodal therapy may offer modest survival advantage at least for diseases with lymph node involvement. Moreover, in the era of individualized treatment for most of the other cancer types, identification of special subgroups comprising those who will derive more or no benefit from adjuvant therapy merits further investigation. The aim of this review is to reveal the historical evolution and future reflections of adjuvant treatment modalities for resected gastric cancer patients. PMID:27190583

  2. Diagnostic imaging to detect and evaluate response to therapy in bone metastases from prostate cancer: current modalities and new horizons.

    Science.gov (United States)

    Evangelista, Laura; Bertoldo, Francesco; Boccardo, Francesco; Conti, Giario; Menchi, Ilario; Mungai, Francesco; Ricardi, Umberto; Bombardieri, Emilio

    2016-07-01

    Different therapeutic options for the management of prostate cancer (PC) have been developed, and some are successful in providing crucial improvement in both survival and quality of life, especially in patients with metastatic castration-resistant PC. In this scenario, diverse combinations of radiopharmaceuticals (for targeting bone, cancer cells and receptors) and nuclear medicine modalities (e.g. bone scan, SPECT, SPECT/CT, PET and PET/CT) are now available for imaging bone metastases. Some radiopharmaceuticals are approved, currently available and used in the routine clinical setting, while others are not registered and are still under evaluation, and should therefore be considered experimental. On the other hand, radiologists have other tools, in addition to CT, that can better visualize bone localization and medullary involvement, such as multimodal MRI. In this review, the authors provide an overview of current management of advanced PC and discuss the choice of diagnostic modality for the detection of metastatic skeletal lesions in different phases of the disease. In addition to detection of bone metastases, the evaluation of response to therapy is another critical issue, since it remains one of the most important open questions that a multidisciplinary team faces when optimizing the management of PC. The authors emphasize the role of nuclear modalities that can presently be used in clinical practice, and also look at future perspectives based on relevant clinical data with novel radiopharmaceuticals. PMID:26956538

  3. Combined-modality treatment for anal cancer. Current strategies and future directions

    Energy Technology Data Exchange (ETDEWEB)

    Roedel, Claus [Dept. of Radiation Oncology, J.W. Goethe Univ., Frankfurt/Main (Germany); Fraunholz, Ingeborg; Rabeneck, Daniela; Weiss, Christian

    2010-07-15

    Background: concurrent chemoradiotherapy (CRT) with 5-fluorouracil (5-FU) and mitomycin C (MMC) is the treatment of choice for anal carcinoma. The most appropriate radiation (RT) dose, fractionation, techniques, and the most effective chemotherapy regimen (agents, number of neoadjuvant, concomitant, adjuvant cycles) remain to be established. Material and methods: this review article focuses on recent randomized trials designed to improve standard 5-FU/MMC-based CRT through the inclusion of (induction, concurrent, maintenance) cisplatin, and describes developments in combining RT with other chemotherapeutic drugs and targeted therapies. Computerized bibliographic searches of PubMed were supplemented with hand searches of reference lists and abstracts of ASCO/ASTRO/ESTRO meetings. Results: based on results of three recent randomized phase III trials, neither induction chemotherapy (RTOG 98-11, ACCORD 03) or maintenance chemotherapy with 5-FU/cisplatin (ACT II) nor RT dose escalation (ACCORD 03) improved the outcome of concurrent 5-FU/MMC-CRT. A randomized phase II trial (EORTC 22011-40014) compared concurrent 5-FU/MMC-CRT with cisplatin/MMC-CRT. The response rate of cisplatin/MMC-CRT was promising, but compliance to this regimen was limited. Current phase I/II studies are evaluating the use of capecitabine, oxalipatin, and the EGFR (epidermal growth factor receptor) inhibitor cetuximab. Conclusion: concurrent 5-FU/MMC-CRT without induction or maintenance chemotherapy remains the standard of care for anal cancer patients. (orig.)

  4. Prostate cancer: emerging pharmacotherapeutic modalities

    OpenAIRE

    Pratap Shankar; Anoop Kumar Verma; Rakesh Kumar Dixit; Amod Kumar Sachan

    2013-01-01

    Prostate cancer is the most common cancer in the world due to factors like old age, family history, ethnicity, diet and some elements exposure, with lot of controversies regarding prevention of prostate cancer. Though the exact pathogenesis is not clear, epidemiological evidence supports a relationship between prostate cancer and hormone levels. In this review article we are focusing on the advances in different pharmacotherapeutic modalities i.e. Chemoprevention, Prostate-Specific Antigen, H...

  5. AUTOFLUORESCENCE BRONCHOSCOPY AS A MODALITY FOR EARLY DIAGNOSIS OF LUNG CANCER

    OpenAIRE

    KAW Nugraha; IDM Artika

    2013-01-01

    Lung cancer has become a complicated health problem in the world. In 2005, approximately 172,500 people diagnosed with lung cancer in the United States. In Indonesia, lung cancer ranks fourth highest. Lung cancer is also the most common cause of death from cancer, so we need appropriate early detection modality to reduce the number of deaths from lung cancer. Compared with other modalities that currently available, Autofluorescence Bronchoscopy (AFB) seems to have better accuracy in early dia...

  6. 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.

  7. Integrating new imaging modalities in breast cancer management

    OpenAIRE

    Pouw, B.

    2016-01-01

    This thesis aimed to integrate new imaging modalities in breast cancer management. In Part 1 the focus was to assess the current status of radioactive seed localisation (RSL) in clinical practice. Both patients as well as physicians or surgeons rated the technique superior compared to the conventional techniques. It is our expectation that when legislation is simplified and standard protocols for this procedure are available the adaptation rate of this procedure will further increase since le...

  8. Testosterone Substitution: Current Modalities and Perspectives

    Directory of Open Access Journals (Sweden)

    Zitzmann M

    2006-01-01

    Full Text Available The clinical picture of male hypogonadism is associated with typical symptoms, such as disturbances of mood and cognitive abilities as well as sexual functions; furtheron, a decrease in muscle mass and strength, an accumulation of body fat and osteopenia/osteoporosis are observed. There are indications that insulin sensitivity is mitigated in a state of androgen depletion. In older men, symptoms of androgen deficiency (late-onset hypogonadism may exhibit a differential profile due to accompanying other chronic illnesses. Restoring serum testosterone levels by replacement therapy can markedly attenuate, if not relieve, the clinical picture of hypogonadism. Recently, new treatment modalities have been introduced, which include short-acting transdermal or buccal modalities as well as the long-acting depot preparation of testosterone undecanoate. This review summarises the pathways of diagnosis of male hypogonadism and discusses the various modern methods of initiation and surveillance of testosterone substitution therapy. Future perspectives regarding pharmacogenetic aspects are discussed.

  9. Current indications and modalities of radiation therapy alone or with chemotherapy in cancer of the rectum; Indications et modalites de la radiotherapie et de la radio-chimiotherapie dans le traitement du cancer du rectum en 1998

    Energy Technology Data Exchange (ETDEWEB)

    Housset, M.; Metry, E.; Touboul, E. [Hopital Tenon, 75 - Paris (France)

    1998-10-01

    Radiation therapy plus chemotherapy has almost completely superseded radiation therapy alone in the postoperative treatment of cancer of the rectum. Although pre-surgical radiation therapy has been shown to reduce local recurrence rates and to improve survival rates as compared to surgery alone and to surgery plus post-surgical radiation therapy, the optimal dose and dose fractionation regimen are not agreed on. The modalities and value of pre-surgical radiation therapy plus chemotherapy are still under study. Also being evaluated is the role of radiation therapy in patients whose surgical treatment included the new technique of complete removal of the rectal mesentery. (authors)

  10. Modality

    DEFF Research Database (Denmark)

    Klinge, Alex; Müller, Henrik Høeg

    Modality: Studies in Form and Function reflects the diversity of theoretical frameworks and the heterogeneity of linguistic phenomena under the general heading of modality. Researchers in the fields of logic, philosophy and linguistics have for many years been pondering the elusive nature of...... modality and grappled with ways of capturing it. The 11 studies included here cover the span from contributions that seek to clarify controversial theoretical constructs to studies which take an empirical approach to linguistic categories and cross-linguistic typological issues. The key concepts addressed...... are the structure of modal subcategories, subjective vs. objective modality, force dynamics, evidentiality, Spanish and English modal auxiliaries, modal uses of Italian tenses, linearization patterns in German verb chains, determinant TAM categories, modal polyfunctionality across languages and...

  11. MRI for breast cancer: Current indications

    International Nuclear Information System (INIS)

    Mammography is the only imaging study that has been proven in multiple large randomized trials to decrease breast cancer mortality. Mammography, however, has its limitations and, as such, other modalities that can complement it are being studied. One of these is dynamic contrast-enhanced breast MRI, which has emerged as an important adjunctive modality and is at present the most sensitive modality that we have to evaluate the breast. The American College of Radiology, in its 2004 practice guidelines, has outlined the 12 current indications for breast MRI. This manuscript reviews and provides examples of each of these

  12. Optimal Composition of Modal Currents For Minimal Quality Factor Q

    CERN Document Server

    Capek, Miloslav

    2016-01-01

    This work describes a powerful, yet simple, procedure how to acquire a current approaching the lower bound of quality factor Q. This optimal current can be determined for an arbitrarily shaped electrically small radiator made of a perfect conductor. Quality factor Q is evaluated by Vandenbosch's relations yielding stored electromagnetic energy as a function of the source current density. All calculations are based on a matrix representation of the integro-differential operators. This approach simplifies the entire development and results in a straightforward numerical evaluation. The optimal current is represented in a basis of modal currents suitable for solving the optimization problem so that the minimum is approached by either one mode tuned to the resonance, or, by two properly combined modes. An overview of which modes should be selected and how they should be combined is provided and results concerning rectangular plate, spherical shell and fractal shapes of varying geometrical complexity are presented...

  13. Laser Illumination Modality of Photoacoustic Imaging Technique for Prostate Cancer

    Science.gov (United States)

    Peng, Dong-qing; Peng, Yuan-yuan; Guo, Jian; Li, Hui

    2016-02-01

    Photoacoustic imaging (PAI) has recently emerged as a promising imaging technique for prostate cancer. But there was still a lot of challenge in the PAI for prostate cancer detection, such as laser illumination modality. Knowledge of absorbed light distribution in prostate tissue was essential since the distribution characteristic of absorbed light energy would influence the imaging depth and range of PAI. In order to make a comparison of different laser illumination modality of photoacoustic imaging technique for prostate cancer, optical model of human prostate was established and combined with Monte Carlo simulation method to calculate the light absorption distribution in the prostate tissue. Characteristic of light absorption distribution of transurethral and trans-rectal illumination case, and of tumor at different location was compared with each other.The relevant conclusions would be significant for optimizing the light illumination in a PAI system for prostate cancer detection.

  14. Modal analysis of multiterminal high voltage direct current transmission

    Energy Technology Data Exchange (ETDEWEB)

    Dagle, J.E.

    1993-12-01

    This report describes a first phase of effort in providing the Bonneville Power Administration (BPA) with comprehensive tools for model-based analysis of interactions between the Pacific HVDC Intertie (PDCI) and the alternating current (ac) system containing it. The work builds upon the transient stability model coded by Control Technologies, Inc. (CTI) for use in the Electric Power Research Institute (EPRI) Extended Transient-Midterm Stability Package (ETMSP). The general thrust of the effort is that CM`s model be interfaced to and tested against all tools provided by EPRI`s Power System Analysis Package (PSAPAC), and that these tools be used to investigate options for PDCI use in testing and control of western system dynamics. This will require refinements to the tools, the model, and western system case data. The PSAPAC tool for eigenanalysis is the Small Signal Stability Package (SSSP), useful for performing modal analysis of the multiterminal HVDC (MTDC) system. Such analyses are necessary to design and test an expanded role of the PDCI for power system control. This study focused on testing the application of the MTDC with SSSP. Modifications were made to enable SSSP to read the MTDC model. The PSAPAC and SSSP tools and the MTDC model were evaluated for accuracy and consistency using several modal analysis techniques, including Prony analysis on ETMSP-generated data. Although SSSP appears to be useful in analyzing the PDCI modes, inconsistencies limit the overall usefulness of that approach. The modal frequencies and damping identified by SSSP are inconsistent, indicating SSSP has difficulty analyzing the MTDC representation of the dc systems. The differences between the new and existing models can be used to identify the particular modeling issues associated with SSSP which are presently resulting in inconsistent results.

  15. Modal analysis of multiterminal high voltage direct current transmission

    Science.gov (United States)

    Dagle, J. E.

    1993-12-01

    This report describes a first phase of effort in providing the Bonneville Power Administration (BPA) with comprehensive tools for model-based analysis of interactions between the Pacific HVDC Intertie (PDCI) and the alternating current (ac) system containing it. The work builds upon the transient stability model coded by Control Technologies, Inc. (CTI) for use in the Electric Power Research Institute (EPRI) Extended Transient-Midterm Stability Package (ETMSP). The general thrust of the effort is that CM's model be interfaced to and tested against all tools provided by EPRI's Power System Analysis Package (PSAPAC) and that these tools be used to investigate options for PDCI use in testing and control of western system dynamics. This will require refinements to the tools, the model, and western system case data. The PSAPAC tool for eigenanalysis is the Small Signal Stability Package (SSSP), useful for performing modal analysis of the multiterminal HVDC (MTDC) system. Such analyses are necessary to design and test an expanded role of the PDCI for power system control. This study focused on testing the application of the MTDC with SSSP. Modifications were made to enable SSSP to read the MTDC model. The PSAPAC and SSSP tools and the MTDC model were evaluated for accuracy and consistency using several modal analysis techniques, including Prony analysis on ETMSP-generated data. Although SSSP appears to be useful in analyzing the PDCI modes, inconsistencies limit the overall usefulness of that approach. The modal frequencies and damping identified by SSSP are inconsistent, indicating SSSP has difficulty analyzing the MTDC representation of the dc systems. The differences between the new and existing models can be used to identify the particular modeling issues associated with SSSP which are presently resulting in inconsistent results.

  16. New modalities to treat laryngeal cancer.

    OpenAIRE

    Prgomet, Drago

    2012-01-01

    Early laryngeal cancer comprises T1 and T2 stages of the disease. Open functional operations achieve local control of the disease in 90–95% of T1 patients and in 70–90% of T2 patients. Primary RT achieves local control in 85–94% of T1 tumors and in 70–80% of patients with T2 tumors. Introduction of endoscopic laser surgery resulted in further popularization of preservation laryngeal surgery, whereby equally successful treatment results are achieved with minimal invasiveness. Quality of voice ...

  17. Pressure ulcers: Current understanding and newer modalities of treatment

    Directory of Open Access Journals (Sweden)

    Surajit Bhattacharya

    2015-01-01

    Full Text Available This article reviews the mechanism, symptoms, causes, severity, diagnosis, prevention and present recommendations for surgical as well as non-surgical management of pressure ulcers. Particular focus has been placed on the current understandings and the newer modalities for the treatment of pressure ulcers. The paper also covers the role of nutrition and pressure-release devices such as cushions and mattresses as a part of the treatment algorithm for preventing and quick healing process of these wounds. Pressure ulcers develop primarily from pressure and shear; are progressive in nature and most frequently found in bedridden, chair bound or immobile people. They often develop in people who have been hospitalised for a long time generally for a different problem and increase the overall time as well as cost of hospitalisation that have detrimental effects on patient′s quality of life. Loss of sensation compounds the problem manifold, and failure of reactive hyperaemia cycle of the pressure prone area remains the most important aetiopathology. Pressure ulcers are largely preventable in nature, and their management depends on their severity. The available literature about severity of pressure ulcers, their classification and medical care protocols have been described in this paper. The present treatment options include various approaches of cleaning the wound, debridement, optimised dressings, role of antibiotics and reconstructive surgery. The newer treatment options such as negative pressure wound therapy, hyperbaric oxygen therapy, cell therapy have been discussed, and the advantages and disadvantages of current and newer methods have also been described.

  18. Exogenous Molecular Probes for Targeted Imaging in Cancer: Focus on Multi-modal Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Joshi, Bishnu P. [Division of Gastroenterology, Department of Medicine, University of Michigan, School of Medicine, 109 Zina Pitcher Place, BSRB 1722, Ann Arbor, MI 48109 (United States); Wang, Thomas D., E-mail: thomaswa@umich.edu [Division of Gastroenterology, Department of Medicine, University of Michigan, School of Medicine, 109 Zina Pitcher Place, BSRB 1722, Ann Arbor, MI 48109 (United States); Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109 (United States)

    2010-06-11

    Cancer is one of the major causes of mortality and morbidity in our healthcare system. Molecular imaging is an emerging methodology for the early detection of cancer, guidance of therapy, and monitoring of response. The development of new instruments and exogenous molecular probes that can be labeled for multi-modality imaging is critical to this process. Today, molecular imaging is at a crossroad, and new targeted imaging agents are expected to broadly expand our ability to detect and manage cancer. This integrated imaging strategy will permit clinicians to not only localize lesions within the body but also to manage their therapy by visualizing the expression and activity of specific molecules. This information is expected to have a major impact on drug development and understanding of basic cancer biology. At this time, a number of molecular probes have been developed by conjugating various labels to affinity ligands for targeting in different imaging modalities. This review will describe the current status of exogenous molecular probes for optical, scintigraphic, MRI and ultrasound imaging platforms. Furthermore, we will also shed light on how these techniques can be used synergistically in multi-modal platforms and how these techniques are being employed in current research.

  19. Monoclonal Antibodies as Treatment Modalities in Head and Neck Cancers

    Directory of Open Access Journals (Sweden)

    Vivek Radhakrishnan

    2015-11-01

    Full Text Available The standard treatments of surgery, radiation, and chemotherapy in head and neck squamous cell carcinomas (HNSCC causes disturbance to normal surrounding tissues, systemic toxicities and functional problems with eating, speaking, and breathing. With early detection, many of these cancers can be effectively treated, but treatment should also focus on retaining the function of the proximal nerves, tissues and vasculature surrounding the tumor. With current research focused on understanding pathogenesis of these cancers in a molecular level, targeted therapy using monoclonal antibodies (MoAbs, can be modified and directed towards tumor genes, proteins and signal pathways with the potential to reduce unfavorable side effects of current treatments. This review will highlight the current MoAb therapies used in HNSCC, and discuss ongoing research efforts to develop novel treatment agents with potential to improve efficacy, increase overall survival (OS rates and reduce toxicities.

  20. Chemoradiation for Advanced Head and Neck Cancer: Potential for Improving Results to Match Those of Current Treatment Modalities for Early-Stage Tumors-Long-Term Results of Hyperfractionated Chemoradiation With Carbogen Breathing and Anemia Correction With Erythropoietin

    International Nuclear Information System (INIS)

    Purpose: To attempt to improve results of chemoradiation for head and neck cancer. Methods and Materials: From March 1996 to April 2007, 98 patients with head and neck cancer (15 Stage III and 83 Stage IV) were treated with a twice-daily hyperfractionated schedule. Eleven patients presented with N0, 11 with N1, 13 with N2A, 17 with N2B, 24 with N2C, and 22 with N3. Each fraction of treatment consisted of 5 mg/m2 of carboplatin plus 115 cGy with carbogen breathing. Treatment was given 5 days per week up to total doses of 350 mg/m2 of carboplatin plus 8050 cGy in 7 weeks. Anemia was corrected with erythropoietin. Results: Ninety-six patients tolerated the treatment as scheduled. All patients tolerated the planned radiation dose. Local toxicity remained at the level expected with irradiation alone. Chemotherapy toxicity was moderate. Ninety-seven complete responses were achieved. After 11 years of follow-up (median, 81 months), actuarial locoregional control, cause-specific survival, overall survival, and nodal control rates at 5 and 10 years were, respectively, 83% and 83%, 68% and 68%, 57% and 55%, and 100% and 100%. Median follow-up of disease-free survivors was 80 months. No significant differences in survival were observed between the different subsites or between the pretreatment node status groups (N0 vs. N+, N0 vs. N1, N0 vs. N2A, N0 vs. N2B, N0 vs. N2C, and N0 vs. N3). Conclusions: Improving results of chemoradiation for advanced head and neck cancer up to the level obtained with current treatments for early-stage tumors is a potentially reachable goal

  1. Sportsman hernia; the review of current diagnosis and treatment modalities.

    Science.gov (United States)

    Paksoy, Melih; Sekmen, Ümit

    2016-01-01

    Groin pain is an important clinical entity that may affect a sportsman's active sports life. Sportsman's hernia is a chronic low abdominal and groin pain syndrome. Open and laparoscopic surgical treatment may be chosen in case of conservative treatment failure. Studies on sportsman's hernia, which is a challenging situation in both diagnosis and treatment, are ongoing in many centers. We reviewed the treatment results of 37 patients diagnosed and treated as sportsman's hernia at our hospital between 2011-2014, in light of current literature. PMID:27436937

  2. Impact of EBUS-TBNA on modalities for tissue acquisition in patients with lung cancer

    OpenAIRE

    José, R. J.; Shaw, P.; M. Taylor; Lawrence, D R; George, P J; Janes, S.M.; Navani, N.

    2013-01-01

    Background: The impact of the introduction of Endobronchial ultrasound with real-time guided transbronchial needle aspiration (EBUS-TBNA) on the use of diagnostic modalities for tissue acquisition in patients with lung cancer is unknown.

  3. Combined modality therapy for stage ⅠB cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Yang Qiuan; Qian Shao; Yang Xingsheng

    2009-01-01

    Objective:To evaluate the current approaches for multimodality therapy for stage ⅠB cervical cancer. Methods:The relevant literature has served as a source for identified high or intermediate risks and management of stage ⅠB cervical cancer. Result:The high risks include pelvic lymph node metastasis (PLNM), positive resection margin (PRM), and the in-volvement of parametrium (IPM). The intermediate risks include deep stromal invasion (DSI), bulky tumor size ( BTS), lymphovascular space invasion (LVSI). Adeno-carcinomatous histo-type is the new risk feature relevant to poor prognoses. Both radical hysterectomy plus bilateral pelvic lymph node dissection(PLND) and radical radiotherapy have proven to be equally effec-tive. Surgery is more performed for stage ⅠB1 disease;radiotherapy or chemoradiotherapy is preferable for stage ⅠB2 disease. For patients with one high risk or two of intermediate risks, radical hysterectomy plus PLND followed by concurrent chemoradiotherapy can improve overall survival(OS) and disease-free survival (DFS). Conclusion:The management should be indi-vidualized for stage ⅠB cervical cancer. The optimized multidisciplinary therapy can benefit pa-tients with the best cure and minimum morbidity and complications.

  4. Risk of Second Cancers According to Radiation Therapy Technique and Modality in Prostate Cancer Survivors

    Energy Technology Data Exchange (ETDEWEB)

    Berrington de Gonzalez, Amy, E-mail: berringtona@mail.nih.gov [Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States); Wong, Jeannette; Kleinerman, Ruth; Kim, Clara; Morton, Lindsay [Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States); Bekelman, Justin E. [Department of Radiation Oncology, Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2015-02-01

    Purpose: Radiation therapy (RT) techniques for prostate cancer are evolving rapidly, but the impact of these changes on risk of second cancers, which are an uncommon but serious consequence of RT, are uncertain. We conducted a comprehensive assessment of risks of second cancer according to RT technique (>10 MV vs ≤10 MV and 3-dimensional [3D] vs 2D RT) and modality (external beam RT, brachytherapy, and combined modes) in a large cohort of prostate cancer patients. Methods and Materials: The cohort was constructed using the Surveillance Epidemiology and End Results-Medicare database. We included cases of prostate cancer diagnosed in patients 66 to 84 years of age from 1992 to 2004 and followed through 2009. We used Poisson regression analysis to compare rates of second cancer across RT groups with adjustment for age, follow-up, chemotherapy, hormone therapy, and comorbidities. Analyses of second solid cancers were based on the number of 5-year survivors (n=38,733), and analyses of leukemia were based on number of 2-year survivors (n=52,515) to account for the minimum latency period for radiation-related cancer. Results: During an average of 4.4 years' follow-up among 5-year prostate cancer survivors (2DRT = 5.5 years; 3DRT = 3.9 years; and brachytherapy = 2.7 years), 2933 second solid cancers were diagnosed. There were no significant differences in second solid cancer rates overall between 3DRT and 2DRT patients (relative risk [RR] = 1.00, 95% confidence interval [CI]: 0.91-1.09), but second rectal cancer rates were significantly lower after 3DRT (RR = 0.59, 95% CI: 0.40-0.88). Rates of second solid cancers for higher- and lower-energy RT were similar overall (RR = 0.97, 95% CI: 0.89-1.06), as were rates for site-specific cancers. There were significant reductions in colon cancer and leukemia rates in the first decade after brachytherapy compared to those after external beam RT. Conclusions: Advanced treatment planning may have reduced rectal

  5. Risk of Second Cancers According to Radiation Therapy Technique and Modality in Prostate Cancer Survivors

    International Nuclear Information System (INIS)

    Purpose: Radiation therapy (RT) techniques for prostate cancer are evolving rapidly, but the impact of these changes on risk of second cancers, which are an uncommon but serious consequence of RT, are uncertain. We conducted a comprehensive assessment of risks of second cancer according to RT technique (>10 MV vs ≤10 MV and 3-dimensional [3D] vs 2D RT) and modality (external beam RT, brachytherapy, and combined modes) in a large cohort of prostate cancer patients. Methods and Materials: The cohort was constructed using the Surveillance Epidemiology and End Results-Medicare database. We included cases of prostate cancer diagnosed in patients 66 to 84 years of age from 1992 to 2004 and followed through 2009. We used Poisson regression analysis to compare rates of second cancer across RT groups with adjustment for age, follow-up, chemotherapy, hormone therapy, and comorbidities. Analyses of second solid cancers were based on the number of 5-year survivors (n=38,733), and analyses of leukemia were based on number of 2-year survivors (n=52,515) to account for the minimum latency period for radiation-related cancer. Results: During an average of 4.4 years' follow-up among 5-year prostate cancer survivors (2DRT = 5.5 years; 3DRT = 3.9 years; and brachytherapy = 2.7 years), 2933 second solid cancers were diagnosed. There were no significant differences in second solid cancer rates overall between 3DRT and 2DRT patients (relative risk [RR] = 1.00, 95% confidence interval [CI]: 0.91-1.09), but second rectal cancer rates were significantly lower after 3DRT (RR = 0.59, 95% CI: 0.40-0.88). Rates of second solid cancers for higher- and lower-energy RT were similar overall (RR = 0.97, 95% CI: 0.89-1.06), as were rates for site-specific cancers. There were significant reductions in colon cancer and leukemia rates in the first decade after brachytherapy compared to those after external beam RT. Conclusions: Advanced treatment planning may have reduced rectal

  6. Fabrication of SERS-fluorescence dual modal nanoprobes and application to multiplex cancer cell imaging

    Science.gov (United States)

    Lee, Sangyeop; Chon, Hyangah; Yoon, Soo-Young; Lee, Eun Kyu; Chang, Soo-Ik; Lim, Dong Woo; Choo, Jaebum

    2011-12-01

    We report a highly sensitive optical imaging technology using surface-enhanced Raman scattering (SERS)-fluorescence dual modal nanoprobes (DMNPs). Fluorescence microscopy is a well-known imaging technique that shows specific protein distributions within cells. However, most currently available fluorescent organic dyes have relatively weak emission intensities and are rapidly photo-bleached. Thus more sensitive and stable probes are needed. In this work we develop DMNPs, which can be used for both SERS and fluorescence detection. SERS detection is a powerful technique that allows ultrasensitive chemical or biochemical analysis through unlimited multiplexing and single molecule sensitivity. Combining advantages of fluorescence and SERS allows these dual modal nanostructures to be used as powerful probes for novel biomedical imaging. In this work, the fabrication and characterization of the SERS-fluorescence DMNPs and application to biological imaging were investigated using markers CD24 and CD44, which are co-expressed in MDA-MB-231 breast cancer cells, as a model system. SERS imaging with DMNPs was found to be a powerful tool to determine the co-localization of CD24 and CD44 in the cell.We report a highly sensitive optical imaging technology using surface-enhanced Raman scattering (SERS)-fluorescence dual modal nanoprobes (DMNPs). Fluorescence microscopy is a well-known imaging technique that shows specific protein distributions within cells. However, most currently available fluorescent organic dyes have relatively weak emission intensities and are rapidly photo-bleached. Thus more sensitive and stable probes are needed. In this work we develop DMNPs, which can be used for both SERS and fluorescence detection. SERS detection is a powerful technique that allows ultrasensitive chemical or biochemical analysis through unlimited multiplexing and single molecule sensitivity. Combining advantages of fluorescence and SERS allows these dual modal nanostructures to be used

  7. Current management of oral cancer

    Institute of Scientific and Technical Information of China (English)

    Robert Ord

    2008-01-01

    @@ This presentation will summarize some of the current areas of interest in the management of oral cancer. The presentation will be divided into a brief review of epidemiology and diagnosis, with a more extensive discussion regarding the controversial areas in surgery and a review of the adjuvant roles of radiation and chemotherapy.

  8. 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.

  9. PENGARUH MODAL SENDIRI DAN CURRENT RATIO TERHADAP SISA HASIL USAHA (SHU) DI KPRI KOTA SEMARANG 2013

    OpenAIRE

    Isna Farah Albana; Kusumantoro

    2015-01-01

    Penelitian ini bertujuan untuk menganalisis pengaruh Modal Sendiri dan Current Ratio secara parsial terhadap SHU pada KPRI di Kota Semarang. Untuk menjawab tujuan dari penelitian ini maka digunakan alat analisis regresi linier berganda. Pada analisis regresi linier berganda, dilakukan uji asumsi klasik yang terdiri dari uji autokorelasi, uji multikolinieritas, dan uji heteroskedastisitas. Pengujian hipotesis menggunakan program SPSS 16.0 for windows. Hasil dari penelitian ini menunjukan bahwa...

  10. New modalities of cancer treatment for NSCLC: focus on immunotherapy

    Directory of Open Access Journals (Sweden)

    Davies M

    2014-02-01

    Full Text Available Marianne Davies Smilow Cancer Hospital at Yale-New Haven Hospital, New Haven, CT, USA Abstract: Recent advances in the understanding of immunology and antitumor immune responses have led to the development of new immunotherapies, including vaccination approaches and monoclonal antibodies that inhibit immune checkpoint pathways. These strategies have shown activity in melanoma and are now being tested in lung cancer. The antibody drugs targeting cytotoxic T-lymphocyte-associated antigen-4 and programmed cell death protein-1 immune checkpoint pathways work by restoring immune responses against cancer cells, and are associated with unconventional response patterns and immune-related adverse events as a result of their mechanism of action. As these new agents enter the clinic, nurses and other health care providers will require an understanding of the unique efficacy and safety profiles with immunotherapy to optimize potential patient benefits. This paper provides a review of the new immunotherapeutic agents in development for lung cancer, and strategies for managing patients on immunotherapy. Keywords: immunotherapy, lung cancer, vaccination, nivolumab, ipilimumab, nursing

  11. New modalities of cancer treatment for NSCLC: focus on immunotherapy

    International Nuclear Information System (INIS)

    Recent advances in the understanding of immunology and antitumor immune responses have led to the development of new immunotherapies, including vaccination approaches and monoclonal antibodies that inhibit immune checkpoint pathways. These strategies have shown activity in melanoma and are now being tested in lung cancer. The antibody drugs targeting cytotoxic T-lymphocyte-associated antigen-4 and programmed cell death protein-1 immune checkpoint pathways work by restoring immune responses against cancer cells, and are associated with unconventional response patterns and immune-related adverse events as a result of their mechanism of action. As these new agents enter the clinic, nurses and other health care providers will require an understanding of the unique efficacy and safety profiles with immunotherapy to optimize potential patient benefits. This paper provides a review of the new immunotherapeutic agents in development for lung cancer, and strategies for managing patients on immunotherapy

  12. Sexual functioning after treatment for testicular cancer - Comparison of treatment modalities

    NARCIS (Netherlands)

    JonkerPool, G; vanBasten, JP; Hoekstra, HJ; vanDriel, MF; Sleijfer, DT; vandeWiel, HBM; Schraffordt Koops, H.

    1997-01-01

    BACKGROUND. This retrospective study evaluates changes in sexual functioning after treatment for testicular cancer and investigates whether there is a relationship with different treatment modalities. METHODS. A self-reported questionnaire was sent to 337 men who had been treated for testicular canc

  13. Dual modality CT/PET imaging in lung cancer staging

    International Nuclear Information System (INIS)

    Purpose: To compare the diagnostic capability of PET-HCT image fusion and helical computed tomography (HCT) for nodal and distant metastases detection in patients with lung cancer. Material and methods: Between February, 2003 and March, 2004 sixty-six consecutive lung cancer patients (45 men and 21 women, mean ages: 63 years old, range: 38 to 96 years old) who underwent HCT and PET-HCT fusion imaging were evaluated retrospectively. All patients had histological confirmation of lung cancer and a definitive diagnosis established on the basis of pathology results and/or clinical follow-up. Results: For global nodal staging (hilar and mediastinal) HCT showed a sensitivity, specificity, positive predictive value and negative predictive value of 72%, 47%, 62% and 58% respectively, versus 94%, 77%, 83% and 92% corresponding to PET-HCT examination. For assessment of advanced nodal stage (N3) PET-HCT showed values of 92%, 100%, 100% and 98% respectively. For detection of distant metastasis, HCT alone had values of 67%, 93%, 84% and 83% respectively versus 100%, 98%, 96% and 100% for the PET-HCT fusion imaging. In 20 (30%) patients under-staged or over-staged on the basis of HCT results, PET-HCT allowed accurate staging. Conclusions: PET-HCT fusion imaging was more effective than HCT alone for nodal and distant metastasis detection and oncology staging. (author)

  14. Detecting diseases of neglected seminal vesicles using imaging modalities: A review of current literature.

    Science.gov (United States)

    Dagur, Gautam; Warren, Kelly; Suh, Yiji; Singh, Navjot; Khan, Sardar A

    2016-05-01

    Seminal vesicles (SVs) are sex accessory organs and part of male genitourinary system. They play a critical role in male fertility. Diseases of the SVs, usually results in infertility. Diseases of the SVs are extremely rare and are infrequently reported in the literature. We address the current literature of SV pathologies, symptoms, diagnosis, and treatment options. We review the clinical importance of SVs from PubMed. The current imaging modalities and instrumentation that help diagnose SV diseases are reviewed. Common pathologies including, infection, cysts, tumors, and congenital diseases of the SVs are addressed. Many times symptoms of hematospermia, pain, irritative and obstructive lower urinary tract symptoms, and infertility are presented in patients with SV diseases. PMID:27326413

  15. Restaging locally advanced rectal cancer by different imaging modalities after preoperative chemoradiation: a comparative study

    International Nuclear Information System (INIS)

    To compare the accuracy of different imaging modalities, alone and in combination in predicting findings at surgery after preoperative chemoradiation for locally advanced rectal cancer. Following chemoradiation, tumors were reclassified on the basis of findings on pelvic computed tomography (CT) (94 patients), endorectal ultrasonography (EUS) (138 patients) alone or by both CT and EUS (80 patients). The ability of the imaging modalities, to predict the pathologic T status, N status, and TNM stage at surgery was evaluated and compared. Mean age of the patients was 64.5 years (range 28–88 years); 55% were male. CT and EUS combined had a positive predictive value of 20% for pathologic pT1 stage, 29% for pT1, 29% for pT2, and 58% for pT3. Predictive values for the operative TNM stage were 50% for stage I, 45% for stage II, and 31% for stage III. These values did not exceed those for each modality alone. The performance of preoperative CT and EUS in predicting the T and TNM stage of rectal cancer at surgery is poor. Neither modality alone nor the two combined is sufficiently accurate to serve as the basis for decisions regarding treatment modification

  16. Current status of multi-modality treatment for malignant pleural mesothelioma in Japan

    International Nuclear Information System (INIS)

    We investigated the current status of multi-modality treatment for malignant pleural mesothelioma in Japan as part of the campaign entitled Comprehensive Strategy Against Asbestos-related Diseases'', which was funded by the 2006 Special Coordination Fund for Promoting Science and Technology from the Japan Science and Technology Agency. We evaluated cases of extrapleural pneumonectomy (EPP) for malignant pleural mesothelioma between January 2002 and December 2006. A questionnaire was sent to a total of 69 institutions, and was returned by 61 of them. A total of 171 patients underwent EPP for malignant pleural mesothelioma during the study period. They consisted of 154 males and 17 females, and the age ranged between 14 and 78 with the average of 59. The side of EPP was on the right in 91 and on the left in 80 cases. One postoperative death due to interstitial pneumonia and 6 in-hospital deaths due to tumor recurrence (n=4), methicillin-resistant Staphylococcus aureus (MRSA) empyema (n=1), and pulmonary infarction (n=1) were noted. Preoperative chemotherapy with cisplatin was given in 38 patients, and 12 out of 38 underwent postoperative hemithorax radiation therapy. The median survival was 23 months. The present study showed an increase of cases and also improvement of surgical mortality of EPP for malignant pleural mesothelioma in comparison with former studies. However, we still do not have clinical evidence regarding the feasibility of multi-modality treatment for malignant pleural mesothelioma. (author)

  17. Cancer immunotherapy: moving beyond current vaccines

    OpenAIRE

    Rosenberg, Steven A.; Yang, James C.; Restifo, Nicholas P

    2004-01-01

    Great progress has been made in the field of tumor immunology in the past decade, but optimism about the clinical application of currently available cancer vaccine approaches is based more on surrogate endpoints than on clinical tumor regression. In our cancer vaccine trials of 440 patients, the objective response rate was low (2.6%), and comparable to the results obtained by others. We consider here results in cancer vaccine trials and highlight alternate strategies that mediate cancer regre...

  18. Role of radiation therapy in the multi-modal treatment of head and neck cancer

    International Nuclear Information System (INIS)

    The role of radiation therapy as part of the multi-modal treatment of head and neck cancer appeared to be important with respect to functional and cosmetic morbidity. As for oral cancer, the value of brachytherapy was excellent in cases of localized disease. As far as the latter technique was applicable, patients with tongue cancer at T1, T2 and T3 could be treated by radiation as the initial choice unless palpable neck node metastasis was present. In contrast, cure of the lesion would not be expected from external irradiation alone even when combined with chemotherapy. Accordingly, in such advanced cases, salvage surgery should be applied with or without radiation and/or chemotherapy. As for maxillary cancer, the introduction of ''trimodal therapy'' has improved the local control rate only to a slight degree. After the application of conservative surgery followed by conventional trimodal combination therapy, local control and five-year survival rates have been improved markedly. (author)

  19. [Current MRI staging of rectal cancer].

    Science.gov (United States)

    Wietek, B M; Kratt, T

    2012-11-01

    Colorectal carcinoma is the second most prevalent cause for cancer, and has very variable outcomes. Advancements in surgery, the change from adjuvant to neo-adjuvant radio-chemo-therapies as well as in clinical diagnostics have improved the prognosis for patients in a multi-modal therapy concept. An accurate primary staging including a reliable prediction of the circumferential resection margin (CRM) has established MR Imaging (MRI) beside intraluminal endoscopic ultrasound (EUS). MRI facilitates the selection of patients likely to benefit from a preoperative therapy, especially in cases of unfavorable factors. Currently the relationship of the tumor to the mesorectal fascia has become a more important prognostic factor than the T-staging, particularly for surgical therapy. In addition further prognostic factors like the depth of infiltration into the perirectal fat and the extramural venous infiltration (EMVI) have important impact on therapy and prognosis. High resolution MRI has proved useful in clarifying the relationship between the tumor and the mesorectal fascia, which represents the CRM at the total mesorectal excision (TME) especially in the upper and middle third. Preoperative evaluation of the other prognostic factors as well as the nodal status is still difficult. It is used increasingly not only for primary staging but also progressively for the monitoring of neoadjuvant therapy. The addition of diffusion weighted imaging (DWI) is an interesting option for the improvement of response evaluation. The following overview provides an introduction of MRI diagnosis as well as its importance for the evaluation of the clinically relevant prognostic factors leading to an improvement of therapy and prognosis of patients with rectal carcinoma. PMID:22893486

  20. Non-invasive imaging modalities for preoperative axillary lymph node staging in patients with breast cancer

    International Nuclear Information System (INIS)

    In the last decade sentinel lymph node biopsy has become a well-established method for axillary lymph node staging in patients with breast cancer. Using preoperative imaging modalities it can be tested whether patients are suitable for sentinel node biopsy or if they should directly undergo an axillary dissection. The imaging modalities used must be mainly characterized by a high positive predictive value (PPV). For this question B-mode ultrasound is the best evaluated method and provides clear morphological signs for a high PPV (>90%) but the sensitivity barely exceeds 50%. It has not yet been proven whether other modalities such as duplex sonography, magnetic resonance imaging, computed tomography (CT) or scintigraphy might achieve a higher sensitivity while still maintaining a high PPV. There is only some evidence that positron emission tomography (PET) might achieve a higher sensitivity. This should be confirmed by further studies because PET or PET/CT will play an increasing role for an initial whole body staging in patients with breast cancer in the near future. (orig.)

  1. ‘E-learning’ modalities in the current era of Medical Education in Pakistan

    OpenAIRE

    Jawaid, Masood; Aly, Syed Moyn

    2014-01-01

    There are a number of e-Learning modalities, some or all of which may be used throughout a medical, dental, nursing or any other health related undergraduate curriculum. The purpose of this paper is to briefly describe what e-learning is along with some of the modalities, their common advantages and limitations. This publication ends with practical implications of these modalities for Pakistan.

  2. Is there room for combined modality treatments? Dosimetric comparison of boost strategies for advanced head and neck and prostate cancer.

    Science.gov (United States)

    Góra, Joanna; Hopfgartner, Johannes; Kuess, Peter; Paskeviciute, Brigita; Georg, Dietmar

    2013-07-01

    The purpose of the study was to determine the dosimetric difference between three emerging treatment modalities--volumetric-modulated arc therapy (VMAT), intensity-modulated proton beam therapy (IMPT) and intensity-modulated carbon ion beam therapy (IMIT)--for two tumour sites where selective boosting of the tumour is applied. For 10 patients with locally advanced head and neck (H&N) cancer and 10 with high-risk prostate cancer (PC) a VMAT plan was generated for PTV initial that included lymph node regions, delivering 50 Gy (IsoE) for H&N and 50.4 Gy (IsoE) for PC patients. Furthermore, separate boost plans (VMAT, IMPT and IMIT) were created to boost PTV boost up to 70 Gy (IsoE) and 78 Gy (IsoE) for H&N and PC cases, respectively. Doses to brainstem, myelon, larynx and parotid glands were assessed for H&N cases. Additionally, various OARs (e.g. cochlea, middle ear, masticator space) were evaluated that are currently discussed with respect to quality of life after treatment. For PC cases, bladder, rectum and femoral heads were considered as OARs. For both tumour sites target goals were easily met. Looking at OAR sparing, generally VMAT + VMAT was worst. VMAT + IMIT had the potential to spare some structures in very close target vicinity (such as cochlea, middle ear, masticator space ) significantly better than VMAT + IMPT. Mean doses for rectal and bladder wall were on average 4 Gy (IsoE) and 1.5 Gy (IsoE) higher, respectively, compared to photons plus particles scenarios. Similar results were found for parotid glands and larynx. Concerning target coverage, no significant differences were observed between the three treatment concepts. Clear dosimetric benefits were observed for particle beam therapy as boost modality. However, the clinical benefit of combined modality treatments remains to be demonstrated. PMID:23824134

  3. Is there room for combined modality treatments? Dosimetric comparison of boost strategies for advanced head and neck and prostate cancer

    International Nuclear Information System (INIS)

    The purpose of the study was to determine the dosimetric difference between three emerging treatment modalities-volumetric-modulated arc therapy (VMAT), intensity-modulated proton beam therapy (IMPT) and intensity-modulated carbon ion beam therapy (IMIT)-for two tumour sites where selective boosting of the tumour is applied. For 10 patients with locally advanced head and neck (H and N) cancer and 10 with high-risk prostate cancer (PC) a VMAT plan was generated for PTVinitial that included lymph node regions, delivering 50 Gy (IsoE) for H and N and 50.4 Gy (IsoE) for PC patients. Furthermore, separate boost plans (VMAT, IMPT and IMIT) were created to boost PTVboost up to 70 Gy (IsoE) and 78 Gy (IsoE) for H and N and PC cases, respectively. Doses to brainstem, myelon, larynx and parotid glands were assessed for H and N cases. Additionally, various organs at risk (OARs) (e.g. cochlea, middle ear, masticator space) were evaluated that are currently discussed with respect to quality of life after treatment. For PC cases, bladder, rectum and femoral heads were considered as OARs. For both tumour sites target goals were easily met. Looking at OAR sparing, generally VMAT + VMAT was worst. VMAT + IMIT had the potential to spare some structures in very close target vicinity (such as cochlea, middle ear, masticator space) significantly better than VMAT + IMPT. Mean doses for rectal and bladder wall were on average 4 Gy (IsoE) and 1.5 Gy (IsoE) higher, respectively, compared to photons plus particles scenarios. Similar results were found for parotid glands and larynx. Concerning target coverage, no significant differences were observed between the three treatment concepts. Clear dosimetric benefits were observed for particle beam therapy as boost modality. However, the clinical benefit of combined modality treatments remains to be demonstrated. (author)

  4. Prostate cancer, treatment modalities and complications: an evaluation of the scientific literature

    Energy Technology Data Exchange (ETDEWEB)

    Santos-Filho, Sebastiao David; Fonseca, Adenilson de Souza da; Bernardo-Filho, Mario [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Inst. de Biologia Roberto Alcantara Gomes. Dept. de Biofisica e Biometria]. E-mail: santos-filho@uer.br; Missailids, Sotiris [The Open University, Milton Keynes (United Kingdom). Dept. of Chemistry and Analytical Sciences

    2008-12-15

    Prostate (PR) cancer (CA) is one of the most common malignant neoplasms in men all over the world. In general, if prostate cancer (PC) is detected early, treatment usually involves either surgical removal of the prostate or radiotherapy (RT). Hormone Therapy (HT) or chemotherapy (CH) is the preferred treatment for more advanced cases of PC or if CA spreads beyond the PT. A number of complications, such as urinary incontinence (IU) or erectile dysfunction (ED), can be associated with some modalities of treatment of the PC. The aim of this work is to evaluate, in PubMed, the number of publications related with prostate cancer and the main modalities of treatment, as well as some clinical complications. The searches were performed in PubMed (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi) in the period 1950 to 2008 using the words: CA, CA and PR or penis or testis, CA and PR and RT, CA and PR and surgery (SU), CA and PR and CH and, CA and PR and HT and CA and PR and RT and IU or ED, CA and PR and SU and IU or ED, CA and PR and CH and IU or ED and, CA and PR and HT and CH and IU or ED, and (V) PC and the same modalities of treatment. The data was obtained on July 20th, 2008. PC, as expected has been cited extensively and surgery has been identified as the most widely referenced modality of treatment. Furthermore, urinary incontinence and erectile dysfunction are important complications that have attracted significant scientific interest. In conclusion, these findings have shown the relevance of the PubMed to analyze quantitatively the publications in cancer and this information could be worthwhile in aiding the comprehension of some clinical aspects related with PC, as well as the development of preventative actions. The analysis of the scientific interest, considering the number of publications in the PubMed, reveals research trends in the field and demonstrates the importance of the surgical procedures in the treatment of the prostate cancer. Moreover, this finding is

  5. Prostate cancer, treatment modalities and complications: an evaluation of the scientific literature

    International Nuclear Information System (INIS)

    Prostate (PR) cancer (CA) is one of the most common malignant neoplasms in men all over the world. In general, if prostate cancer (PC) is detected early, treatment usually involves either surgical removal of the prostate or radiotherapy (RT). Hormone Therapy (HT) or chemotherapy (CH) is the preferred treatment for more advanced cases of PC or if CA spreads beyond the PT. A number of complications, such as urinary incontinence (IU) or erectile dysfunction (ED), can be associated with some modalities of treatment of the PC. The aim of this work is to evaluate, in PubMed, the number of publications related with prostate cancer and the main modalities of treatment, as well as some clinical complications. The searches were performed in PubMed (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi) in the period 1950 to 2008 using the words: CA, CA and PR or penis or testis, CA and PR and RT, CA and PR and surgery (SU), CA and PR and CH and, CA and PR and HT and CA and PR and RT and IU or ED, CA and PR and SU and IU or ED, CA and PR and CH and IU or ED and, CA and PR and HT and CH and IU or ED, and (V) PC and the same modalities of treatment. The data was obtained on July 20th, 2008. PC, as expected has been cited extensively and surgery has been identified as the most widely referenced modality of treatment. Furthermore, urinary incontinence and erectile dysfunction are important complications that have attracted significant scientific interest. In conclusion, these findings have shown the relevance of the PubMed to analyze quantitatively the publications in cancer and this information could be worthwhile in aiding the comprehension of some clinical aspects related with PC, as well as the development of preventative actions. The analysis of the scientific interest, considering the number of publications in the PubMed, reveals research trends in the field and demonstrates the importance of the surgical procedures in the treatment of the prostate cancer. Moreover, this finding is

  6. Current and emerging treatments for pancreatic cancer.

    Science.gov (United States)

    Regine, W F; John, W J; Mohiuddin, M

    1997-10-01

    The worldwide annual pancreatic cancer death rate equals its estimated annual incidence. Surgery has been considered the only curative modality for this disease, but only 5 to 15% of patients are candidates for potentially curative resection. Evidence that postoperative adjuvant treatment improves outcome has been limited to a single randomised trial of a well tolerated split-course chemoradiation regimen. More intensive regimens have since been developed and are associated with, at best, a modest improvement in patient outcome. The potentially significant morbidity associated with pancreaticoduodenectomy, which can compromise the delivery of postoperative adjuvant chemoradiation, has led to the development of preoperative adjuvant ('neoadjuvant') chemoradiation in these patients. Although experience suggests that such an approach is feasible, its ultimate impact awaits further evaluation. Combined modality therapy has produced the most promising results in patients with unresectable or locally advanced disease. However, only modest improvements in median survival and minimal increases in long term survival have so far been achieved. This observation has encouraged many investigators to devise innovative methods of delivering therapy, including radioisotope implantation and intraoperative radiation therapy (IORT). Combined modality therapy with radioisotope implantation appears to have the greatest potential for improving local control and survival in these patients. IORT may be associated with lower morbidity than radioisotope implantation, but its impact may be limited by the radiobiological disadvantage associated with single dose boost therapy. Although new radiosensitising drugs are being tested, the problem of distant metastasis remains significant. New chemotherapeutic agents such as gemcitabine appear to have the potential to produce better results than those achieved over the last 35 years with fluorouracil. Investigations into the optimal integration of

  7. Tolerability of Combined Modality Therapy for Rectal Cancer in Elderly Patients Aged 75 Years and Older

    International Nuclear Information System (INIS)

    Purpose: To determine the rate of treatment deviations during combined modality therapy for rectal cancer in elderly patients aged 75 years and older. Methods and Materials: We reviewed the records of consecutively treated patients with rectal cancer aged 75 years and older treated with combined modality therapy at Massachusetts General Hospital and Brigham and Women’s Hospital from 2002 to 2007. The primary endpoint was the rate of treatment deviation, defined as a treatment break, dose reduction, early discontinuation of therapy, or hospitalization during combined modality therapy. Patient comorbidity was rated using the validated Adult Comorbidity Evaluation 27 Test (ACE-27) comorbidity index. Fisher’s exact test and the Mantel–Haenszel trend test were used to identify predictors of treatment tolerability. Results: Thirty-six eligible patients had a median age of 79.0 years (range, 75–87 years); 53% (19/36) had no or mild comorbidity and 47% (17/36) had moderate or severe comorbidity. In all, 58% of patients (21/36) were treated with preoperative chemoradiotherapy (CRT) and 33% (12/36) with postoperative CRT. Although 92% patients (33/36) completed the planned radiotherapy (RT) dose, 25% (9/36) required an RT-treatment break, 11% (4/36) were hospitalized, and 33% (12/36) had a dose reduction, break, or discontinuation of concurrent chemotherapy. In all, 39% of patients (14/36) completed ≥4 months of adjuvant chemotherapy, and 17% (6/36) completed therapy without a treatment deviation. More patients with no to mild comorbidity completed treatment than did patients with moderate to severe comorbidity (21% vs. 12%, p = 0.66). The rate of deviation did not differ between patients who had preoperative or postoperative CRT (19% vs. 17%, p = 1.0). Conclusions: The majority of elderly patients with rectal cancer in this series required early termination of treatment, treatment interruptions, or dose reductions. These data suggest that further intensification

  8. Current Status of Cryotherapy for Prostate and Kidney Cancer

    OpenAIRE

    Cho, Seok; Kang, Seok Ho

    2014-01-01

    In terms of treating diseases, minimally invasive treatment has become a key element in reducing perioperative complications. Among the various minimally invasive treatments, cryotherapy is often used in urology to treat various types of cancers, especially prostate cancer and renal cancer. In prostate cancer, the increased incidence of low-risk, localized prostate cancer has made minimally invasive treatment modalities an attractive option. Focal cryotherapy for localized unilateral disease ...

  9. Knowledge, attitude and practice for breast cancer risk factors and screening modalities in staff nurses of Ayub teaching hospital Abbottabad

    International Nuclear Information System (INIS)

    Background: Breast cancer is the commonest cancer modality in female worldwide. Avoiding the risk factors can reduce its incidence and adhering to screening and early detection can reduce its mortality. A sufficient knowledge regarding the risk factors and screening modalities is therefore essential. We assessed the knowledge level about these parameters in our staff nurses. Methods: A self-administered questionnaire survey was performed. Knowledge regarding the risk factors and screening modalities were categorised into good, fair, poor and very poor categories. Results: Knowledge regarding most of the factors was found to be fair. A few things were termed as good knowledge like role of breast-feeding in protecting against breast cancer. Practice regarding the screening modalities was not satisfactory. Only a few nurses had good knowledge of the risk factors and screening modalities. Practice of the Screening modalities was also poor. Conclusion: There is a need to improve the nursing curriculum, training at the workplace and motivate them for screening practices. They should be encouraged to talk to their patients and their female attendants about prevention and early detection of breast cancer. (author)

  10. What Are the Recommended Timing and Screening Modalities in Women at Higher Risk for Developing Breast Cancer? A Clin-IQ

    Science.gov (United States)

    Jatala, Summer; Fitzgerald, Shawn; Tietze, Pamela; Ramakrishnan, Kalyanakrishnan; McCarthy, Laine H.; Wickersham, Elizabeth

    2016-01-01

    Early detection of breast cancer is desirable to prevent progression to advanced disease. This subject has been one of significant study and debate for women at normal risk, and recommendations continue to evolve. However, with regard to women at high risk, the recommendations from various health care professional organizations, including the recent recommendations from the United States Preventative Services Task Force, are different and also inconsistent concerning when to begin screening and which modalities should be used. We review several randomized controlled trials and consensus opinions regarding when to begin screening for breast cancer and how to best screen women at high risk. Specifically, we address women with known personal history of breast cancer, prior mantle radiation, or specific family history (including genetic family history) of breast cancer. The purpose of this inquiry is to present current evidence and suggest a clinical pathway regarding the screening of women at high risk for breast cancer. PMID:26848484

  11. What Are the Recommended Timing and Screening Modalities for Women at Higher Risk of Developing Breast Cancer? A Clin-IQ

    Directory of Open Access Journals (Sweden)

    Summer Jatala

    2015-01-01

    Full Text Available Early detection of breast cancer is desirable to prevent progression to advanced disease. This subject has been one of significant study and debate for women at normal risk, and recommendations continue to evolve. However, with regard to women at high risk, the recommendations from various health care professional organizations, including the U.S. Preventive Services Task Force, are different and also inconsistent concerning when to begin screening and which modalities should be used. We review several randomized controlled trials and consensus opinions regarding when to begin screening for breast cancer and how to best screen women at high risk. Specifically, we address women with known personal history of breast cancer, prior mantle radiation or specific family history (including genetic family history of breast cancer. The purpose of this inquiry is to present current evidence and suggest a clinical pathway regarding the screening of women at high risk for breast cancer.

  12. Prostate Cancer: Current Treatment and Prevention Strategies

    OpenAIRE

    Chen, Fang-zhi; Zhao, Xiao-kun

    2013-01-01

    Abstract Prostate cancer is one of the life threatening disorders of male. Although, over the last two decades, a high rate of overdiagnosis, and overtreatment has lowered the incidence rate of prostate cancer, the treatment or prevention strategies are not enough to control the high rate of disease related mortality. Current medical treatment approaches include surgery, radiation therapy, chemotherapy, hormonal therapy, cryosurgery and other methods. These approaches are more or less effecti...

  13. Recent evidence, advances, and current practices in surgical treatment of lung cancer.

    Science.gov (United States)

    Suda, Kenichi; Sato, Katsuaki; Mizuuchi, Hiroshi; Kobayashi, Yoshihisa; Shimoji, Masaki; Tomizawa, Kenji; Takemoto, Toshiki; Iwasaki, Takuya; Sakaguchi, Masahiro; Mitsudomi, Tetsuya

    2014-11-01

    In the last 10-15 years, strategies and modalities of lung cancer treatment have changed dramatically. Meanwhile, the treatment objectives, the lung cancers themselves, have also changed, probably owing to early detection by computed tomography and aging of the population. In particular, the proportions of smaller lung cancers, lung adenocarcinomas with ground-glass opacity, and lung cancers in older patients are increasing. Along with these changes, surgeons have innovated and evaluated novel procedures for pulmonary resection. These include the application of minimally invasive surgical techniques, such as video-assisted thoracoscopic surgery (VATS) and robotic surgery, and sub-lobar resection, such as wedge resection and segmentectomy, for small peripheral lung cancers. Currently, VATS has gained wide acceptance and several institutions in Japan have started using robotic surgery for lung cancers. Two important clinical trials of sub-lobar resection for small peripheral lung cancers are now underway in Japan. In addition, surgery itself is of growing importance in lung cancer treatment. In particular, recent evidence supports the use of surgery in strictly selected patients with locally advanced disease, lung cancers with N2 lymph node metastases, small cell lung cancers, recurrent oligo-metastasis after pulmonary resection, or relapsed tumors after drug treatment. Surgical treatment also provides abundant tumor samples for molecular analysis, which can be used for drug selection in the adjuvant setting or after disease relapse. In the era of personalized treatment, surgery is still one of the most important treatment modalities to combat lung cancer. PMID:25453375

  14. National Cancer Data Base Analysis of Radiation Therapy Consolidation Modality for Cervical Cancer: The Impact of New Technological Advancements

    International Nuclear Information System (INIS)

    Purpose: To utilize the National Cancer Data Base to evaluate trends in brachytherapy and alternative radiation therapy utilization in the treatment of cervical cancer, to identify associations with outcomes between the various radiation therapy modalities. Methods and Materials: Patients with International Federation of Gynecology and Obstetrics stage IIB-IVA cervical cancer in the National Cancer Data Base who received treatment from January 2004 to December 2011 were analyzed. Overall survival was estimated by the Kaplan-Meier method. Univariate and multivariable analyses were performed to identify factors associated with type of boost radiation modality used and its impact on survival. Results: A total of 7654 patients had information regarding boost modality. A predominant proportion of patients were Caucasian (76.2%), had stage IIIB (48.9%) disease with squamous (82.0%) histology, were treated at academic/research centers (47.7%) in the South (34.8%), and lived 0 to 5 miles (27.9%) from the treating facility. A majority received brachytherapy (90.3%). From 2004 to 2011, brachytherapy use decreased from 96.7% to 86.1%, whereas intensity modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT) use increased from 3.3% to 13.9% in the same period (P<.01). Factors associated with decreased brachytherapy utilization included older age, stage IVA disease, smaller tumor size, later year of diagnosis, lower-volume treatment centers, and facility type. After controlling for significant factors from survival analyses, IMRT or SBRT boost resulted in inferior overall survival (hazard ratio, 1.86; 95% confidence interval, 1.35-2.55; P<.01) as compared with brachytherapy. In fact, the survival detriment associated with IMRT or SBRT boost was stronger than that associated with excluding chemotherapy (hazard ratio, 1.61′ 95% confidence interval, 1.27-2.04′ P<.01). Conclusions: Consolidation brachytherapy is a critical treatment component for

  15. National Cancer Data Base Analysis of Radiation Therapy Consolidation Modality for Cervical Cancer: The Impact of New Technological Advancements

    Energy Technology Data Exchange (ETDEWEB)

    Gill, Beant S. [Department of Radiation Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Lin, Jeff F. [Department of Gynecologic Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Krivak, Thomas C. [Department of Gynecologic Oncology, Western Pennsylvania Hospital, Pittsburgh, Pennsylvania (United States); Sukumvanich, Paniti; Laskey, Robin A.; Ross, Malcolm S.; Lesnock, Jamie L. [Department of Gynecologic Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Beriwal, Sushil, E-mail: beriwals@upmc.edu [Department of Radiation Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States)

    2014-12-01

    Purpose: To utilize the National Cancer Data Base to evaluate trends in brachytherapy and alternative radiation therapy utilization in the treatment of cervical cancer, to identify associations with outcomes between the various radiation therapy modalities. Methods and Materials: Patients with International Federation of Gynecology and Obstetrics stage IIB-IVA cervical cancer in the National Cancer Data Base who received treatment from January 2004 to December 2011 were analyzed. Overall survival was estimated by the Kaplan-Meier method. Univariate and multivariable analyses were performed to identify factors associated with type of boost radiation modality used and its impact on survival. Results: A total of 7654 patients had information regarding boost modality. A predominant proportion of patients were Caucasian (76.2%), had stage IIIB (48.9%) disease with squamous (82.0%) histology, were treated at academic/research centers (47.7%) in the South (34.8%), and lived 0 to 5 miles (27.9%) from the treating facility. A majority received brachytherapy (90.3%). From 2004 to 2011, brachytherapy use decreased from 96.7% to 86.1%, whereas intensity modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT) use increased from 3.3% to 13.9% in the same period (P<.01). Factors associated with decreased brachytherapy utilization included older age, stage IVA disease, smaller tumor size, later year of diagnosis, lower-volume treatment centers, and facility type. After controlling for significant factors from survival analyses, IMRT or SBRT boost resulted in inferior overall survival (hazard ratio, 1.86; 95% confidence interval, 1.35-2.55; P<.01) as compared with brachytherapy. In fact, the survival detriment associated with IMRT or SBRT boost was stronger than that associated with excluding chemotherapy (hazard ratio, 1.61′ 95% confidence interval, 1.27-2.04′ P<.01). Conclusions: Consolidation brachytherapy is a critical treatment component for

  16. Combined modality treatment including intraoperative radiotherapy in locally advanced and recurrent rectal cancer

    International Nuclear Information System (INIS)

    Background: Treatment of locally advanced and recurrent rectal cancer usually has a high local recurrence rate and poor survival. Promising results have been reported by combined external radiotherapy, extensive surgery and intraoperative radiotherapy (IORT). Methods: One hundred fifteen patients with locally advanced rectal cancers fixed to the pelvic wall or locally recurrent rectal cancers underwent preoperative external radiotherapy with 46-50 Gy. Six to 8 weeks later radical pelvic surgery was attempted, and was combined with intraoperative electron beam radiotherapy (15-20 Gy) in 66 patients. The patients were followed closely to evaluate complication rate, local and distant recurrence rate and survival. Results: Surgery with no macroscopic tumour remaining was obtained in 65% of the patients with no postoperative deaths. Pelvic infection was the major complication (21%). Although the observation time is short (3-60 months), the local recurrence rate seems low (22%) and survival seems promising (about 60% at 4 years) in patients with complete tumour resection, in contrast to patients with residual tumour (none living at 4 years). Conclusions: The combined modality treatment with preoperative external radiotherapy and extensive pelvic surgery with IORT is sufficiently promising to start a randomized trial on the clinical value of IORT as a boost treatment in the multidisciplinary approach to this disease

  17. Chemotherapy, radiotherapy and combined modality for Hodgkin's disease, with emphasis on second cancer risk

    DEFF Research Database (Denmark)

    Franklin, J.G.; Paus, M.D.; Pluetschow, A.;

    2005-01-01

    BACKGROUND: Second malignancies (SM) are a major late effect of treatment for Hodgkin's disease (HD). Reliable comparisons of SM risk between alternative treatment strategies are lacking. OBJECTIVES: Radiotherapy (RT), chemotherapy (CT) and combined chemo-radiotherapy (CRT) for newly......-diagnosed Hodgkin's disease are compared with respect to SM risk, overall (OS) and progression-free (PFS) survival. Further, involved-field (IF-)RT is compared to extended-field (EF-)RT. SEARCH STRATEGY: We searched the Cochrane Controlled Trials Register, PubMed, EMBASE, CancerLit, LILACS, relevant conference...... proceedings, trials lists and publications. SELECTION CRITERIA: RCTs accruing 30+ patients and completing accrual before/during 2000, comparing at least two treatment modalities for newly-diagnosed HD. DATA COLLECTION AND ANALYSIS: Individual patient data were collected and assessed for data quality...

  18. Anal cancer: current and future treatment strategies

    Directory of Open Access Journals (Sweden)

    Chin JY

    2013-01-01

    Full Text Available Joanna Y Chin, Theodore S Hong, Jennifer Y WoDepartment of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USAAbstract: Anal cancer is a relatively rare malignancy, accounting for approximately 2% of gastrointestinal cancers. Concurrent chemoradiation with 5-fluorouracil/mitomycin remains the standard of care for the treatment of anal cancer. There is currently no proven role for platinum-based induction or adjuvant chemotherapy in anal cancer, even in cases of bulky disease. Multiple trials have shown that radiosensitization with concurrent chemotherapy is beneficial over radiation alone, and in particular, efforts to remove or substitute mitomycin from the chemoradiation regimen have been unsuccessful. Because local-regional control remains a challenge in the management of anal cancer, future studies will need to focus on radiation dose-escalation and/or addition of further chemotherapy or targeted agents. Patient selection, eg, with PET-CT or with biomarkers including HPV status, may be necessary to define patients who need more aggressive local treatment, ie, for patients with bulky disease, or to de-escalate treatment in others, ie, patients with early-stage, localized cancer.Keywords: anal cancer, chemoradiation, IMRT

  19. Exercise after breast cancer treatment: current perspectives

    Directory of Open Access Journals (Sweden)

    Dieli-Conwright CM

    2015-10-01

    Full Text Available Christina M Dieli-Conwright, Breanna Z Orozco Division of Biokinesiology and Physical Therapy, Women's Health and Exercise Laboratory, University of Southern California, Los Angeles, CA, USA Abstract: Over the past 2 decades, great strides have been made in the field of exercise-oncology research, particularly with breast cancer. This area of research is particularly important since there are >2.8 million breast cancer survivors who are in need of an intervention that can offset treatment-related side effects. Noticeable reductions in physical fitness (ie, cardiopulmonary fitness and muscular strength, negative changes in body composition (ie, increase in body mass, decrease in lean body mass, and increase in fat mass, increased fatigue, depression, or anxiety are some of the common side effects of cancer treatments that negatively impact overall quality of life and increase the risk for the development of comorbidities. Exercise plays a vital role in improving cardiopulmonary function, psychological events, muscular strength, and endurance in breast cancer survivors, and thus should be considered as a key factor of lifestyle intervention to reverse negative treatment-related side effects. The purpose of this review is to address current perspectives on the benefits of aerobic and resistance exercise after breast cancer treatments. This review is focused on the well-established benefits of exercise on physical and emotional well-being, bone health, lymphedema management, and the postulated benefits of exercise on risk reduction for recurrence of breast cancer. Keywords: breast cancer, exercise, physical well-being

  20. Effectiveness of Integrative Modalities for Pain and Anxiety in Children and Adolescents with Cancer: A Systematic Review

    OpenAIRE

    Thrane, Susan

    2013-01-01

    Throughout the trajectory of the cancer experience, children and adolescents will likely face pain and anxiety in a variety of circumstances. Integrative therapies may be used either alone or as an adjunct to standard analgesics. Children are often very receptive to integrative therapies such as music, art, guided imagery, massage, therapeutic play, distraction, and other modalities (Doellman, 2003).

  1. Exercise after breast cancer treatment: current perspectives.

    Science.gov (United States)

    Dieli-Conwright, Christina M; Orozco, Breanna Z

    2015-01-01

    Over the past 2 decades, great strides have been made in the field of exercise-oncology research, particularly with breast cancer. This area of research is particularly important since there are >2.8 million breast cancer survivors who are in need of an intervention that can offset treatment-related side effects. Noticeable reductions in physical fitness (ie, cardiopulmonary fitness and muscular strength), negative changes in body composition (ie, increase in body mass, decrease in lean body mass, and increase in fat mass), increased fatigue, depression, or anxiety are some of the common side effects of cancer treatments that negatively impact overall quality of life and increase the risk for the development of comorbidities. Exercise plays a vital role in improving cardiopulmonary function, psychological events, muscular strength, and endurance in breast cancer survivors, and thus should be considered as a key factor of lifestyle intervention to reverse negative treatment-related side effects. The purpose of this review is to address current perspectives on the benefits of aerobic and resistance exercise after breast cancer treatments. This review is focused on the well-established benefits of exercise on physical and emotional well-being, bone health, lymphedema management, and the postulated benefits of exercise on risk reduction for recurrence of breast cancer. PMID:26543382

  2. Treatment modalities of oral mucositis after radiation of head and neck cancers

    International Nuclear Information System (INIS)

    Acute mucositis is common after radiotherapy for head and neck cancers. During the past 3 decades, there was a gradual evolution in the treatment modalities for locally advanced carcinomas (concomitant radio-chemotherapy, accelerated radiotherapy). These new strategies are accompanied by an increase in early mucosal reactions. At the present time, there is no widely accepted prophylaxis or effective treatment. Many traditional remedies or new agents seem ineffective (Sucralfate, Chlorhexidine, GM-CSF, Silver nitrate, Prostaglandin, anti-oxidants, Benzydamine hydrochloride), while others seem promising (Povidone-iodine, nonabsorbable antibiotic lozenges and anti-fungal, local GM-CSF, Glutamide, Low-energy laser, corticosteroids). Radioprotectors are controversial and should be only used in experimental protocols and not in routine practice. However, some recommendations can be proposed: general prevention and global care before cancer therapy should be systematic (oral hygiene, dental and periodontal treatment, advice to avoid the use of tobacco and alcohol); frequent oral rinsing with a bland mouthwash (Povidone-iodine or others) should be used at the start of treatment because there are significant modifications of the oral microflora increased by a disturbed salivary flow; these mouthwashes could be associated with nonabsorbable antibiotic lozenges or anti-fungal topical (bicarbonates, Amphotericine B); Systematic percutaneous fluoroscopic gastrostomy should be decided before any aggressive treatments (concomitant radio-chemotherapy, accelerated radiotherapy); pain should be controlled; finally, the radiation technique should be optimized (mucosal sparing block, conformal radiotherapy and intensity modulated radiation therapy). (authors)

  3. Vulvar cancer: initial management and systematic review of literature on currently applied treatment approaches.

    Science.gov (United States)

    Sznurkowski, Jacek Jan

    2016-07-01

    This review provides guidelines and aims to estimate utilisation rates of treatment modalities applied in vulvar cancer. Current standards of treatment are as follows: wide local excision instead of radical vulvectomy in the case of small tumour (T cancer', 'treatment' identified seven full-text manuscripts, including data on 1114 patients. Utilisation rates of neoadjuvant radiochemotherapy, chemotherapy alone, surgery, adjuvant radiotherapy and adjuvant radiochemotherapy were 5.9%, 0.3%, 89.3%, 22.6% and 0.2% respectively. An evidence-based estimation of appropriate rates of surgery, radiotherapy and chemotherapy for vulvar cancer is needed to compare management reflecting guidelines with presented here real frequency of applied modalities. PMID:26880231

  4. Effectiveness of integrative modalities for pain and anxiety in children and adolescents with cancer: a systematic review.

    Science.gov (United States)

    Thrane, Susan

    2013-01-01

    Throughout the trajectory of the cancer experience, children and adolescents will likely face pain and anxiety in a variety of circumstances. Integrative therapies may be used either alone or as an adjunct to standard analgesics. Children are often very receptive to integrative therapies such as music, art, guided imagery, massage, therapeutic play, distraction, and other modalities. The effect of integrative modalities on pain and anxiety in children with cancer has not been systematically examined across the entire cancer experience. An in-depth search of PubMed, CINAHL, MedLine, PsychInfo, and Web of Science, integrative medicine journals, and the reference lists of review articles using the search terms pain, anxiety, pediatric, child*, oncology, cancer, neoplasm, complementary, integrative, nonconventional, and unconventional yielded 164 articles. Of these, 25 warranted full-text review. Cohen's d calculations show medium (d = 0.70) to extremely large (8.57) effect sizes indicating that integrative interventions may be very effective for pain and anxiety in children undergoing cancer treatment. Integrative modalities warrant further study with larger sample sizes to better determine their effectiveness in this population. PMID:24371260

  5. Prostate cancer, treatment modalities and complications: an evaluation of the scientific literature

    Directory of Open Access Journals (Sweden)

    Sebastião David Santos-Filho

    2008-12-01

    Full Text Available Prostate (PR cancer (CA is one of the most common malignant neoplasms in men all over the world. In general, if prostate cancer (PC is detected early, treatment usually involves either surgical removal of the prostate or radiotherapy (RT. Hormone Therapy (HT or chemotherapy (CH is the preferred treatment for more advanced cases of PC or if CA spreads beyond the PT. A number of complications, such as urinary incontinence (IU or erectile dysfunction (ED, can be associated with some modalities of treatment of the PC. The aim of this work is to evaluate, in PubMed, the number of publications related with prostate cancer and the main modalities of treatment, as well as some clinical complications. The searches were performed in PubMed (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi in the period 1950 to 2008 using the words: (i CA, (ii CA and PR or penis or testis, (iii CA and PR and RT, CA and PR and surgery (SU, CA and PR and CH and, CA and PR and HT and (iv CA and PR and RT and IU or ED, CA and PR and SU and IU or ED, CA and PR and CH and IU or ED and, CA and PR and HT and CH and IU or ED, and (V PC and the same modalities of treatment. The data was obtained on July 20th, 2008. PC, as expected has been cited extensively and surgery has been identified as the most widely referenced modality of treatment. Furthermore, urinary incontinence and erectile dysfunction are important complications that have attracted significant scientific interest. In conclusion, these findings have shown the relevance of the PubMed to analyze quantitatively the publications in cancer and this information could be worthwhile in aiding the comprehension of some clinical aspects related with PC, as well as the development of preventative actions. The analysis of the scientific interest, considering the number of publications in the PubMed, reveals research trends in the field and demonstrates the importance of the surgical procedures in the treatment of the prostate cancer

  6. Improved survival with combined modality treatment for Stage IV breast cancer

    International Nuclear Information System (INIS)

    Between 1974 and 1977, 85 patients with breast cancer at first postmastectomy relapse were irradiated (Radiation 3500 to 6000 rad--3/5 weeks) to all clinically evident lesions. Radiation fields were properly shaped to include a maximum 40% active bone marrow. After 3 to 4 weeks rest, chemotherapy was started as adjuvant therapy for residual or subclinical disease (ADR 30 mg/M2 Day 1 and 8, 5-FU 400 mg/M2 Day 1 and 8, CY 100 mg/M2 Day 1 through 14: repeated after 14 days). ADR was discontinued at 500/M2 and substituted by MTX 30 mg/M2 Day 1 and 8 for a total of 2 years. Irradiated sites were chest wall in 35, supraclavicular and internal mammary nodes in 22, bone in 56, single lung lesions in 12, brain in 24. Controls were 52 comparable but non-randomized patients treated with chemotherapy only. Forty days after x-irradiation 68 patients (80%) were free of disease (NED) while in 17 cases (20%) some residual was still present (RED). In 28 of 68 cases (41%) NED after x-irradiation and 13 of 17 (76%) in RED group developed second relapse after a median interval of 26 and 20 mos., respectively. Four of 52 patients (8%) in the control group had complete regression with a median interval to second relapse of 7 mos. Median survival was 30 mos., 24 mos., and 13 mos., respectively, for NED, RED and chemotherapy only. Eighteen patients (26%) are free of disease after 36 to 48 mos. in the combined modality group; none in the chemotherapy group. Combined treatment cases did not show untolerable myelodepression. In 10 long-surviving patients a marked subcutaneous and skin fibrosis developed because of drug additive effect. Stage IV breast cancers rendered clinically free of disease with x-irradiation and subsequently treated with chemotherapy survive significantly longer than with chemotherapy alone

  7. The Result of Combined Modality Treatment for Limited Stage Small Cell Lung Cancer

    International Nuclear Information System (INIS)

    From July 1984 to September 1988, 27 patients with limited stage small cell lung cancer were treated with combined modality(combination chemotherapy Plus radiotherapy) at the Department of Therapeutic Radiology in Kyungpook National University Hospital. Of the 27 patients, 19(70%) achieved a complete response, 6(22%) a partial response, and 2(8%) no response. Female, performance status HO, serum enolase level below 30ng/ml, radiation dose over 4500 cGy, and 4 or more cycles of chemotherapy had a favorable effect on the rates of complete response, although there were no statistical differences according to the variables. Median survival time was 10 Months and overall 1- and 2-year survival rates were 40.7% and 12.2%, respectively. Complete response(p<0.05), performance status HO(p<0.05), 4 or more cycles of chemotherapy(p<0.05), and radiation dose over 4500 cGy had a significantly favorable effect on 2-year survival rate. Prophylactic cranial irradiation or sex had no effect on survival. The results of this study suggest that radiation treatment should be combined with combination chemotherapy in the therapeutic strategy of SCLC of limited stage

  8. Management of locally advanced breast cancer: Evolution and current practice

    OpenAIRE

    Rustogi Ashish; Budrukkar Ashwini; Dinshaw Ketayun; Jalali Rakesh

    2005-01-01

    Locally advanced breast cancer (LABC) accounts for a sizeable number (30-60%) of breast cancer cases and is a common clinical scenario in developing countries. The treatment of LABC has evolved from single modality treatment, consisting of radical mutilating surgery or higher doses of radiotherapy in inoperable disease to multimodality management, which along with the above two included systemic therapy. Neoadjuvant chemotherapy (NACT) has made a tremendous impact on the management of ...

  9. Coupling and tuning of modal frequencies in direct current biased microelectromechanical systems arrays

    Energy Technology Data Exchange (ETDEWEB)

    Kambali, Prashant N.; Swain, Gyanadutta; Pandey, Ashok Kumar, E-mail: ashok@iith.ac.in [Department of Mechanical and Aerospace Engineering, IIT Hyderabad, Yeddumailaram 502205 (India); Buks, Eyal [Faculty of Electrical Engineering, Technion-Israel Institute of Technology, Haifa 32000 (Israel); Gottlieb, Oded [Faculty of Mechanical Engineering, Technion-Israel Institute of Technology, Haifa 32000 (Israel)

    2015-08-10

    Understanding the coupling of different modal frequencies and their tuning mechanisms has become essential to design multi-frequency MEMS devices. In this work, we fabricate a MEMS beam with fixed boundaries separated from two side electrodes and a bottom electrode. Subsequently, we perform experiments to obtain the frequency variation of in-plane and out-of-plane mechanical modes of the microbeam with respect to both DC bias and laser heating. We show that the frequencies of the two modes coincide at a certain DC bias, which in turn can also be varied due to temperature. Subsequently, we develop a theoretical model to predict the variation of the two modes and their coupling due to a variable gap between the microbeam and electrodes, initial tension, and fringing field coefficients. Finally, we discuss the influence of frequency tuning parameters in arrays of 3, 33, and 40 microbeams, respectively. It is also found that the frequency bandwidth of a microbeam array can be increased to as high as 25 kHz for a 40 microbeam array with a DC bias of 80 V.

  10. Coupling and tuning of modal frequencies in direct current biased microelectromechanical systems arrays

    International Nuclear Information System (INIS)

    Understanding the coupling of different modal frequencies and their tuning mechanisms has become essential to design multi-frequency MEMS devices. In this work, we fabricate a MEMS beam with fixed boundaries separated from two side electrodes and a bottom electrode. Subsequently, we perform experiments to obtain the frequency variation of in-plane and out-of-plane mechanical modes of the microbeam with respect to both DC bias and laser heating. We show that the frequencies of the two modes coincide at a certain DC bias, which in turn can also be varied due to temperature. Subsequently, we develop a theoretical model to predict the variation of the two modes and their coupling due to a variable gap between the microbeam and electrodes, initial tension, and fringing field coefficients. Finally, we discuss the influence of frequency tuning parameters in arrays of 3, 33, and 40 microbeams, respectively. It is also found that the frequency bandwidth of a microbeam array can be increased to as high as 25 kHz for a 40 microbeam array with a DC bias of 80 V

  11. Current Operative Management of Breast Cancer: An Age of Smaller Resections and Bigger Cures

    International Nuclear Information System (INIS)

    Surgical resection was the first effective treatment for breast cancer and remains the most important treatment modality for curative intent. Refinements in operative techniques along with the use of adjuvant radiotherapy and advanced chemotherapeutic agents have facilitated increasingly focused breast cancer operations. Surgical management of breast cancer has shifted from extensive and highly morbid procedures, to the modern concept obtaining the best possible cosmetic result in tandem with the appropriate oncological resection. An ever-growing comprehension of breast cancer biology has led to substantial advances in molecular diagnosis and targeted therapies. An emerging frontier involves the breast cancer microenvironment, as a thorough understanding, while currently lacking, represents a critical opportunity for diagnosis and treatment. Collectively, these improvements will continue to push all therapeutic interventions, including operative, toward the goal of becoming more focused, targeted, and less morbid

  12. Hybrid anisotropic nanostructures for dual-modal cancer imaging and image-guided chemo-thermo therapies.

    Science.gov (United States)

    Zhang, Ruiping; Cheng, Kai; Antaris, Alexander L; Ma, Xiaowei; Yang, Min; Ramakrishnan, Sindhuja; Liu, Guifeng; Lu, Alex; Dai, Hongjie; Tian, Mei; Cheng, Zhen

    2016-10-01

    The multimodality theranostic system, which can integrate two or more different therapeutic modalities and multimodal imaging agents into a nanoentity, shows great promising prospects for the cancer treatment. Herein, we developed an efficient and novel strategy to synthesize hybrid anisotropic nanoparticles (HANs) with intrinsic multimodal theranostic capability [chemotherapy, photothermal therapy, magnetic resonance imaging (MRI), and photoacoustic imaging (PAI)]. For the first time, under the guidance of MRI and PAI, the chemotherapy and thermotherapy induced by administration of multifunctional hybrid nanoprobes were applied simultaneously to the treatment of colon cancer-bearing mice in vivo. PMID:27394161

  13. Long term observations in combined modality therapy for limited stage small cell lung cancer

    International Nuclear Information System (INIS)

    Purpose/Objective: With the discovery that patients with small cell lung cancer (SCLC) exhibit a high level of sensitivity to both chemotherapy and radiotherapy, the treatment of SCLC became a model for the success of combined modality treatment. In this retrospective review, we analyze the outcomes and patterns of failure when patients are treated with chemotherapy and thoracic irradiation. The relative values of sequential and concurrent chemotherapy, in conjunction with chest irradiation, are assessed. The potential benefit of prophylactic cranial irradiation is explored. The impact of prognostic factors for long term survival of SCLC patients are examined to identify pretreatment patient characteristics and treatment parameters which might predict for a favorable outcome. Materials and Methods: We identified 190 patients treated at M.D. Anderson Cancer Center from January 1985 to December 1992 with curative intent for limited stage SCLC. Prognostic factors were determined using univariate and multivariate analysis. The significant covariates for each outcome endpoint were evaluated. Probabilities of local failure, overall survival, relapse-free survival, and distant metastasis-free survival were calculated from the time of treatment using actuarial life table analysis. Results: The median age was 61, with 51% males. There were 119 patients treated sequentially, and 71 concurrently. The Karnofsky Performance Status was >= 90 in 48% of patients in the concurrent cohort, vs. 35% of the sequential group. Prophylactic cranial irradiation (PCI) was delivered in 117 cases (62%). There were 51 long term survivors, defined as survival >=36 months. The median follow-up in surviving patients was 75 months. At the time of the analysis, 166 patients (87%) had expired. The crude 2 and 3 year survival rate for the entire group was 38.4% and 26.8%, respectively. The actuarial 2-year survival was 39.9%, and at 3 years the actuarial survival was 27.8%. The median actuarial

  14. Current role of surgical therapy in gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Ryan Swan; Thomas J Miner

    2006-01-01

    Surgery is currently the only potentially curative treatment for gastric cancer. Since the inception of the gastrectomy for cancer of the stomach, there has been debate over the bounds of surgical therapy, balancing potential long-term survival with perioperative morbidity and mortality. This review delineates the current role of surgery in preoperative staging, curative resection, and palliative treatment for gastric cancer.

  15. Breast and gynecologic cancer-related extremity lymphedema: a review of diagnostic modalities and management options

    OpenAIRE

    Tiwari, Pankaj; Coriddi, Michelle; Salani, Ritu; Povoski, Stephen P.

    2013-01-01

    Lymphedema remains a poorly understood entity that can occur after lymphadenectomy. Herein, we will review the pathogenesis of lymphedema, diagnostic modalities and the natural history of extremity involvement. We will review the incidence of upper extremity lymphedema in patients treated for breast malignancies and lower extremity lymphedema in those treated for gynecologic malignancy. Finally, we will review traditional treatment modalities for lymphedema, as well as introduce new surgical ...

  16. Clinical utility of brain stimulation modalities following traumatic brain injury: current evidence

    Directory of Open Access Journals (Sweden)

    Li S

    2015-06-01

    Full Text Available Shasha Li,1,2 Ana Luiza Zaninotto,2,3 Iuri Santana Neville,4 Wellingson Silva Paiva,4 Danuza Nunn,2 Felipe Fregni21Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Spaulding Neuromodulation Center, Harvard Medical School, Boston, MA, USA; 3Division of Psychology, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil; 4Division of Neurosurgery, University of São Paulo Medical School, São Paulo, São Paulo, BrazilAbstract: Traumatic brain injury (TBI remains the main cause of disability and a major public health problem worldwide. This review focuses on the neurophysiology of TBI, and the rationale and current state of evidence of clinical application of brain stimulation to promote TBI recovery, particularly on consciousness, cognitive function, motor impairments, and psychiatric conditions. We discuss the mechanisms of different brain stimulation techniques including major noninvasive and invasive stimulations. Thus far, most noninvasive brain stimulation interventions have been nontargeted and focused on the chronic phase of recovery after TBI. In the acute stages, there is limited available evidence of the efficacy and safety of brain stimulation to improve functional outcomes. Comparing the studies across different techniques, transcranial direct current stimulation is the intervention that currently has the higher number of properly designed clinical trials, though total number is still small. We recognize the need for larger studies with target neuroplasticity modulation to fully explore the benefits of brain stimulation to effect TBI recovery during different stages of recovery.Keywords: traumatic brain injury, brain stimulation, neuroplasticity

  17. Tumor targeting chitosan nanoparticles for dual-modality optical/MR cancer imaging.

    Science.gov (United States)

    Nam, Taehwan; Park, Sangjin; Lee, Seung-Young; Park, Kyeongsoon; Choi, Kuiwon; Song, In Chan; Han, Moon Hee; Leary, James J; Yuk, Simseok Andrew; Kwon, Ick Chan; Kim, Kwangmeyung; Jeong, Seo Young

    2010-04-21

    We report tumor targeting nanoparticles for optical/MR dual imaging based on self-assembled glycol chitosan to be a potential multimodal imaging probe. To develop an optical/MR dual imaging probe, biocompatible and water-soluble glycol chitosan (M(w) = 50 kDa) were chemically modified with 5beta-cholanic acid (CA), resulting in amphiphilic glycol chitosan-5beta-cholanic acid conjugates (GC-CA). For optical imaging near-infrared fluorescence (NIRF) dye, Cy5.5, was conjugated to GC-CA resulting in Cy5-labeled GC-CA conjugates (Cy5.5-GC-CA). Moreover, in order to chelate gadolinium (Gd(III)) in the Cy5.5-GC-CA conjugates, 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA) was directly conjugated in Cy5.5-GC-CA. Finally, the excess GdCl(3) was added to DOTA modified Cy5.5-GC-CA conjugates in distilled water (pH 5.5). The freshly prepared Gd(III) encapsulated Cy5.5-GC-CA conjugates were spontaneously self-assembled into stable Cy5.5 labeled and Gd(III) encapsulated chitosan nanoparticles (Cy5.5-CNP-Gd(III)). The Cy5.5-CNP-Gd(III) was spherical in shape and approximately 350 nm in size. From the cellular experiment, it was demonstrated that Cy5.5-CNP-Gd(III) were efficiently taken up and distributed in cytoplasm (NIRF filter; red). When the Cy5.5-GC-Gd(III) were systemically administrated into the tail vein of tumor-bearing mice, large amounts of nanoparticles were successfully localized within the tumor, which was confirmed by noninvasive near-infrared fluorescence and MR imaging system simultaneously. These results revealed that the dual-modal imaging probe of Cy5.5-CNP-Gd(III) has the potential to be used as an optical/MR dual imaging agent for cancer treatment. PMID:20201550

  18. Lung cancer in Lithuania: current situation and new approaches in treatment

    International Nuclear Information System (INIS)

    Incidence and mortality of lung cancer have increased over the past decades; results of lung cancer treatment are insufficient and survival is poor. New methods of combined modality treatment of lung cancer (including new modalities of radiotherapy, new schemes of multi-drug chemotherapy, laser therapy and photodynamic therapy) are effective and can help improve quality of life and survival of patients with lung cancer. (authors)

  19. Smoking behaviours of current cancer patients in Canada

    Science.gov (United States)

    Liu, J.; Chadder, J.; Fung, S.; Lockwood, G.; Rahal, R.; Halligan, M.; Mowat, D.; Bryant, H.

    2016-01-01

    Evidence shows that continued smoking by cancer patients leads to adverse treatment outcomes and affects survival. Smoking diminishes treatment effectiveness, exacerbates side effects, and increases the risk of developing additional complications. Patients who continue to smoke also have a higher risk of developing a second primary cancer or experiencing a cancer recurrence, both of which ultimately contribute to poorer quality of life and poorer survival. Here, we present a snapshot of smoking behaviours of current cancer patients compared with the non-cancer patient population in Canada. Minimal differences in smoking behaviours were noted between current cancer patients and the rest of the population. Based on 2011–2014 data from the Canadian Community Health Survey, 1 in 5 current cancer patients (20.1%) reported daily or occasional smoking. That estimate is comparable to findings in the surveyed non-cancer patient population, of whom 19.3% reported smoking daily or occasionally. Slightly more male cancer patients than female cancer patients identified as current smokers. A similar distribution was observed in the non-cancer patient population. There is an urgent need across Canada to better support cancer patients in quitting smoking. As a result, the quality of patient care will improve, as will cancer treatment and survival outcomes, and quality of life for these patients.

  20. Multi-modality endoscopic imaging for the detection of colorectal cancer

    Science.gov (United States)

    Wall, Richard Andrew

    Optical coherence tomography (OCT) is an imaging method that is considered the optical analog to ultrasound, using the technique of optical interferometry to construct two-dimensional depth-resolved images of tissue microstructure. With a resolution on the order of 10 um and a penetration depth of 1-2 mm in highly scattering tissue, fiber optics-coupled OCT is an ideal modality for the inspection of the mouse colon with its miniaturization capabilities. In the present study, the complementary modalities laser-induced fluorescence (LIF), which offers information on the biochemical makeup of the tissue, and surface magnifying chromoendoscopy, which offers high contrast surface visualization, are combined with OCT in endoscopic imaging systems for the greater specificity and sensitivity in the differentiation between normal and neoplastic tissue, and for the visualization of biomarkers which are indicative of early events in colorectal carcinogenesis. Oblique incidence reflectometry (OIR) also offers advantages, allowing the calculation of bulk tissue optical properties for use as a diagnostic tool. The study was broken up into three specific sections. First, a dual-modality OCTLIF imaging system was designed, capable of focusing light over 325-1300 nm using a reflective distal optics design. A dual-modality fluorescence-based SMC-OCT system was then designed and constructed, capable of resolving the stained mucosal crypt structure of the in vivo mouse colon. The SMC-OCT instrument's OIR capabilities were then modeled, as a modified version of the probe was used measure tissue scattering and absorption coefficients.

  1. A case report of successful intraoperative photo- dynamic therapy as the step of combined modality treatment in patient with stage IIIb breast cancer

    Directory of Open Access Journals (Sweden)

    E. К. Saribekyan

    2013-01-01

    Full Text Available The case of successful combined modality treatment in patient with stage IIIB T4bN1M0 breast cancer is reported. The first step included 2 courses of neoadjuvant polychemotherapy in CAF regimen with decrease of tumor size. The second step was irradiation (total dose of 45 Gy of breast and areas of regional metastasis. The third step was radical mastectomy by Madden with polypositional intraoperative photodynamic therapy with photosens (the output laser power 1500 mW, light dose 30 J/cm2, total time of irradiation – 25.6 min. The histological study of surgical specimen showed infiltrative ductal carcinoma with metastases in 3 nodes without fat invasion. In the post-operative period the patient had 3 courses of adjuvant chemotherapy in CAF regimen. Currently the duration of recurrence-free survival after treatment is 4 years. 

  2. Modality-dependent dose requirements in the Austrian breast cancer early detection program. First results from technical quality assurance

    International Nuclear Information System (INIS)

    The Austrian Breast Cancer Early Detection Program (BKFP) has officially started in January 2014. In order to ensure that all participating women can rely on a sufficient cancer detection rate while at the same time the required dose is as low as reasonably achievable, all participating radiology institutes (approx. 200) have to fulfill strict quality assurance requirements. The control and certification is performed by the Reference Center for Technical Quality Assurance (RefZQS), which has been developing the methods and tolerances in a pilot project since 2007. The limits are defined in the EUREF-Oeprotocol which is based on the European EPQC guidelines. From the requirement for optimized image quality while simultaneously following the ALARA principle, we found modality-dependent dose requirements, which we had expected but which have now been compiled for the first time for Austria.

  3. Extended Lymphadenectomy and "Mesopancreas" Excision during Pancreatoduodenectomy for Cancer; is it worth it? Review of Current Evidence

    Directory of Open Access Journals (Sweden)

    Elissaios Kontis

    2016-03-01

    Full Text Available Pancreatic cancer is a malignancy with overall poor prognosis. Surgery is the only treatment modality, which could provide cure. Therefore every effort possible should be made for pancreatectomy to achieve R0 resection. However, even after R0 resection, the survival outcomes are still far behind from other solid intrabdominal tumors. Extended lymphadenectomy and “mesopancreas” excision are the two main factors where focus has been given, in order to improve the outcomes of pancreatectomy for pancreatic head cancer. We present an up to date comprehensive review of the current evidence on the topics of extended lymphadenectomy and “mesopancreas” excision during pancreatoduodenectomy for cancer.

  4. The Adoption of New Adjuvant Radiation Therapy Modalities Among Medicare Beneficiaries With Breast Cancer: Clinical Correlates and Cost Implications

    International Nuclear Information System (INIS)

    Purpose: New radiation therapy modalities have broadened treatment options for older women with breast cancer, but it is unclear how clinical factors, geographic region, and physician preference affect the choice of radiation therapy modality. Methods and Materials: We used the Surveillance, Epidemiology, and End Results-Medicare database to identify women diagnosed with stage I-III breast cancer from 1998 to 2007 who underwent breast-conserving surgery. We assessed the temporal trends in, and costs of, the adoption of intensity modulated radiation therapy (IMRT) and brachytherapy. Using hierarchical logistic regression, we evaluated the relationship between the use of these new modalities and patient and regional characteristics. Results: Of 35,060 patients, 69.9% received conventional external beam radiation therapy (EBRT). Although overall radiation therapy use remained constant, the use of IMRT increased from 0.0% to 12.6% from 1998 to 2007, and brachytherapy increased from 0.7% to 9.0%. The statistical variation in brachytherapy use attributable to the radiation oncologist and geographic region was 41.4% and 9.5%, respectively (for IMRT: 23.8% and 22.1%, respectively). Women undergoing treatment at a free-standing radiation facility were significantly more likely to receive IMRT than were women treated at a hospital-based facility (odds ratio for IMRT vs EBRT: 3.89 [95% confidence interval, 2.78-5.45]). No such association was seen for brachytherapy. The median radiation therapy cost per treated patient increased from $5389 in 2001 to $8539 in 2007. Conclusions: IMRT and brachytherapy use increased substantially from 1998 to 2007; overall, radiation therapy costs increased by more than 50%. Radiation oncologists played an important role in treatment choice for both types of radiation therapy, whereas geographic region played a bigger role in the use of IMRT than brachytherapy

  5. Activatable albumin-photosensitizer nanoassemblies for triple-modal imaging and thermal-modulated photodynamic therapy of cancer.

    Science.gov (United States)

    Hu, Dehong; Sheng, Zonghai; Gao, Guanhui; Siu, Fungming; Liu, Chengbo; Wan, Qian; Gong, Ping; Zheng, Hairong; Ma, Yifan; Cai, Lintao

    2016-07-01

    Photodynamic therapy (PDT) is a noninvasive and effective approach for cancer treatment. The main bottlenecks of clinical PDT are poor selectivity of photosensitizer and inadequate oxygen supply resulting in serious side effects and low therapeutic efficiency. Herein, a thermal-modulated reactive oxygen species (ROS) strategy using activatable human serum albumin-chlorin e6 nanoassemblies (HSA-Ce6 NAs) for promoting PDT against cancer is developed. Through intermolecular disulfide bond crosslinking and hydrophobic interaction, Ce6 photosensitizer is effectively loaded into the HSA NAs, and the obtained HSA-Ce6 NAs exhibit excellent reduction response, as well as enhanced tumor accumulation and retention. By the precision control of the overall body temperature instead of local tumor temperature increasing from 37 °C to 43 °C, the photosensitization reaction rate of HSA-Ce6 NAs increases 20%, and the oxygen saturation of tumor tissue raise 52%, significantly enhancing the generation of ROS for promoting PDT. Meanwhile, the intrinsic fluorescence and photoacoustic properties, and the chelating characteristic of porphyrin ring can endow the HSA-Ce6 NAs with fluorescence, photoacoustic and magnetic resonance triple-modal imaging functions. Upon irradiation of low-energy near-infrared laser, the tumors are completely suppressed without tumor recurrence and therapy-induced side effects. The robust thermal-modulated ROS strategy combined with albumin-based activatable nanophotosensitizer is highly potential for multi-modal imaging-guided PDT and clinical translation. PMID:27061266

  6. Focal therapy for prostate cancer: The current status

    OpenAIRE

    Marshall, Susan; Taneja, Samir

    2015-01-01

    Purpose In an era of increasing prostate cancer incidence and earlier detection, the assessment of clinical significance of prostate cancer is critical. Minimally invasive therapies are increasingly being investigated in localized prostate cancer. Methods and results In this review, we discuss the current status of magnetic resonance imaging targeted fusion prostate biopsy and focal therapy for prostate cancer, its rationale, and techniques. Conclusion Focal therapy offers a promising outlook...

  7. Na(+) Micro-Current Value Detection as a New Modality for Identification of Benign and Malignant Disease in Surgery.

    Science.gov (United States)

    Zhang, Xu-Feng; Long, Zhi-Da; Liu, Xue-Min; Ma, Feng; Li, Qiang; Lv, Yi

    2016-01-01

    Increase of intracellular positive ions (mainly Na(+)) indicates greater possibility of cell malignancy. The present study investigated the correlation between the Na(+) micro-current value (MCV) and tissue characteristics (normal, benign or malignant). 346 tissue samples have been detected within 30 min after surgical isolation by Na(+) detector. MCV in 102 malignant tumor was significantly higher than that in benign/borderline tumor or normal tissue (33.3 ± 8.9 μA vs. 24.4 ± 8.6 μA and 14.0 ± 4.0 μA, p detector and pathological examination was different in tissues from different organs or systems, which was high in pancreas, bile duct system, gastrointestinal system, esophagus, breasts, lungs, nose &throat and thyroids, but poor in urinary tissue. The overall coincidence rate was 83.1% (108/130) between Na(+) detector and pathological examination. The sensitivity and specificity of correct diagnosis by Na(+) detector was 83.3% (70/84) and 82.6% (38/46), respectively. This new modality may have diagnostic potential in complementing frozen examination in differentiating malignant tumor from benign or normal tissue, justifying tumor metastatic scope and confirming surgical margin. PMID:27103487

  8. Current Research and Management of Ovarian Cancer in China

    Institute of Scientific and Technical Information of China (English)

    GUMeijiao; SHIWei

    2002-01-01

    Ovarian cancer is ne of the most lethal malignant tumors in China,represents the third most common cancer after cervical cancer and endometrial cancer,and the first leading cause of death from hynaecological cancers.Due to the lack of effective screening strategies and the absence of symptoms in early-stage of disease,over 70% of patients present at an advanced stage.Despite the advances in surgical techniques and conventional chemotheraphy,the prognosis of ovarian cancer has not been improved significantly,and indeed the long-term survival for patients with advanced disease does not exceed 20%.The aetiology of ovarian cancer temains poorly understood.In China,the major focus of research is to clarify the mechanism underlying ovarian cancer,develop more effective life-saving diagnostic and therapeutic measures,and undertake more population-based studies.This article summarizes current research,diagnosis and management of ovarian cancer in China.

  9. Chemoprevention of gastric cancer: current status

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    The development of gastric cancer is a multi-factor process. In addition to genetic factors, environmental factors including smoking, low gastric acidity, excessive intake of salt or salty food and low consumption of fresh fruits and vegetables all contribute to the development of gastric cancer. Of particular interest, epidemiological and experimental studies have demonstrated that Helicobacter pylori (H. pylori) infection is causally linked to gastric cancer. Most studies using micronutrient supplementation have failed to demonstrate any preventive effect against the development of gastric cancer. The use of non-steroidal anti-inflammatory drugs has been consistently observed to protect against the development of gastric cancer. Recently, eradication of H. pylori infection by a chemopreventative approach is being studied in a number of trials. Studies using precancerous lesions as an end point of the treatment have produced conflicting and mostly negative results. Trials using cancer as an end point are being cautiously carried out in high-risk populations, and will provide the definitive answer to this important question. In the end, vaccination may be proven to be the optimal strategy in human for the management of H. pylori infection and prevention of gastric cancer.

  10. Novel compounds in the treatment of lung cancer: current and developing therapeutic agents

    Science.gov (United States)

    Bao, Rudi; Chan, Pokman

    2011-01-01

    Lung cancer is the leading cause of cancer-related death in the United States. Though incremental advances have been made in the treatment of this devastating disease during the past decade, new therapies are urgently needed. Traditional cytotoxic agents have been combined with other modalities with improved survival for early-stage patients. Newer cytotoxic agents targeting the same or different mechanisms have been developed at different stages. Optimization of various chemotherapy regimens in different settings is one of the aims of current clinical trials. Some predictive biomarkers (eg, excision repair cross-complementing 1, ERCC1) and histotypes (eg, adenocarcinoma) are found to be associated with resistance/response to some cytotoxic drugs. Another notable advance is the addition of targeted therapy to lung cancer treatment. Targeted agents such as erlotinib and bevacizumab have demonstrated clinical benefits and gained Food and Drug Administration approval for lung cancer. More agents targeting various signaling pathways critical to lung cancer are at different stages of development. Along with the effort of new targeted drug discovery, biomarkers such as epidermal growth factor receptor and anaplastic lymphoma kinase mutations have proven useful for patient selection, and more predictive biomarkers have been actively evaluated in non-small cell lung cancer. The paradigm of lung cancer treatment has shifted towards biomarker-based personalized medicine.

  11. [NCCN Asian consensus statement - can Asian patients with cancer accept treatment modalities from NCCN guidelines ?].

    Science.gov (United States)

    Ozono, Seiichiro; Hinotsu, Shiro; Namiki, Mikio; Akaza, Hideyuki

    2014-06-01

    To spread the National Comprehensive Cancer Network(NCCN)guidelines widely in Asia, committee members from Asian countries have been preparing an Asia Consensus Statement(ACS)along the NCCN guidelines. The ACS for Kidney Cancer guidelines and Prostate Cancer guidelines were issued in 2009 and in 2011, respectively. In addition, second versions of both these guidelines were issued in 2011 and 2013, respectively. In this review, the process and contents of NCCN ACS have been described. PMID:25129079

  12. Therapeutic vaccines as a promising treatment modality against prostate cancer: rationale and recent advances

    OpenAIRE

    Singh, B Harpreet; Gulley, James L.

    2014-01-01

    Cancer immunotherapy was deemed the medical breakthrough of 2013, in part because it can induce a rapid, durable, self-propagating and adaptable immune response. Specifically in prostate cancer, immunotherapy has emerged as a viable and attractive treatment strategy. To date, therapeutic cancer vaccines and immune checkpoint inhibitors are the two classes of immunotherapy that have demonstrated improvements in overall survival in patients with advanced tumors. The 2010 Food and Drug Administr...

  13. Current Immunotherapeutic Approaches in Pancreatic Cancer

    Directory of Open Access Journals (Sweden)

    Shigeo Koido

    2011-01-01

    Full Text Available Pancreatic cancer is a highly aggressive and notoriously difficult to treat. As the vast majority of patients are diagnosed at advanced stage of the disease, only a small population is curative by surgical resection. Although gemcitabine-based chemotherapy is typically offered as standard of care, most patients do not survive longer than 6 months. Thus, new therapeutic approaches are needed. Pancreatic cancer cells that develop gemcitabine resistance would still be suitable targets for immunotherapy. Therefore, one promising treatment approach may be immunotherapy that is designed to target pancreatic-cancer-associated antigens. In this paper, we detail recent work in immunotherapy and the advances in concept of combination therapy of immunotherapy and chemotherapy. We offer our perspective on how to increase the clinical efficacy of immunotherapies for pancreatic cancer.

  14. Imaging Surveillance of Patients with Breast Cancer after Primary Treatment: Current Recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Jung Hyun; Kim, Min Jung; Kim, Eun-Kyung; Moon, Hee Jung [Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 120-752 (Korea, Republic of)

    2015-11-01

    Women who have been treated for breast cancer are at risk for second breast cancers, such as ipsilateral recurrence or contralateral metachronous breast cancer. As the number of breast cancer survivors increases, interest in patient management and surveillance after treatment has also increased. However, post-treatment surveillance programs for patients with breast cancer have not been firmly established. In this review, we focus on the imaging modalities that have been used in post-treatment surveillance for patients with breast cancer, such as mammography, ultrasonography, magnetic resonance imaging, and positron emission tomography, the effectiveness of each modality for detecting recurrence, and how they can be applied to manage patients.

  15. Current Immunotherapeutic Approaches in Pancreatic Cancer

    OpenAIRE

    Jianlin Gong; Shigeo Koido; Hisao Tajiri; Hideo Komita; Masaki Ito; Kan Uchiyama; Kenichi Satoh; Keisuke Nagatsuma; Hiroshi Matsudaira; Toyokazu Yukawa; Shunichi Odahara; Jimi Mitobe; Yoshihisa Namiki; Shintaro Tsukinaga; Akitaka Takahara

    2011-01-01

    Pancreatic cancer is a highly aggressive and notoriously difficult to treat. As the vast majority of patients are diagnosed at advanced stage of the disease, only a small population is curative by surgical resection. Although gemcitabine-based chemotherapy is typically offered as standard of care, most patients do not survive longer than 6 months. Thus, new therapeutic approaches are needed. Pancreatic cancer cells that develop gemcitabine resistance would still be suitable targets for immuno...

  16. Exercise after breast cancer treatment: current perspectives

    OpenAIRE

    Dieli-Conwright CM; Orozco BZ

    2015-01-01

    Christina M Dieli-Conwright, Breanna Z Orozco Division of Biokinesiology and Physical Therapy, Women's Health and Exercise Laboratory, University of Southern California, Los Angeles, CA, USA Abstract: Over the past 2 decades, great strides have been made in the field of exercise-oncology research, particularly with breast cancer. This area of research is particularly important since there are >2.8 million breast cancer survivors who are in need of an intervention that can offs...

  17. Diet and colorectal cancer risk: current views

    Directory of Open Access Journals (Sweden)

    A. Giacosa, M. Rondanelli, H. Cena, F. Frascio, M.J. Hill

    2007-03-01

    Full Text Available SUMMARY Large bowel cancer (CRC is amongst the most common cancers in North America, Australasia and western Europe. The major risk factors of CRC are genetic and dietary. Evidence regarding genetic polymorphisms which may influence the metabolism of nutrients thought to be important in the aetiology of CRC and colorectal adenomatous polyps is discussed. At present, the strongest evidence of genenutrient interaction in relation to CRC is for folate and genetic variants associated with differences in metabolism of folate. Significant trends of increasing CRC risk with increasing intake emerged for total energy, bread and pasta, cakes and desserts, and refined sugar have been observed in recent Italian studies. Most vegetables, including pulses, were inversely associated with CRC. Among macronutrients, a high intake of starch and saturated fat seemed to lead to an increased risk of cancer. High intakes of polyunsaturated fatty acids (chiefly derived from olive oil and seed oils showed a marginal inverse association with CRC. In the present paper the relation between meat consumption and cancer risk is reviewed showing that there is little evidence to support this relationship. Key words: cancer risk, colorectal cancer, diet, energy intake, genetic polymorphism, prevention, physical activity

  18. Current Controversies in Lung Cancer Staging.

    Science.gov (United States)

    Carter, Brett W; Godoy, Myrna C B; Wu, Carol C; Erasmus, Jeremy J; Truong, Mylene T

    2016-07-01

    Lung cancer remains the leading cause of cancer-related mortality in the United States, and accurate staging of disease plays an important role in the formulation of treatment strategies and optimization of patient outcomes. The International Association for the Study of Lung Cancer has recently proposed changes to the upcoming eighth edition of the tumor, node, and metastasis (TNM-8) staging system used for lung cancer. This revised classification is based on significant differences in patient survival identified on analysis of a new large international database of lung cancer cases. Key changes include: further modifications to the T descriptors based on 1 cm increments in tumor size; grouping of tumors resulting in partial or complete lung atelectasis/pneumonitis; grouping of tumors involving a main bronchus with respect to distance from the carina; reassignment of diaphragmatic invasion; elimination of mediastinal pleural invasion as a descriptor; and further subdivision of metastatic disease into distinct descriptors based on the number of extrathoracic metastases and involved organs. Because of these changes, several new stage groups have been developed, and others have shifted. Although TNM-8 represents continued improvement upon modifications previously made to the staging system, reflecting an evolving understanding of tumor behavior and patient management, several limitations and unaddressed issues persist. Understanding the proposed revisions to TNM-8 and awareness of key limitations and potential controversial issues still unaddressed will allow radiologists to accurately stage patients with lung cancer and optimize treatment decisions. PMID:27306388

  19. Multifunctional dendrimer-based nanoparticles for in vivo MR/CT dual-modal molecular imaging of breast cancer

    Directory of Open Access Journals (Sweden)

    Li K

    2013-07-01

    Full Text Available Kangan Li,1,4,5,* Shihui Wen,2,* Andrew C Larson,4,5 Mingwu Shen,2 Zhuoli Zhang,4,5 Qian Chen,3 Xiangyang Shi,2,3 Guixiang Zhang1 1Department of Radiology, Shanghai First People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; 2College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai, People’s Republic of China; 3State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Donghua University, Shanghai, People’s Republic of China; 4Departments of Radiology and Biomedical Engineering, Northwestern University, Chicago, IL, USA; 5Robert H Lurie Comprehensive Cancer Center, Chicago, IL, USA *These authors contributed equally to this work Abstract: Development of dual-mode or multi-mode imaging contrast agents is important for accurate and self-confirmatory diagnosis of cancer. We report a new multifunctional, dendrimer-based gold nanoparticle (AuNP as a dual-modality contrast agent for magnetic resonance (MR/computed tomography (CT imaging of breast cancer cells in vitro and in vivo. In this study, amine-terminated generation 5 poly(amidoamine dendrimers modified with gadolinium chelate (DOTA-NHS and polyethylene glycol monomethyl ether were used as templates to synthesize AuNPs, followed by Gd(III chelation and acetylation of the remaining dendrimer terminal amine groups; multifunctional dendrimer-entrapped AuNPs (Gd-Au DENPs were formed. The formed Gd-Au DENPs were used for both in vitro and in vivo MR/CT imaging of human MCF-7 cancer cells. Both MR and CT images demonstrate that MCF-7 cells and the xenograft tumor model can be effectively imaged. The Gd-Au DENPs uptake, mainly in the cell cytoplasm, was confirmed by transmission electron microscopy. The cell cytotoxicity assay, cell morphology observation, and flow cytometry show that the developed Gd-Au DENPs have good biocompatibility in the given concentration range. Our results

  20. Current relevance of hypoxia in head and neck cancer

    OpenAIRE

    Bredell, Marius G; Ernst, Jutta; El-Kochairi, Ilhem; Dahlem, Yuliya; Ikenberg, Kristian; Schumann, Desiree M.

    2016-01-01

    Head and Neck cancer (HNC) is a complex mix of cancers and one of the more common cancers with a relatively poor prognosis. One of the factors that may assist us in predicting survival and allow us to adjust our treatment strategies is the presence of tumor hypoxia. In this overview we aim to evaluate the current evidence and potential clinical relevance of tumor hypoxia in head and neck cancer according to an extensive search of current literature. An abundance of evidence and often contradi...

  1. Long-term quality of life after intensified multi-modality treatment of oral cancer including intra-arterial induction chemotherapy and adjuvant chemoradiation

    OpenAIRE

    Kovács, Adorján F.; Stefenelli, Ulrich; Thorn, Gerrit

    2015-01-01

    Background: Quality of life (QoL) studies are well established when accompanying trials in head and neck cancer, but studies on long-term survivors are rare. Aims: The aim was to evaluate long-term follow-up patients treated with an intensified multi-modality therapy. Setting and Design: Cross-sectional study, tertiary care center. Patients and Methods: A total of 135 oral/oropharyngeal cancer survivors having been treated with an effective four modality treatment (intra-arterial induction ch...

  2. Development of Therapeutic Modality of Esophageal Cancer Using Ho-166 Stent

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Doo; Park, Kwang Kyun; Lee, Min Geol [Yonsei University Medical College, Seoul (Korea, Republic of); Park, Kyung Bae [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1997-09-01

    The prognosis of esophageal cancer is poor due absence of serosa which prevent local invasion to the surrounding organs such as aorta, mediastinum, trachea, and bronchi. We developed a Ho-166 Coated Radioactive Self-Expandable Metallic Stent which is a new herapeutic device in the treatment of esophageal cancer and underwent an animal experiment in mongrel dogs. We observed mucosal destruction by 4-6 mCi of Ho-166 without serious complications such as perforation of esophageal wall. Therefore, Ho-166 coated self-expandable stent appears to be an effective therapeutic device in the palliative treatment of esophageal cancer. 17 refs., 4 figs. (author)

  3. Response to combined modality therapy correlates with survival in locally advanced non-small-cell lung cancer

    International Nuclear Information System (INIS)

    Purpose: Although concurrent chemoradiotherapy can now achieve demonstrated long-term survival in patients with locally advanced non-small-cell lung cancer (LANSCLC), it is difficult to predict which patients will benefit most from this therapeutic approach. Studies have suggested that local control, and the response to therapy, may be linked to improved survival; however, detailed analysis of the impact of tumor response to chemoradiotherapy on survival has not been thoroughly reported. Therefore, we sought to determine the impact of the response rate on survival for patients who were treated with combined modality therapy for LANSCLC. Methods and Materials: We reviewed the data from 116 patients enrolled between 1994 and 1997 in three trials investigating paclitaxel-based concurrent chemoradiotherapy for LANSCLC. Tumor size measurements were assessed immediately before and 2 months after completion of combined modality therapy to determine the response and to calculate the percentage of decrease in tumor size. Results: Patients with a response (complete or partial) had an improved 4-year overall survival rate compared with patients with no response (stable or progressive disease; 21.1% vs. 3.3%, p <0.0001) in the 109 assessable patients. Progression-free survival also improved significantly with response. An analysis of the percentage of decrease in tumor size vs. survival was performed (n = 74) using Cox proportion model analysis. After combined modality therapy, a 20%, 40%, 60%, 80%, and 100% decrease in tumor size conferred a 39%, 63%, 78%, 86%, and 92% reduction in risk of death compared with a 0% decrease in tumor size (p <0.0001). Conclusion: The response by conventional response criteria correlated strongly with improved overall survival and progression-free survival and an increasing percentage of decrease in tumor size resulted in a reduction in the risk of death. Additional investigation of the degree of response as a factor predictive of improved

  4. Vascular invasion in pancreatic cancer:Imaging modalities,preoperative diagnosis and surgical management

    Institute of Scientific and Technical Information of China (English)

    Nicolas; C; Buchs; Michael; Chilcott; Pierre-Alexandre; Poletti; Leo; H; Buhler; Philippe; Morel

    2010-01-01

    Pancreatic cancer is associated with a poor prognosis,and surgical resection remains the only chance for curative therapy.In the absence of metastatic disease,which would preclude resection,assessment of vascular invasion is an important parameter for determining resectability of pancreatic cancer.A frequent error is to misdiagnose an involved major vessel.Obviously,surgical exploration with pathological examination remains the"gold standard"in terms of evaluation of resectability,especially from the point ...

  5. Variation in treatment modalities, costs and outcomes of rectal cancer patients in Poland

    OpenAIRE

    Herman, Krzysztof J.; Komorowski, Andrzej L.; Wysocki, Wojciech M.; Tabor, Jacek; Herman, Roman M.; Śliwczyński, Andrzej

    2015-01-01

    Aim of the study To evaluate outcome, costs and treatment differences in rectal cancer patients between various regions in Poland. Material and methods Data from the Polish National Health Fund of all patients with rectal cancer diagnosed and treated between 2005 and 2007 were analyzed. Overall, relative 5-year survival and the percentage of patients receiving chemotherapy, radiotherapy and surgery were analyzed. The possible influence of cost of treatment per patient and mean number of recta...

  6. Current management of locally recurrent rectal cancer

    DEFF Research Database (Denmark)

    Nielsen, Mette Bak; Laurberg, Søren; Holm, Thorbjörn

    2011-01-01

    ABSTRACT Objective: A review of the literature was undertaken to provide an overview of the surgical management of locally recurrent rectal cancer (LRRC) after the introduction of total mesorectal excision (TME). Method: A systematic literature search was undertaken using PubMed, Embase, Web of...

  7. Oral Cancer Chernoprevention: Current Status and Future Direction.

    Science.gov (United States)

    Messadi, Diana V; Sato, Kazumichi

    2016-02-01

    The aim of this study is to review the current status of cancer chemoprevention and its effectiveness in treatment of oral premalignant lesions and prevention of their progression to oral cancer. The challenges encountered in the different oral cancer chemoprevention clinical trials, including lack of surrogate endpoints, reversal of histologic premalignant changes as study endpoints, tobacco use, human papillomavirus, delivery system, adverse effects and risk of bias in clinical studies, are presented. PMID:26930753

  8. Current status and prospect of therapy with advanced cancer

    International Nuclear Information System (INIS)

    Symtomatic or palliative therapy of the patients with advanced cancer must be directed to the relief of specific distressing symptoms caused by or associated with neoplasm. The radiotherapy must have a clear concepts of the potential accomplishments of other treatment modalities, such as neurosurgery, anesthesiology, chemotherapy, pharmacology and psychotherapy, so that he may use his own method in proper perspective. I discussed following is an list of contents in this papers. Relief of pain, Psychotherapy, SVC obstruction, Obstructive jaundice, Brain and lung metastasis, prevention of fracture, Skin metastasis, Liver metastasis and treatment of advanced pediaric tumor etc. For the future: 1) Establishment of Stage and Grade of advanced cancer. 2) Development of new chemotherapeutic drug and immunotherapy. 3) Combination of multidisciplinary team and multidisciplinary treatment. (author)

  9. Staging Lung Cancer: Current Controversies and Strategies

    OpenAIRE

    Riyad Karmy-Jones; Hyland, Robert H.; Lewis, Joseph W; Paul Kvale

    1997-01-01

    A consistent approach to staging is required for the rational management of lung cancer. This paper was prepared at the request of the Standards Committee of the Canadian Thoracic Society, and reviews and discusses the relative merits of the available methods of staging. Whichever methods are chosen by a particular institution, the following points must be stressed. No patient can be considered automatically "unresectable" when chest radiography and/ or computed tomography demonstrate adenopa...

  10. Focal Targeted Therapy Will Be a Future Treatment Modality for Early Stage Prostate Cancer

    NARCIS (Netherlands)

    J.J.M.C.H. de la Rosette; V. Mouraviev; T.J. Polascik

    2009-01-01

    Context: Focal targeted therapy of early stage prostate cancer (PCa) can ideally facilitate the concept of personalized medicine in contemporary surgical oncology. Objective: To present indications and outcomes of subtotal glandular ablation. This treatment approach aims at the elimination of the ca

  11. Correlation between combined imaging modalities of 18F-FDG PET/CT and 3.0T MRI and expression of Ki-67 in breast cancer

    International Nuclear Information System (INIS)

    Objective: To explore the correlation between combined imaging modalities of 18F-FDG PET/CT and 3.0T MRI and expression of Ki-67 (proliferating cell nuclear antigen)in breast cancer. Methods: A retrospective study was carried out in eighteen patients with pathologically confirmed primary breast cancer,who underwent both 18F-FDG PET/CT and 3.0T MRI examinations before operation. The interval between immunohistochemistry and combined imaging examinations was not more than one week after operation. The correlations between maximum standardized uptake value (SUVmax) as well as the score of combined imaging modalities and the expression level of Ki-67 were analyzed. Results: (1) A positive correlation between SUVmax and expression level of Ki-67 was demonstrated in breast cancer lesions (r=0.473, P<0.05). (2) A significantly positive correlation between the score of combined imaging modalities and the expression level of Ki-67 was also noted (r=0.674, P<0.01). Conclusion: Tumor proliferation can be reflected by the combined imaging modalities of 18F-FDG PET/CT and 3.0T MRI, indicating a potential role in predicting prognosis of breast cancer. (authors)

  12. Current Surgical Aspects of Palliative Treatment for Unresectable Pancreatic Cancer

    International Nuclear Information System (INIS)

    Despite all improvements in both surgical and other conservative therapies, pancreatic cancer is steadily associated with a poor overall prognosis and remains a major cause of cancer mortality. Radical surgical resection has been established as the best chance these patients have for long-term survival. However, in most cases the disease has reached an incurable state at the time of diagnosis, mainly due to the silent clinical course at its early stages. The role of palliative surgery in locally advanced pancreatic cancer mainly involves patients who are found unresectable during open surgical exploration and consists of combined biliary and duodenal bypass procedures. Chemical splanchnicectomy is another modality that should also be applied intraoperatively with good results. There are no randomized controlled trials evaluating the outcomes of palliative pancreatic resection. Nevertheless, data from retrospective reports suggest that this practice, compared with bypass procedures, may lead to improved survival without increasing perioperative morbidity and mortality. All efforts at developing a more effective treatment for unresectable pancreatic cancer have been directed towards neoadjuvant and targeted therapies. The scenario of downstaging tumors in anticipation of a future oncological surgical resection has been advocated by trials combining gemcitabine with radiation therapy or with the tyrosine kinase inhibitor erlotinib, with promising early results

  13. Gastric cancer in Africa: current management and outcomes.

    Science.gov (United States)

    Asombang, Akwi W; Rahman, Rubayat; Ibdah, Jamal A

    2014-04-14

    Gastric cancer is the fourth most common cancer and second most common cause of cancer death worldwide. Globally, gastric cancer poses a significant public health burden - both economically and socially. In 2008, the economic burden from premature cancer deaths and disability was $895 billion and gastric cancer was the second highest cancer responsible for healthy life lost. With the expected increase in cancer deaths and non-communicable diseases, these costs are expected to rise and impact patient care. World Health Organization, estimates a 15% increase in non-communicable disease worldwide, with more than 20% increase occurring in Africa between 2010 and 2020. Mali, West Africa, is ranked 15(th) highest incidence of gastric cancer worldwide at a rate of 20.3/100000, yet very scarce published data evaluating etiology, prevention or management exist. It is understood that risk factors of gastric cancer are multifactorial and include infectious agents (Helicobacter pylori, Epstein-Barr virus), genetic, dietary, and environmental factors (alcohol, smoking). Interestingly, African patients with gastric cancer are younger, in their 3(rd)-4(th) decade, and present at a late stage of the disease. There is sparse data regarding gastric cancer in Africa due to lack of data collection and under-reporting, which impacts incidence and mortality rates. Currently, GLOBOCAN, an International Agency for Research on Cancer resource, is the most comprehensive available resource allowing comparison between nations. In resource limited settings, with already restricted healthcare funding, data is needed to establish programs in Africa that increase gastric cancer awareness, curtail the economic burden, and improve patient management and survival outcomes. PMID:24833842

  14. Targeted Therapy of Cancer Using Photodynamic Therapy in Combination with Multi-faceted Anti-Tumor Modalities

    Directory of Open Access Journals (Sweden)

    Malini Olivo

    2010-05-01

    Full Text Available Photodynamic therapy (PDT has emerged as one of the important therapeutic options in the management of cancer and other diseases. PDT involves a tumor-localized photosensitizer (PS, which when appropriately illuminated by visible light converts oxygen into cytotoxic reactive oxygen species (ROS, that attack key structural entities within the targeted cells, ultimately resulting in necrosis or apoptosis. Though PDT is a selective modality, it can be further enhanced by combining other targeted therapeutic strategies that include the use of synthetic peptides and nanoparticles for selective delivery of photosensitizers. Another potentially promising strategy is the application of targeted therapeutics that exploit a myriad of critical pathways involved in tumorigenesis and metastasis. Vascular disrupting agents that eradicate tumor vasculature during PDT and anti-angiogenic agents that targets specific molecular pathways and prevent the formation of new blood vessels are novel therapeutic approaches that have been shown to improve treatment outcome. In addition to the well-documented mechanisms of direct cell killing and damage to the tumor vasculature, PDT can also activate the body’s immune response against tumors. Numerous pre-clinical studies and clinical observations have demonstrated the immuno-stimulatory capability of PDT. Herein, we aim to integrate the most important findings with regard to the combination of PDT and other novel targeted therapy approaches, detailing its potential in cancer photomedicine.

  15. Urgent Calls for Effective Earlier Disease Detection and Multi-Modal Therapeutic Strategies in Pancreatic Cancer

    Directory of Open Access Journals (Sweden)

    Muhammad Wasif Saif

    2009-07-01

    Full Text Available Pancreatic carcinoma is unfortunately usually a fatal disease. Pancreatic cancer in its early stages is a protean disease that can be difficult to distinguish from other common disorders that may cause similar symptoms. Early diagnosis is therefore often a problem. Many patients have sought care for symptoms for weeks to months before a definitive diagnosis of pancreatic cancer is made. The collective median survival time of all patients is 4-6 months. Most patients eventually succumb to local invasion and metastatic disease. Patients who are deemed resectable with potential curative resection (only about 20% of patients, median survival time ranges from 12-19 months, and the 5-year survival rate remains 15-20%.

  16. Nonsurgical combined modality therapies in non-small cell lung cancer

    International Nuclear Information System (INIS)

    Nonsurgical combined approaches of non-small cell lung cancer represent a concept that has only been investigated so far with chemotherapy and radiation therapy. Thoracic irradiation of locoregional disease is associated with a high rate of local control and a 5-10% long-term (5-year) survival; however, distant metastases remain the main cause of failure. This observation suggests that the tumor is often microscopically disseminated at the time of diagnosis. Systemic therapy therefore must be associated to radiation therapy to try to control both the undetectable metastases and the local disease. However, the results reported so far have been disappointing, probably because of the modest activity of the available chemotherapy. Further progress with the combined approach requires new developments in the chemotherapy of non-small cell lung cancer, particularly the introduction of new active drugs.67 references

  17. Parametric modal transition systems

    DEFF Research Database (Denmark)

    Beneš, Nikola; Křetínský, Jan; Larsen, Kim Guldstrand; Møller, M.H.; Srba, J.

    2011-01-01

    Modal transition systems (MTS) is a well-studied specification formalism of reactive systems supporting a step-wise refinement methodology. Despite its many advantages, the formalism as well as its currently known extensions are incapable of expressing some practically needed aspects in the...... refinement process like exclusive, conditional and persistent choices. We introduce a new model called parametric modal transition systems (PMTS) together with a general modal refinement notion that overcome many of the limitations and we investigate the computational complexity of modal refinement checking....

  18. Urdu/Hindi modals

    OpenAIRE

    Rajesh, Bhatt; Bögel, Tina; Butt, Miriam; Hautli, Annette; Sulger, Sebastian

    2011-01-01

    In this paper we survey the various ways of expressing modality in Urdu/Hindi and show that Urdu/Hindi modals provide interesting insights on current discussions of the semantics of modality. There are very few dedicated modals in Urdu/Hindi: most of which has been arrived at constructionally via a combination of a certain kind of verb with a certain kind of embedded verb form and a certain kind of case. Among the range of constructions yielded by such combinations, there is evidence for a tw...

  19. Dosimetric comparison in a cancer of the Cervix with different therapeutic modalities

    International Nuclear Information System (INIS)

    Cervical cancer is usually treated with radiotherapy composed of 3D (RC3D) and supine position, and is usually not usually outline the small intestine in cases of exclusively pelvic irradiation. In our Center we wanted to check what dose receives the small intestine in these cases and if the positioning of the patient or used irradiation technique influence the distribution of the histogram dose-volume. (Author)

  20. 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

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

    International Nuclear Information System (INIS)

    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. A Phase III clinical trial of exercise modalities on treatment side-effects in men receiving therapy for prostate cancer; ACTRN12609000200280

  2. A Clinical Study of Melasma and a Comparison of the Therapeutic Effect of Certain Currently Available Topical Modalities for its Treatment

    OpenAIRE

    Sardesai, Vidyadhar R; Kolte, Jennifer N; Babu N Srinivas

    2013-01-01

    Background: Melasma is a common acquired facial hypermelanosis. Conventional treatment of melasma includes a sunscreen and hypopigmenting agents. The treatment of this recalcitrant disorder is often difficult and unsatisfactory. Aims: The objective is to carry out a detailed clinical study of melasma and to assess the therapeutic effect and side effects of certain currently available topical modalities for the treatment of melasma. Materials and Methods: 160 patients of all age groups and bot...

  3. Combined-modality treatment and organ preservation in bladder cancer. Do molecular markers predict outcome?

    International Nuclear Information System (INIS)

    Purpose: in invasive bladder cancer, several groups have reported the value of organ preservation by a combined-treatment approach, including transurethral resection (TUR-BT) and radiochemotherapy (RCT). As more experience is acquired with this organ-sparing treatment, patient selection needs to be optimized. Clinical factors are limited in their potential to identify patients most likely to respond to RCT, thus, additional molecular markers for predicting treatment response of individual lesions are sorely needed. Patients and methods: the apoptotic index (AI) and Ki-67 index were evaluated by immunohistochemistry on pretreatment biopsies of 134 patients treated for bladder cancer by TUR-BT and RCT. Expression of each marker as well as clinicopathologic factors were then correlated with initial response, local control and cancer-specific survival with preserved bladder in univariate and multivariate analysis. Results: the median AI for all patients was 1.5% (range 0.2-7.4%). The percentage of Ki-67-positive cells in the tumors ranged from 0.2% to 85% with a median of 14.2%. A significant correlation was found for AI and tumor differentiation (G1/2: AI = 1.3% vs. G3/4: AI = 1.6%; p = 0.01). A complete response at restaging TUR-BT was achieved in 76% of patients. Factors predictive of complete response included T-category (p < 0.0001), resection status (p = 0.02), lymphovascular invasion (p = 0.01), and Ki-67 index (p = 0.02). For local control, AI (p = 0.04) and Ki-67 index (p = 0.05) as well as T-category (p = 0.005), R-status (p = 0.05), and lymphatic vessel invasion (p = 0.05) reached statistical significance. Out of the molecular markers only high Ki-67 levels were associated to cause-specific survival with preserved bladder. On multivariate analysis, T-category was the strongest independent factor for initial response, local control and cancer-specific survival with preserved bladder. Conclusion: The indices of pretreatment apoptosis and Ki-67 predict a

  4. Current major cancer targets for nanoparticle systems.

    Science.gov (United States)

    Wesselinova, Diana

    2011-02-01

    This review presents some common features of nanoparticles - activity, toxicity and biological activity. Humans are exposed to tiny particles via dust storms, volcanic ash, and other natural processes and the body systems are well adapted to protect from these potentially harmful intruders. Technological advancement has also changed the character of particulate pollution, increasing the proportion of nanometer-sized particles - "nanoparticles" and expanding the variety of chemical compositions. Studies have shown a strong correlation between particulate air pollution levels, respiratory and cardiovascular diseases, various cancers, and mortality. Adverse effects of nanoparticles on human health depend on individual factors such as genetics and existing disease, as well as exposure, and nanoparticle chemistry, size, shape, agglomeration state, and electromagnetic properties. The key to understand the toxicity of nanoparticles is their size, smaller than cells and cellular organelles, which allows them to penetrate these basic biological structures, disrupting their normal function. Examples of toxic effects include tissue inflammation, and altered cellular redox balance toward oxidation, causing abnormal function or cell death. Some of these materials have desirable characteristics for industrial applications, as nanostructured materials often exhibit beneficial properties, from UV absorbance in sunscreen to oil-less lubrication of motors. In the sense of the huge surrounding positive and negative influence of known and unknown NP-impacts it seems very important to understand and forecast the processes in the body, due to the interaction between these two sides - organism. How nanoparticles can be used as drug delivery systems and imaging devices to increase the efficacy per dose of therapeutic or imaging contrast agents; how nanoparticles will be further developed to improve their functionality in cancer treatment and imaging? How reacts the immune system of the

  5. Breast cancer. Current approach in the treatment

    International Nuclear Information System (INIS)

    Of 115 women who had surgery for a malignant breast tumor proven by biopsy at the Department of General Surgery, Hospital 'Jose Ramon Lopez Tabrane' of Matanzas during the period January 2007 to May 2008 a study was conducted observational, analytical (study cohort) and using certain variables, with the aim of analyzing the behavior of this disease in our environment. Data were collected from medical records of patients admitted a breast lump in that period and files Statistics and Provincial Hospital Pathology 'Jose Ramon Lopez Tabrane'. The percentage method was applied to the description found in our sample, expressing the results in tabular form, with the objective facilitate their interpretation. The most affected age range between 65 and 74, but followed very near the range between 55 and 64. The most frequent clinical stage II, followed by the III. The left breast has proven to be most affected in outer quadrant exceeded. Veronesi conservative technique was the most used in our study. We recommend promoting breast self-examination and use of media We recommend promoting breast self-examination and use of media such as mammography as a method of early diagnosis of breast cancer and the creation of a file to the technical assessment conservative based on the survival and the immediate and mediate complications of this technique, and the best instruction in family practice clinical diagnosis of breast diseases and specialized inter consultation. (Author)

  6. Radiotherapy through intensity modulation (IMRT). A new modality in the treatment of head and neck cancer

    International Nuclear Information System (INIS)

    Objective: To describe the treatment and evaluate the advantages of IMRT in the treatment of head and neck cancer. Material and methods: Four years ago, at the Cancer Center of the Pontificia Universidad Catolica, the IMRT technique for the treatment of head and neck tumors was implemented. The IMRT technique is based on modifying the intensity of the radiation beam through a multisheet collimator in order to produce a more exact distribution in the radiation doses. The results are evaluated with dose/ volume histograms. The distributions of doses and toxicity for tridimensional con formed therapy (CRT-3D) and IMRT are compared. Results: The distribution of the dose in the dose/volume histograms showed a better coverage of the white volume (PTV), with IMRT. The doses received by the organs under risk: salivary glands, eyes, ears and brain diminish with IMRT. The spinal marrow is protected with IMRT without dividing the treatment area, preventing points with lower dosage that could reduce control of the tumor. Conclusions: IMRT achieves a better conformation of the dose obtaining a better coverage of the tumor and higher protection of the organs under risk

  7. Combined modality treatment of chemotherapy and thoracic radiotherapy for limited-stage small cell lung cancer

    International Nuclear Information System (INIS)

    Small cell lung cancer (SCLC) differs from other types of lung cancer in its more aggressive clinical course and superior responsiveness to chemo- and radiotherapy. Median survival of patients with unresectable limited disease was reported only 3 months by supportive care alone. SCLC was treated by surgery in 1950s, but results were disappointing. In a British study in the 1960s, radiotherapy proved superior to surgery in survival. However, most patients treated with thoracic radiotherapy alone died of instant metastases with median survival of 5-9 months, indicating a need for primary systemic treatment. In the 1970s, combined chemotherapy came to be the main treatment for SCLC; high response rate and improved survival led to the idea that thoracic radiotherapy added only toxicities with no therapeutic advantage in chemotherapy-treated patients. Considering the fact that 80% of patients treated with chemotherapy alone relapsed in primary sites, and that radio-therapy achieved response in 90% of limited disease patients, it is reasonable to attempt to combine systemic chemotherapy and thoracic radio-therapy to improve therapeutic results for this disease. In 1980s, several randomized trials comparing chemotherapy alone versus chemotherapy with thoracic radiotherapy were conducted to clarify the role of thoracic radio-therapy in combination with chemotherapy for limited SCLC. (author). 20 refs., 3 tabs

  8. WSTO9 (TOOKAD) mediated photodynamic therapy as an alternative modality in the treatment of prostate cancer

    Science.gov (United States)

    Chen, Qun; Huang, Zheng; Luck, David L.; Beckers, Jill; Brun, Pierre-Herve; Wilson, Brian C.; Scherz, Avigdor; Salomon, Yoram; Hetzel, Fred W.

    2002-06-01

    Photodynamic therapy (PDT) utilizes optical energy to activate a pre-administered photosensitizer drug to achieve a localized tumor control. In the presented study, PDT mediated with a second-generation photosensitizer, WST09 (TOOKAD, Steba Biotech, The Netherlands), is investigated as an alternative therapy in the treatment of prostate cancer. In vivo canine prostate is used as the animal model. PDT was performed by irradiating the surgically exposed prostates both superficially and interstitially with a diode laser (763 nm) to activate the intra-operatively i.v. infused photosensitizer. During light irradiation, tissue optical properties, and temperature were monitored. During the one-week to 3-month period post PDT treatment, the dogs recovered well with little or no complications. The prostates were harvested and subjected to histopathological evaluations. Maximum lesion size of over 3 cm in dimension could be achieved with a single treatment, suggesting the therapy is extremely effective in destroying prostatic tissue. Although we found there was loss of epithelial lining in prostatic urethra, there was no evidence it had caused urinary tract side effects as reported in those studies utilizing transurethral irradiation. In conclusion, we found second generation photosensitizer WST09 mediated PDT may provide an excellent alternative to treat prostate cancer.

  9. A clinical study of melasma and a comparison of the therapeutic effect of certain currently available topical modalities for its treatment

    Directory of Open Access Journals (Sweden)

    Vidyadhar R Sardesai

    2013-01-01

    Full Text Available Background: Melasma is a common acquired facial hypermelanosis. Conventional treatment of melasma includes a sunscreen and hypopigmenting agents. The treatment of this recalcitrant disorder is often difficult and unsatisfactory. Aims: The objective is to carry out a detailed clinical study of melasma and to assess the therapeutic effect and side effects of certain currently available topical modalities for the treatment of melasma. Materials and Methods: 160 patients of all age groups and both sexes were treated sequentially with five different combination regimes for 3 months. Assessment of the response was done subjectively as well as by melasma area and severity index (MASI. Results: Out of the five modalities studied, the modified Kligman′s formula was the most effective. However, it had comparatively higher incidence of side effects. Conclusions: Among the currently available topical modalities for the treatment of melasma, the most effective combination is the modified Kligman′s formula. However, in view of the side effects it causes, it must be used with caution and proper counseling.

  10. Current Status and Challenges of Cancer Clinical Trials in Korea

    OpenAIRE

    Shim, Byoung Yong; Park, Se Hoon; Lee, Soonil; Kim, Jin-Soo; Lee, Kyoung Eun; Kang, Yoon-Koo; Ahn, Myung-Ju

    2015-01-01

    Purpose Cancer clinical trials in Korea have rapidly progressed in terms of quantity and quality during the last decade. This study evaluates the current status of cancer clinical trials in Korea and their associated problems. Materials and Methods We analyzed the clinical trials approved by the Korea Food and Drug Administration (KFDA) between 2007 and 2013. A nationwide on-line survey containing 22 questions was also performed with several cooperative study groups and individual researchers...

  11. Cost-Effective Screening for Breast Cancer Worldwide: Current State and Future Directions

    Directory of Open Access Journals (Sweden)

    A. Sarvazyan

    2008-01-01

    Full Text Available Affordability of healthcare is highly limited by its skyrocketing cost. Access to screening and diagnostic medical equipment and medicine in developing countries is inadequate for the majority of the population. There is a tremendous worldwide need to detect breast cancer at its earliest stage. These needs must be balanced by the ability of countries to provide breast cancer screening technology to their populations. We reviewed the diagnostic accuracy, procedure cost and cost-effectiveness of currently available technique for breast screening and diagnosis including clinical breast examination, mammography, ultrasound, magnetic resonance imaging, biopsy and a new modality for cancer diagnostics termed elasticity imaging that has emerged in the last decade. Clinical results demonstrate that elasticity imaging even in its simplest and least sophisticated versions, like tactile imaging, has significant diagnostic potential comparable and exceeding that of conventional imaging techniques. In view of many countries with limited resources, effective yet less expensive modes of screening must be considered worldwide. The tactile imaging is one method that has the potential to provide cost-effective breast cancer screening and diagnostics.

  12. Interpreting Metaphor of Modality in Advertising English

    Science.gov (United States)

    Xu, Jian

    2009-01-01

    Based on a review of the historical and current studies on modality, this paper aims at interpreting metaphor of modality and its functions in advertising English according to theories of modality system and metaphor of modality in systemic-functional linguistics with a corpus we have collected. It is pointed out that metaphor of modality, a usual…

  13. Hemibody radiation, an active therapeutic modality for the management of patients with small cell lung cancer

    International Nuclear Information System (INIS)

    In a previously published paper, the results of a preliminary clinical trial comparing systemic radiation (upper and lower hemibody technique) versus systemic chemotherapy in the management of all stages of small cell lung cancer (SCLC), suggested that hemibody radiation (HBI) was as efficient as systemic chemotherapy, particularly for patients with early disease. We are now presenting the final results of the above trial. The two year survival has shown that as many patients in the HBI as in the chemotherapy arm have reached this endpoint. However, there is a difference in favor of chemotherapy on both the median and one year survival for those patients with advanced stages. Therefore, as of June 1981, we have initiated a study incorporating HBI as a consolidating-maintenance agent for patients with all stages of the disease who have received a three and one half months induction systemic chemotherapy plus local chest irradiation. Up to date, 65 patients have been entered and our median survival for those who received the complete treatment is 62.5 weeks

  14. Bladder Preservation by Combined Modality Therapy for Invasive Bladder Cancer: A Five-Year Follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Jae Ho; Lim, Ji Hoon; Seong, Jin Sil; Pyo, Hong Ryull; Koom, Woong Soup; Suh, Chang Ok; Hong, Sung Jun [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2001-12-15

    Purpose : To determine the long-term results of bladder-preserving approach by transurethral resection of the bladder (TURB), systemic chemotherapy, and radiation therapy for muscle-invasive bladder cancer Methods and materials : From 1991 Jan, through 1994 Dec., 25 patients with muscle invading clinical stage T2 to T4NxM0 bladder cancer were treated width induction by maximal TURB and (arm 1, n=4) three cycles of chemotherapy [MVAC(methotrexate, vincristine, adriamycin, ciplatin)] followed by 64.8 Gy of radiation with concomitant cisplatin, or two cycles of chemotherapy [MCV (methotrexate, ciplatin, vincristine)] after irradiation with concomitant cisplatin (arm 2, n=14), or concurrent chemoradiation only (arm 3, n=7). Tumor response was scored as a clinical complete response (CR) when the cystoscopic tumor-site biopsy and urine cytology results were negative. Those with less than a CR underwent cystectomy. The median follow-up of al patients was 70 months. Results : Most treatment toxicities were mild to moderate. Grade 3 acute hematologic toxicity and chronic cystitis were observed in only 1 and 2 patients, respectively. Overall 5 year survival was 67.3%. Complete remission rate was 80% (20/25). Sixth-three percent of all survivors retained their bladders. In multivariate analysis, prognostic factors that significantly affect survival were T-stage (p=0.013) and Complete remission (p=0.002). Conclusion : Combined modality therapy with TURB, chemotherapy, and radiation has a 67.3% overall 5 year survival rate. This result is similar to cystectomy-based studies for patients of similar clinical stages. Sixty-three percent of long term survivors preserved their bladders.

  15. Bladder Preservation by Combined Modality Therapy for Invasive Bladder Cancer: A Five-Year Follow-up

    International Nuclear Information System (INIS)

    Purpose : To determine the long-term results of bladder-preserving approach by transurethral resection of the bladder (TURB), systemic chemotherapy, and radiation therapy for muscle-invasive bladder cancer Methods and materials : From 1991 Jan, through 1994 Dec., 25 patients with muscle invading clinical stage T2 to T4NxM0 bladder cancer were treated width induction by maximal TURB and (arm 1, n=4) three cycles of chemotherapy [MVAC(methotrexate, vincristine, adriamycin, ciplatin)] followed by 64.8 Gy of radiation with concomitant cisplatin, or two cycles of chemotherapy [MCV (methotrexate, ciplatin, vincristine)] after irradiation with concomitant cisplatin (arm 2, n=14), or concurrent chemoradiation only (arm 3, n=7). Tumor response was scored as a clinical complete response (CR) when the cystoscopic tumor-site biopsy and urine cytology results were negative. Those with less than a CR underwent cystectomy. The median follow-up of al patients was 70 months. Results : Most treatment toxicities were mild to moderate. Grade 3 acute hematologic toxicity and chronic cystitis were observed in only 1 and 2 patients, respectively. Overall 5 year survival was 67.3%. Complete remission rate was 80% (20/25). Sixth-three percent of all survivors retained their bladders. In multivariate analysis, prognostic factors that significantly affect survival were T-stage (p=0.013) and Complete remission (p=0.002). Conclusion : Combined modality therapy with TURB, chemotherapy, and radiation has a 67.3% overall 5 year survival rate. This result is similar to cystectomy-based studies for patients of similar clinical stages. Sixty-three percent of long term survivors preserved their bladders

  16. Manganese oxide and docetaxel co-loaded fluorescent polymer nanoparticles for dual modal imaging and chemotherapy of breast cancer.

    Science.gov (United States)

    Abbasi, Azhar Z; Prasad, Preethy; Cai, Ping; He, Chunsheng; Foltz, Warren D; Amini, Mohammad Ali; Gordijo, Claudia R; Rauth, Andrew M; Wu, Xiao Yu

    2015-07-10

    Multifunctional nanoparticles (NPs) have found important applications in diagnosis, chemotherapy, and image-guided surgery of tumors. In this work, we have developed polymeric theranostic NPs (PTNPs) containing the anticancer drug docetaxel (DTX), a fluorescent dye, and magnetic manganese oxide (MnO) NPs for dual modal imaging and chemotherapy. PTNPs ~150 nm in diameter were synthesized by co-loading hydrophobic DTX and MnO NPs ~5 nm in diameter, into the matrix of a fluorescent dye-labeled amphiphilic polymer. The PTNPs enabled high loading efficiency and sustained in vitro release of DTX. Energy-dependent cellular uptake and extended cytoplasmic retention of the PTNPs in MDA-MB-231 human breast cancer cells were observed by fluorescence microscopy examination. DTX-loaded PTNPs exhibited higher cytotoxicity than free DTX with a 3 to 4.4-fold decrease in drug dose required for 50% cell growth inhibition. The hydrophilic backbone of the amphiphilic polymer improved the fluidity of PTNPs which enhanced the longitudinal relaxivity (r1) of loaded MnO NPs by 2.7-fold with r1=2.4mM(-1)s(-1). Whole body fluorescence imaging (FI) and magnetic resonance imaging (MRI) showed significant accumulation and prolonged retention of PTNPs in orthotopic MDA-MB-231 breast tumors. These results suggest that the new amphiphilic polymer-based PTNP system, able to simultaneously deliver a poorly soluble anticancer drug, enhance MRI contrast, and stain tumor tissue by fluorescence, is a good candidate for cancer theranostic applications. PMID:25908171

  17. Ordinary Modalities

    Czech Academy of Sciences Publication Activity Database

    Materna, Pavel

    - , - (2005), s. 57-70. ISSN 0024-5836 R&D Projects: GA ČR(CZ) GA401/04/2073 Institutional research plan: CEZ:AV0Z90090514 Keywords : logical modalities * empirical modalities * nomical necessity Subject RIV: AA - Philosophy ; Religion

  18. Cancer Survivorship Research: A Review of the Literature and Summary of Current NCI-Designated Cancer Center Projects

    OpenAIRE

    Harrop, J. Phil; Dean, Julie A.; Paskett, Electra D.

    2011-01-01

    The number of cancer survivors and amount of cancer survivorship research has grown substantially during the past three decades. This paper provides a review of interventional and observational cancer survivorship research efforts as well as a summary of current cancer survivorship research projects being conducted by National Cancer Institute-designated cancer centers in an effort to identify areas that need further attention.

  19. Selective bladder preservation by combined modality therapy for invasive bladder cancer

    International Nuclear Information System (INIS)

    Purpose/Objective: To assess the success of selective organ preservation or radical cystectomy in a large group of patients with muscle-invasive bladder cancer treated with induction by combined transurethral resection (TURBT), systemic chemotherapy and radiation therapy. Materials and Methods: 106 patients (median age 68 years) were treated with induction by maximal TURBT and 2 cycles of chemotherapy (methotrexate, cisplatin, vinblastine - MCV) followed by 39.6 Gy irradiation in 1.8 Gy fractions with concomitant cisplatin. Tumor response was then evaluated by cystoscopy, rebiopsy, and urine cytology. Complete responders were consolidated with radiation to 64.8 Gy and further cisplatin. Any subsequent isolated invasive local relapse was managed by cystectomy. Patients with any less than a complete response (CR) were recommended cystectomy. Median follow-up was 4.4 years. Kaplan-Meier analysis was used to assess outcome. Results: 74 CR patients (70%) and 7 non-cystectomy candidates with less than a CR (7%) received consolidation chemotherapy and radiation. 13 incomplete responders (12%) underwent immediate cystectomy. 6 patients underwent cystectomy because they could not tolerate induction chemo-radiation. 1 complete response patient underwent radical cystectomy. 83 patients completed their planned therapy but 5 died of treatment related toxicity during induction chemotherapy. Five year actuarial overall survival and disease-specific survival were 52% and 60% respectively. For T2 patients, actuarial overall survival was 63%, and for T3-4, 45%. Five year survival with an intact functioning bladder was 43%. Five year freedom from distant metastases was 66%. Of those who had a CR after TURBT and MCV, the risk of a subsequent invasive bladder relapse was 18% at 5 years. Of those who had a CR after the completion of induction chemotherapy and 39.6 Gy, this risk was 21%. 18 patients (17%) have experienced a non-invasive bladder relapse requiring further TUR and

  20. Current strategies for the prevention of breast cancer

    Directory of Open Access Journals (Sweden)

    Advani P

    2014-05-01

    Full Text Available Pooja Advani, Alvaro Moreno-AspitiaDepartment of Hematology and Oncology, Mayo Clinic, Jacksonville, FL, USAAbstract: Due to the high incidence of breast cancer in the United States, optimal strategies for its prevention are imperative. This entails identification of women who are at an increased risk for breast cancer and an integrative approach that includes effective screening methods as well as nutritional, pharmacologic, and surgical management. Several breast cancer risk-assessment tools, such as the Gail and Claus models, can help clinicians determine the quantitative risk of breast cancer. The role of selective estrogen receptor modulators, such as tamoxifen and raloxifene, for the prevention of breast cancer has been well established. Several other agents, such as aromatase inhibitors, are currently being investigated. The potential adverse effects of these chemopreventive agents, which include an impact on the quality of life, must be discussed with the patient before deciding on this approach. Additionally, breast cancer risk factors have been identified over the years; some of them are modifiable, but others are not. Although there is no conclusive evidence to suggest the protective role of specific dietary components, alcohol consumption and obesity are associated with an increased breast cancer risk; thus lifestyle changes can lead to a lower risk of developing breast cancer. Surgical approaches, including bilateral risk-reduction mastectomy and salpingo-oophorectomy, are usually limited to women with a hereditary predisposition to development of breast cancer. The objective of this review is to summarize the various approaches directed at reducing the incidence of breast cancer.Keywords: chemoprevention, tamoxifen, raloxifene, prophylactic surgery

  1. Clinical usefulness of breast-specific gamma imaging as an adjunct modality to mammography for diagnosis of breast cancer: a systemic review and meta-analysis

    International Nuclear Information System (INIS)

    The purpose of this study was to assess the diagnostic performance of breast-specific gamma imaging (BSGI) as an adjunct modality to mammography for detecting breast cancer. Comprehensive searches of MEDLINE (1984 to August 2012) and EMBASE (1994 to August 2012) were performed. A summary receiver operating characteristic curve (SROC) was constructed to summarize the overall test performance of BSGI. The sensitivities for detecting subcentimetre cancer and ductal carcinoma in situ (DCIS) were pooled. The potential of BSGI to complement mammography was also evaluated by identifying mammography-occult breast cancer. Analysis of the studies revealed that the overall validity estimates of BSGI in detecting breast cancer were as follows: sensitivity 95 % (95 % CI 93-96 %), specificity 80 % (95 % CI 78-82 %), positive likelihood ratio 4.63 (95 % CI 3.13-6.85), negative likelihood ratio 0.08 (95 % CI 0.05-0.14), and diagnostic odds ratio 56.67 (95 % CI 26.68-120.34). The area under the SROC was 0.9552 and the Q* point was 0.8977. The pooled sensitivities for detecting subcentimetre cancer and DCIS were 84 % (95 % CI 80-88 %) and 88 % (95 % CI 81-92 %), respectively. Among patients with normal mammography, 4 % were diagnosed with breast cancer by BSGI, and among those with mammography suggestive of malignancy or new biopsy-proven breast cancer, 6 % were diagnosed with additional cancers in the breast by BSGI. BSGI had a high diagnostic performance as an excellent adjunct modality to mammography for detecting breast cancer. The ability to identify subcentimetre cancer and DCIS was also high. (orig.)

  2. Clinical usefulness of breast-specific gamma imaging as an adjunct modality to mammography for diagnosis of breast cancer: a systemic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Yu.; Wei, Wei; Yang, Hua-Wei; Liu, Jian-Lun [Affiliated Cancer Hospital of Guangxi Medical University, Department of Breast Surgery of Guangxi Cancer Hospital, Nanning, Guangxi (China)

    2013-03-15

    The purpose of this study was to assess the diagnostic performance of breast-specific gamma imaging (BSGI) as an adjunct modality to mammography for detecting breast cancer. Comprehensive searches of MEDLINE (1984 to August 2012) and EMBASE (1994 to August 2012) were performed. A summary receiver operating characteristic curve (SROC) was constructed to summarize the overall test performance of BSGI. The sensitivities for detecting subcentimetre cancer and ductal carcinoma in situ (DCIS) were pooled. The potential of BSGI to complement mammography was also evaluated by identifying mammography-occult breast cancer. Analysis of the studies revealed that the overall validity estimates of BSGI in detecting breast cancer were as follows: sensitivity 95 % (95 % CI 93-96 %), specificity 80 % (95 % CI 78-82 %), positive likelihood ratio 4.63 (95 % CI 3.13-6.85), negative likelihood ratio 0.08 (95 % CI 0.05-0.14), and diagnostic odds ratio 56.67 (95 % CI 26.68-120.34). The area under the SROC was 0.9552 and the Q* point was 0.8977. The pooled sensitivities for detecting subcentimetre cancer and DCIS were 84 % (95 % CI 80-88 %) and 88 % (95 % CI 81-92 %), respectively. Among patients with normal mammography, 4 % were diagnosed with breast cancer by BSGI, and among those with mammography suggestive of malignancy or new biopsy-proven breast cancer, 6 % were diagnosed with additional cancers in the breast by BSGI. BSGI had a high diagnostic performance as an excellent adjunct modality to mammography for detecting breast cancer. The ability to identify subcentimetre cancer and DCIS was also high. (orig.)

  3. A comparison of patient characteristics, prognosis, treatment modalities, and survival according to age group in gastric cancer patients

    Directory of Open Access Journals (Sweden)

    Tural Deniz

    2012-11-01

    Full Text Available Abstract Background The aim of this study was to investigate age-specific incidence rates and to compare disease stage, treatment, and survival according to age group in patients with gastric adenocarcinoma. Methods Gastric cancer patients treated at our hospital between 1999 and 2010 were retrospectively evaluated. We divided the cases into two subgroups: group 1 consisted of patients older than 70 years at the time of treatment, and group 2 included patients aged 70 years or younger. In all, 151 patients over 70 years of age and 715 patients age 70 years or younger were analyzed. Categorical and continuous variables were summarized using descriptive statistics and compared using statistical software. Overall survival rates were estimated via the Kaplan-Meier method. Results Median age at diagnosis was 58 years (range: 22 to 90 years. Between 1999 and 2002 the annual median age for patients aged older than70 years was 9.8%, which increased to 20% between 2007 and 2010. The one-year survival rate for patients with metastatic disease (stage IV was 10.9% (95% CI: 8.9% to 12.9% and 27.8% (95% CI: 17.3% to 38.2% in groups 1 and 2, respectively (P = 0.015. The five-year survival rate for patients with non-metastatic disease (in whom curative surgery was performed was 15.5% (95% CI = 12% to 19% and 26.9% (95% CI = 25.9% to 27.9% in groups 1 and 2, respectively (P = 0.03. There were no significant differences in gender, tumor localization in the stomach, tumor histology, perineural invasion (PNI, lymphovascular invasion (LVI, tumor stage, or type of surgery between the two groups. However, fewer of the patients in group 1 underwent adjuvant treatment (P = 0.02 and palliative chemotherapy (P = 0.007 than group 2 patients that were non-metastatic and metastatic at presentation, respectively. Conclusions Groups 1 and 2 were similar in terms of histopathological features and surgical modality; however, the survival rate was lower in group 1 than in group 2

  4. Current role of antibody therapy in patients with metastatic colorectal cancer

    DEFF Research Database (Denmark)

    Pfeiffer, P; Qvortrup, C; Eriksen, J G

    2007-01-01

    In less than 10 years, the number and importance of non-surgical treatment modalities in patients with colorectal cancer (CRC) have increased dramatically, both in the adjuvant and the advanced settings. However, despite the improvement of cytotoxic therapy in CRC, many patients still develop...... arsenal in CRC to a great extent, but they will also add to the complexity of treatment of CRC. In this review, we summarize the current status of antibody therapy in patients with CRC...... progressive disease and unfortunately in patients with disease resistant to 5-fluorouracil/folinic acid, irinotecan and oxaliplatin, no effective cytotoxic therapy is known. The rapidly expanding knowledge in tumor biology has encouraged optimism for the possibility to find and target tumor...

  5. Management of locally advanced breast cancer: Evolution and current practice

    Directory of Open Access Journals (Sweden)

    Rustogi Ashish

    2005-01-01

    Full Text Available Locally advanced breast cancer (LABC accounts for a sizeable number (30-60% of breast cancer cases and is a common clinical scenario in developing countries. The treatment of LABC has evolved from single modality treatment, consisting of radical mutilating surgery or higher doses of radiotherapy in inoperable disease to multimodality management, which along with the above two included systemic therapy. Neoadjuvant chemotherapy (NACT has made a tremendous impact on the management of LABC. NACT was initiated to institute systemic therapy upfront at the earliest in this group of patients with a high risk of micrometastasis burden. While NACT did not yield a survival advantage, it has however made breast conservation possible in selected group of cases. Large number of studies and many randomised trials have been done in women with LABC in order to improve the therapeutic decisions and also the local control and survival. With this background we have reviewed various treatment options in patients with LABC which should possibly help in guiding the clinicians for optimal management of LABC.

  6. Current treatment for colorectal cancer metastatic to the liver

    NARCIS (Netherlands)

    Cromheecke, M; de Jong, KP; Hoekstra, HJ

    1999-01-01

    Surgery is currently the only available treatment option which offers the potential for cure for patients with liver metastases from colorectal cancer. Of those who undergo a potentially curative operation for their primary tumour but subsequently recur, almost 80% will develop evidence of metastati

  7. Current feasibility of endocrine therapy for breast cancer

    Directory of Open Access Journals (Sweden)

    I. V. Vysotskaya

    2014-07-01

    Full Text Available The paper considers the current feasibility of endocrine therapy for breast cancer (BC. It presents trials of the efficacy of fulvestrant in the treatment of patients with BC. Practically all clinical trials have demonstrated that the drug is well tolerated, without causing any significant systemic estrogen-like effects, as well as complications associated with the use of aromatase inhibitors.

  8. Current issues in the targeted therapy of advanced colorectal cancer.

    NARCIS (Netherlands)

    Knijn, N.; Tol, J.; Punt, C.J.A.

    2010-01-01

    Currently used cytotoxic drugs in the treatment of advanced colorectal cancer (ACC) are primarily the fluoropyrimidines, irinotecan, and oxaliplatin. The introduction of targeted therapy has increased the therapeutic arsenal. Two classes of monoclonal antibodies have been approved for clinical use i

  9. Treatment modalities of oral mucositis after radiation of head and neck cancers; Prise en charge des mucites apres radiotherapie des cancers des voies aerodigestives superieures

    Energy Technology Data Exchange (ETDEWEB)

    Lapeyre, M.; Charra-Brunaud, C.; Kaminsky, M.C.; Geoffrois, L.; Dolivet, G.; Pourel, N.; Marchal, C.; Bey, P.; Maire, F.; Simon, M. [Centre Alexis-Vautrin, 54 - Vandoeuvre-les-Nancy (France); Toussaint, B. [Hopital Central, Service de Chirurgie ORL, 54 - Nancy (France)

    2001-11-01

    Acute mucositis is common after radiotherapy for head and neck cancers. During the past 3 decades, there was a gradual evolution in the treatment modalities for locally advanced carcinomas (concomitant radio-chemotherapy, accelerated radiotherapy). These new strategies are accompanied by an increase in early mucosal reactions. At the present time, there is no widely accepted prophylaxis or effective treatment. Many traditional remedies or new agents seem ineffective (Sucralfate, Chlorhexidine, GM-CSF, Silver nitrate, Prostaglandin, anti-oxidants, Benzydamine hydrochloride), while others seem promising (Povidone-iodine, nonabsorbable antibiotic lozenges and anti-fungal, local GM-CSF, Glutamide, Low-energy laser, corticosteroids). Radioprotectors are controversial and should be only used in experimental protocols and not in routine practice. However, some recommendations can be proposed: general prevention and global care before cancer therapy should be systematic (oral hygiene, dental and periodontal treatment, advice to avoid the use of tobacco and alcohol); frequent oral rinsing with a bland mouthwash (Povidone-iodine or others) should be used at the start of treatment because there are significant modifications of the oral microflora increased by a disturbed salivary flow; these mouthwashes could be associated with nonabsorbable antibiotic lozenges or anti-fungal topical (bicarbonates, Amphotericine B); Systematic percutaneous fluoroscopic gastrostomy should be decided before any aggressive treatments (concomitant radio-chemotherapy, accelerated radiotherapy); pain should be controlled; finally, the radiation technique should be optimized (mucosal sparing block, conformal radiotherapy and intensity modulated radiation therapy). (authors)

  10. Current status of primary pharmacotherapy and future perspectives toward upfront therapy for metastatic hormone-sensitive prostate cancer.

    Science.gov (United States)

    Shiota, Masaki; Eto, Masatoshi

    2016-05-01

    Since 1941, androgen deprivation therapy has been the primary treatment for metastatic hormone-sensitive prostate cancer. Androgen deprivation therapy consists of several regimens that vary according to therapeutic modality, as well as treatment schedule. Androgen deprivation therapy initially shows excellent antitumor effects, such as relief of cancer-related symptoms, tumor marker decline and tumor shrinking. However, most metastatic hormone-sensitive prostate cancer cases eventually develop castration resistance and become lethal. Taxanes, such as docetaxel and cabazitaxel, as well as novel androgen receptor-targeting agents, such as abiraterone acetate and enzalutamide, have emerged for metastatic castration-resistant prostate cancer. The concept and principle of primary therapy for metastatic hormone-sensitive prostate cancer has remained unchanged for decades. Recently, upfront docetaxel chemotherapy has been shown to prolong overall survival in men with metastatic hormone-sensitive prostate cancer, and would lead to a paradigm shift in primary pharmacotherapy for metastatic hormone-sensitive prostate cancer. This raises the possibility of upfront use of taxanes, as well as novel androgen receptor-targeting agents combined with androgen deprivation therapy. The present review summarizes the current status of primary pharmacotherapy for metastatic hormone-sensitive prostate cancer, and discusses future perspectives in this field. PMID:27062039

  11. Modal Similarity

    OpenAIRE

    Vigo , Dr. Ronaldo

    2009-01-01

    Just as Boolean rules define Boolean categories, the Boolean operators define higher-order Boolean categories referred to as modal categories. We examine the similarity order between these categories and the standard category of logical identity (i.e. the modal category defined by the biconditional or equivalence operator). Our goal is 4-fold: first, to introduce a similarity measure for determining this similarity order; second, to show that such a measure is a good predictor of the similari...

  12. Loco-regional failures in head and neck cancer. Can they be effectively salvaged by nonsurgical therapeutic modalities?

    Energy Technology Data Exchange (ETDEWEB)

    Datta N.R.; Nagar Y.S.; Singh S.; Naryan L. [Sanjay Gandhi Post Graduate Inst. of Medical Sciences, Lucknow (India)

    2003-02-01

    This retrospective study was carried out to ascertain the extent of efficacy of nonsurgical salvage modalities, mainly chemotherapy (CT) alone or chemoradiotherapy (CTRT), for loco-regional failures in head and neck cancer (HNC). Between 1991 and 1999, 131 patients with HNC, mostly stages III and IV, who had loco-regional residual (n=78) or recurrent lesions (n=53) following curative therapy with either radiotherapy (RT), neoadjuvant CT (NACT) followed by RT, or concurrent CTRT were included in this analysis. Of these, 84 patients (residual, 58; recurrent, 26), did not receive any form of salvage therapy, while 47 had either CT alone (n=22) or CTRT (n=25). Endpoints evaluated were: loco-regional response (LRR), post-salvage survival (PS), overall survival (OS), and normal tissue acute and late morbidities. Salvage therapy enabled a LRR in 46.8% of the patients. Both OS and PS were also significantly better for those who received salvage therapy (P<0.001). CTRT appears to offer significantly better salvage than CT alone for all the evaluated endpoints. Multivariate analysis for LRR, PS, and OS consistently showed the salvage RT dose to be a significant predictor. Early and late effects of salvage therapy were not influenced by either the salvage or total RT doses. Loco-regional failures in advanced HNC can be effectively salvaged by CTRT to significantly prolong OS and PS. However, to achieve an optimum therapeutic ratio, the choice of drugs, their schedule, and the RT dose need to be defined through randomized trials. (author)

  13. Efficacy and safety of a modular multi-modal exercise program in prostate cancer patients with bone metastases: a randomized controlled trial

    International Nuclear Information System (INIS)

    The presence of bone metastases has excluded participation of prostate cancer patients in exercise intervention studies to date and is also a relative contraindication to supervised exercise in the community setting because of concerns of fragility fracture. However, this group of patients often have developed significant muscle atrophy and functional impairments from prior and continuing androgen deprivation that is exacerbated by subsequent and more intensive interventions such as chemotherapy. The aim of this study is to determine the efficacy and safety of a modular multi-modal exercise program in prostate cancer patients with bone metastases. Multi-site randomized controlled trial in Western Australia and New South Wales to examine the efficacy and safety of a modular multi-modal physical exercise program in 90 prostate cancer survivors with bone metastases. Participants will be randomized to (1) modular multi-modal exercise intervention group or (2) usual medical care group. The modular multi-modal exercise group will receive a 3-month supervised exercise program based on bone lesion location/extent. Measurements for primary and secondary endpoints will take place at baseline, 3 months (end of the intervention) and 6 months follow-up. Delaying or preventing skeletal complication and improving physical function for men with bone metastases would provide clinically meaningful benefits to patients. However, exercise programs must be designed and executed with careful consideration of the skeletal complications associated with bone metastatic disease and cumulative toxicities from androgen deprivation such as osteoporosis and increased risk of fractures. The results from this study will form the basis for the development of a specific exercise prescription in this patient group in order to alleviate disease burden, counteract the adverse treatment related side-effects and enhance quality of life. ACTRN: http://www.anzctr.org.au/ACTRN12611001158954.aspx

  14. Brain Cancer Stem Cells: Current Status on Glioblastoma Multiforme

    Directory of Open Access Journals (Sweden)

    Gilbert Bernier

    2011-03-01

    Full Text Available Glioblastoma multiforme (GBM, an aggressive brain tumor of astrocytic/neural stem cell origin, represents one of the most incurable cancers. GBM tumors are highly heterogeneous. However, most tumors contain a subpopulation of cells that display neural stem cell characteristics in vitro and that can generate a new brain tumor upon transplantation in mice. Hence, previously identified molecular pathways regulating neural stem cell biology were found to represent the cornerstone of GBM stem cell self-renewal mechanism. GBM tumors are also notorious for their resistance to radiation therapy. Notably, GBM “cancer stem cells” were also found to be responsible for this radioresistance. Herein, we will analyze the data supporting or not the cancer stem cell model in GBM, overview the current knowledge regarding GBM stem cell self-renewal and radioresistance molecular mechanisms, and discuss the potential therapeutic application of these findings.

  15. Brain Cancer Stem Cells: Current Status on Glioblastoma Multiforme

    Energy Technology Data Exchange (ETDEWEB)

    Facchino, Sabrina; Abdouh, Mohamed [Developmental Biology Laboratory, Hopital Maisonneuve-Rosemont, 5415 Boul. l' Assomption, Montreal, H1T 2M4 (Canada); Bernier, Gilbert, E-mail: gbernier.hmr@ssss.gouv.qc.ca [Developmental Biology Laboratory, Hopital Maisonneuve-Rosemont, 5415 Boul. l' Assomption, Montreal, H1T 2M4 (Canada); Faculté de Médecine, Université de Montréal, Montréal, H3T 1J4 (Canada)

    2011-03-30

    Glioblastoma multiforme (GBM), an aggressive brain tumor of astrocytic/neural stem cell origin, represents one of the most incurable cancers. GBM tumors are highly heterogeneous. However, most tumors contain a subpopulation of cells that display neural stem cell characteristics in vitro and that can generate a new brain tumor upon transplantation in mice. Hence, previously identified molecular pathways regulating neural stem cell biology were found to represent the cornerstone of GBM stem cell self-renewal mechanism. GBM tumors are also notorious for their resistance to radiation therapy. Notably, GBM “cancer stem cells” were also found to be responsible for this radioresistance. Herein, we will analyze the data supporting or not the cancer stem cell model in GBM, overview the current knowledge regarding GBM stem cell self-renewal and radioresistance molecular mechanisms, and discuss the potential therapeutic application of these findings.

  16. Brain Cancer Stem Cells: Current Status on Glioblastoma Multiforme

    International Nuclear Information System (INIS)

    Glioblastoma multiforme (GBM), an aggressive brain tumor of astrocytic/neural stem cell origin, represents one of the most incurable cancers. GBM tumors are highly heterogeneous. However, most tumors contain a subpopulation of cells that display neural stem cell characteristics in vitro and that can generate a new brain tumor upon transplantation in mice. Hence, previously identified molecular pathways regulating neural stem cell biology were found to represent the cornerstone of GBM stem cell self-renewal mechanism. GBM tumors are also notorious for their resistance to radiation therapy. Notably, GBM “cancer stem cells” were also found to be responsible for this radioresistance. Herein, we will analyze the data supporting or not the cancer stem cell model in GBM, overview the current knowledge regarding GBM stem cell self-renewal and radioresistance molecular mechanisms, and discuss the potential therapeutic application of these findings

  17. Radiotherapy in prostate cancer. Innovative techniques and current controversies

    Energy Technology Data Exchange (ETDEWEB)

    Geinitz, Hans [Krankenhaus der Barmherzigen Schwestern, Linz (Austria). Dept. of Radiation Oncology; Linz Univ. (Austria). Medical Faculty; Roach, Mack III [California Univ., San Francisco, CA (United States). Dept. of Radiation Oncology; Van As, Nicholas (ed.) [The Institute of Cancer Research, Sutton Surrey (United Kingdom)

    2015-04-01

    Examines in detail the role of innovative radiation techniques in the management of prostate cancer, including IMRT, IGRT, BART, and modern brachytherapy. Explores a range of current controversies in patient treatment. Intended for both radiation oncologists and urologists. Radiation treatment is rapidly evolving owing to the coordinated research of physicists, engineers, computer and imaging specialists, and physicians. Today, the arsenal of ''high-precision'' or ''targeted'' radiotherapy includes multimodal imaging, in vivo dosimetry, Monte Carlo techniques for dose planning, patient immobilization techniques, intensity-modulated radiotherapy (IMRT), image-guided radiotherapy (IGRT), biologically adapted radiotherapy (BART), quality assurance methods, novel methods of brachytherapy, and, at the far end of the scale, particle beam radiotherapy using protons and carbon ions. These approaches are like pieces of a puzzle that need to be put together to provide the prostate cancer patient with high-level optimized radiation treatment. This book examines in detail the role of the above-mentioned innovative radiation techniques in the management of prostate cancer. In addition, a variety of current controversies regarding treatment are carefully explored, including whether prophylactic treatment of the pelvic lymphatics is essential, the magnitude of the effect of dose escalation, whether a benefit accrues from hypofractionation, and what evidence exists for the superiority of protons or heavy ions. Radiotherapy in Prostate Cancer: Innovative Techniques and Current Controversies is intended for both radiation oncologists and urologists with an interest in the up-to-date capabilities of modern radiation oncology for the treatment of prostate cancer.

  18. Minimizing second cancer risk following radiotherapy: current perspectives

    International Nuclear Information System (INIS)

    Secondary cancer risk following radiotherapy is an increasingly important topic in clinical oncology with impact on treatment decision making and on patient management. Much of the evidence that underlies our understanding of secondary cancer risks and our risk estimates are derived from large epidemiologic studies and predictive models of earlier decades with large uncertainties. The modern era is characterized by more conformal radiotherapy technologies, molecular and genetic marker approaches, genome-wide studies and risk stratifications, and sophisticated biologically based predictive models of the carcinogenesis process. Four key areas that have strong evidence toward affecting secondary cancer risks are 1) the patient age at time of radiation treatment, 2) genetic risk factors, 3) the organ and tissue site receiving radiation, and 4) the dose and volume of tissue being irradiated by a particular radiation technology. This review attempts to summarize our current understanding on the impact on secondary cancer risks for each of these known risk factors. We review the recent advances in genetic studies and carcinogenesis models that are providing insight into the biologic processes that occur from tissue irradiation to the development of a secondary malignancy. Finally, we discuss current approaches toward minimizing the risk of radiation-associated secondary malignancies, an important goal of clinical radiation oncology

  19. Prognostic stratification of colorectal cancer patients: current perspectives

    International Nuclear Information System (INIS)

    Tumor staging according to the American Joint Committee on Cancer/Union for International Cancer Control tumor, node, metastasis (TNM) system is currently regarded as the standard for staging of patients with colorectal cancer. This system provides the strongest prognostic information for patients with early stage disease and those with advanced disease. For patients with intermediate levels of disease, it is less able to predict disease outcome. Therefore, additional prognostic markers are needed to improve the management of affected patients. Ideal markers are readily assessable on hematoxylin and eosin-stained tumor slides, and in this way are easily applicable worldwide. This review summarizes the histological features of colorectal cancer that can be used for prognostic stratification. Specifically, we refer to the different histological variants of colorectal cancer that have been identified, each of these variants carrying distinct prognostic significance. Established markers of adverse outcomes are lymphatic and venous invasion, as well as perineural invasion, but underreporting still occurs in the routine setting. Tumor budding and tumor necrosis are recent advances that may help to identify patients at high risk for recurrence. The prognostic significance of the antitumor inflammatory response has been known for quite a long time, but a lack of standardization prevented its application in routine pathology. However, scales to assess intra- and peritumoral inflammation have recently emerged, and can be expected to strengthen the prognostic significance of the pathology report

  20. {sup 18}F-FDG PET/CT for initial staging in breast cancer patients. Is there a relevant impact on treatment planning compared to conventional staging modalities?

    Energy Technology Data Exchange (ETDEWEB)

    Krammer, J.; Schnitzer, A.; Kaiser, C.G.; Buesing, K.A.; Schoenberg, S.O.; Wasser, K. [University of Heidelberg, Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, Mannheim (Germany); Sperk, E. [University of Heidelberg, Department of Radiation Oncology, University Medical Centre Mannheim, Medical Faculty Mannheim, Mannheim (Germany); Brade, J. [University of Heidelberg, Institute of Medical Statistics, Biomathematics and Data Processing, Medical Faculty Mannheim, Mannheim (Germany); Wasgindt, S.; Suetterlin, M. [University of Heidelberg, Department of Gynaecology and Obstetrics, University Medical Centre Mannheim, Medical Faculty Mannheim, Mannheim (Germany); Sutton, E.J. [Memorial Sloan-Kettering Cancer Center, Evelyn H. Lauder Breast Center, Department of Radiology, New York, NY (United States)

    2015-08-15

    To evaluate the impact of whole-body {sup 18}F-FDG PET/CT on initial staging of breast cancer in comparison to conventional staging modalities. This study included 102 breast cancer patients, 101 patients were eligible for evaluation. Preoperative whole-body staging with PET/CT was performed in patients with clinical stage ≥ T2 tumours or positive local lymph nodes (n = 91). Postoperative PET/CT was performed in patients without these criteria but positive sentinel lymph node biopsy (n = 10). All patients underwent PET/CT and a conventional staging algorithm, which included bone scan, chest X-ray and abdominal ultrasound. PET/CT findings were compared to conventional staging and the impact on therapeutic management was evaluated. PET/CT led to an upgrade of the N or M stage in overall 19 patients (19 %) and newly identified manifestation of breast cancer in two patients (2 %). PET/CT findings caused a change in treatment of 11 patients (11 %). This is within the range of recent studies, all applying conventional inclusion criteria based on the initial T and N status. PET/CT has a relevant impact on initial staging and treatment of breast cancer when compared to conventional modalities. Further studies should assess inclusion criteria beyond the conventional T and N status, e.g. tumour grading and receptor status. (orig.)

  1. Gd-based upconversion nanocarriers with yolk-shell structure for dual-modal imaging and enhanced chemotherapy to overcome multidrug resistance in breast cancer

    Science.gov (United States)

    Pan, Yuanwei; Zhang, Ling'e.; Zeng, Leyong; Ren, Wenzhi; Xiao, Xueshan; Zhang, Jichao; Zhang, Lili; Li, Aiguo; Lu, Guangming; Wu, Aiguo

    2015-12-01

    Multidrug resistance (MDR) of cancers is still a major challenge, and it is very important to develop visualized nanoprobes for the diagnosis and treatment of drug resistant cancers. In this work, we developed a multifunctional delivery system based on DOX-encapsulated NaYF4:Yb/Er@NaGdF4 yolk-shell nanostructures for simultaneous dual-modal imaging and enhanced chemotherapy in drug resistant breast cancer. Using the large pore volume of the nanostructure, the delivery system had a high loading efficiency and excellent stability. Also, an in vitro and in vivo toxicity study showed the good biocompatibility of the as-prepared yolk-shell nanomaterials. Moreover, by nanocarrier delivery, the uptake of DOX could be greatly increased in drug resistant MCF-7/ADR cells. Compared with free DOX, the as-prepared delivery system enhanced the chemotherapy efficacy against MCF-7/ADR cells, indicating the excellent capability for overcoming MDR. Furthermore, core-shell NaYF4:Yb/Er@NaGdF4 improved the upconversion luminescence (UCL) performance, and the designed delivery system could also be applied for simultaneous UCL and magnetic resonance (MR) imaging, which could be a good candidate as a dual-modal imaging nanoprobe. Therefore, we developed a multifunctional yolk-shell delivery system, which could have potential applications as a visualized theranostic nanoprobe to overcome MDR in breast cancer.

  2. Clinical Challenges to Current Molecularly Targeted Therapies in Lung Cancer

    Science.gov (United States)

    Chhabra, Gagan; Eggert, Ashley; Puri, Neelu

    2016-01-01

    Lung cancer is difficult to treat with a poor prognosis and a five year survival of 15%. Current molecularly targeted therapies are initially effective in non-small cell lung cancer (NSCLC) patients; however, they are plagued with difficulties including induced resistance and small therapeutically responsive populations. This mini review describes the mechanism of resistance to several molecularly targeted therapies which are currently being used to treat NSCLC. The major targets discussed are c-Met, EGFR, HER2, ALK, VEGFR, and BRAF. The first generation tyrosine kinase inhibitors (TKIs) resulted in resistance; however, second and third generation TKIs are being developed, which are generally more efficacious and have potential to treat NSCLC patients with resistance to first generation TKIs. Combination therapies could also be effective in preventing TKI resistance in NSCLC patients.

  3. [18F]FDG-PET in lung cancer: current status

    OpenAIRE

    Jane Dobbs, H; Quint, Leslie Eisenbud; Miles, K A

    2005-01-01

    Increasingly, evidence of safety, effectiveness and cost-effectiveness is required to support funding of new diagnostic technologies. However, diagnostic imaging is a rapidly changing speciality with new data constantly being added to the evidence base. This article aims to review the evidence base for the application of fluorodeoxyglucose positron emission tomography ([18F]FDG-PET) in lung cancer and to identify areas in which the evidence base is evolving. Currently, there is strong evidenc...

  4. Inter-modality variation in gross tumor volume delineation in 18FDG-PET guided IMRT treatment planning for lung cancer.

    Science.gov (United States)

    Song, Yulin; Chan, Maria; Burman, Chandra; Cann, Donald

    2006-01-01

    Rapid advances in 18FDG-PET/CT technology and novel co-registration algorithms have created a strong interest in 18FDG-PET/CT's application in intensity modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT). Accurate target volume delineation, particularly identification of pathologically positive lymph nodes, could translate into favorable treatment outcome. However, gross tumor volume (GTV) delineation on both CT and 18FDG-PET is very sensitive to observer variation. The objectives of the study were to investigate the inter-modality variation in gross tumor volume delineation defined by two imaging modalities for lung cancer: CT and 18FDG-PET/CT and its dosimetric implications in intensity modulated radiation therapy (IMRT). PMID:17946204

  5. Prognostic stratification of colorectal cancer patients: current perspectives

    Directory of Open Access Journals (Sweden)

    Schneider NI

    2014-07-01

    Full Text Available Nora I Schneider, Cord LangnerInstitute of Pathology, Medical University of Graz, Graz, AustriaAbstract: Tumor staging according to the American Joint Committee on Cancer/Union for International Cancer Control tumor, node, metastasis (TNM system is currently regarded as the standard for staging of patients with colorectal cancer. This system provides the strongest prognostic information for patients with early stage disease and those with advanced disease. For patients with intermediate levels of disease, it is less able to predict disease outcome. Therefore, additional prognostic markers are needed to improve the management of affected patients. Ideal markers are readily assessable on hematoxylin and eosin-stained tumor slides, and in this way are easily applicable worldwide. This review summarizes the histological features of colorectal cancer that can be used for prognostic stratification. Specifically, we refer to the different histological variants of colorectal cancer that have been identified, each of these variants carrying distinct prognostic significance. Established markers of adverse outcomes are lymphatic and venous invasion, as well as perineural invasion, but underreporting still occurs in the routine setting. Tumor budding and tumor necrosis are recent advances that may help to identify patients at high risk for recurrence. The prognostic significance of the antitumor inflammatory response has been known for quite a long time, but a lack of standardization prevented its application in routine pathology. However, scales to assess intra- and peritumoral inflammation have recently emerged, and can be expected to strengthen the prognostic significance of the pathology report.Keywords: colorectal cancer, lymphatic invasion, blood-vessel invasion, perineural invasion, tumor budding, tumor necrosis

  6. Current oncologic concepts and emerging techniques for imaging of head and neck squamous cell cancer [

    Directory of Open Access Journals (Sweden)

    Sadick, Haneen

    2012-12-01

    Full Text Available [english] The incidence of head and neck squamous cell carcinoma (HNSCC is increasing and currently they account for 5% of all malignancies worldwide. Inspite of ongoing developments in diagnostic imaging and new therapeutic options, HNSCC still represents a multidisciplinary challenge.One of the most important prognostic factors in HNSCC is the presence of lymph node metastases. Patients with confirmed nodal involvement have a considerable reduction of their 5-year overall survival rate. In the era of individually optimised surgery, chemotherapy and intensity modulated radiotherapy, the main role of pre- and posttherapeutic imaging remains cancer detection at an early stage and accurate follow-up. The combined effort of early diagnosis and close patient monitoring after surgery and/or radio-chemotherapy influences disease progression and outcome predicition in patients with HNSCC.This review article focuses on currrent oncologic concepts and emerging tools in imaging of head and neck squamous cell cancer. Besides the diagnostic spectrum of the individual imaging modalities, their limitations are also discussed. One main part of this article is dedicated to PET-CT which combines functional and morphological imaging. Furthermore latest developments in MRI are presented with regard to lymph node staging and response prediction. Last but not least, a clinical contribution in this review explains, which information the head and neck surgeon requires from the multimodality imaging and its impact on operation planning.

  7. Long-term outcomes in breast cancer patients with ten or more positive axillary nodes treated with combined-modality therapy: The importance of radiation field selection

    International Nuclear Information System (INIS)

    Purpose: To determine the long-term outcome of a consistent treatment approach with electron beam postmastectomy radiation therapy (PMRT) in breast cancer patients with ≥10 positive nodes treated with combined-modality therapy. Methods and Materials: TSixty-three breast cancer patients with ≥10 positive lymph nodes were treated with combined-modality therapy using an electron beam en face technique for PMRT at University of Florida. Patterns of recurrence were studied for correlation with radiation fields. Potential clinical and treatment variables were tested for possible association with local-regional control (LRC), disease-free survival (DFS), and overall survival (OS). Results: TAt 5, 10, and 15 years, OS rates were 57%, 36%, and 27%, respectively; DFS rates were 46%, 37%, and 34%; and LRC rates were 87%, 87%, and 87%. No clinical or treatment variables were associated with OS or DFS. The use of supplemental axillary radiation (SART) (p = 0.012) and pathologic N stage (p = 0.053) were associated with improved LRC. Patients who received SART had a higher rate of LRC than those who did not. Moderate to severe arm edema developed in 17% of patients receiving SART compared with 7% in patients not treated with SART (p = 0.28). Conclusions: TA substantial percentage of patients with ≥10 positive lymph nodes survive breast cancer. The 10-year overall survival in these patients was 36%. The addition of SART was associated with better LRC

  8. Intensity-modulated radiotherapy for lung cancer: current status and future developments

    OpenAIRE

    Chan, C; Lang, S.; Rowbottom, C; Guckenberger, M.; Faivre-Finn, C

    2014-01-01

    Radiotherapy plays an important role in the management of lung cancer, with over 50% of patients receiving this modality at some point during their treatment. Intensity-modulated radiotherapy (IMRT) is a technique that adds fluence modulation to beam shaping, which improves radiotherapy dose conformity around the tumor and spares surrounding normal structures. Treatment with IMRT is becoming more widely available for the treatment of lung cancer, despite the paucity of high level evidence sup...

  9. Novel compounds in the treatment of lung cancer: current and developing therapeutic agents

    OpenAIRE

    Bao, Rudi; Chan, PokMan

    2011-01-01

    Lung cancer is the leading cause of cancer-related death in the United States. Though incremental advances have been made in the treatment of this devastating disease during the past decade, new therapies are urgently needed. Traditional cytotoxic agents have been combined with other modalities with improved survival for early-stage patients. Newer cytotoxic agents targeting the same or different mechanisms have been developed at different stages. Optimization of various chemotherapy regimens...

  10. Novel compounds in the treatment of lung cancer: current and developing therapeutic agents

    OpenAIRE

    Bao, Rudi

    2011-01-01

    Rudi Bao, Pokman ChanOncology, Curis Inc, Lexington, MA, USAAbstract: Lung cancer is the leading cause of cancer-related death in the United States. Though incremental advances have been made in the treatment of this devastating disease during the past decade, new therapies are urgently needed. Traditional cytotoxic agents have been combined with other modalities with improved survival for early-stage patients. Newer cytotoxic agents targeting the same or different mechanisms have been develo...

  11. Radiation and breast cancer: a review of current evidence

    International Nuclear Information System (INIS)

    This paper summarizes current knowledge on ionizing radiation-associated breast cancer in the context of established breast cancer risk factors, the radiation dose–response relationship, and modifiers of dose response, taking into account epidemiological studies and animal experiments. Available epidemiological data support a linear dose–response relationship down to doses as low as about 100 mSv. However, the magnitude of risk per unit dose depends strongly on when radiation exposure occurs: exposure before the age of 20 years carries the greatest risk. Other characteristics that may influence the magnitude of dose-specific risk include attained age (that is, age at observation for risk), age at first full-term birth, parity, and possibly a history of benign breast disease, exposure to radiation while pregnant, and genetic factors

  12. Gastric cancer in Africa: Current management and outcomes

    OpenAIRE

    Asombang, Akwi W; Rahman, Rubayat; Ibdah, Jamal A.

    2014-01-01

    Gastric cancer is the fourth most common cancer and second most common cause of cancer death worldwide. Globally, gastric cancer poses a significant public health burden - both economically and socially. In 2008, the economic burden from premature cancer deaths and disability was $895 billion and gastric cancer was the second highest cancer responsible for healthy life lost. With the expected increase in cancer deaths and non-communicable diseases, these costs are expected to rise and impact ...

  13. Current lifestyle of young adults treated for cancer in childhood.

    OpenAIRE

    Evans, S E; Radford, M

    1995-01-01

    The aim of this study was to look at the current lifestyle of young adult survivors of childhood cancer between the ages of 16 and 30 years to document their achievements and expose any psychosocial problems. Sixty six young adult survivors were contacted and asked if they and their siblings (16-30 years) would take part in a lifestyle study; 48 patients and 38 sibling controls were interviewed. This took the form of a structured lifestyle questionnaire, a self esteem questionnaire (Oxford Ps...

  14. A randomized assessment of three quality of life (QOL) questionnaires for prostate cancer patients undergoing different radiation treatment modalities

    International Nuclear Information System (INIS)

    Purpose: The goal of this prospective, randomized study was to assess and compare compliance of patients diagnosed with prostate cancer to completing three different validated QOL instruments pre-treatment and six months later. Materials and Methods: Between April 2000 and April 2001, 124 patients were asked to fill out only one of three randomly selected QOL questionnaires (version A, B, C). Each addressed urinary and sexual function. One also addressed patients' physical, social, family, emotional, and functional well being. Study patients received External Beam Radiation Therapy (EBRT) or Brachytherapy (BRACHY), according to departmental policy. Exclusion criteria included current/previous hormone therapy and prostatectomy. Patients were asked to return the questionnaire at their first treatment visit. The three tools were: A The Functional Assessment of Cancer Therapy for Prostate Patients (FACT-P), The Sexual Adjustments Questionnaire (SAQ), and The American Urological Association (AUA) Questionnaire. The Fact-P questionnaire elicits information about physical, social, family, emotional, and functional well being as they relate to prostate cancer. SAQ focuses on sexual function; the AUA on urinary symptoms. B SAQ and AUA only; identical to Version A, but does not address physical, social, family, emotional, and functional well-being. C The International Prostate Symptom Score (I-PSS) Questionnaire, which addresses urinary symptoms and Patient Sexual Function Questionnaire, which focuses on erectile function. Additionally, patients were asked to respond yes/no to four variables designed to evaluate these questionnaires: 1) ease of understanding, 2) too personal, 3)addresses concerns regarding urinary function and sexual potency and 4) willingness to complete questionnaire in six months. These variables were examined for any trends that may exist between the different questionnaires. Results: Fifteen (12%) of the 124 patients returned incomplete questionnaires

  15. Non-invasive imaging modalities for preoperative axillary lymph node staging in patients with breast cancer; Nichtinvasive bildgebende Verfahren zum praeoperativen axillaeren Lymphknotenstaging beim Mammakarzinom

    Energy Technology Data Exchange (ETDEWEB)

    Wasser, K.; Schnitzer, A.; Schoenberg, S.O. [Universitaetsmedizin Mannheim, Institut fuer Klinische Radiologie und Nuklearmedizin, Mannheim (Germany); Brade, J. [Universitaetsmedizin Mannheim, Institut fuer Medizinische Statistik, Mannheim (Germany)

    2010-11-15

    In the last decade sentinel lymph node biopsy has become a well-established method for axillary lymph node staging in patients with breast cancer. Using preoperative imaging modalities it can be tested whether patients are suitable for sentinel node biopsy or if they should directly undergo an axillary dissection. The imaging modalities used must be mainly characterized by a high positive predictive value (PPV). For this question B-mode ultrasound is the best evaluated method and provides clear morphological signs for a high PPV (>90%) but the sensitivity barely exceeds 50%. It has not yet been proven whether other modalities such as duplex sonography, magnetic resonance imaging, computed tomography (CT) or scintigraphy might achieve a higher sensitivity while still maintaining a high PPV. There is only some evidence that positron emission tomography (PET) might achieve a higher sensitivity. This should be confirmed by further studies because PET or PET/CT will play an increasing role for an initial whole body staging in patients with breast cancer in the near future. (orig.) [German] Die Waechterlymphknotenbiopsie hat sich in den letzten 10 Jahren fuer das axillaere Lymphknotenstaging des Mammakarzinoms fest etabliert. Durch praeoperative bildgebende Verfahren kann getestet werden, ob sich Patientinnen fuer eine Waechterlymphknotenbiopsie eignen oder direkt einer axillaeren Dissektion unterzogen werden sollten. Diese bildgebenden Verfahren muessen sich in erster Linie durch einen hohen positiven Vorhersagewert (PVW) auszeichnen. Die B-Bild-Sonographie ist diesbezueglich bisher am besten evaluiert. Sie liefert eindeutige morphologische Kriterien fuer einen hohen PVW (>90%). Die Sensitivitaet liegt dabei allerdings kaum ueber 50%. Bisher ist nicht erwiesen, dass andere Verfahren wie die Duplexsonographie, die MRT, die CT oder Szintigraphie eine bessere Sensitivitaet bei hohem PVW liefern. Lediglich fuer die Positronenemissionstomographie (PET) bestehen Hinweise

  16. Risk of Hormone Escape in a Human Prostate Cancer Model Depends on Therapy Modalities and Can Be Reduced by Tyrosine Kinase Inhibitors

    Science.gov (United States)

    Guyader, Charlotte; Céraline, Jocelyn; Gravier, Eléonore; Morin, Aurélie; Michel, Sandrine; Erdmann, Eva; de Pinieux, Gonzague; Cabon, Florence; Bergerat, Jean-Pierre; Poupon, Marie-France; Oudard, Stéphane

    2012-01-01

    Almost all prostate cancers respond to androgen deprivation treatment but many recur. We postulated that risk of hormone escape -frequency and delay- are influenced by hormone therapy modalities. More, hormone therapies induce crucial biological changes involving androgen receptors; some might be targets for escape prevention. We investigated the relationship between the androgen deprivation treatment and the risk of recurrence using nude mice bearing the high grade, hormone-dependent human prostate cancer xenograft PAC120. Tumor-bearing mice were treated by Luteinizing-Hormone Releasing Hormone (LHRH) antagonist alone, continuous or intermittent regimen, or combined with androgen receptor (AR) antagonists (bicalutamide or flutamide). Tumor growth was monitored. Biological changes were studied as for genomic alterations, AR mutations and protein expression in a large series of recurrent tumors according to hormone therapy modalities. Therapies targeting Her-2 or AKT were tested in combination with castration. All statistical tests were two-sided. Tumor growth was inhibited by continuous administration of the LH-RH antagonist degarelix (castration), but 40% of tumors recurred. Intermittent castration or complete blockade induced by degarelix and antiandrogens combination, inhibited tumor growth but increased the risk of recurrence (RR) as compared to continuous castration (RRintermittent: 14.5, RRcomplete blockade: 6.5 and 1.35). All recurrent tumors displayed new quantitative genetic alterations and AR mutations, whatever the treatment modalities. AR amplification was found after complete blockade. Increased expression of Her-2/neu with frequent ERK/AKT activation was detected in all variants. Combination of castration with a Her-2/neu inhibitor decreased recurrence risk (0.17) and combination with an mTOR inhibitor prevented it. Anti-hormone treatments influence risk of recurrence although tumor growth inhibition was initially similar. Recurrent tumors displayed

  17. In vivo molecular imaging of colorectal cancer using quantum dots targeted to vascular endothelial growth factor receptor 2 and optical coherence tomography/laser-induced fluorescence dual-modality imaging

    Science.gov (United States)

    Carbary-Ganz, Jordan L.; Welge, Weston A.; Barton, Jennifer K.; Utzinger, Urs

    2015-09-01

    Optical coherence tomography/laser induced fluorescence (OCT/LIF) dual-modality imaging allows for minimally invasive, nondestructive endoscopic visualization of colorectal cancer in mice. This technology enables simultaneous longitudinal tracking of morphological (OCT) and biochemical (fluorescence) changes as colorectal cancer develops, compared to current methods of colorectal cancer screening in humans that rely on morphological changes alone. We have shown that QDot655 targeted to vascular endothelial growth factor receptor 2 (QD655-VEGFR2) can be applied to the colon of carcinogen-treated mice and provides significantly increased contrast between the diseased and undiseased tissue with high sensitivity and specificity ex vivo. QD655-VEGFR2 was used in a longitudinal in vivo study to investigate the ability to correlate fluorescence signal to tumor development. QD655-VEGFR2 was applied to the colon of azoxymethane (AOM-) or saline-treated control mice in vivo via lavage. OCT/LIF images of the distal colon were taken at five consecutive time points every three weeks after the final AOM injection. Difficulties in fully flushing unbound contrast agent from the colon led to variable background signal; however, a spatial correlation was found between tumors identified in OCT images, and high fluorescence intensity of the QD655 signal, demonstrating the ability to detect VEGFR2 expressing tumors in vivo.

  18. PAGET'S DISEASE: CURRENT TREATMENT MODALITIES

    Directory of Open Access Journals (Sweden)

    Yulia Leonidovna Korsakova

    2010-01-01

    Full Text Available Paget's disease is a chronic local bone disease included into a group of metabolic osteopathies in which rearrangement foci emerge in one or several bones. The disease is characterized by the appearance of ostealgia, skeletal deformity, or, for example, hearing loss occurring with skull lesion or hip or knee arthrosis and, less frequently, sarcoma or giant cell tumor. There is evidence that bisphosphonates may control the activity of Paget's disease as they inhibit the function of osteoclasts. The use of these drugs reduces the intensity of osteoalgia and the level of biochemical markers for bone resorption and osteogenesis and can decelerate or reverse the early osteolytic phase of the disease. It is promising to use of zolendronic acid (Aclasta, 5 mg, a new heterocyclic amino-containing bisphosphonate that has a significantly higher efficacy than previously used antiresorptive agents.

  19. PAGET'S DISEASE: CURRENT TREATMENT MODALITIES

    Directory of Open Access Journals (Sweden)

    Yulia Leonidovna Korsakova

    2010-06-01

    Full Text Available Paget's disease is a chronic local bone disease included into a group of metabolic osteopathies in which rearrangement foci emerge in one or several bones. The disease is characterized by the appearance of ostealgia, skeletal deformity, or, for example, hearing loss occurring with skull lesion or hip or knee arthrosis and, less frequently, sarcoma or giant cell tumor. There is evidence that bisphosphonates may control the activity of Paget's disease as they inhibit the function of osteoclasts. The use of these drugs reduces the intensity of osteoalgia and the level of biochemical markers for bone resorption and osteogenesis and can decelerate or reverse the early osteolytic phase of the disease. It is promising to use of zolendronic acid (Aclasta, 5 mg, a new heterocyclic amino-containing bisphosphonate that has a significantly higher efficacy than previously used antiresorptive agents.

  20. Modal Indicators for Operational Modal Identification

    DEFF Research Database (Denmark)

    Zhang, L.; Brincker, Rune; Andersen, P.

    2001-01-01

    Modal validation is of paramount importance for all two-stage time domain modal identification algorithms. However, due to a higher noise/signal ratio in operational/ambient modal analysis, being able to determine the right model order and to distinguish between structural modes and computational...... Realization Algorithm (ERA). The three identification algorithms are implemented from a unified point-of-view with the modal indicators. Numerical simulations are conducted on a two-story building structure and on an aircraft model and it is investigated how the modal indicators work to distinguish the...... modes become more significant than in traditional modal analysis. The two major modal indicators, i.e. Modal Confidence Factor (MCF) and Modal Amplitude Coherence (MAmC) are extended to two-stage time domain modal identification algorithms, together with a newly developed indicator, named as Modal...

  1. Modality and Task Switching Interactions using Bi-Modal and Bivalent Stimuli

    Science.gov (United States)

    Sandhu, Rajwant; Dyson, Benjamin J.

    2013-01-01

    Investigations of concurrent task and modality switching effects have to date been studied under conditions of uni-modal stimulus presentation. As such, it is difficult to directly compare resultant task and modality switching effects, as the stimuli afford both tasks on each trial, but only one modality. The current study investigated task and…

  2. 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.

  3. Current lifestyle of young adults treated for cancer in childhood.

    Science.gov (United States)

    Evans, S E; Radford, M

    1995-05-01

    The aim of this study was to look at the current lifestyle of young adult survivors of childhood cancer between the ages of 16 and 30 years to document their achievements and expose any psychosocial problems. Sixty six young adult survivors were contacted and asked if they and their siblings (16-30 years) would take part in a lifestyle study; 48 patients and 38 sibling controls were interviewed. This took the form of a structured lifestyle questionnaire, a self esteem questionnaire (Oxford Psychologists Press), and an unstructured interview. Fifty five per cent of patients achieved five or more A-C grades at 'O' level/GCSE compared with 62% of siblings and a national average of 30%. Despite that these patients were significantly less likely to go on to higher education than their siblings. The two groups were equally employable and earning similar salaries. There were three cases of known employer prejudice. A slightly higher percentage of patients than siblings had their driving licence. Seventeen patients felt their appearance had changed and eight felt that they had a residual physical mobility problem. Both groups were socially active and equally likely to partake in competitive sports. There was no overall difference in the self esteem of the two groups. In general the survivors of childhood cancer were coping well in their young adult life and achieving the same lifestyle goals as their siblings. However, significant problems have been identified. PMID:7618909

  4. Current status and perspectives of brachytherapy for cervical cancer.

    Science.gov (United States)

    Toita, Takafumi

    2009-02-01

    Standard definitive radiotherapy for cervical cancer consists of whole pelvic external beam radiotherapy (EBRT) and intracavitary brachytherapy (ICBT). In Japan, high-dose-rate ICBT (HDR-ICBT) has been utilized in clinical practice for more than 40 years. Several randomized clinical trials demonstrated that HDR-ICBT achieved comparative outcomes, both for pelvic control and incidences of late complications, to low-dose-rate (LDR) ICBT. In addition, HDR-ICBT has some potential advantages over LDR-ICBT, leading to further improvement in treatment results. Prior to the current computer planning systems, some excellent treatment planning concepts were established. At present, systems modified from these concepts, or novel approaches, such as image-guided brachytherapy (IGBT) are under investigation. One serious problem to be solved in HDR-ICBT for cervical cancer is that of the discrepancy in standard treatment schedules for combination HDR-ICBT and EBRT between the United States and Japan. Prospective studies are ongoing to assess the efficacy and toxicity of the Japanese schedule. PMID:19225920

  5. Cancer Stem Cells in Breast: Current Opinion and Future Challenges

    OpenAIRE

    Charafe-Jauffret, Emmanuelle; Monville, Florence; Ginestier, Christophe; Dontu, Gabriela; Birnbaum, Daniel; Wicha, Max S.

    2008-01-01

    There is increasing evidence for the cancer stem cell hypothesis, which holds that cancers are driven by a cellular subcomponent that has stem cell properties, that is, self-renewal, tumorigenicity and multilineage differentiation capacity. The cancer stem cell hypothesis modifies our conceptual approach of oncogenesis and shall have implications in breast cancer prevention, detection and treatment, especially in metastatic breast cancer for which no curative treatment exists. Given the speci...

  6. Current role of multiparametric magnetic resonance imaging in the management of prostate cancer

    Science.gov (United States)

    Katelaris, Nikolas Christopher; Bolton, Damien Michael; Weerakoon, Mahesha; Toner, Liam; Katelaris, Phillip Mark

    2015-01-01

    The purpose of this review was to evaluate the current role of multiparametric magnetic resonance imaging (mp-MRI) in the management of prostate cancer (PC). The diagnosis of PC remains controversial owing to overdetection of indolent disease, which leads to overtreatment and subsequent patient harm. mp-MRI has the potential to equilibrate the imbalance between detection and treatment. The limitation of the data for analysis with this new technology is problematic, however. This issue has been compounded by a paradigm shift in clinical practice aimed at utilizing this modality, which has been rolled out in an ad hoc fashion often with commercial motivation. Despite a growing body of literature, pertinent clinical questions remain. For example, can mp-MRI be calibrated to reliably detect biologically significant disease? As with any new technology, objective evaluation of the clinical applications of mp-MRI is essential. The focus of this review was on the evaluation of mp-MRI of the prostate with respect to clinical utility. PMID:25964833

  7. Feasibility of CBCT-based target and normal structure delineation in prostate cancer radiotherapy: Multi-observer and image multi-modality study

    International Nuclear Information System (INIS)

    Background and purpose: In-room cone-beam CT (CBCT) imaging and adaptive treatment strategies are promising methods to decrease target volumes and to spare organs at risk. The aim of this work was to analyze the inter-observer contouring uncertainties of target volumes and organs at risks (oars) in localized prostate cancer radiotherapy using CBCT images. Furthermore, CBCT contouring was benchmarked against other image modalities (CT, MR) and the influence of subjective image quality perception on inter-observer variability was assessed. Methods and materials: Eight prostate cancer patients were selected. Seven radiation oncologists contoured target volumes and oars on CT, MRI and CBCT. Volumes, coefficient of variation (COV), conformity index (cigen), and coordinates of center-of-mass (COM) were calculated for each patient and image modality. Reliability analysis was performed for the support of the reported findings. Subjective perception of image quality was assessed via a ten-scored visual analog scale (VAS). Results: The median volume for prostate was larger on CT compared to MRI and CBCT images. The inter-observer variation for prostate was larger on CBCT (CIgen = 0.57 ± 0.09, 0.61 reliability) compared to CT (CIgen = 0.72 ± 0.07, 0.83 reliability) and MRI (CIgen = 0.66 ± 0.12, 0.87 reliability). On all image modalities values of the intra-observer reliability coefficient (0.97 for CT, 0.99 for MR and 0.94 for CBCT) indicated high reproducibility of results. For all patients the root mean square (RMS) of the inter-observer standard deviation (σ) of the COM was largest on CBCT with σ(x) = 0.4 mm, σ(y) = 1.1 mm, and σ(z) = 1.7 mm. The concordance in delineating OARs was much stronger than for target volumes, with average CIgen > 0.70 for rectum and CIgen > 0.80 for bladder. Positive correlations between CIgen and VAS score of the image quality were observed for the prostate, seminal vesicles and rectum. Conclusions: Inter-observer variability for target

  8. Multi-modality PET-CT imaging of breast cancer in an animal model using nanoparticle x-ray contrast agent and 18F-FDG

    Science.gov (United States)

    Badea, C. T.; Ghaghada, K.; Espinosa, G.; Strong, L.; Annapragada, A.

    2011-03-01

    Multi-modality PET-CT imaging is playing an important role in the field of oncology. While PET imaging facilitates functional interrogation of tumor status, the use of CT imaging is primarily limited to anatomical reference. In an attempt to extract comprehensive information about tumor cells and its microenvironment, we used a nanoparticle xray contrast agent to image tumor vasculature and vessel 'leakiness' and 18F-FDG to investigate the metabolic status of tumor cells. In vivo PET/CT studies were performed in mice implanted with 4T1 mammary breast cancer cells.Early-phase micro-CT imaging enabled visualization 3D vascular architecture of the tumors whereas delayedphase micro-CT demonstrated highly permeable vessels as evident by nanoparticle accumulation within the tumor. Both imaging modalities demonstrated the presence of a necrotic core as indicated by a hypo-enhanced region in the center of the tumor. At early time-points, the CT-derived fractional blood volume did not correlate with 18F-FDG uptake. At delayed time-points, the tumor enhancement in 18F-FDG micro-PET images correlated with the delayed signal enhanced due to nanoparticle extravasation seen in CT images. The proposed hybrid imaging approach could be used to better understand tumor angiogenesis and to be the basis for monitoring and evaluating anti-angiogenic and nano-chemotherapies.

  9. [Current perspectives on supportive care for lung cancer patients].

    Science.gov (United States)

    Serena, A; Zurkinden, C; Castellani, P; Eicher, M

    2015-05-20

    The fight against cancer comprises not only survival of the disease but also survival with the highest possible quality of life. Thus, supportive care in cancer aims at reducing physical and psycho-emotional symptom burden. Furthermore, supportive care in cancer includes self-management-support for patients and their families/caregivers. Due to high symptom prevalence and poor prognosis, lung cancer patients express more unmet supportive care needs than other patient populations with cancer. Interventions to meet these needs have been developed in the last decade. They involve new models of care that incorporate the role of a lung cancer nurse in comprehensive cancer centers and eHealth-systems to support lung cancer patients and their families/caregivers. PMID:26152086

  10. The Role of VATS in Lung Cancer Surgery: Current Status and Prospects for Development

    OpenAIRE

    Dariusz Dziedzic; Tadeusz Orlowski

    2015-01-01

    Since the introduction of anatomic lung resection by video-assisted thoracoscopic surgery (VATS) 20 years ago, VATS has experienced major advances in both equipment and technique, introducing a technical challenge in the surgical treatment of both benign and malignant lung disease. The demonstrated safety, decreased morbidity, and equivalent efficacy of this minimally invasive technique have led to the acceptance of VATS as a standard surgical modality for early-stage lung cancer and increasi...

  11. CURRENT CONCEPTS IN MANAGEMENT OF ORAL CANCER – SURGERY

    OpenAIRE

    Jatin P. Shah; Gil, Ziv

    2008-01-01

    Oral cancer is the sixth most common cancer worldwide, with a high prevalence in South Asia. Tobacco and alcohol consumption remain the most dominant etiologic factors, however HPV has been recently implicated in oral cancer. Surgery is the most well established mode of initial definitive treatment for a majority of oral cancers. The factors that affect choice of treatment are related to the tumor and the patient. Primary site, location, size, proximity to bone, and depth of infiltration are ...

  12. Current medical treatment of estrogen receptor-positive breast cancer

    Institute of Scientific and Technical Information of China (English)

    Franco; Lumachi; Davide; A; Santeufemia; Stefano; MM; Basso

    2015-01-01

    Approximately 80% of breast cancers(BC) are estrogen receptor(ER)-positive and thus endocrine therapy(ET) should be considered complementary to surgery in the majority of patients. The advantages of oophorectomy, adrenalectomy and hypophysectomy in women with advanced BC have been demonstrated many years ago, and currently ET consist of(1) ovarian function suppression(OFS), usually obtained using gonadotropinreleasing hormone agonists(Gn RHa);(2) selective estrogen receptor modulators or down-regulators(SERMs or SERDs); and(3) aromatase inhibitors(AIs), or a combination of two or more drugs. For patients aged less than 50 years and ER+ BC, there is no conclusive evidence that the combination of OFS and SERMs(i.e., tamoxifen) or chemotherapy is superior to OFS alone. Tamoxifen users exhibit a reduced risk of BC, both invasive and in situ, especially during the first 5 years of therapy, and extending the treatment to 10 years further reduced the risk of recurrences. SERDs(i.e., fulvestrant) are especially useful in the neoadjuvant treatment of advanced BC, alone or in combination with either cytotoxic agents or AIs. There are two types of AIs: type Ⅰ are permanent steroidal inhibitors of aromatase, while type Ⅱ are reversible nonsteroidal inhibitors. Several studies demonstrated the superiority of the third-generation AIs(i.e., anastrozole and letrozole) compared with tamoxifen, and adjuvant therapy with AIs reduces the recurrence risk especially in patients with advanced BC. Unfortunately, some cancers are or became ET-resistant, and thus other drugs have been suggested in combination with SERMs or AIs, including cyclin-dependent kinase 4/6 inhibitors(palbociclib) and mammalian target of rapamycin(m TOR) inhibitors, such as everolimus. Further studies are required to confirm their real usefulness.

  13. Current Stem Cell Biomarkers and Their Functional Mechanisms in Prostate Cancer

    Science.gov (United States)

    Zhang, Kaile; Zhou, Shukui; Wang, Leilei; Wang, Jianlong; Zou, Qingsong; Zhao, Weixin; Fu, Qiang; Fang, Xiaolan

    2016-01-01

    Currently there is little effective treatment available for castration resistant prostate cancer, which is responsible for the majority of prostate cancer related deaths. Emerging evidence suggested that cancer stem cells might play an important role in resistance to traditional cancer therapies, and the studies of cancer stem cells (including specific isolation and targeting on those cells) might benefit the discovery of novel treatment of prostate cancer, especially castration resistant disease. In this review, we summarized major biomarkers for prostate cancer stem cells, as well as their functional mechanisms and potential application in clinical diagnosis and treatment of patients. PMID:27447616

  14. Research on cancer diagnosis in Malaysia: current status.

    Science.gov (United States)

    Looi, L M; Zubaidah, Z; Cheah, P L; Cheong, S K; Gudum, H R; Iekhsan, O; Ikram, S I; Jamal, R; Mak, J W; Othman, N H; Puteri, J N; Rosline, H; Sabariah, A R; Seow, H F; Sharifah, N A

    2004-06-01

    Cancer is a major morbidity and mortality concern in Malaysia. Based on National Cancer Registry data, the Malaysian population is estimated to bear a cancer burden of about 40,000 new cases per year, and a cumulative lifetime risk of about 1:4. Cancer research in Malaysia has to consider needs relevant to our population, and resources constraints. Hence, funding bodies prioritise cancers of high prevalence, unique to our community and posing specific clinical problems. Cancer diagnosis is crucial to cancer management. While cancer diagnosis research largely aims at improvements in diagnostic information towards more appropriate therapy, it also impacts upon policy development and other areas of cancer management. The scope of cancer diagnosis upon which this paper is based, and their possible impact on other R&D areas, has been broadly categorized into: (1) identification of aetiological agents and their linkages to the development of precancer and cancer (impact on policy development, cancer prevention and treatment), (2) cancer biology and pathogenesis (impact on cancer prevention, treatment strategies and product development), (3) improvements in accuracy, sensitivity and specificity in cancer detection, monitoring and classification (impact on technology development) and (4) prognostic and predictive parameters (impact on treatment strategies). This paper is based on data collected by the Working Group on Cancer Diagnosis Research for the First National Conference on Cancer Research Coordination in April 2004. Data was collated from the databases of Institutions/Universities where the authors are employed, the Ministry of Science, Technology and Innovation (MOSTI) and targeted survey feedback from key cancer researchers. Under the 7th Malaysia Plan, 76 cancer projects were funded through the Intensified Research in Priority Areas (IRPA) scheme of MOSTI, amounting to almost RM15 million of grant money. 47(61.8%) of these projects were substantially in cancer

  15. The current status of imaging diagnosis of breast cancer

    International Nuclear Information System (INIS)

    In recent years, the incidence and the mortality rate of female breast cancer in our country is increasing, Early diagnosis of breast cancer is particularly important. Precious preoperative staging in the breast cancer is advantageous for the treatment planning. Evaluating the efficacy of chemotherapy is beneficial for adjusting the follow-up plan. Imaging examination has become an important role in breast cancer management. At present, commonly used equipment include mammography, ultrasound, CT, and MRI, etc. This article reviews the present study status of these tools in diagnosis of breast cancer. A reasonable and effective choice of those tools can facilitate clinic diagnosis and treatment. (authors)

  16. Risk of hormone escape in a human prostate cancer model depends on therapy modalities and can be reduced by tyrosine kinase inhibitors.

    Directory of Open Access Journals (Sweden)

    Charlotte Guyader

    Full Text Available Almost all prostate cancers respond to androgen deprivation treatment but many recur. We postulated that risk of hormone escape--frequency and delay--are influenced by hormone therapy modalities. More, hormone therapies induce crucial biological changes involving androgen receptors; some might be targets for escape prevention. We investigated the relationship between the androgen deprivation treatment and the risk of recurrence using nude mice bearing the high grade, hormone-dependent human prostate cancer xenograft PAC120. Tumor-bearing mice were treated by Luteinizing-Hormone Releasing Hormone (LHRH antagonist alone, continuous or intermittent regimen, or combined with androgen receptor (AR antagonists (bicalutamide or flutamide. Tumor growth was monitored. Biological changes were studied as for genomic alterations, AR mutations and protein expression in a large series of recurrent tumors according to hormone therapy modalities. Therapies targeting Her-2 or AKT were tested in combination with castration. All statistical tests were two-sided. Tumor growth was inhibited by continuous administration of the LH-RH antagonist degarelix (castration, but 40% of tumors recurred. Intermittent castration or complete blockade induced by degarelix and antiandrogens combination, inhibited tumor growth but increased the risk of recurrence (RR as compared to continuous castration (RR(intermittent: 14.5, RR(complete blockade: 6.5 and 1.35. All recurrent tumors displayed new quantitative genetic alterations and AR mutations, whatever the treatment modalities. AR amplification was found after complete blockade. Increased expression of Her-2/neu with frequent ERK/AKT activation was detected in all variants. Combination of castration with a Her-2/neu inhibitor decreased recurrence risk (0.17 and combination with an mTOR inhibitor prevented it. Anti-hormone treatments influence risk of recurrence although tumor growth inhibition was initially similar. Recurrent

  17. Detection of cervical lymph node metastasis in head and neck cancer patients with clinically N0 neck—a meta-analysis comparing different imaging modalities

    International Nuclear Information System (INIS)

    How to properly manage clinically negative neck of head and neck cancer patients is a controversial topic. Research is now directed toward finding a method sensitive enough to bring the risk of occult metastases below 20%. The aim of this review was to compare the diagnostic accuracy of different imaging modalities, including CT, MRI, PET and US, in clinically N0 head and neck cancer patients. For this systematic review and meta-analysis, PubMed and the Cochrane Database were searched for relevant original articles published up to May 2011. Inclusion criteria were as follows: articles were reported in English; CT, MRI, PET or US were performed to identify cervical metastases in clinically N0 head and neck squamous cell carcinoma; and data were sufficient for the calculation of true-positive or false-negative values. A bivariate random effect model was used to obtain pooled sensitivity and specificity. The positive and negative test probability of neck metastasis was generated based on Bayesian theory and collected data for different pre-test possibilities. Of the 168 identified relevant articles, 7 studies fulfilled all inclusion criteria for CT, 6 studies for MRI, 11 studies for PET and 8 studies for US. There was no difference in sensitivity and specificity among these imaging modalities, except CT was superior to US in specificity. The pooled estimates for sensitivity were 52% (95% confidence interval [CI], 39% ~ 65%), 65% (34 ~ 87%) 66% (47 ~ 80%), and 66% (45 ~ 77%), on a per-neck basis for CT, MRI, PET and US, respectively. The pooled estimates for specificity were 93% (87% ~ 97%), 81% (64 ~ 91%), 87% (77 ~ 93%), and 78% (71 ~ 83%) for CT, MRI, PET and US, respectively. With pre-examination nodal metastasis probabilities set at 10%, 20% and 30%, the post-exam probabilities of positive nodal metastasis rates were 47%, 66% and 77% for CT; 27%, 46% and 59% for MRI; 36%, 56% and 69% for PET; and 25%, 42% and 56% for US, respectively. Negative nodal metastasis

  18. Current Status and Development of Traditional Chemotherapy in Non-small Cell Lung Cancer under the Background of Targeted Therapy

    Directory of Open Access Journals (Sweden)

    Guowei ZHANG

    2015-09-01

    Full Text Available In recent years, along with rapid development of targeted therapy in non-small cell lung cancer, traditional chemotherapy get less and less attention. Yet it still can not be ignored in the current that how to locate and use traditional chemotherapy so patients could derive maximum benefit. For this purpose, through the literature review and analysis, we point out there are still many traditional chemotherapy irreplaceable places whatever patients’ driver gene status. And there are some new treatment modalities of traditional chemotherapy which have been developed to further improve patients’ survival. At the same time, through exposition of predictive bio-markers development in chemotherapy, we pointed out that the future of traditional chemotherapy must be part of “targeted therapy”.

  19. Is there room for combined modality treatments? Dosimetric comparison of boost strategies for advanced head and neck and prostate cancer

    OpenAIRE

    Góra, Joanna; Hopfgartner, Johannes; Kuess, Peter; Paskeviciute, Brigita; Georg, Dietmar

    2013-01-01

    The purpose of the study was to determine the dosimetric difference between three emerging treatment modalities—volumetric-modulated arc therapy (VMAT), intensity-modulated proton beam therapy (IMPT) and intensity-modulated carbon ion beam therapy (IMIT)—for two tumour sites where selective boosting of the tumour is applied. For 10 patients with locally advanced head and neck (H&N) cancer and 10 with high-risk prostate cancer (PC) a VMAT plan was generated for PTVinitial that included lymph n...

  20. Cancer Treatment-Related Cardiotoxicity: Understanding the Current State of Knowledge and Developing Future Research Priorities

    Science.gov (United States)

    Cancer Treatment-Related Cardiotoxicity: Understanding the Current State of Knowledge and Developing Future Research Priorities, a 2013 workshop sponsored by the Epidemiology and Genomics Research Program.

  1. Increased use of multidisciplinary treatment modalities adds little to the outcome of rectal cancer treated by optimal total mesorectal excision.

    LENUS (Irish Health Repository)

    Chang, Kah Hoong

    2012-10-01

    Total mesorectal excision (TME) is the standard surgical treatment for rectal cancer. The roles of chemotherapy and radiotherapy have become more defined, accompanied by improvements in preoperative staging and histopathological assessment. We analyse our ongoing results in the light of changing patterns of treatment over consecutive time periods.

  2. Pathological examination of breast cancer biomarkers: current status in Japan.

    Science.gov (United States)

    Masuda, Shinobu

    2016-07-01

    This article reviews the current status of pathological evaluation for biomarkers in Japan. The introduced issues are the international trends for estimation of biomarkers considering diagnosis and treatment decision, and pathological issues under discussion, and how Japanese Breast Cancer Society (JBCS) members have addressed issues related to pathology and biomarkers evaluation. As topics of immunohistochemical study, (1) ASCO/CAP guidelines, (2) Ki67 and other markers, (3) quantification and image analysis, (4) application of cytologic samples, (5) pre-analytical process, and (6) Japan Pathology Quality Assurance System are introduced. Various phases of concepts, guidelines, and methodologies are co-existed in today's clinical practice. It is expected in near future that conventional methods and molecular procedures will be emerged, and Japanese Quality assurance/Quality control (QA/QC) system will work practically. What we have to do in the next generation are to validate novel procedures, to evaluate the relationship between traditional concepts and newly proposed ideas, to establish a well organized QA/QC system, and to standardize pre-analytical process that are the basis of all procedures using pathological tissues. PMID:25239167

  3. Cancer of the Pancreas: Molecular Pathways and Current Advancement in Treatment

    Science.gov (United States)

    Polireddy, Kishore; Chen, Qi

    2016-01-01

    Pancreatic cancer is one of the most lethal cancers among all malignances, with a median overall survival of cancers harbor a variety of genetic alternations that render it difficult to treat even with targeted therapy. Recent studies revealed that pancreatic cancers are highly enriched with a cancer stem cell (CSC) population, which is resistant to chemotherapeutic drugs, and therefore escapes chemotherapy and promotes tumor recurrence. Cancer cell epithelial to mesenchymal transition (EMT) is highly associated with metastasis, generation of CSCs, and treatment resistance in pancreatic cancer. Reviewed here are the molecular biology of pancreatic cancer, the major signaling pathways regulating pancreatic cancer EMT and CSCs, and the advancement in current clinical and experimental treatments for pancreatic cancer.

  4. Current Understanding of the Role of PPARγ in Gastrointestinal Cancers

    Directory of Open Access Journals (Sweden)

    Bing Zou

    2009-01-01

    Full Text Available Numerous studies have indicated that PPARγ plays multiple roles such as in inflammation, cell cycle control, cell proliferation, apoptosis, and carcinogenesis, thus PPARγ contributes to the homeostasis. Many in vitro studies have showed that ligand-induced activation of PPARγ possess antitumor effect in many cancers including CRC. However, the role of PPARγ in gastrointestinal cancers, especially in colorectal cancer, is rather controversial. Nevertheless, some recent studies with the positive results on the possible application of PPARγ ligands, such as Bezafibrate or Rosiglitazone in gastrointestinal cancers, have suggested a potential usefulness of PPARγ agonists in cancer prevention and therapy. In this review, the authors discuss the recent developments in the role of PPARγ in gastrointestinal cancers.

  5. Current Status and Future Perspectives in Differentiated Thyroid Cancer

    OpenAIRE

    Kim, Tae Yong; Kim, Won Gu; Kim, Won Bae; Shong, Young Kee

    2014-01-01

    Thyroid cancer is increasing all over the world. The exact cause of this increase is still debated and there are conflicting reports. Sophisticated molecular studies suggest that environmental chemicals may have effects of thyroid carcinogenesis. The development of powerful molecular biology techniques has enabled targeted next-generation sequencing for detection of mutations in thyroid cancer, and this technique can make a specific diagnosis of thyroid cancer in cytologically indeterminate c...

  6. Smoking behaviours of current cancer patients in Canada

    OpenAIRE

    Liu, J; Chadder, J.; S Fung; Lockwood, G.; Rahal, R.; Halligan, M.; Mowat, D.; Bryant, H.

    2016-01-01

    Evidence shows that continued smoking by cancer patients leads to adverse treatment outcomes and affects survival. Smoking diminishes treatment effectiveness, exacerbates side effects, and increases the risk of developing additional complications. Patients who continue to smoke also have a higher risk of developing a second primary cancer or experiencing a cancer recurrence, both of which ultimately contribute to poorer quality of life and poorer survival. Here, we present a snapshot of smoki...

  7. Cancer Treatment Using Peptides: Current Therapies and Future Prospects

    OpenAIRE

    Jyothi Thundimadathil

    2012-01-01

    This paper discusses the role of peptides in cancer therapy with special emphasis on peptide drugs which are already approved and those in clinical trials. The potential of peptides in cancer treatment is evident from a variety of different strategies that are available to address the progression of tumor growth and propagation of the disease. Use of peptides that can directly target cancer cells without affecting normal cells (targeted therapy) is evolving as an alternate strategy to convent...

  8. Personalizing medicine for metastatic colorectal cancer: Current developments

    OpenAIRE

    Marques, Andrea Marin; Turner, Alice; de Mello, Ramon Andrade

    2014-01-01

    Metastatic colorectal cancer (mCRC) is still one of the tumor types with the highest incidence and mortality. In 2012, colorectal cancer was the second most prevalence cancer among males (9%) and the third among females (8%). In this disease, early diagnosis is important to improve treatment outcomes. However, at the time of diagnosis, about one quarter of patients already have metastases, and overall survival of these patients at 5-years survival is very low. Because of these poor statistics...

  9. Current Guidelines for the Diagnosis and Treatment of Breast Cancer

    OpenAIRE

    Hayes, Teresa G.; Peterson, Leif E; Weinberg, Armin D.

    1998-01-01

    The management of breast cancer is a significant public health issue. Early detection of breast cancer through screening mammography, physician clinical examination and breast self-examination can reduce breast cancer mortality by approximately 30%. Most major health organisations agree that yearly mammographic screening should begin at the age of 40 years, although there is some controversy about the need for mammography between the ages of 40 and 49 years. The use of mammographic screening ...

  10. Metastatic Bladder Cancer: A Review of Current Management

    OpenAIRE

    Andrew Fletcher; Ananya Choudhury; Nooreen Alam

    2011-01-01

    Bladder cancer continues to result in substantial morbidity and mortality for affected individuals. Advances in the management of metastatic bladder cancer have been limited. Chemotherapy with platinum-based regimes remains the mainstay of first-line treatment. Studies investigating alternative regimes have offered no survival advantage. Targeted therapies may offer benefit either as single agent or in combination with chemotherapy. Symptoms due to metastatic bladder cancer impact patients' q...

  11. Adjuvant Therapy of Colon Cancer: Current Status and Future Developments

    OpenAIRE

    Morse, Michael A.

    2005-01-01

    Options for the adjuvant therapy of resected stage III colon cancer have expanded beyond the previously well-accepted standard of 5-fluorouracil (5-FU) combined with leucovorin. The Xeloda in Adjuvant Colon Cancer Therapy (X-ACT) study confirmed that capecitabine (Xeloda) is at least as effective and is less toxic than a bolus 5-FU and leucovorin regimen for patients with stage III colon cancer. This study, in addition to National Surgical Adjuvant Breast and Bowel Project (NSABP) C-06, which...

  12. Therapeutic potential of snake venom in cancer therapy: current perspectives

    OpenAIRE

    Vyas, Vivek Kumar; Brahmbhatt, Keyur; Bhatt, Hardik; Parmar, Utsav

    2013-01-01

    Many active secretions produced by animals have been employed in the development of new drugs to treat diseases such as hypertension and cancer. Snake venom toxins contributed significantly to the treatment of many medical conditions. There are many published studies describing and elucidating the anti-cancer potential of snake venom. Cancer therapy is one of the main areas for the use of protein peptides and enzymes originating from animals of different species. Some of these proteins or pep...

  13. What are the current and potential future roles for endoscopic ultrasound in the treatment of pancreatic cancer?

    Science.gov (United States)

    Oh, Stephen Y; Irani, Shayan; Kozarek, Richard A

    2016-04-10

    Pancreatic adenocarcinoma is the fourth leading cause of cancer-related death in the United States. Due to the aggressive tumor biology and late manifestations of the disease, long-term survival is extremely uncommon and the current 5-year survival rate is 7%. Over the last two decades, endoscopic ultrasound (EUS) has evolved from a diagnostic modality to a minimally invasive therapeutic alternative to radiologic procedures and surgery for pancreatic diseases. EUS-guided celiac plexus intervention is a useful adjunct to conventional analgesia for patients with pancreatic cancer. EUS-guided biliary drainage has emerged as a viable option in patients who have failed endoscopic retrograde cholangiopancreatography. Recently, the use of lumen-apposing metal stent to create gastrojejunal anastomosis under EUS and fluoroscopic guidance in patients with malignant gastric outlet obstruction has been reported. On the other hand, anti-tumor therapies delivered by EUS, such as the injection of anti-tumor agents, brachytherapy and ablations are still in the experimental stage without clear survival benefit. In this article, we provide updates on well-established EUS-guided interventions as well as novel techniques relevant to pancreatic cancer. PMID:27076870

  14. A comparison of patient characteristics, prognosis, treatment modalities, and survival according to age group in gastric cancer patients

    OpenAIRE

    Tural Deniz; Selçukbiricik Fatih; Serdengeçti Süheyla; Büyükünal Evin

    2012-01-01

    Abstract Background The aim of this study was to investigate age-specific incidence rates and to compare disease stage, treatment, and survival according to age group in patients with gastric adenocarcinoma. Methods Gastric cancer patients treated at our hospital between 1999 and 2010 were retrospectively evaluated. We divided the cases into two subgroups: group 1 consisted of patients older than 70 years at the time of treatment, and group 2 included patients aged 70 years or younger. In all...

  15. Dual-Modality Photoacoustic and Ultrasound Imaging System for Noninvasive Sentinel Lymph Node Detection in Patients with Breast Cancer

    OpenAIRE

    Alejandro Garcia-Uribe; Todd N. Erpelding; Arie Krumholz; Haixin Ke; Konstantin Maslov; Catherine Appleton; Margenthaler, Julie A.; Wang, Lihong V.

    2015-01-01

    The detection of regional lymph node metastases is important in cancer staging as it guides the prognosis of the patient and the strategy for treatment. Sentinel lymph node biopsy (SLNB) is an accurate, less invasive alternative to axillary lymph node dissection. The sentinel lymph node hypothesis states that the pathological status of the axilla can be accurately predicted by determining the status of the first lymph nodes that drain from the primary tumor. Physicians use radio-labeled sulfu...

  16. Adjuvant Androgen Deprivation Therapy Loses Its Therapeutic Benefit after Premature Termination: An Experience of Combined Modality Treatment on Prostate Cancer

    OpenAIRE

    Kang-Hsing Fan; Yen-Chao Chen; Cheng-Keng Chuang; Min-Li Hsieh; Ji-Hong Hong

    2009-01-01

    Background: To investigate the effect of the premature termination of recommendedandrogen deprivation therapy (ADT) as an adjunct to radiotherapy.Methods: Between December 2001 and March 2004, 92 patients with non-metastaticprostate cancer underwent primary, curative radiotherapy via an intensitymodulatedtechnique. Four patients (5%) were treated with a dosage of 70.2Gy, while 74 (80%) and 14 patients (15%) were treated to 72 and 75.6 Gy.Thirty patients (33%) received pelvic irradiation to 45...

  17. Multifunctional polypyrrole@fe3o4 nanoparticles for dual-modal imaging and in vivo photothermal cancer therapy

    KAUST Repository

    Tian, Qiwei

    2013-11-27

    Magnetic Fe3O4 crystals are produced in situ on preformed polypyrrole (PPY) nanoparticles by rationally converting the residual Fe species in the synthetic system. The obtained PPY@Fe3O4 composite nanoparticles exhibit good photostability and biocompatibility, and they can be used as multifunctional probes for MRI, thermal imaging, and photothermal ablation of cancer cells. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  18. Outcome of combined modality treatment including neoadjuvant chemotherapy of 128 cases of locally advanced breast cancer: Data from a tertiary cancer center in northern India

    OpenAIRE

    Raina, V.; M Kunjahari; N K Shukla; SVS Deo; Sharma, A.; Mohanti, B. K.; D N Sharma

    2011-01-01

    Background: Breast cancer is now the most common cancer in many parts of India and the incidence varies from 12 to 31/100000, and is rising. Locally advanced breast cancer (LABC) accounts for 30 - 35% of all cases of breast cancers in India. LABC continues to present a challenge and imposes a major health impact in our country. Materials and Methods: We carried out a analysis of our LABC patients who received neoadjuvant chemotherapy (NACT) at our hospital over a 10-year period, from January ...

  19. Psychological Issues in Cancer Genetics: Current Research and Future Priorities.

    Science.gov (United States)

    Hopwood, Penelope

    1997-01-01

    Data concerning the psychological impact of high risk of cancer are reviewed, including implications of genetic testing, breast screening,and accuracy of women's risk estimates. Work in progress on prophylactic mastectomy and chemoprevention is reviewed. Research on cancer families, and interventions and prevention strategies for high-risk…

  20. Transvaginal ultrasonography in ovarian cancer screening: current perspectives

    Directory of Open Access Journals (Sweden)

    van Nagell Jr JR

    2013-12-01

    Full Text Available John R van Nagell Jr, John T HoffDepartment of Obstetrics and Gynecology, University of Kentucky Chandler Medical Center/Markey Cancer Center, Lexington, KY, USAAbstract: Transvaginal ultrasonography (TVS is an integral part of all major ovarian cancer screening trials. TVS is accurate in detecting abnormalities in ovarian volume and morphology, but is less reliable in differentiating benign from malignant ovarian tumors. When used as the only screening test, TVS is sensitive, but has a low positive predictive value. Therefore, serum biomarkers and tumor morphology indexing are used together with TVS to identify ovarian tumors at high risk for malignancy. This allows preoperative triage of high-risk cases to major cancer centers for therapy while decreasing unnecessary surgery for benign disease. Ovarian cancer screening has been associated with a decrease in stage at detection in most trials, thereby allowing treatment to be initiated when the disease is most curable.Keywords: ovarian cancer, ultrasound, screening, serum Ca-125

  1. Overall survival and local control following combined modality therapy and selective bladder preservation for invasive bladder cancer

    International Nuclear Information System (INIS)

    Purpose/Objective: Bladder preservation, in the interest of quality of life, is secondary to the primary treatment goal of curing the patient. To evaluate the long term efficacy of a selective bladder preserving approach we updated our prospective series which now includes 40 patients surviving and under surveillance for 5 or more years. Materials and Methods: From 1986 through 1993, 106 patients (median age 68 years) with muscle-invading tumor (stages T2-T4a, Nx, M0) initiated a protocol of maximal transurethral resection followed by 2 cycles of methotrexate, cisplatin and vinblastine plus cisplatin x2 with 40Gy pelvic irradiation. Complete responders and all non-cystectomy candidates received consolidation by cisplatin and 24.8Gy. Incomplete responders underwent immediate radical cystectomy as did those who developed recurrent invasive tumor. Median follow-up is 53 months. Results: Of all 106 patients who initiated induction Combined Modality Treatment (CMT): 1) 83 patients or 78% completed CMT; 33% developed moderate or severe leukopenia, 2) 74 patients (70%) had a Complete Response (CR), 3) the 5 year actuarial overall survival is 52%; for clinical stage T2 and T3-T4a this is 63% and 45%, respectively, 4) 36 patients (34%) have had cystectomy, all for tumor (6 because CMT wasn't tolerated, 13 for < CR, 17 for recurrence); no patient required cystectomy for complications; the 5 year survival with an intact functioning bladder is 43%, 5) 31 patients (20%) have had relapse of a superficial TCC with 4 requiring cystectomy after failing conservative management with a subsequent median follow-up of 58 months. Conclusion: These data demonstrate 1) that induction CMT with transurethral surgery and chemo-radiotherapy and selection for organ-conservation by response have a 52% overall survival which is comparable to immediate cystectomy-based prospective studies of patients with similar age and clinical stages and 2) that the majority of long term survivors retain fully

  2. Aspirin and Zileuton and Biomarker Expression in Nasal Tissue of Current Smokers | Division of Cancer Prevention

    Science.gov (United States)

    This randomized phase II trial studies the effects of aspirin and zileuton on genes related to tobacco use in current smokers. Smokers are at increased risk for developing lung and other cancers. Aspirin and zileuton may interfere with genes related to tobacco use and may be useful in preventing lung cancer in current smokers. |

  3. Therapies targeting cancer stem cells: Current trends and future challenges

    Institute of Scientific and Technical Information of China (English)

    Denisa; L; Dragu; Laura; G; Necula; Coralia; Bleotu; Carmen; C; Diaconu; Mihaela; Chivu-Economescu

    2015-01-01

    Traditional therapies against cancer, chemo- and radiotherapy, have multiple limitations that lead to treatment failure and cancer recurrence. These limitations are related to systemic and local toxicity, while treatment failure and cancer relapse are due to drug resistance and self-renewal, properties of a small population of tumor cells called cancer stem cells(CSCs). These cells are involved in cancer initiation, maintenance, metastasis and recurrence. Therefore, in order to develop efficient treatments that can induce a longlasting clinical response preventing tumor relapse it is important to develop drugs that can specifically target and eliminate CSCs. Recent identification of surface markers and understanding of molecular feature associated with CSC phenotype helped with the design of effective treatments. In this review we discuss targeting surface biomarkers, signaling pathways that regulate CSCs self-renewal and differentiation, drug-efflux pumps involved in apoptosis resistance, microenvironmental signals that sustain CSCs growth, manipulation of mi RNA expression, and induction of CSCs apoptosis and differentiation, with specific aim to hamper CSCs regeneration and cancer relapse. Some of these agents are under evaluation in preclinical and clinical studies, most of them for using in combination with traditional therapies. The combined therapy using conventional anticancer drugs with CSCs-targeting agents, may offer a promising strategy for management and eradication of different types of cancers.

  4. Early Gastric Cancer: Current Advances of Endoscopic Diagnosis and Treatment.

    Science.gov (United States)

    Zhu, Linlin; Qin, Jinyu; Wang, Jin; Guo, Tianjiao; Wang, Zijing; Yang, Jinlin

    2016-01-01

    Endoscopy is a major method for early gastric cancer screening because of its high detection rate, but its diagnostic accuracy depends heavily on the availability of endoscopic instruments. Many novel endoscopic techniques have been shown to increase the diagnostic yield of early gastric cancer. With the improved detection rate of EGC, the endoscopic treatment has become widespread due to advances in the instruments available and endoscopist's experience. The aim of this review is to summarize frequently-used endoscopic diagnosis and treatment in early gastric cancer (EGC). PMID:26884753

  5. Early Gastric Cancer: Current Advances of Endoscopic Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Linlin Zhu

    2016-01-01

    Full Text Available Endoscopy is a major method for early gastric cancer screening because of its high detection rate, but its diagnostic accuracy depends heavily on the availability of endoscopic instruments. Many novel endoscopic techniques have been shown to increase the diagnostic yield of early gastric cancer. With the improved detection rate of EGC, the endoscopic treatment has become widespread due to advances in the instruments available and endoscopist’s experience. The aim of this review is to summarize frequently-used endoscopic diagnosis and treatment in early gastric cancer (EGC.

  6. Epigenetic biomarkers in prostate cancer: Current and future uses.

    Science.gov (United States)

    Chiam, Karen; Ricciardelli, Carmela; Bianco-Miotto, Tina

    2014-01-28

    Epigenome alterations are characteristic of nearly all human malignancies and include changes in DNA methylation, histone modifications and microRNAs (miRNAs). However, what induces these epigenetic alterations in cancer is largely unknown and their mechanistic role in prostate tumorigenesis is just beginning to be evaluated. Identification of the epigenetic modifications involved in the development and progression of prostate cancer will not only identify novel therapeutic targets but also prognostic and diagnostic markers. This review will focus on the use of epigenetic modifications as biomarkers for prostate cancer. PMID:22391123

  7. Dual-modality image guided high intensity focused ultrasound device design for prostate cancer: A numerical study

    Science.gov (United States)

    Hobson, Dexter; Curiel, Laura; Chapelon, Jean-Yves; Pichardo, Samuel

    2012-10-01

    In this study the feasibility of designing a multi-element prostate cancer treatment device using Magnetic Resonance Imaging and ultrasound imaging for guidance was determined. A parametric study was performed to determine the optimal focal length (L), operating frequency (f), element size (a) and central hole radius for lodging an imaging probe (r) of a device that would safely treat cancerous tissue within the prostate. Images from the Visible Human Project were used to determine simulated organ sizes and treatment locations. Elliptical tumors were placed throughout the simulated prostate and their lateral and axial limits were selected as test locations. Using Tesla C1060 (NVIDIA, Santa Clara, CA, USA) graphics processors, the Bio-Heat Transfer Equation was implemented to calculate the heating produced during the simulated treatment. L, f a and r were varied from 45 to 75mm, 2.25 to 3.00MHz, 1.5 to 8 times λ and 9 to 11mm, respectively. Results indicated that a device of 761 elements with a combination of L, f a and r of 68mm, 2.75MHz, 2.05λ and 9mm, respectively, could safely ablate tumors within the prostate and spare the surrounding organs.

  8. A Current Review of Targeted Therapeutics for Ovarian Cancer

    Directory of Open Access Journals (Sweden)

    Susana M. Campos

    2010-01-01

    Full Text Available Difficult to detect, ovarian cancer typically presents at an advanced stage. Significant progress has been achieved in the treatment of ovarian cancer with therapeutics focused on DNA replication or cell division. However, despite sensitivity to induction chemotherapy the majority of patients will develop recurrent disease. Conventional agents for recurrent disease offer little in terms of long-term responses. Various targeted therapeutics have been explored in the management of ovarian cancer. These include monoclonal antibodies to epidermal growth factor receptors, small molecule tyrosine kinase inhibitors, monoclonal antibodies directed at the vascular endothelial growth factor (bevacizumab, and the small tyrosine kinase inhibitors that target the vascular endothelial growth factor receptor. Recently, several other agents have come forth as potential therapeutic agents in the management of ovarian cancer. These include monoclonal antibodies to the folate receptor, triple angiokinase inhibitors, PARP inhibitors, aurora kinase inhibitors, inhibitors of the Hedgehog pathway, folate receptor antagonists, and MTOR inhibitors.

  9. Therapeutic potential of snake venom in cancer therapy: current perspectives.

    Science.gov (United States)

    Vyas, Vivek Kumar; Brahmbhatt, Keyur; Bhatt, Hardik; Parmar, Utsav

    2013-02-01

    Many active secretions produced by animals have been employed in the development of new drugs to treat diseases such as hypertension and cancer. Snake venom toxins contributed significantly to the treatment of many medical conditions. There are many published studies describing and elucidating the anti-cancer potential of snake venom. Cancer therapy is one of the main areas for the use of protein peptides and enzymes originating from animals of different species. Some of these proteins or peptides and enzymes from snake venom when isolated and evaluated may bind specifically to cancer cell membranes, affecting the migration and proliferation of these cells. Some of substances found in the snake venom present a great potential as anti-tumor agent. In this review, we presented the main results of recent years of research involving the active compounds of snake venom that have anticancer activity. PMID:23593597

  10. Current and emerging therapies for the treatment of pancreatic cancer

    OpenAIRE

    Moss, Rebecca

    2010-01-01

    Rebecca A Moss, Clifton LeeThe Cancer Institute of New Jersey, New Brunswick, NJ, USAAbstract: Pancreatic adenocarcinoma carries a dismal prognosis and remains a significant cause of cancer morbidity and mortality. Most patients survive less than 1 year; chemotherapeutic options prolong life minimally. The best chance for long-term survival is complete resection, which offers a 3-year survival of only 15%. Most patients who do undergo resection will go on to die of their disease. Research in ...

  11. Use of bisphosphonates in prostate cancer: Current status

    OpenAIRE

    Nayyar, Rishi; Gupta, Narmada P

    2007-01-01

    Bisphosphonates are a relatively newer class of drugs which have been used for the prevention of skeletal related complications of age related osteoporosis or metastatic disease from carcinoma breast or multiple myeloma. Their role in the management of prostate cancer is still under evolution. We hereby review the ongoing and some published randomized trials to define the role of bisphosphonates in various stages of prostate cancer.

  12. [Current Status and Perspective of Chemoradiotherapy for Uterine Cervical Cancer].

    Science.gov (United States)

    Toita, Takafumi; Ariga, Takuro; Kasuya, Goro; Hashimoto, Seiji; Maemoto, Hitoshi; Heianna, Joichi; Kakinohana, Yasumasa; Murayama, Sadayuki

    2015-10-01

    Fifteen years has passed since the NCI announced the clinical importance of concurrent chemoradiotherapy (CCRT) in radiotherapy for patients with locoregionally advanced uterine cervical cancer. Numerous clinical trials have been performed to further improve the outcomes of CCRT. In addition to investigations of chemotherapeutic regimens and schedules, adaptation of novel radiotherapy methods such as image-guided brachytherapy (IGBT) and intensity-modulated radiotherapy (IMRT) is encouraged in CCRT for cervical cancer. PMID:26489545

  13. Prospective comparison of 18F-FDG PET with conventional imaging modalities (CT, MRI, US) in lymph node staging of head and neck cancer

    International Nuclear Information System (INIS)

    The aims of this study were to investigate the detection of cervical lymph node metastases of head and neck cancer by positron emission tomographic (PET) imaging with fluorine-18 fluorodeoxyglucose (FDG) and to perform a prospective comparison with computed tomography (CT), magnetic resonance imaging (MRI), sonographic and histopathological findings. Sixty patients with histologically proven squamous cell carcinoma were studied by PET imaging before surgery. Preoperative endoscopy (including biopsy), CT, MRI and sonography of the cervical region were performed in all patients within 2 weeks preceding 18F-FDG whole-body PET. FDG PET images were analysed visually and quantitatively for objective assessment of regional tracer uptake. Histopathology of the resected neck specimens revealed a total of 1284 lymph nodes, 117 of which showed metastatic involvement. Based on histopathological findings, FDG PET correctly identified lymph node metastases with a sensitivity of 90% and a specificity of 94% (P-6). CT and MRI visualized histologically proven lymph node metastases with a sensitivity of 82% (specificity 85%) and 80% (specificity 79%), respectively (P-6). Sonography revealed a sensitivity of 72% (P-6). The comparison of 18F-FDG PET with conventional imaging modalities demonstrated statistically significant correlations (PET vs CT, P = 0.017; PET vs MRI, P = 0.012; PET vs sonography, P = 0.0001). Quantitative analysis of FDG uptake in lymph node metastases using body weight-based standardized uptake values (SUVBW) showed no significant correlation between FDG uptake (3.7±2.0) and histological grading of tumour-involved lymph nodes (P = 0.9). Interestingly, benign lymph nodes had increased FDG uptake as a result of inflammatory reactions (SUVBW-range: 2-15.8). This prospective, histopathologically controlled study confirms FDG PET as the procedure with the highest sensitivity and specificity for detecting lymph node metastases of head and neck cancer and has become a

  14. Lung cancer screening: history, current perspectives, and future directions

    Science.gov (United States)

    Sharma, Divakar; Newman, Thomas G.

    2015-01-01

    Lung cancer has remained the leading cause of death worldwide among all cancers. The dismal 5-year survival rate of 16% is in part due to the lack of symptoms during early stages and lack of an effective screening test until recently. Chest X-ray and sputum cytology were studied extensively as potential screening tests for lung cancer and were conclusively proven to be of no value. Subsequently, a number of studies compared computed tomography (CT) with the chest X-ray. These studies did identify lung cancer in earlier stages. However, they were not designed to prove a reduction in mortality. Later trials have focused on low-dose CT (LDCT) as a screening tool. The largest US trial – the National Lung Screening Trial (NLST) – enrolled approximately 54,000 patients and revealed a 20% reduction in mortality. While a role for LDCT in lung cancer screening has been established, the issues of high false positive rates, radiation risk, and cost effectiveness still need to be addressed. The guidelines of the international organizations that now include LDCT in lung cancer screening are reviewed. Other methods that may improve earlier detection such as positron emission tomography, autofluorescence bronchoscopy, and molecular biomarkers are also discussed. PMID:26528348

  15. Optimal breast cancer screening strategies for older women: current perspectives

    Directory of Open Access Journals (Sweden)

    Braithwaite D

    2016-02-01

    Full Text Available Dejana Braithwaite,1 Joshua Demb,1 Louise M Henderson2 1Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, 2Department of Radiology, University of North Carolina, Chapel Hill, NC, USA Abstract: Breast cancer is a major cause of cancer-related deaths among older women, aged 65 years or older. Screening mammography has been shown to be effective in reducing breast cancer mortality in women aged 50–74 years but not among those aged 75 years or older. Given the large heterogeneity in comorbidity status and life expectancy among older women, controversy remains over screening mammography in this population. Diminished life expectancy with aging may decrease the potential screening benefit and increase the risk of harms. In this review, we summarize the evidence on screening mammography utilization, performance, and outcomes and highlight evidence gaps. Optimizing the screening strategy will involve separating older women who will benefit from screening from those who will not benefit by using information on comorbidity status and life expectancy. This review has identified areas related to screening mammography in older women that warrant additional research, including the need to evaluate emerging screening technologies, such as tomosynthesis among older women and precision cancer screening. In the absence of randomized controlled trials, the benefits and harms of continued screening mammography in older women need to be estimated using both population-based cohort data and simulation models. Keywords: aging, breast cancer, precision cancer screening

  16. Analysis of toxicity in a group of patients treated for pancreatic cancer with combined modality 3D radiation therapy

    International Nuclear Information System (INIS)

    Purpose: To evaluate the acute toxicity of a group of 37 pancreatic cancer patients treated with noncoplanar, nonopposed, conformal radiation therapy with concurrent chemotherapy (5-FU). Materials and Methods: We retrospectively evaluated a group of initially nonadvanced 37 pancreatic cancer patients treated with combined concurrent chemotherapy and 3D radiation therapy treated between 1992 until 1995. During this period we began treating the initially unresectable patients with preoperative chemo-RT (50.4 Gy) after treating an initial group of unresectable patients to a higher dose of 66.6 Gy. We also include a group of patients who received postop chemo-RT after Whipple resection (59.4 Gy). All radiation was delivered at a 1.8 Gy per fraction dose rate. The total group was made up of 37 patients of whom 21 were male (57%) and 16 female (43%). There were 22 (59%) head of pancreas lesions, 10 (27%) body of pancreas lesions, and 5 (14%) head and body of pancreas cancers. Of these 37 patients 7 (19%) were treated with chemo-RT as their only treatment, 10 patients (29%) were treated post Whipple resection, and 20 patients (54%) were treated with preoperative intent. Results: Three patients (8%) required a treatment break, one with a body and 2 with head lesions. Two of these patients stopped RT short of planned dose (32.56 and 46.8 Gy) both suffering from nausea, vomiting, and anorexia with the third, who finished a planned 66.6 Gy dose, after a 4 day rest for leukopenia. One of 20 patients (5%) preop patients underwent the planned post chemo-RT Whipple resection, while 4 of the 20 patients (20%), remained unresectable, but without disease progression and had Iodine 125 interstitial implants at exploration delivering a minimal tumor dose of 120 Gy on top or the 50.4 Gy delivered preoperatively. Four patients (11%) maintained a minimal Karnofsky score of 100, 23 patients (62%) maintained a minimal KPS of 90, 6 patients (16%) maintained a minimal KPS of 80, and 4

  17. Wavelength-Modulated Differential Photoacoustic (WM-DPA) imaging: a high dynamic range modality towards noninvasive diagnosis of cancer

    Science.gov (United States)

    Dovlo, Edem; Lashkari, Bahman; Choi, Sung soo Sean; Mandelis, Andreas

    2016-03-01

    This study explores wavelength-modulated differential photo-acoustic (WM-DPA) imaging for non-invasive early cancer detection via sensitive characterization of functional information such as hemoglobin oxygenation (sO2) levels. Well-known benchmarks of tumor formation such as angiogenesis and hypoxia can be addressed this way. While most conventional photo-acoustic imaging has almost entirely employed high-power pulsed lasers, frequency-domain photo-acoustic radar (FD-PAR) has seen significant development as an alternative technique. It employs a continuous wave laser source intensity-modulated and driven by frequency-swept waveforms. WM-DPA imaging utilizes chirp modulated laser beams at two distinct wavelengths for which absorption differences between oxy- and deoxygenated hemoglobin are minimum (isosbestic point, 805 nm) and maximum (680 nm) to simultaneously generate two signals detected using a standard commercial array transducer as well as a single-element transducer that scans the sample. Signal processing is performed using Lab View and Matlab software developed in-house. Minute changes in total hemoglobin concentration (tHb) and oxygenation levels are detectable using this method since background absorption is suppressed due to the out-of-phase modulation of the laser sources while the difference between the two signals is amplified, thus allowing pre-malignant tumors to become identifiable. By regulating the signal amplitude ratio and phase shift the system can be tuned to applications like cancer screening, sO2 quantification and hypoxia monitoring in stroke patients. Experimental results presented demonstrate WM-DPA imaging of sheep blood phantoms in comparison to single-wavelength FD-PAR imaging. Future work includes the functional PA imaging of small animals in vivo.

  18. Regret on choice of colorectal cancer screening modality was associated with poorer screening compliance: a 4-year prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Martin C S Wong

    Full Text Available Very few studies examined the issue of regret on choosing colorectal cancer (CRC screening tests. We evaluated the determinants of regret and tested the hypothesis that regret over screening choices was associated with poorer screening compliance.A bowel cancer screening centre invited all Hong Kong citizens aged 50-70 years who were asymptomatic of CRC to participate in free-of-charge screening programmes. Upon attendance they attended health seminars on CRC and its screening, and were offered an option to choose yearly faecal immunochemical test (FIT for up to four years vs. one direct colonoscopy. They were not allowed to switch the screening option after decision. A self-administered, four-item validated survey was used to assess whether they regretted over their choice (> 2 = regretful from a scale of 0 [no regret]-5 [extreme regret]. A binary logistic regression model evaluated if initial regret over their choice was associated with poorer programme compliance.From 4,341 screening participants who have chosen FIT or colonoscopy, 120 (2.8% regretted over their decision and 1,029 (23.7% were non-compliant with the screening programme. Younger subjects and people who felt pressure when making their decision were associated with regret. People who regretted their decision were 2.189 (95% C.I. 1.361-3.521, p = 0.001 times more likely to be non-compliant with the programme.This study is the first to show that regret over the initial CRC screening choice was associated with later non-compliance. Screening participants who expressed regret over their choice should receive additional reminders to improve their programmatic compliance.

  19. Hypofractionated Intensity Modulated Radiation Therapy in Combined Modality Treatment for Bladder Preservation in Elderly Patients With Invasive Bladder Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Turgeon, Guy-Anne [Department of Oncology, Division of Radiation Oncology, McGill University Health Centre, Montreal, Quebec (Canada); Souhami, Luis, E-mail: luis.souhami@muhc.mcgill.ca [Department of Oncology, Division of Radiation Oncology, McGill University Health Centre, Montreal, Quebec (Canada); Cury, Fabio L.; Faria, Sergio L.; Duclos, Marie [Department of Oncology, Division of Radiation Oncology, McGill University Health Centre, Montreal, Quebec (Canada); Sturgeon, Jeremy [Department of Medical Oncology, McGill University Health Centre, Montreal, Quebec (Canada); Kassouf, Wassim [Department of Urology, McGill University Health Centre, Montreal, Quebec (Canada)

    2014-02-01

    Purpose/Objective(s): To review our experience with bladder-preserving trimodality treatment (TMT) using hypofractionated intensity modulated radiation therapy (IMRT) for the treatment of elderly patients with muscle-invasive bladder cancer. Methods and Materials: Retrospective study of elderly patients treated with TMT using hypofractionated IMRT (50 Gy in 20 fractions) with concomitant weekly radiosensitizing chemotherapy. Eligibility criteria were as follows: age ≥70 years, a proven diagnosis of muscle-invasive transitional cell bladder carcinoma, stage T2-T3N0M0 disease, and receipt of TMT with curative intent. Response rate was assessed by cystoscopic evaluation and bladder biopsy. Results: 24 patients with a median age of 79 years were eligible. A complete response was confirmed in 83% of the patients. Of the remaining patients, 1 of them underwent salvage cystectomy, and no disease was found in the bladder on histopathologic assessment. After a median follow-up time of 28 months, of the patients with a complete response, 2 patients had muscle-invasive recurrence, 1 experienced locoregional failure, and 3 experienced distant metastasis. The overall and cancer-specific survival rates at 3 years were 61% and 71%, respectively. Of the surviving patients, 75% have a disease-free and functioning bladder. All patients completed hypofractionated IMRT, and 19 patients tolerated all 4 cycles of chemotherapy. Acute grade 3 gastrointestinal or genitourinary toxicities occurred in only 4% of the patients, and acute grade 3 or 4 hematologic toxicities, liver toxicities, or both were experienced by 17% of the cohort. No patient experienced grade 4 gastrointestinal or genitourinary toxicity. Conclusions: Hypofractionated IMRT with concurrent radiosensitizing chemotherapy appears to be an effective and well-tolerated curative treatment strategy in the elderly population and should be considered for patients who are not candidates for cystectomy or who wish to avoid

  20. Hypofractionated Intensity Modulated Radiation Therapy in Combined Modality Treatment for Bladder Preservation in Elderly Patients With Invasive Bladder Cancer

    International Nuclear Information System (INIS)

    Purpose/Objective(s): To review our experience with bladder-preserving trimodality treatment (TMT) using hypofractionated intensity modulated radiation therapy (IMRT) for the treatment of elderly patients with muscle-invasive bladder cancer. Methods and Materials: Retrospective study of elderly patients treated with TMT using hypofractionated IMRT (50 Gy in 20 fractions) with concomitant weekly radiosensitizing chemotherapy. Eligibility criteria were as follows: age ≥70 years, a proven diagnosis of muscle-invasive transitional cell bladder carcinoma, stage T2-T3N0M0 disease, and receipt of TMT with curative intent. Response rate was assessed by cystoscopic evaluation and bladder biopsy. Results: 24 patients with a median age of 79 years were eligible. A complete response was confirmed in 83% of the patients. Of the remaining patients, 1 of them underwent salvage cystectomy, and no disease was found in the bladder on histopathologic assessment. After a median follow-up time of 28 months, of the patients with a complete response, 2 patients had muscle-invasive recurrence, 1 experienced locoregional failure, and 3 experienced distant metastasis. The overall and cancer-specific survival rates at 3 years were 61% and 71%, respectively. Of the surviving patients, 75% have a disease-free and functioning bladder. All patients completed hypofractionated IMRT, and 19 patients tolerated all 4 cycles of chemotherapy. Acute grade 3 gastrointestinal or genitourinary toxicities occurred in only 4% of the patients, and acute grade 3 or 4 hematologic toxicities, liver toxicities, or both were experienced by 17% of the cohort. No patient experienced grade 4 gastrointestinal or genitourinary toxicity. Conclusions: Hypofractionated IMRT with concurrent radiosensitizing chemotherapy appears to be an effective and well-tolerated curative treatment strategy in the elderly population and should be considered for patients who are not candidates for cystectomy or who wish to avoid

  1. Prostate cancer chemoprevention: Current status and future prospects

    International Nuclear Information System (INIS)

    Chemoprevention is a strategy that aims to reduce the incidence and burden of cancer through the development of agents to prevent, reverse or delay the carcinogenic process. Prostate cancer is a suitable target for prevention because it has a high incidence and prevalence, as well as a long latency and disease-related mortality, and furthermore it is a disease in which lifestyle and environmental factors may play critical roles. The development of chemoprevention strategies against prostate cancer will have a huge impact, both medically and economically. Large-scale clinical trials suggest that some agents such as selenium, lycopene, soy, green tea, vitamins D and E, anti-inflammatory and inhibitors of 5α-reductase are effective in preventing prostate cancer. Although each agent has the potential to affect the natural history of the disease, it is important to develop strategies to strategically proceed for the design and selection of test agents in order to demonstrate clinical benefit with the minimum of adverse effects. Appropriate selection of agent(s), disease stage, trial design and endpoints is critical in selecting the most promising regimens to accomplish these goals. This review highlights the present status of prostate cancer chemoprevention and discusses future prospects for chemopreventive strategies that are safe and clinically beneficial

  2. Performance of 18F-FDG PET/CT as a postoperative surveillance imaging modality for asymptomatic advanced gastric cancer patients

    International Nuclear Information System (INIS)

    The purpose of this study was to investigate the diagnostic performance of postoperative fluorine-18 fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) as a surveillance modality for advanced gastric cancer patients who were asymptomatic and negative by conventional follow-up. We retrospectively collected 46 advanced gastric cancer patients who received approximately 1-year-postoperative 18F-FDG PET/CT surveillance following curative resection (mean age 60.6 ± 11.5 years). 18F-FDG PET/CT was interpreted by nuclear medicine physicians who were blind to the clinical information. Final confirmation was determined by clinical follow-up using tumor markers, conventional CT scan, upper gastrointestinal endoscopy and with/without subsequent histopathologic diagnosis. Four patients developed recurrence (8.7%; 1 local and 3 distant recurrences). For local recurrence, 18F-FDG PET/CT found four hypermetabolic lesions and one was local recurrence. For distant recurrence, seven hypermetabolic lesions were found in six patients and true-positive was three lesions. False-positive cases were mainly turned out to be physiologic small bowel uptake. Regardless of the recurrence site, the sensitivity, specificity, positive predictive value and negative predictive value of 18F-FDG PET/CT were 100% (4/4, 95% confidence interval (CI) 39.6-100%), 88.1% (37/42, 95% CI 73.6-95.5%), 44.4% (4/9, 95% CI 15.3-77.3%) and 100% (37/37, 95% CI 88.3-100%), respectively in the patient-based analysis. Our study showed good specificity of postoperative surveillance 18F-FDG PET/CT for detecting recurrence. Careful caution should be made for interpreting some false-positive hypermetabolic lesions in postoperative 18F-FDG PET/CT, especially at the local anastomosis site. (author)

  3. Dual-modality FDG-PET/CT in follow-up of patients with recurrent iodine-negative differentiated thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Freudenberg, Lutz S.; Mueller, Stefan P.; Jentzen, Walter; Bockisch, Andreas [University of Duisburg/Essen, Department of Nuclear Medicine, Essen (Germany); Frilling, Andrea [University of Duisburg/Essen, Department of General, Visceral and Transplantation Surgery, Essen (Germany); Kuehl, Hilmar; Antoch, Gerald [University of Duisburg/Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany)

    2007-12-15

    The usefulness of combined 2-[{sup 18}F] fluoro-2-deoxy-D-glucose positron emission tomography and computed tomography (FDG-PET/CT) in locating suspected recurrence in patients with iodine-negative differentiated thyroid cancer (DTC) was evaluated. Thirty-six patients with DTC and suspected iodine-negative recurrence underwent restaging with FDG-PET/CT. The images of CT, FDG-PET, both modalities viewed side by side (CT+PET), and FDG-PET/CT were evaluated by two physicians separately. Imaging results were correlated with either histology (n = 20) and/or clinical follow-up of at least 36 months. Recurrent disease was diagnosed in 22/36 patients. FDG-PET alone, CT alone, CT+PET, and FDG-PET/CT showed a sensitivity of 82%, 73%, 91%, and 96%, respectively. Specificities were 79%, 71%, 79%, and 100%, respectively. FDG-PET/CT significantly improved specificity compared with CT+PET and resulted in a further treatment modification in 5/36 patients (14%). CT alone was especially sensitive for lung metastases, FDG-PET alone for the remainder of the body. Accurate fusion of functional and morphologic data by FDG-PET/CT improves the staging accuracy of patients with suspected recurrence of iodine-negative DTC. This has an impact on patient management in a substantial number of patients. (orig.)

  4. Surgical Excision with Forehead Flap as Single Modality Treatment for Basal Cell Cancer of Central Face: Single Institutional Experience of 50 Cases

    Directory of Open Access Journals (Sweden)

    Jagdeep Rao

    2014-01-01

    Full Text Available Basal cell carcinoma (BCC is the most common skin cancer worldwide. The WHO has defined it as “a locally invasive, slowly spreading tumor which rarely metastasizes, arising in the epidermis or hair follicles and in which the peripheral cells usually simulate the basal cells of the epidermis.” Here we discuss the management of BCCs of central face with surgical excision and reconstruction with forehead flap as single modality treatment. Material and Methods. This is a retrospective review of 50 patients who underwent surgical excision of BCC involving the facial region followed by primary reconstruction using forehead flaps at a single institution. There were 20 males and 30 females, mean age of 59 years. Results. No recurrence at primary site was observed during the follow-up of 1–4 yrs. There was no ectropion or exposure sequela. However, epiphora was evident. Size of lesions ranged from 2 to 6 cm. Keloid formation was seen in 2 (4% patients. Functional and cosmetic outcomes were satisfactory. Conclusion. For the face, the best reconstructive effort eventually fails in the face of tumor recurrence. The forehead flap represents one of the best methods for repair of extensive facial defects. Complete tumor extirpation, the primary event, is the key.

  5. Current trends in the chemotherapy of colorectal cancer.

    Science.gov (United States)

    Berciano-Guerrero, M A; Villa-Guzmán, J C; Acosta-Guerrero, R; Castañeda-Peñalvo, G; Rodríguez-Flores, J

    2012-01-01

    The increase in the therapeutic arsenal in the last 20 years, has given rise to changes in treating colorectal cancer (CRC) with only pyrimidines to combine several cytotoxic drugs. However, the present question is to determine the optimal sequence of this combination. This review presents an update of data on chemical and clinical features of chemotherapy used for colorectal cancer and the mechanisms of cellular resistance and potential predictive and prognostic biomarkers, which may contribute to a better selection of a therapeutic strategy. PMID:22830343

  6. The current pattern of reconstructive surgery for breast cancer

    OpenAIRE

    A. Kh. Ismagilov; A. R. Khamitov; A. S. Vanesyan

    2015-01-01

    In Russia, breast cancer (BC) occupies a leading place in the pattern of cancers, the incidence of which is 20.9 %, among the female population; in 2013 there were 60,717 new cases, including women under the age of 40 years (15 %). While considering the history of the development of breast surgery from the operation performed by W. S. Halsted to its technique modified by J. L. Madden and the identification of sentinel lymph nodes, we can observe improved quality of life in patients in referen...

  7. [Cancer-related Cognitive Impairment: Current Knowledge and Future Challenges].

    Science.gov (United States)

    Tanimukai, Hitoshi

    2015-01-01

    Cancer patients often suffer from various distresses, including cognitive impairment. Cognitive impairment during and after cancer diagnosis and treatment are collectively called "Cancer-related cognitive impairment (CRCI)". The number of publications about cognitive impairment due to cancer therapy, especially chemotherapy, hormonal therapy, and radiotherapy, has been growing. Patients often worry not only about their disease condition and therapies, but also experience concerns regarding their memory, attention, and ability to concentrate. Even subtle CRCI can have a significant impact on social relationships, the ability to work, undergo treatment, accomplish meaningful goals, and the quality of life. Longitudinal studies of cancer patients indicated that up to 75% experience CRCI during treatment. Furthermore, CRCI may persist for many years following treatment. However, it is not well understood by most physicians and medical staff. CRCI can be mediated through increased inflammatory cytokines and hormonal changes. In addition, the biology of the cancer, stress, and attentional fatigue can also contribute to CRCI. Genetic factors and co-occurring symptoms may explain some of the inter-individual variability in CRCI. Researchers and patients are actively trying to identify effective interventional methods and useful coping strategies. Many patients are willing to discuss their disease condition and future treatment with medical staff and/or their families. Some patients also hope to discuss their end-of-life care. However, it is difficult to express their will after developing cognitive impairment. Advance care planning (ACP) can help in such situations. This process involves discussion between a patient, their family, and clinicians to clarify and reflect on values, treatment preferences, and goals to develop a shared understanding of how end-of-life care should proceed. The number of cancer patients with cognitive impairment has been increasing owing to the

  8. Modal Epistemology and Conceivability

    DEFF Research Database (Denmark)

    Philosophical argumentation often depends on modal facts, i.e. facts about what is possible, contingent, or necessary. For thought and cognition outside the domain of philosophy modal facts are also often decisive. It seems we have an easy access to modal facts, but how so? Through a presentation...... of the state-of-the-art in modal epistemology I wish to outline a research project based on conceivability that will try to explain how we come to know modal facts....

  9. Modal Functional (`Dialectica') Interpretation

    OpenAIRE

    Hernest, Dan; Trifonov, Trifon

    2012-01-01

    We adapt our light Dialectica interpretation to usual and light modal formulas (with universal quantification on boolean and natural variables) and prove it sound for a non-standard modal arithmetic based on Goedel's T and classical S_4. The range of this light modal Dialectica is the usual (non-modal) classical Arithmetic in all finite types (with booleans); the propositional kernel of its domain is Boolean and not S_4. The `heavy' modal Dialectica interpretation is a new technique; it canno...

  10. Prognostic factors in ovarian cancer : current evidence and future prospects

    NARCIS (Netherlands)

    Crijns, APG; Boezen, HM; Schouten, JP; Arts, HJG; Hofstra, RMW; Willemse, PHB; de Vries, EGE; van der Zee, AGJ

    2003-01-01

    In ovarian cancer, translational research on the prognostic impact of molecular biological factors has until now not led to clinical implementation of any of these factors. This is partly due to the often conflicting results of different prognostic factor studies on the same molecular biological fac

  11. Diabetes and Cancer: a Review of Current Knowledge.

    Science.gov (United States)

    Wojciechowska, J; Krajewski, W; Bolanowski, M; Kręcicki, T; Zatoński, T

    2016-05-01

    Diabetes mellitus (DM), one of the most common life-threatening illnesses worldwide, is a group of metabolic diseases, characterized by sustained hyperglycemia. The global prevalence of diabetes mellitus among adults reached 387 millions in 2014 and is still rising. It is suggested there is a strong association between diabetes mellitus (especially type 2 diabetes mellitus) and carcinogenesis. The possible biological links between diabetes mellitus and cancer comprise hyperinsulinemia, hyperglycemia and fat-induced chronic inflammation. Although, the strongest association refers to pancreas and liver, there are many other organs involved in carcinogenesis in diabetic patients including breast, endometrium, bladder and kidney.Recent studies suggest that there is also association between cancer incidence and anti-diabetic medications. It was observed that some medications decrease the risk of carcinogenesis and some increase that risk. The majority of studies concern metformin, a drug of choice in type 2 diabetes mellitus, and its anti-neoplastic and tumor-suppressing activity. The positive effect of metformin was found in numerous researches investigating breast, pancreas, liver, colon, ovaries and prostate tumors.Because a variety of studies have suggested that diabetes mellitus and cancer are frequently coexisting diseases, recently published studies try to explain the influence of diabetes mellitus and anti-diabetic medications on carcinogenesis in different organs.We present the review of the latest studies investigating the association between both diabetes mellitus and anti-diabetic medications and cancer incidence and prognosis.Particularly we highlight the problem of concomitant head and neck cancers in diabetics, rarely analysed and often omitted in studies. PMID:27219686

  12. Conservative treatment modalities in retinoblastoma

    Directory of Open Access Journals (Sweden)

    Bhavna Chawla

    2013-01-01

    Full Text Available Retinoblastoma is the most common primary intraocular malignancy of childhood. A potentially curable cancer, its treatment has improved significantly over the last few decades. The purpose of this article is to review the literature on various conservative treatment modalities available for the treatment of retinoblastoma and their effectiveness, when used alone or in combination. Pubmed, Medline, Embase, and the Cochrane library were searched through 2012 for published peer reviewed data on conservative treatment modalities for retinoblastoma. Various studies show that while enucleation remains the standard of care for advanced intraocular tumors, conservative modalities that can result in globe salvage and preservation of useful vision are being increasingly employed. Such modalities include systemic chemotherapy, focal consolidation with transpupillary thermotherapy, laser photocoagulation and cryotherapy, plaque brachytherapy, and delivery of local chemotherapy using subconjunctival, sub-tenon, or intra-arterial routes. When used alone or in combination, these treatment modalities can help in avoidance of external beam radiotherapy or enucleation, thus reducing the potential for long-term side effects, while salvaging useful vision. Radioactive plaque brachytherapy has an established role in selected patients with intraocular retinoblastoma. Local injections of chemotherapeutic agents via the sub-tenon or sub-conjunctival route have been used with varying degrees of success, usually as an adjunct to systemic chemotherapy. Intra-arterial ophthalmic artery delivery of melphalan has shown promising results. It is important to recognize that today, several treatment options are available that can obviate the need for enucleation, and cure the cancer with preservation of functional vision. A thorough knowledge and understanding of these conservative treatment modalities is essential for appropriate management.

  13. Immunotherapy for non-small cell lung cancer: current concepts and clinical trials.

    Science.gov (United States)

    Mayor, Marissa; Yang, Neng; Sterman, Daniel; Jones, David R; Adusumilli, Prasad S

    2016-05-01

    Recent successes in immunotherapeutic strategies are being investigated to combat cancers that have less than ideal responses to standard of care treatment, such as non-small-cell lung cancer. In this paper, we summarize concepts and the current status of immunotherapy for non-small cell lung cancer, including salient features of the major categories of immunotherapy-monoclonal antibody therapy, immune checkpoint blockade, immunotoxins, anticancer vaccines, and adoptive cell therapy. PMID:26516195

  14. Prostate-specific antigen: does the current evidence support its use in prostate cancer screening?

    LENUS (Irish Health Repository)

    Duffy, Michael J

    2012-02-01

    Although widely used, the value of prostate-specific antigen (PSA) in screening asymptomatic men for prostate cancer is controversial. Reasons for the controversy relate to PSA being less than an ideal marker in detecting early prostate cancer, the possibility that screening for prostate cancer may result in the overdetection and thus overtreatment of indolent disease and the lack of clarity as to the definitive or best treatment for men diagnosed with localized prostate cancer. Although the results from some randomized prospective trials suggest that screening with PSA reduces mortality from prostate cancer, the overall benefit was modest. It is thus currently unclear as to whether the modest benefit of reduced mortality outweighs the harms of overdetection and overtreatment. Thus, prior to undergoing screening for prostate cancer, men should be informed of the risks and benefits of early detection. Newly emerging markers that may complement PSA in the early detection of prostate cancer include specific isoforms of PSA and PCA3.

  15. Curative effects, prognostic factors, and adverse reactions of different treatment modalities of chemotherapy in patients with non-small cell lung cancer

    International Nuclear Information System (INIS)

    Objective: To explore the curative effects,prognostic factors,and adverse reactions of different treatment modalities of chemotherapy in patients with non-small cell lung cancer (NSCLC). Methods: 151 NSCLC patients were randomly assigned into 3 groups to undergo concurrent chemoradiotherapy (n=43), sequential chemo-radiotherapy (n=49), or pure chemotherapy (n=59). The clinical data were analyzed. Results: The short-term effective rates of the concurrent and sequential chemo-radiotherapy groups were 81.4% and 73.5% respectively with no significantly difference between them, but both significantly higher than that of the pure chemotherapy group (39.0%, both P<0.05). The mortality of the concurrent chemo-radiation group was 53.5%, significantly lower than those of the sequential chemo-radiotherapy and pure chemotherapy groups (67.3% and 67.8% respectively, both P<0.05). The median survival time of the concurrent chemo-radiotherapy group was 26 months,significantly longer than those of the sequential chemo-radiotherapy and pure chemotherapy groups (12 and 11 months respectively, both P<0.05). The l-year survival rates of the 3 groups were 80.2%, 47.1%, and 45.6%. The 2-year survival rates were 58.2%, 38.5%, and 24.4%, and the 3-year survival rates were 32.7%, 27.5%, and 0, respectively. The white blood cell decrease rates of the grades Ⅲ∼Ⅳ of the concurrent chemo-radiotherapy group were significantly higher than those of the other 2 groups (both P<0.05). There were no significant differences in the rates of radiation esophagitis and radiation pneumonitis between the concurrent and sequential chemo-radiotherapy groups. Age, performance status score, clinical staging, and treatment modality were the 4 influencing factors in the prognosis of NSCLC (all P<0.05). Conclusion: Relatively safe with tolerable adverse reactions, concurrent chemo-radiotherapy is superior to sequential chemo-radiotherapy, particularly to pure chemotherapy, in increase of median survival time

  16. Prospective, longitudinal, multi-modal functional imaging for radical chemo-IMRT treatment of locally advanced head and neck cancer: the INSIGHT study

    International Nuclear Information System (INIS)

    Radical chemo-radiotherapy (CRT) is an effective organ-sparing treatment option for patients with locally advanced head and neck cancer (LAHNC). Despite advances in treatment for LAHNC, a significant minority of these patients continue to fail to achieve complete response with standard CRT. By constructing a multi-modality functional imaging (FI) predictive biomarker for CRT outcome for patients with LAHNC we hope to be able to reliably identify those patients at high risk of failing standard CRT. Such a biomarker would in future enable CRT to be tailored to the specific biological characteristics of each patients’ tumour, potentially leading to improved treatment outcomes. The INSIGHT study is a single-centre, prospective, longitudinal multi-modality imaging study using functional MRI and FDG-PET/CT for patients with LAHNC squamous cell carcinomas receiving radical CRT. Two cohorts of patients are being recruited: one treated with, and another treated without, induction chemotherapy. All patients receive radical intensity modulated radiotherapy with concurrent chemotherapy. Patients undergo functional imaging before, during and 3 months after completion of radiotherapy, as well as at the time of relapse, should that occur within the first two years after treatment. Serum samples are collected from patients at the same time points as the FI scans for analysis of a panel of serum markers of tumour hypoxia. The primary aim of the INSIGHT study is to acquire a prospective multi-parametric longitudinal data set comprising functional MRI, FDG PET/CT, and serum biomarker data from patients with LAHNC undergoing primary radical CRT. This data set will be used to construct a predictive imaging biomarker for outcome after CRT for LAHNC. This predictive imaging biomarker will be used in future studies of functional imaging based treatment stratification for patients with LAHNC. Additional objectives are: defining the reproducibility of FI parameters; determining robust

  17. Multi-modal imaging of angiogenesis in a nude rat model of breast cancer bone metastasis using magnetic resonance imaging, volumetric computed tomography and ultrasound.

    Science.gov (United States)

    Bäuerle, Tobias; Komljenovic, Dorde; Berger, Martin R; Semmler, Wolfhard

    2012-01-01

    , respectively. DCE-US allows for real-time imaging of vascularization in bone metastases after injection of microbubbles. In conclusion, in a model of site-specific breast cancer bone metastases multi-modal imaging techniques including MRI, VCT and US offer complementary information on morphology and functional parameters of angiogenesis in these skeletal lesions. PMID:22929330

  18. The current status and future prospects of breast cancer screening using ultrasonography at our facility

    International Nuclear Information System (INIS)

    We report the results obtained by breast cancer screening of the general population using both ultrasonography and mammography conducted by the Tochigi Public Health Service Association. An investigation of breast cancer screening carried out on approximately 140,000 participants between 2000 and 2007 showed that ultrasonography and mammography are remarkably complementary for detection of breast cancer, particularly for women in their 40s and 50s, and that each modality improves the sensitivity of breast cancer detection by approximately 20%. The following issues are pivotal for establishing a breast cancer ultrasonography screening system that is able to maintain high precision and adequate efficiency: technical training of sonographers and physicians who must interpret the sonographic images, quality control of equipment, and an interpretation system that allows previous sonographs to be used as a reference. In independent combined screening systems using ultrasonography and mammography, the high recall rate becomes an issue. Comparative interpretation of sonographic images with previous sonographs is effective for resolving this. However, hopes abound for a comprehensive assessment system that allows simultaneous imaging and interpretation of both ultrasonography and mammography. (author)

  19. The Role of VATS in Lung Cancer Surgery: Current Status and Prospects for Development

    Directory of Open Access Journals (Sweden)

    Dariusz Dziedzic

    2015-01-01

    Full Text Available Since the introduction of anatomic lung resection by video-assisted thoracoscopic surgery (VATS 20 years ago, VATS has experienced major advances in both equipment and technique, introducing a technical challenge in the surgical treatment of both benign and malignant lung disease. The demonstrated safety, decreased morbidity, and equivalent efficacy of this minimally invasive technique have led to the acceptance of VATS as a standard surgical modality for early-stage lung cancer and increasing application to more advanced disease. Formerly there was much debate about the feasibility of the technique in cancer surgery and proper lymph node handling. Although there is a lack of proper randomized studies, it is now generally accepted that the outcome of a VATS procedure is at least not inferior to a resection via a traditional thoracotomy.

  20. Prostate Cancer Registries: Current Status and Future Directions

    OpenAIRE

    Gandaglia, G; Bray, F.; Cooperberg, MR; Karnes, RJ; Leveridge, MJ; Moretti, K; Murphy, DG; Penson, DF; Miller, DC

    2016-01-01

    © 2015 European Association of Urology. Context: Disease-specific registries that enroll a considerable number of patients play a major role in prostate cancer (PCa) research. Objective: To evaluate available registries, describe their strengths and limitations, and discuss the potential future role of PCa registries in outcomes research. Evidence acquisition: We performed a literature review of the Medline, Embase, and Web of Science databases. The search strategy included the terms prostate...

  1. CURRENT TREATMENTS FOR UROTHELIAL CANCER OF THE UPPER URINARY TRACT

    OpenAIRE

    S. V. Afonin; M. I. Volkova; V. B. Matveev

    2014-01-01

    TNephroureterectomy is by right considered to be the gold standard for treatment in patients with urothelial cancer of the upper urinary tract. Nevertheless, various surgical treatments are now being intensively developed and introduced into clinical practice and a possibility of using adjuvant and neoadjuvant chemotherapy is also being studied. The review summarizes data on various methods of treatment, its efficiency, long-term results and prognosis.

  2. Ambulatory surgery for the patient with breast cancer: current perspectives

    OpenAIRE

    Tan, Ern Yu; Pek, Chong Han; Tey,Boon Lim, John

    2016-01-01

    Chong Han Pek,1 John Tey,2 Ern Yu Tan1 1Department of General Surgery, 2Department of Anaesthesiology, Intensive Care and Pain Medicine, Tan Tock Seng Hospital, Singapore, Singapore Abstract: Ambulatory breast cancer surgery is well accepted and is the standard of care at many tertiary centers. Rather than being hospitalized after surgery, patients are discharged on the day of surgery or within 23 hours. Such early discharge does not adversely affect patient outcomes and has the added benefit...

  3. Current and emerging therapies for the treatment of pancreatic cancer

    Directory of Open Access Journals (Sweden)

    Rebecca A Moss

    2010-07-01

    Full Text Available Rebecca A Moss, Clifton LeeThe Cancer Institute of New Jersey, New Brunswick, NJ, USAAbstract: Pancreatic adenocarcinoma carries a dismal prognosis and remains a significant cause of cancer morbidity and mortality. Most patients survive less than 1 year; chemotherapeutic options prolong life minimally. The best chance for long-term survival is complete resection, which offers a 3-year survival of only 15%. Most patients who do undergo resection will go on to die of their disease. Research in chemotherapy for metastatic disease has made only modest progress and the standard of care remains the purine analog gemcitabine. For resectable pancreatic cancer, presumed micrometastases provide the rationale for adjuvant chemotherapy and chemoradiation (CRT to supplement surgical management. Numerous randomized control trials, none definitive, of adjuvant chemotherapy and CRT have been conducted and are summarized in this review, along with recent developments in how unresectable disease can be subcategorized according to the potential for eventual curative resection. This review will also emphasize palliative care and discuss some avenues of research that show early promise.Keywords: neoadjuvant therapy, palliative care adeno carcinoma, mortality

  4. Current aspects of radiation-induced cancer risk assessment

    International Nuclear Information System (INIS)

    The agenda of the closed meeting of the commission shows the following main topics: 1) Recent dosimetry /Ro 87/ and new data on cancer mortality in the Atomic Bomb survivors of Hiroshima and Nagasaki as a function of age at the time of exposure /Pr 87; Si 87; IC 87.1/. 2) Models and assumptions given in the epidemiological tables of the U.S. National Institute of Health (NIH) /NIH 85/ for assessment of probability of cancer induction due to exposure to ionizing radiation (probability of causation), and possibilities of interpreting these data so as to match them with conditions in the F.R.G. 3) Results of epidemiological studies with occupationally exposed persons working in nuclear installations or medical establishments, and with population groups living in the environs of nuclear installations. 4) Recent knowledge about radon-induced lung cancer, and recommendations of and measures taken by other countries for reducing radon concentrations in buildings. The summarizing appraisals and recommendations agreed upon by the SSK members upon discussion of the items are given in this publication. (orig./MG) With 31 figs., 41 tabs

  5. Imaging in primary penile cancer: current status and future directions

    Energy Technology Data Exchange (ETDEWEB)

    Kochhar, Rohit; Taylor, Ben [Christie, NHS Foundation Trust, Department of Radiology, Manchester (United Kingdom); Sangar, Vijay [Christie, NHS Foundation Trust, Department of Urology, Manchester (United Kingdom)

    2010-01-15

    Penile cancer is a rare neoplasm in the developed world. Clinical assessment often results in inaccurate staging and radiological techniques have a key role in staging and postoperative assessment. Magnetic resonance imaging (MRI) depicts penile anatomy in detail and is the most accurate technique for local staging and postoperative follow-up. MRI and ultrasound (US), although helpful for assessment of lymph nodes, are not reliable enough for accurate nodal staging. US-guided fine needle aspiration cytology (FNAC), however, remains a valuable tool to confirm metastases in suspicious inguinal nodes. Lymphoscintigraphy with dynamic sentinel node biopsy (DSNB) is a promising technique used to predict occult lymph node metastases. Novel imaging techniques such as positron emission tomography/computed tomography (PET-CT) and nanoparticle enhanced MRI have high sensitivity and specificity for lymph node metastases but their availability is limited and clinical utility is not fully established. The radiologist needs to be familiar with the normal penile anatomy, imaging appearances of pre- and post-treatment penile cancer, and the advantages and limitations of the available imaging techniques. This review highlights the above points and presents a systematic approach to make the best use of imaging in the management of patients with penile cancer. (orig.)

  6. Operational Modal Analysis Tutorial

    DEFF Research Database (Denmark)

    Brincker, Rune; Andersen, Palle

    In this paper the basic principles in operational modal testing and analysis are presented and discussed. A brief review of the techniques for operational modal testing and identification is presented, and it is argued, that there is now a wide range of techniques for effective identification of...... modal parameters of practical interest - including the mode shape scaling factor - with a high degree of accuracy. It is also argued that the operational technology offers the user a number of advantages over traditional modal testing. The operational modal technology allows the user to perform a modal...

  7. Dosimetric comparison in a cancer of the Cervix with different therapeutic modalities; Comparacion dosimetrica en un cancer de Cervix con distintas modalidades terapeuticas

    Energy Technology Data Exchange (ETDEWEB)

    Alonso Iracheta, L.; Casa de Julian, M. A. de la; Samper Ots, P.; Penas Cabrera, M. D. de las; Jimenez Gonzalez, J. M.

    2013-07-01

    Cervical cancer is usually treated with radiotherapy composed of 3D (RC3D) and supine position, and is usually not usually outline the small intestine in cases of exclusively pelvic irradiation. In our Center we wanted to check what dose receives the small intestine in these cases and if the positioning of the patient or used irradiation technique influence the distribution of the histogram dose-volume. (Author)

  8. Outcome of combined modality treatment including neoadjuvant chemotherapy of 128 cases of locally advanced breast cancer: Data from a tertiary cancer center in northern India

    Directory of Open Access Journals (Sweden)

    V Raina

    2011-01-01

    Full Text Available Background: Breast cancer is now the most common cancer in many parts of India and the incidence varies from 12 to 31/100000, and is rising. Locally advanced breast cancer (LABC accounts for 30 - 35% of all cases of breast cancers in India. LABC continues to present a challenge and imposes a major health impact in our country. Materials and Methods: We carried out a analysis of our LABC patients who received neoadjuvant chemotherapy (NACT at our hospital over a 10-year period, from January 1995 to December 2004. We analyzed the response to NACT, disease-free survival (DFS, and overall survival (OS. Results: Patients with stages IIIA, IIIB, and IIIC were included. LABC comprised of 26.24% (609 patients of new patients. One hundred and twenty-eight (31.1% patients received NACT. Median age was 48 years and estrogen receptor was positive in 64%. Chemotherapy protocol was an FEC (5-Fluorouracil, Epirubicin, Cyclophosphamide regimen in the following doses: Cyclophosphamide 600 mg/m2, 5-FU 600 mg/m2, and Epirubicin 75 mg/m2 given every three weeks, six doses, followed by modified radical mastectomy (MRM and locoregional radiotherapy. The overall response rate (complete response (CR + partial response (PR was 84.4%, clinical CR (cCR was 13.3% and pathological CR (pCR was 7.8%. Median DFS and OS were 33 and 101 months, respectively. The disease-free survival (DFS and overall survival (OS at five years were 41 and 58%, respectively. Conclusions: This study analyzes the outcome in patients who received NACT, in the largest number of LABC patients from a single center in India, and our results are comparable to the results reported from other centers.

  9. Current status and implications of microRNAs in ovarian cancer diagnosis and therapy

    Directory of Open Access Journals (Sweden)

    Zaman Mohd Saif

    2012-12-01

    Full Text Available Abstract Ovarian cancer is the fifth most common cancer among women and causes more deaths than any other type of female reproductive cancer. Currently, treatment of ovarian cancer is based on the combination of surgery and chemotherapy. While recurrent ovarian cancer responds to additional chemotherapy treatments, the progression-free interval becomes shorter after each cycle, as chemo-resistance increases until the disease becomes incurable. There is, therefore, a strong need for prognostic and predictive markers to help optimize and personalize treatment in order to improve the outcome of ovarian cancer. An increasing number of studies indicate an essential role for microRNAs in ovarian cancer progression and chemo-resistance. MicroRNAs (miRNAs are small endogenous non-coding RNAs (~22bp which are frequently dysregulated in cancer. Typically, miRNAs are involved in crucial biological processes, including development, differentiation, apoptosis and proliferation. Two families of miRNAs, miR-200 and let-7, are frequently dysregulated in ovarian cancer and have been associated with poor prognosis. Both have been implicated in the regulation of epithelial-to-mesenchymal transition, a cellular transition associated with tumor aggressiveness, tumor invasion and chemo-resistance. Moreover, miRNAs also have possible implications for improving cancer diagnosis; for example miR-200 family, let-7 family, miR-21 and miR-214 may be useful in diagnostic tests to help detect ovarian cancer at an early stage. Additionally, the use of multiple target O-modified antagomirs (MTG-AMO to inhibit oncogenic miRNAs and miRNA replacement therapy for tumor suppressor miRNAs are essential tools for miRNA based cancer therapeutics. In this review we describe the current status of the role miRNAs play in ovarian cancer and focus on the possibilities of microRNA-based therapies and the use of microRNAs as diagnostic tools.

  10. Radionuclide liver cancer therapies: from concept to current clinical status.

    Science.gov (United States)

    Vente, Maarten A D; Hobbelink, Monique G G; van Het Schip, Alfred D; Zonnenberg, Bernard A; Nijsen, Johannes F W

    2007-07-01

    Primary and secondary liver cancer have longtime been characterized by an overall poor prognosis since the majority of patients are not candidates for surgical resection with curative intent, systemic chemotherapy alone has rarely resulted in long-term survival, and the role of conventional external beam radiation therapy has traditionally been limited due to the relative sensitivity of the liver parenchyma to radiation. Therefore, a host of new treatment options have been developed and clinically introduced, including radioembolization techniques, which are the main topic of this paper. In these locoregional treatments liver malignancies are passively targeted because, unlike the normal liver, the blood supply of intrahepatic tumors is almost uniquely derived from the hepatic artery. These internal radiation techniques consist of injecting either yttrium-90 ((90)Y) microspheres, or iodine-131 ((131)I) or rhenium-188 ((188)Re) labeled lipiodol into the hepatic artery. Radioactive lipiodol is used exclusively for treatment of primary liver cancer, whereas (90)Y microsphere therapy is applied for treatment of both primary and metastatic liver cancers. Favorable clinical results have been achieved, particularly when (90)Y microspheres were used in conjunction with systemic chemotherapy. The main advantages of radiolabeled lipiodol treatment are that it is relatively inexpensive (especially (188)Re-HDD-lipiodol) and that the administration procedure is somewhat less complex than that of the microspheres. Holmium-166 ((166)Ho) loaded poly(L-lactic acid) microspheres have also been developed and are about to be clinically introduced. Since (166)Ho is a combined beta-gamma emitter and highly paramagnetic as well, it allows for both (quantitative) scintigraphic and magnetic resonance imaging. PMID:17630919

  11. High risk bladder cancer: current management and survival

    Directory of Open Access Journals (Sweden)

    Anna M. Leliveld

    2011-04-01

    Full Text Available PURPOSE: To evaluate the pattern of care in patients with high risk non muscle invasive bladder cancer (NMIBC in the Comprehensive Cancer Center North-Netherlands (CCCN and to assess factors associated with the choice of treatment, recurrence and progression free survival rates. MATERIALS AND METHODS: Retrospective analysis of 412 patients with newly diagnosed high risk NMIBC. Clinical, demographic and follow-up data were obtained from the CCCN Cancer Registry and a detailed medical record review. Uni and multivariate analysis was performed to identify factors related to choice of treatment and 5 year recurrence and progression free survival. RESULTS: 74/412 (18% patients with high risk NMIBC underwent a transurethral resection (TUR as single treatment. Adjuvant treatment after TUR was performed in 90.7% of the patients treated in teaching hospitals versus 71.8 % in non-teaching hospitals (p 80 years OR 0.1 p = 0.001 and treatment in non-teaching hospitals (OR 0.25; p < 0.001 were associated with less adjuvant treatment after TUR. Tumor recurrence occurred in 191/392 (49% and progression in 84 /392 (21.4% patients. The mean 5-years progression free survival was 71.6% (95% CI 65.5-76.8. CONCLUSION: In this pattern of care study in high risk NMIBC, 18% of the patients were treated with TUR as single treatment. Age and treatment in non-teaching hospitals were associated with less adjuvant treatment after TUR. None of the variables sex, age, comorbidity, hospital type, stage and year of treatment was associated with 5 year recurrence or progression rates.

  12. [Current status of castration-resistant prostate cancer translational research].

    Science.gov (United States)

    Maeno, Atsushi; Habuchi, Tomonori

    2016-01-01

    Recently, new drugs including abiraterone and enzalutamide have been able to be used for castration resistant prostate cancer(CRPC) patients. However, a subset of these patients who receive the new drugs does not response to the therapies. Furthermore, most patients who initially response to the drugs, progress to secondary resistance eventually. Therefore, it is important to investigate a novel therapeutic target and a novel treatment-selection marker for CRPC. In this review, we focused on AR-V7, TMPRSS2-ERG fusion gene and EP4 antagonist as representative translational researches. PMID:26793877

  13. Prostate Cancer Screening, Yes or No? the Current Controversy

    Directory of Open Access Journals (Sweden)

    Ali Razi

    2004-06-01

    Full Text Available

    Purpose: The increasing incidence of prostate cancer and different viewpoints of medical authorities to it, has lead to conversion of preliminary plan of screening test to a requisite. The objective of this study is to clarify the obscure aspects of this subject using the literature review.

    Materials and Methods: We reviewed the following items in the literature: prostate cancer screening, introduction of relevant tests, screening criteria according to World Health Organization, screening experience in different countries, community notification, specialists training in order to establish an integrated approach and treatment, anxiety relief, and promotion of patient awareness in this field.

    Results: It has been shown that, except in China, programmed and official screening of prostatic cancer has not been accepted by concordant responsible authorities, neither in developed countries nor in developing ones. However, it is performed informally in different parts of the world.

    Conclusion: There is no unanimous consensus about performance of screening for prostate cancer. Continuing

  14. Personal characteristics, therapy modalities and individual DNA repair capacity as predictive factors of acute skin toxicity in an unselected cohort of breast cancer patients receiving radiotherapy

    International Nuclear Information System (INIS)

    Background and purpose: Intrinsic and extrinsic factors can affect the occurrence of side effects of radiotherapy. The influence of therapy modalities, personal characteristics and individual DNA repair capacity on the risk of acute skin toxicity was thus evaluated. Materials and methods: In a prospective study of 478 female breast cancer patients receiving adjuvant radiotherapy of the breast after breast-conserving surgery, acute skin toxicity was documented systematically using a modified version of the common toxicity criteria. Prognostic personal and treatment characteristics were identified for the entire cohort. Individual DNA repair capacity was determined in a subgroup of 113 patients with alkaline comet assay using phytohemagglutinin stimulated lymphocytes. Using proportional hazards analysis to account for cumulative biologically effective radiation dose, the hazard for the development of acute skin reactions (moist desquamation) associated with DNA repair capacity was modeled. Results: Of the 478 participants, 84 presented with acute reactions by the end of treatment. Higher body mass index was significantly associated with an increased risk for acute reactions (hazard ratio=1.09 per 1 kg/m2), adjusted for treating hospital and photon beam quality. The comet assay parameters examined, including background DNA damage in non-irradiated cells, DNA damage induced by 5 Gy, and DNA repair capacity, were not significantly associated with risk of acute skin toxicity. Conclusions: Higher BMI is predictive of acute skin toxicity, however, individual repair parameters as determined by the alkaline comet assay are not informative enough. More comprehensive analyses including late effects of radiotherapy and repair kinetics optimized for different radiation-induced DNA lesions are warranted

  15. Focal therapy for prostate cancer: current status and future perspectives.

    Science.gov (United States)

    Miano, R; Asimakopoulos, A; Da Silva, R; Bove, P; Jones, S; De La Rosette, J; Kim, F

    2015-09-01

    Focal therapy is a relatively new and extremely attractive option of treatment for prostate cancer. It has been described as the "middle approach" between active surveillance and radical treatment, aiming to destroy the tumor itself or the region containing the tumor in order to preserve surrounding non-cancerous tissue. The goal is to maintain disease control at acceptable levels, while preserving erectile, urinary, and rectal function. While a lot of technologies have been described for delivering targeted therapy to the prostate, such as cryoablation, high intensity focused ultrasound, photodynamic therapy, irreversible electroporation and laser, the key point is the patient selection. Recent advances in mpMRI and the introduction of new biopsy techniques that use MR images as a guidance, have significantly improved localization of the tumor lesions and the detection rate, evolving prostate biopsy toward targeted rather than systematic biopsies. The future challenge to clinicians is to precisely risk-stratify patients to differentiate between those who would profit from focal treatment and who would not. Forthcoming research efforts should pursue to identify molecular, genetic, and imaging characteristics that distinguish aggressive prostate tumors from indolent lesions. PMID:26013953

  16. Berry fruits for cancer prevention: current status and future prospects.

    Science.gov (United States)

    Seeram, Navindra P

    2008-02-13

    Overwhelming evidence suggests that edible small and soft-fleshed berry fruits may have beneficial effects against several types of human cancers. The anticancer potential of berries has been related, at least in part, to a multitude of bioactive phytochemicals that these colorful fruits contain, including polyphenols (flavonoids, proanthocyanidins, ellagitannins, gallotannins, phenolic acids), stilbenoids, lignans, and triterpenoids. Studies show that the anticancer effects of berry bioactives are partially mediated through their abilities to counteract, reduce, and also repair damage resulting from oxidative stress and inflammation. In addition, berry bioactives also regulate carcinogen and xenobiotic metabolizing enzymes, various transcription and growth factors, inflammatory cytokines, and subcellular signaling pathways of cancer cell proliferation, apoptosis, and tumor angiogenesis. Berry phytochemicals may also potentially sensitize tumor cells to chemotherapeutic agents by inhibiting pathways that lead to treatment resistance, and berry fruit consumption may provide protection from therapy-associated toxicities. Although a wide variety of berry fruits are consumed worldwide, this paper focuses on those commonly consumed in North America, namely, blackberries, black raspberries, blueberries, cranberries, red raspberries, and strawberries. In addition, a large body of studies on singly purified berry bioactives is available, but this paper focuses on studies of "whole berries" per se, that is, as berry extracts and purified fractions, juices, and freeze-dried powders. Potential mechanisms of anticancer action and bioavailability of berry phenolics, as well as gaps in knowledge and recommendations for future berry research, are also briefly discussed. PMID:18211019

  17. Chemoprevention of prostate cancer: current status and future directions.

    Science.gov (United States)

    Lieberman, Ronald

    2002-01-01

    Prostate cancer chemoprevention can be described as the administration of natural products and pharmaceutical agents that inhibit one or more steps in the natural history of prostatic carcinogenesis. The principle components of the chemoprevention strategy are closely connected to this natural history and include: (a) agents and their molecular targets; (b) strategic intermediate endpoint biomarkers (IEBs) and their critical pathways; (c) cohorts identified by genetic and acquired risk factors and (d) efficient designs that combine these elements into a cohesive clinical trial. The primary goal is to find effective noncytotoxic agents that modulate the promotion and progression from normal epithelium to dysplasia to high-grade prostatic intraepithelial neoplasia (HGPIN) to locally invasive cancer and metastatic disease. Another important target for chemoprevention is to modulate progression to clinically aggressive disease and to maintain an androgen-sensitive clinical state and delay the emergence of androgen resistance. There is a rationale for use of antiandrogens as the lead class, e.g., 5 alpha receptor inhibitors (5ARI), for chemoprevention of prostate cancer. Nevertheless, the desire to improve the therapeutic index, achieve synergy (5ARI may have only modest anticancer effects) and prevent the emergence of drug (androgen) resistance provide incentives for developing other effective agents and combinations. The availability of more than a dozen classes of noncytotoxic pharmaceutical and natural products already in clinical development create many opportunities for rational combination therapy. Several agent classes have a pharmacodynamic basis for combination with antiandrogens including antiproliferatives, selective estrogen receptor modulators (SERMs), proapoptotic antioxidant micronutrients and selective cyclo-oxygenase (COX)-2 inhibitors. Many other rational pharmacodynamic combinations without antiandrogens are feasible. It is anticipated that in the

  18. Targeting cancer testis antigens for biomarkers and immunotherapy in colorectal cancer: Current status and challenges

    Institute of Scientific and Technical Information of China (English)

    Anil; Suri; Nirmala; Jagadish; Shikha; Saini; Namita; Gupta

    2015-01-01

    Colorectal cancer ranks third among the estimatedcancer cases and cancer related mortalities in United States in 2014. Early detection and efficient therapy remains a significant clinical challenge for this disease. Therefore, there is a need to identify novel tumor asso-ciated molecules to target for biomarker development and immunotherapy. In this regard, cancer testis antigens have emerged as a potential targets for developing novel clinical biomarkers and immunotherapy for various malignancies. These germ cell specific proteins exhibit aberrant expression in cancer cells and contribute in tumorigenesis. Owing to their unique expression profile and immunogenicity in cancer patients, cancer testis antigens are clinically referred as the most promising tumor associated antigens. Several cancer testis antigens have been studied in colorectal cancer but none of them could be used in clinical practice. This review is an attempt to address the promising cancer testis antigens in colorectal cancer and their possible clinical implications as biomarkers and immunotherapeutic targets with particular focus on challenges and future interventions.

  19. Current situation of interventional treatment for non-small cell lung cancer

    International Nuclear Information System (INIS)

    Primary bronchogenic carcinoma, which referred to as lung cancer, is one of the most common malignant tumors in china. The 2010 China Health Statistical Yearbook indicates that in 2005 the mortality of lung cancer was at the first place of all cancers. Non-small-cell lung cancer (NSCLC) accounts for 8.5% of all the lung cancers, most of the patents are diagnosed in their late stages and have lost the chance of operation resection, and the 5-year survival rate is only about 15%. Being of technical simplicity, mild side reaction, satisfactory local effect and reliable reproducibility, interventional therapy has become an important and non-surgical method for advanced NSCLC, and has been widely applied in clinical practice. This paper aims to make a review about the current situation of interventional treatment for non-small cell lung cancer. (authors)

  20. Interval to Biochemical Failure Predicts Clinical Outcomes in Patients With High-Risk Prostate Cancer Treated by Combined-Modality Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Shilkrut, Mark; McLaughlin, P. William [Department of Radiation Oncology, University of Michigan Health System, Ann Arbor, Michigan (United States); Merrick, Gregory S. [Schiffler Cancer Center, Wheeling Jesuit University, Wheeling, West Virginia (United States); Vainshtein, Jeffrey M.; Feng, Felix Y. [Department of Radiation Oncology, University of Michigan Health System, Ann Arbor, Michigan (United States); Hamstra, Daniel A., E-mail: dhamm@med.umich.edu [Department of Radiation Oncology, University of Michigan Health System, Ann Arbor, Michigan (United States)

    2013-07-15

    Purpose: To validate the prognostic value of interval to biochemical failure (IBF) in patients with high-risk prostate cancer (HiRPCa) treated with combined-modality radiation therapy (CMRT) with or without androgen deprivation therapy (ADT). Methods and Materials: We conducted a retrospective review of HiRPCa (prostate-specific antigen >20 ng/mL, Gleason score [GS] 8-10, or clinical T stage T3-T4) treated with either dose-escalated external beam radiation therapy (EBRT) or CMRT. Interval to biochemical failure was classified as ≤18 or >18 months from the end of all therapy to the date of biochemical failure (BF). Kaplan-Meier methods and Cox proportional hazards regression were used to evaluate the prognostic value of IBF ≤18 months for distant metastasis (DM) and prostate cancer-specific mortality (PCSM). Results: Of 958 patients with a median follow-up of 63.2 months, 175 patients experienced BF. In those with BF, there were no differences in pretreatment clinical characteristics between the EBRT and CMRT groups, except for a higher proportion of patients with GS 8-10 in the CMRT group (70% vs 52%, P=.02). Median IBF after all therapy was 24.0 months (interquartile range 9.6-46.0) in the EBRT group and 18.9 months (interquartile range 9.2-34.5) in the CMRT group (P=.055). On univariate analysis, IBF ≤18 months was associated with increased risk of DM and PCSM in the entire cohort and the individual EBRT and CMRT groups. On multivariate analysis, only GS 9-10 and IBF ≤18 months, but not the radiation therapy regimen or ADT use, predicted DM (hazard ratio [HR] 3.7, P<.01, 95% confidence interval [CI] 1.4-10.3 for GS 9-10; HR 3.9, P<.0001, 95% CI 2.4-6.5 for IBF ≤18 months) and PCSM (HR 14.8, P<.009, 95% CI 2.0-110 for GS 9-10; HR 4.4, P<.0001, 95% CI 2.4-8.1 for IBF ≤18 months). Conclusions: Short IBF was highly prognostic for higher DM and PCSM in patients with HiRPCa. The prognostic value of IBF for DM and PCSM was not affected by the radiation

  1. Current principles of effective therapy for ovarian cancer

    Directory of Open Access Journals (Sweden)

    L. A. Ashrafyan

    2015-01-01

    Full Text Available In spite of all of modern medicine»s advances, ovarian cancer (OC mortality remains to be incommensurably high and to hold the lead among gynecological cancers. The initial cause of this deplorable statistics is the absence of a clear concept of the pathogenesis of OC and hence the justified prevention and methodology of early diagnosis of the disease; in this connection, therapy that proves to be ineffective is frequently used by medical oncologists in their daily practice. As a consequence, there is a high proportion of its further progression: the rates of early and late recurrences were about 30 and 60–65 %, respectively; most of which are drug resistant to further chemotherapy cycles. By taking into account these strikingly modest statistics, it becomes apparent that oncologists desire to make changes in the existing treatment regimen to achieve meaningful results. To use target drugs is one of these promising areas owing to new views on the concept of the pathogenesis of OC.Nevertheless, considering a wide variety of the signaling cascades and molecules, which are involved in the process of carcinogenesis, even target compounds, if they have only one point of application, cannot always produce their desirable therapeutic effect and their co-administration is responsible for high toxicity. In this light, the most effective drugs are indole-3-carbinol and epigallocathechin-3-gallate, which virtually cause no adverse reactions and can block various molecular targets at different levels of the mechanism of malignant transformation. Based on L. A. Ashrafyan, s concept of two pathogenetic variants of sporadic OC (2009 and on the recent findings in molecular biology and epigenetics, the incorporation of the above medications into the standard treatment regimen for OC should increase survival rates and change the nature of recurrence by that of more locally advanced forms. On this basis, a clinical trial was carried out to study

  2. Preserving fertility in young patients with endometrial cancer: current perspectives

    Directory of Open Access Journals (Sweden)

    Kalogera E

    2014-07-01

    Full Text Available Eleftheria Kalogera, Sean C Dowdy, Jamie N Bakkum-Gamez Division of Gynecologic Surgery, Mayo Clinic, Rochester, MN, USA Abstract: Endometrial cancer (EC is the most common gynecologic malignancy in developed countries and affects predominantly postmenopausal women. It is estimated, however, that 15%–25% of women will be diagnosed before menopause. As more women choose to defer childbearing until later in life, the feasibility and safety of fertility-sparing EC management have been increasingly studied. Definitive treatment of total hysterectomy and bilateral salpingo-oophorectomy precludes future fertility and may thus be undesirable by women who wish to maintain their reproductive potential. However, the consideration of conservative management carries the oncologic risks of unstaged EC and the risk of missing a synchronous ovarian cancer. It is further complicated by the lack of consensus regarding the initial assessment, treatment, and surveillance. Conservative treatment with progestins has been shown to be a feasible and safe fertility-sparing approach for women with low grade, early stage EC with no myometrial invasion. The two most commonly adopted regimens are medroxyprogesterone acetate at 500–600 mg daily and megestrol acetate at 160 mg daily for a minimum of 6–9 months, with initial response rates commonly reported between 60% and 80% and recurrence rates between 25% and 40%. Photodynamic therapy and hysteroscopic EC excision have recently been reported as alternative approaches to progestin therapy alone. However, limited efficacy and safety data exist. Live birth rates after progestin therapy have typically been reported around 30%; however, when focusing only on those who do pursue fertility after successful treatment, the live birth rates were found to be higher than 60%. Assisted reproductive technology has been associated with a higher live birth rate compared with spontaneous conception, most likely reflecting the

  3. Experimental modal analysis

    DEFF Research Database (Denmark)

    Ibsen, Lars Bo; Liingaard, Morten

    This technical report concerns the basic theory and principles for experimental modal analysis. The sections within the report are: Output-only modal analysis software (section 1.1), general digital analysis (section 1.2), basics of structural dynamics and modal analysis (section 1.3) and system...

  4. Radon and lung cancer - history and current issues

    International Nuclear Information System (INIS)

    Its historical roots date back to the late middle ages when silver mining was started in the Schneeberg region. Today the problem of mining-associated exposure to radon persists in uranium mining. In addition there is the problem of radon exposure in building which has been detected some 20 years ago. The author briefly surveys the history and causes of radon exposure and resulting issues of modern radiation protection. Inhalation of indoor-air-borne radon decay products in buildings consitutes the greatest shave of the population's exposure to natural and artificial radiation sources. Next to tobacco smoking, these natural radionuclides have to be rated as the most important environmental noxions agent for lung cancer induction. (Uhe)

  5. Cytochrome P450-based cancer gene therapy: current status.

    Science.gov (United States)

    Kan, On; Kingsman, Susan; Naylor, Stuart

    2002-12-01

    Results from a number of preclinical studies have demonstrated that a P450-based gene-directed enzyme prodrug therapy (GDEPT) strategy for the treatment of cancer is both safe and efficacious. This strategy has now moved forward into the clinic. At least two different approaches using different delivery methods (retroviral vector MetXia [Oxford BioMedica] and encapsulated P450 expressing cells), different cytochrome P450 isoforms (human CYP2B6 versus rat CYP2B1) and different prodrugs (cyclophosphamide [CPA] versus ifosfamide [IFA]) have concluded Phase I/II clinical trial with encouraging results. In the future, P450-based GDEPT can potentially be further enhanced by improved vectors for P450 gene delivery and disease-targeted promoters for focused gene expression at the target site. In addition, there is scope for developing synthetic P450s and their respective prodrugs to improve both enzyme kinetics and the profile of the active moiety. PMID:12517265

  6. Imaging and intervention in prostate cancer: Current perspectives and future trends

    Directory of Open Access Journals (Sweden)

    Sanjay Sharma

    2014-01-01

    Full Text Available Prostate cancer is the commonest malignancy in men that causes significant morbidity and mortality worldwide. Screening by digital rectal examination (DRE and serum prostate-specific antigen (PSA is used despite its limitations. Gray-scale transrectal ultrasound (TRUS, used to guide multiple random prostatic biopsies, misses up to 20% cancers and frequently underestimates the grade of malignancy. Increasing the number of biopsy cores marginally increases the yield. Evolving techniques of real-time ultrasound elastography (RTE and contrast-enhanced ultrasound (CEUS are being investigated to better detect and improve the yield by allowing "targeted" biopsies. Last decade has witnessed rapid developments in magnetic resonance imaging (MRI for improved management of prostate cancer. In addition to the anatomical information, it is capable of providing functional information through diffusion-weighted imaging (DWI, magnetic resonance spectroscopy (MRS, and dynamic contrast-enhanced (DCE MRI. Multi-parametric MRI has the potential to exclude a significant cancer in majority of cases. Inclusion of MRI before prostatic biopsy can reduce the invasiveness of the procedure by limiting the number of cores needed to make a diagnosis and support watchful waiting in others. It is made possible by targeted biopsies as opposed to random. With the availability of minimally invasive therapeutic modalities like high-intensity focused ultrasound (HIFU and interstitial laser therapy, detecting early cancer is even more relevant today. [18F]--fluorodeoxyglucose positron emission tomography/computed tomography ( 18 FDG PET/CT has no role in the initial evaluation of prostate cancer. Choline PET has been recently found to be more useful. Fluoride-PET has a higher sensitivity and resolution than a conventional radionuclide bone scan in detecting skeletal metastases.

  7. Current status of cancer immunodetection with radiolabeled human monoclonal antibodies.

    Science.gov (United States)

    De Jager, R; Abdel-Nabi, H; Serafini, A; Pecking, A; Klein, J L; Hanna, M G

    1993-04-01

    The use of radiolabeled murine monoclonal antibodies (MoAbs) for cancer immunodetection has been limited by the development of human antimouse antibodies (HAMA). Human monoclonal antibodies do not elicit a significant human antihuman (HAHA) response. The generation and production of human monoclonal antibodies met with technical difficulties that resulted in delaying their clinical testing. Human monoclonal antibodies of all isotypes have been obtained. Most were immunoglobulin (Ig) M directed against intracellular antigens. Two antibodies, 16.88 (IgM) and 88BV59 (IgG3k), recognize different epitopes on a tumor-associated antigen, CTA 16.88, homologous to cytokeratins 8, 18, and 19. CTA 16.88 is expressed by most epithelial-derived tumors including carcinomas of the colon, pancreas, breast, ovary, and lung. The in vivo targeting by these antibodies is related to their localization in nonnecrotic areas of tumors. Repeated administration of 16.88 over 5 weeks to a cumulative dose of 1,000 mg did not elicit a HAHA response. Two of 53 patients developed a low titer of HAHA 1 to 3 months after a single administration of 88BV59. Planar imaging of colorectal cancer with Iodine-131 (131I)-16.88 was positive in two studies in 9 of 12 and 16 of 20 patients preselected by immunohistochemistry. Tumors less than 2 cm in diameter are usually not detected. The lack of immunogenicity and long tumor residence time (average = 17 days) makes 16.88 a good candidate for therapy. Radioimmunlymphoscintigraphy with indium-111 (111In)-LiLo-16.88 administered by an intramammary route was used in the presurgical staging of primary breast cancer. The negative predictive value of lymph node metastases for tumors less than 3 cm was 90.5%. Planar and single photon emission computed tomography imaging of colorectal carcinoma with technetium-99m (99mTc) 88BV59 was compared with computed tomography (CT) scan in 36 surgical patients. The antibody scan was more sensitive than the CT scan in detecting

  8. Current opinion on lymphadenectomy in pancreatic cancer surgery

    Institute of Scientific and Technical Information of China (English)

    Theodoros E Pavlidis; Efstathios T Pavlidis; Athanasios K Sakantamis

    2011-01-01

    BACKGROUND: Adenocarcinoma of the pancreas exhibits aggressive behavior in growth, inducing an extremely poor prognosis with an overall median 5-year survival rate of only 1%-4%. Curative resection is the only potential therapeutic opportunity. DATA  SOURCES: A PubMed search of relevant articles published up to 2009 was performed to identify information about the value of lymphadenectomy and its extent in curative resection of pancreatic adenocarcinoma. RESULTS: Despite recent advances in chemotherapy, radio-therapy or even immunotherapy, surgery still remains the major factor that affects the outcome. The initial promising performance in Japan gave conflicting results in Western countries for the extended and more radical pancreatectomy;it has failed to prove beneficial. Four prospective, randomized trials on extended versus standard lymphadenectomy during pancreatic cancer surgery have shown no improvement in long-term survival by the extended resection. The exact lymph node status, including malignant spread and the total number retrieved as well as the lymph node ratio, is the most important prognostic factor. Positive lymph nodes after pancreatectomy are present in 70%. Paraaortic lymph node spread indicates poor prognosis. CONCLUSIONS: Undoubtedly, a standard lymphadenectomy including >15 lymph nodes must be no longer preferred in patients with the usual head location. The extended lymphadenectomy does not have any place, unless in randomized trials. In cases with body or tail location, the radical antegrade modular pancreatosplenectomy gives promising results. Nevertheless, accurate localization and detailed examination of the resected specimen are required for better staging.

  9. Anesthesia and cancer recurrences: The current knowledge and evidence

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2015-01-01

    Full Text Available Surgical removal of solid tumors is of utmost importance as total resection can be curative. The surgical insult however itself may result in tumor micrometastasis coupled with depression of cell-mediated immunity culminating in tumor recurrence. Recent research suggests that few anesthetic agents or procedures can influence pathophysiology of metastasis in the postoperative period. Whereas opioids and volatile anesthetics have been implicated in angiogenesis and immunosuppression, evidences accumulated over the recent years have undoubtedly highlighted the attenuation of immunosuppression by regional anesthetic agents thereby making it superior over general anesthesia in preventing cancer recurrence. As anesthetic drugs are given at that time when patient is at the maximum risk of spread of metastasis, thus an understanding of the effect of anesthesia drugs and their impact on tumor metastasis is important so that appropriate anesthetic strategy can be made to improve long term survival in these patients. The purpose of the present review is therefore to emphasize the pivotal role of various anesthetic agents and anesthesia techniques in preventing tumor recurrence after surgery.

  10. Multi-Modality Phantom Development

    Energy Technology Data Exchange (ETDEWEB)

    Huber, Jennifer S.; Peng, Qiyu; Moses, William W.

    2009-03-20

    Multi-modality imaging has an increasing role in the diagnosis and treatment of a large number of diseases, particularly if both functional and anatomical information are acquired and accurately co-registered. Hence, there is a resulting need for multi modality phantoms in order to validate image co-registration and calibrate the imaging systems. We present our PET-ultrasound phantom development, including PET and ultrasound images of a simple prostate phantom. We use agar and gelatin mixed with a radioactive solution. We also present our development of custom multi-modality phantoms that are compatible with PET, transrectal ultrasound (TRUS), MRI and CT imaging. We describe both our selection of tissue mimicking materials and phantom construction procedures. These custom PET-TRUS-CT-MRI prostate phantoms use agargelatin radioactive mixtures with additional contrast agents and preservatives. We show multi-modality images of these custom prostate phantoms, as well as discuss phantom construction alternatives. Although we are currently focused on prostate imaging, this phantom development is applicable to many multi-modality imaging applications.

  11. Gastric cancer: Current status of lymph node dissection.

    Science.gov (United States)

    Degiuli, Maurizio; De Manzoni, Giovanni; Di Leo, Alberto; D'Ugo, Domenico; Galasso, Erica; Marrelli, Daniele; Petrioli, Roberto; Polom, Karol; Roviello, Franco; Santullo, Francesco; Morino, Mario

    2016-03-14

    D2 procedure has been accepted in Far East as the standard treatment for both early (EGC) and advanced gastric cancer (AGC) for many decades. Recently EGC has been successfully treated with endoscopy by endoscopic mucosal resection or endoscopic submucosal dissection, when restricted or extended Gotoda's criteria can be applied and D1+ surgery is offered only to patients not fitted for less invasive treatment. Furthermore, two randomised controlled trials (RCTs) have been demonstrating the non inferiority of minimally invasive technique as compared to standard open surgery for the treatment of early cases and recently the feasibility of adequate D1+ dissection has been demonstrated also for the robot assisted technique. In case of AGC the debate on the extent of nodal dissection has been open for many decades. While D2 gastrectomy was performed as the standard procedure in eastern countries, mostly based on observational and retrospective studies, in the west the Medical Research Council (MRC), Dutch and Italian RCTs have been conducted to show a survival benefit of D2 over D1 with evidence based medicine. Unfortunately both the MRC and the Dutch trials failed to show a survival benefit after the D2 procedure, mostly due to the significant increase of postoperative morbidity and mortality, which was referred to splenopancreatectomy. Only 15 years after the conclusion of its accrual, the Dutch trial could report a significant decrease of recurrence after D2 procedure. Recently the long term survival analysis of the Italian RCT could demonstrate a benefit for patients with positive nodes treated with D2 gastrectomy without splenopancreatectomy. As nowadays also in western countries D2 procedure can be done safely with pancreas preserving technique and without preventive splenectomy, it has been suggested in several national guidelines as the recommended procedure for patients with AGC. PMID:26973384

  12. The current pattern of reconstructive surgery for breast cancer

    Directory of Open Access Journals (Sweden)

    A. Kh. Ismagilov

    2015-01-01

    Full Text Available In Russia, breast cancer (BC occupies a leading place in the pattern of cancers, the incidence of which is 20.9 %, among the female population; in 2013 there were 60,717 new cases, including women under the age of 40 years (15 %. While considering the history of the development of breast surgery from the operation performed by W. S. Halsted to its technique modified by J. L. Madden and the identification of sentinel lymph nodes, we can observe improved quality of life in patients in reference to the lower rate of the manifestation of lymphedemas. However, patients who have undergone this or that mastectomy are observed to have lower self-appraisal scores, a change in their professional sphere, irritability and apprehensiveness Thus, the decreased rate of the manifestation of lymphedema and obvious postoperative traumatization are not the only components of quality of life in patients with BC. According to the data obtained by E. Frank et al. (1978, G.P. Maguire et al. (1978, and F. Meerwein (1981, removal of the breast itself leads to a woman’s loss of femininity, attractiveness, and sexiness, which was also confirmed and reported by L. Aerts et al. (2014. In this connection, classical radical mastectomy begins to give way to organ-sparing treatment. Taking into account that psychotherapy and external prosthetics do not alleviate the above problems and that there are always women with established BC who have contraindications to organ-sparing treatment, breast reconstructive plastic operations arouse more and more interest. Reconstruction of the breast implies restoration of both its shape and contours to be maximally brought closer to its preoperative level. However, with regard to cancer alertness to breast reconstructive surgery, not only aesthetic requirements are imposed. The next step in improving quality of life in patients with BC was the emergence and development of breast-sparing mastectomies, the first point of these

  13. Clinical proteomics-driven precision medicine for targeted cancer therapy: current overview and future perspectives.

    Science.gov (United States)

    Zhou, Li; Wang, Kui; Li, Qifu; Nice, Edouard C; Zhang, Haiyuan; Huang, Canhua

    2016-04-01

    Cancer is a common disease that is a leading cause of death worldwide. Currently, early detection and novel therapeutic strategies are urgently needed for more effective management of cancer. Importantly, protein profiling using clinical proteomic strategies, with spectacular sensitivity and precision, offer excellent promise for the identification of potential biomarkers that would direct the development of targeted therapeutic anticancer drugs for precision medicine. In particular, clinical sample sources, including tumor tissues and body fluids (blood, feces, urine and saliva), have been widely investigated using modern high-throughput mass spectrometry-based proteomic approaches combined with bioinformatic analysis, to pursue the possibilities of precision medicine for targeted cancer therapy. Discussed in this review are the current advantages and limitations of clinical proteomics, the available strategies of clinical proteomics for the management of precision medicine, as well as the challenges and future perspectives of clinical proteomics-driven precision medicine for targeted cancer therapy. PMID:26923776

  14. Targeted therapies with companion diagnostics in the management of breast cancer: current perspectives.

    Science.gov (United States)

    Myers, Meagan B

    2016-01-01

    Breast cancer is a multifaceted disease exhibiting both intertumoral and intratumoral heterogeneity as well as variable disease course. Over 2 decades of research has advanced the understanding of the molecular substructure of breast cancer, directing the development of new therapeutic strategies against these actionable targets. In vitro diagnostics, and specifically companion diagnostics, have been integral in the successful development and implementation of these targeted therapies, such as those directed against the human epidermal growth factor receptor 2. Lately, there has been a surge in the development, commercialization, and marketing of diagnostic assays to assist in breast cancer patient care. More recently, multigene signature assays, such as Oncotype DX, MammaPrint, and Prosigna, have been integrated in the clinical setting in order to tailor decisions on adjuvant endocrine and chemotherapy treatment. This review provides an overview of the current state of breast cancer management and the use of companion diagnostics to direct personalized approaches in the treatment of breast cancer. PMID:26858530

  15. ASWAGANDHA (WITHANIA SOMNIFERA) – AYURVEDIC BEQUEST FOR THE PATIENTS OF CANCER: AN UPDATE ON CURRENT RESEARCH

    OpenAIRE

    Rao Paramkusha Madupu; Khemani Naresh

    2010-01-01

    Aswagandha (Withania somnifera) is a popularly known medicinal plant said in Ayurveda. It has been used to promote vigor and strength. The current ongoing researches are approving the plant can be useful in malignacies at various levels and with different mechanisms. An effort has been made in this paper to review such results focused at cancer therapy and management. Aswagandha (Withania somnifera) is also known as Indian ginseng proves to be a beacon for blinded minds of cancer sufferers.

  16. Current Studies of Acupuncture in Cancer-Induced Bone Pain Animal Models

    OpenAIRE

    Hee Kyoung Ryu; Yong-Hyeon Baek; Yeon-Cheol Park; Byung-Kwan Seo

    2014-01-01

    Acupuncture is generally accepted as a safe and harmless treatment option for alleviating pain. To explore the pain mechanism, numerous animal models have been developed to simulate specific human pain conditions, including cancer-induced bone pain (CIBP). In this study, we analyzed the current research methodology of acupuncture for the treatment of CIBP. We electronically searched the PubMed database for animal studies published from 2000 onward using these search terms: (bone cancer OR can...

  17. Current Innovations in Sentinel Lymph Node Mapping for the Staging and Treatment of Resectable Lung Cancer

    OpenAIRE

    Hachey, Krista J.; Colson, Yolonda L.

    2014-01-01

    Despite surgical resectability, early stage lung cancer remains a challenge to cure. Survival outcomes are hindered by variable performance of adequate lymphadenectomy and the limitations of current pathologic nodal staging. Sentinel lymph node (SLN) mapping, a mainstay in the management of breast cancer and melanoma, permits targeted nodal sampling for efficient and accurate staging that can influence both intraoperative and adjuvant treatment decisions. Unfortunately, standard SLN identific...

  18. Current practice of radioiodine treatment in the management of differentiated thyroid cancer in Germany

    International Nuclear Information System (INIS)

    This prospective, observational study of a cohort of thyroid cancer patients in Germany focusses on the ''real-world'' practice in the management of thyroid cancer patients. This report includes data from 2376 patients with primary differentiated thyroid carcinoma first diagnosed in the year 1996. The study reveals considerable differences in actual practice concerning surgery and radioiodine treatment. The results indicate that consensus is lacking with respect to the multimodality treatment approach for differentiated thyroid carcinoma. Our analysis represents the most current and comprehensive national assessment of presenting patient characteristics, diagnostic tests, treatment and complications for thyroid cancer. (orig.)

  19. Current Challenges in Prostate Cancer Management and the Rationale behind Targeted Focal Therapy

    Directory of Open Access Journals (Sweden)

    Al B. Barqawi

    2012-01-01

    Full Text Available Among men, prostate cancer has a high prevalence, with relatively lower cancer-specific mortality risk compared to lung and colon cancer. Prostate-specific antigen (PSA screening has increased prostate cancer awareness since its implementation as a screening tool almost 25 years ago, but, due to the largely indolent course of this disease and the unspecific nature of the PSA test, increased incidence has largely been associated with cancers that would not go on to cause death (clinically insignificant, leading to an overdiagnosis challenge and an ensuing overtreatment consequences. The overtreatment problem is exacerbated by the high risk of side effects that current treatment techniques have, putting patients’ quality of life at risk with little or no survival benefit. The goals of this paper are to evaluate the rise, prevalence, and impact of the overdiagnosis and ensuing overtreatment problems, as well as highlight potential solutions. In this effort, a review of major epidemiological and screening studies, cancer statistics from the advent of prostate-specific antigen screening to the present, and reports on patient concerns and treatment outcomes was conducted to present the dominant factors that underlie current challenges in prostate cancer treatment and illuminate potential solutions.

  20. Current and future strategies in radiotherapy of childhood low-grade glioma of the brain. Part I. Treatment modalities of radiation therapy

    International Nuclear Information System (INIS)

    Background: Treatment of childhood low-grade gliomas is a challenging issue owing to their low incidence and the lack of consensus about ''optimal'' treatment approach. Material and Methods: Reports in the literature spanning 60 years of radiation therapy, including orthovoltage, megavoltage and recently modern high-precision treatments, were reviewed with respect to visual function, survival, prognostic factors, dose prescriptions, target volumes, and treatment techniques. Based on these experiences, future strategies in the management of childhood low-grade glioma are presented. Results: Evaluation of published reports is difficult because of inconsistencies in data presentation, relatively short follow-up in some series and failure to present findings and results in a comparable way. Even with the shortcomings of the reports available in the literature, primarily concerning indications, age at treatment, dose response, timing and use of ''optimal'' treatment fields, radiation therapy continues to play an important role in the management of these tumors achieving long-term survival rates up to 80% or more. Particularly in gliomas of the visual pathway, high local tumor control and improved or stable function is achieved in approximately 90% of cases. Data on dose-response relationships recommend dose prescriptions between 45 and 54 Gy with standard fractionation. There is consensus now to employ radiation therapy in older children in case of progressive disease only, regardless of tumor location and histologic subtype. In younger children, the role of radiotherapy is unclear. Recent advances in treatment techniques, such as 3-D treatment planning and various ''high-precision'' treatments achieved promising initial outcome, however with limited patient numbers and short follow-ups. Conclusions: Radiation therapy is an effective treatment modality in children with low-grade glioma regarding tumor control and improvement and/or preservation of neurologic function or

  1. Current and future strategies in radiotherapy of childhood low-grade glioma of the brain. Part I. Treatment modalities of radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kortmann, R.D.; Timmermann, B.; Plasswilm, L.; Paulsen, F.; Jeremic, B.; Kay, S.; Bamberg, M. [Dept. of Radiooncology, Univ. of Tuebingen (Germany); Taylor, R.E. [Radiotherapy Dept., Cookridge Hospital, Leeds (United Kingdom); Scarzello, G. [Dept. of Radiotherapy, Padua General Hospital (Italy); Gnekow, A.K. [Children' s Hospital, Augsburg (Germany); Dieckmann, K. [Dept. of Radiooncology, General Hospital Vienna (Austria)

    2003-08-01

    Background: Treatment of childhood low-grade gliomas is a challenging issue owing to their low incidence and the lack of consensus about ''optimal'' treatment approach. Material and Methods: Reports in the literature spanning 60 years of radiation therapy, including orthovoltage, megavoltage and recently modern high-precision treatments, were reviewed with respect to visual function, survival, prognostic factors, dose prescriptions, target volumes, and treatment techniques. Based on these experiences, future strategies in the management of childhood low-grade glioma are presented. Results: Evaluation of published reports is difficult because of inconsistencies in data presentation, relatively short follow-up in some series and failure to present findings and results in a comparable way. Even with the shortcomings of the reports available in the literature, primarily concerning indications, age at treatment, dose response, timing and use of ''optimal'' treatment fields, radiation therapy continues to play an important role in the management of these tumors achieving long-term survival rates up to 80% or more. Particularly in gliomas of the visual pathway, high local tumor control and improved or stable function is achieved in approximately 90% of cases. Data on dose-response relationships recommend dose prescriptions between 45 and 54 Gy with standard fractionation. There is consensus now to employ radiation therapy in older children in case of progressive disease only, regardless of tumor location and histologic subtype. In younger children, the role of radiotherapy is unclear. Recent advances in treatment techniques, such as 3-D treatment planning and various ''high-precision'' treatments achieved promising initial outcome, however with limited patient numbers and short follow-ups. Conclusions: Radiation therapy is an effective treatment modality in children with low-grade glioma regarding tumor control

  2. Coincidence and modality

    OpenAIRE

    Kang, Li

    2011-01-01

    How should we understand de re modal features of objects, if there are such features? Any answer to the question is connected to how we should think about coincident objects, objects which occupy the same spatio-temporal region and share the same underlying matter. This thesis is mainly about the connections between de re modality and coincidence. My interest in the connections is twofold: First, how do theories of de re modality interact with theories about coincidence? Details of interactio...

  3. Modal testing the EOLE

    Energy Technology Data Exchange (ETDEWEB)

    Carne, T.G.; Lauffer, J.P.; Gomez, A.J.

    1987-01-01

    Modal testing an immense and flexible wind turbine poses a number of problems. It requires innovative excitation techniques since the modal frequencies of this type of structure are quite low. Also, substantial energy must be input to the structure to obtain reasonable levels of response. In this paper, the results of the modal test of the 110 m tall EOLE wind turbine are presented which had a number of modal frequencies below 1.0 Hz. Step-relaxation and wind were used to excite the structure. 5 refs., 14 figs., 2 tabs.

  4. Enriched coalgebraic modal logic

    OpenAIRE

    Wilkinson, Toby

    2013-01-01

    We formalise the notion of enriched coalgebraic modal logic, and determine conditions on the category V (over which we enrich), that allow an enriched logical connection to be extended to a framework for enriched coalgebraic modal logic. Our framework uses V-functors L: A ? A and T: X ? X, where L determines the modalities of the resulting modal logics, and T determines the coalgebras that provide the semantics. We introduce the V-category Mod(A, ?) of models for an L-algebra (A, ?), and ...

  5. Advances in Modal Logic

    DEFF Research Database (Denmark)

    Modal logic is a subject with ancient roots in the western logical tradition. Up until the last few generations, it was pursued mainly as a branch of philosophy. But in recent years, the subject has taken new directions with connections to topics in computer science and mathematics. This volume is...... the proceedings of the conference of record in its fi eld, Advances in Modal Logic. Its contributions are state-of-the-art papers. The topics include decidability and complexity results for specifi c modal logics, proof theory of modal logic, logics for reasoning about time and space, provability...

  6. It does belong together: Cross-modal correspondences influence cross-modal integration during perceptual learning

    Directory of Open Access Journals (Sweden)

    Lionel eBrunel

    2015-04-01

    Full Text Available Experiencing a stimulus in one sensory modality is often associated with an experience in another sensory modality. For instance, seeing a lemon might produce a sensation of sourness. This might indicate some kind of cross-modal correspondence between vision and gustation. The aim of the current study was to provide explore whether such cross-modal correspondences influence cross-modal integration during perceptual learning. To that end, we conducted 2 experiments. Using a speeded classification task, Experiment 1 established a cross-modal correspondence between visual lightness and the frequency of an auditory tone. Using a short-term priming procedure, Experiment 2 showed that manipulation of such cross-modal correspondences led to the creation of a crossmodal unit regardless of the nature of the correspondence (i.e., congruent, Experiment 2a or incongruent, Experiment 2b. However, a comparison of priming-effects sizes suggested that cross-modal correspondences modulate cross-modal integration during learning and thus leading to new learned units that have different stability over time. We discuss the implications of our results for the relation between cross-modal correspondence and perceptual learning in the context of a Bayesian explanation of cross-modal correspondences.

  7. Preserving fertility in patients undergoing treatment for breast cancer: current perspectives

    Directory of Open Access Journals (Sweden)

    Moffat R

    2014-07-01

    Full Text Available Rebecca Moffat,1 Uwe Güth2 1Women’s Hospital, Clinic for Gynecologic Endocrinology and Reproductive Medicine, University Hospital Basel, Basel, 2Department of Gynecology and Obstetrics, Breast Center, SenoSuisse, Cantonal Hospital Winterthur, Winterthur, Switzerland Abstract: Invasive breast cancer (BC is the most frequent cancer of young women. Considering the trend toward postponing childbearing until the later reproductive years, the number of childless women at diagnosis of BC will continue to increase. The American Society of Clinical Oncology and the American Society for Reproductive Medicine have recommended that the impact of cancer treatments on fertility should be addressed with all cancer patients of reproductive age and that options for fertility preservation, such as cryopreservation of embryos and oocytes, ovarian tissue, in vitro maturation of immature oocytes, and ovarian suppression with gonadotropin-releasing hormone analogs, should be discussed routinely. To optimally counsel patients on how to best weigh the risks and benefits of fertility preservation, both the health care provider and the patient must know about the options, their risks, and their likelihood of success. The aim of this review is to summarize current knowledge on fertility preservation options for young BC patients, surrogates of ovarian function, psychosocial aspects of infertility after cancer treatment, women’s attitudes towards childbearing after cancer treatment, and health care providers’ attitudes towards fertility preservation. Keywords: breast cancer, fertility preservation, oncofertility, chemotherapy

  8. Soft-boundary graphene nanoribbon formed by a graphene sheet above a perturbed ground plane: conductivity pro?le and SPP modal current distribution

    CERN Document Server

    Forati, Ebrahim

    2013-01-01

    An infinite sheet of graphene lying above a perturbed ground plane is studied. The perturbation is a two dimensional ridge, and a bias voltage is applied between the graphene and the ground plane, resulting in a graphene nanoribbonlike structure with a soft-boundary (SB) The spatial distribution of the graphene conductivity forming the soft-boundary is studied as a function of the ridge parameters and the bias voltage. The current distribution of the fundamental TM surface plasmon polariton (SPP) is considered. The effect of the ridge parameters and shape of the soft boundary on the current distributions are investigated, and the conditions are studied under which the mode remains confined to the vicinity of the ridge region.

  9. The status of current epidemiological knowledge of radiocarcinogenecity: other, miscellaneous cancers

    International Nuclear Information System (INIS)

    Currently available epidemiological data indicate low or intermediate levels of sensitivity for radiation-induced cancers of most tissues and organ systems other than lung, thyroid and female breast, and leukaemia. However, the estimated risks for these ''other, miscellaneous'' cancers may reflect deficiencies in the data as a result of small study populations, insufficient population dose to detect an effect, uncertainties in dosimetry or the confounding or modifying effects of unknown or unevaluated risk factors. Additional information is necessary to improve existing risk estimates for the malignancies in the other, miscellaneous category. This may be obtained by continued follow-up of the populations currently under study, application of new and developing molecular technologies to identify and quantify radiation exposures for individuals, and pooled or parallel analyses of multiple populations. Cancers of the following tissues are briefly discussed:- digestive system, genito-urinary system, brain or central nervous system, lymphoma, multiple myeloma, bone and skin. (Author)

  10. Video: Modalities and Methodologies

    Science.gov (United States)

    Hadfield, Mark; Haw, Kaye

    2012-01-01

    In this article, we set out to explore what we describe as the use of video in various modalities. For us, modality is a synthesizing construct that draws together and differentiates between the notion of "video" both as a method and as a methodology. It encompasses the use of the term video as both product and process, and as a data collection…

  11. Current status of high dose rate brachytherapy in cervical cancer in Korea and optimal treatment schedule

    Energy Technology Data Exchange (ETDEWEB)

    Huh, Seung Jae [College of Medicine, Sungkyunkwan Univ., Seoul (Korea, Republic of)

    1998-12-01

    Brachytherapy is an essential part of radiotherapy for uterine cervical cancer. The low dose rate (LDR) regimen has been the major technique of intracavitary therapy for cervical cancer. However, there has been an expansion in the last 20 years of high dose rate (HDR) machines using Ir-192 sources. Since 1979, HDR brachytherapy has been used for the treatment of uterine cervical cancer in Korea. The number of institutions employing HDR has been increasing, while the number of low dose rate system has been constant. In 1995, there was a total 27 HDR brachytherapy units installed and 1258 cases of patients with cervical cancer were treated with HDR. Most common regimens of HDR brachytherapy are total dose of 30-39 Gy at point A with 10-13 fractions in three fractions per week, 24-32 Gy with 6-8 fractions in two fractions per week, and 30-35 Gy with 6-7 fractions in two fractions per week. The average fractionation regimen of HDR brachytherapy is about 8 fractions of 4. 1 Gy each to point A. In Korea, treatment results for HDR brachytherapy are comparable with the LDR series and appears to be a safe and effective alternative to LDR therapy for the treatment of cervical carcinoma. Studies from the major centers report the five-year survival rate of cervical cancer as, 78-86% for Stage I, 68-85% for stage II, and 38-56% for Stage III. World-wide questionnaire study and Japanese questionnaire survey of multiple institutions showed no survival difference in any stages and dose-rate effect ratio (HDR/LDR) was calculated to be 0.54 to 0.58. However, the optimum treatment doses and fractionation schemes appropriate to generate clinical results comparable to conventional LDR schemes have yet to be standardized. In conclusion, HDR intracavitary radiotherapy is increasingly practiced in Korea and an effective treatment modality for cervical cancer. To determine the optimum radiotherapy dose and fractionation schedule, a nation-wide prospective study is necessary in Korea. In

  12. Modal Filters for Infrared Interferometry

    Science.gov (United States)

    Ksendzov, Alexander; MacDonald, Daniel R.; Soibel, Alexander

    2009-01-01

    Modal filters in the approximately equal to 10-micrometer spectral range have been implemented as planar dielectric waveguides in infrared interferometric applications such as searching for Earth-like planets. When looking for a small, dim object ("Earth") in close proximity to a large, bright object ("Sun"), the interferometric technique uses beams from two telescopes combined with a 180 phase shift in order to cancel the light from a brighter object. The interferometer baseline can be adjusted so that, at the same time, the light from the dimmer object arrives at the combiner in phase. This light can be detected and its infrared (IR) optical spectra can be studied. The cancellation of light from the "Sun" to approximately equal to 10(exp 6) is required; this is not possible without special devices-modal filters- that equalize the wavefronts arriving from the two telescopes. Currently, modal filters in the approximately equal to 10-micrometer spectral range are implemented as single- mode fibers. Using semiconductor technology, single-mode waveguides for use as modal filters were fabricated. Two designs were implemented: one using an InGaAs waveguide layer matched to an InP substrate, and one using InAlAs matched to an InP substrate. Photon Design software was used to design the waveguides, with the main feature all designs being single-mode operation in the 10.5- to 17-micrometer spectral range. Preliminary results show that the filter's rejection ratio is 26 dB.

  13. ORGAN-SPARING SURGERY FOR RECTAL CANCER: EVOLUTION, CURRENT TRENDS, AND PROSPECTS

    Directory of Open Access Journals (Sweden)

    R. I. Tamrazov

    2015-02-01

    Full Text Available The article describes the main stages of the development of sphincter-saving surgery for rectal cancer. An historical look at this issue from the standpoint of research of past years in our country and abroad, as well as analysis of current sphincter-preserving surgery and future directions in this area.

  14. Current relevance of cervical ultrasonography in staging cancer of the esophagus and gastroesophageal junction

    NARCIS (Netherlands)

    Schreurs, Liesbeth; Verhoef, C.C.; van der Jagt, E.J.; van Dam, G.M.; Groen, H.; Plukker, J.T.

    2008-01-01

    Purpose: To evaluate the value of external ultrasonography (US) of the neck in current dedicated preoperative staging of patients with cancer of the esophagus and gastroesophageal junction (GEJ). Materials and methods: We analyzed 180 consecutive patients (154 men, 26 women, and mean age 63 (38-84)

  15. Current nutrition promotion, beliefs and barriers among cancer nurses in Australia and New Zealand.

    Science.gov (United States)

    Puhringer, Petra G; Olsen, Alicia; Climstein, Mike; Sargeant, Sally; Jones, Lynnette M; Keogh, Justin W L

    2015-01-01

    Rationale. Many cancer patients and survivors do not meet nutritional and physical activity guidelines, thus healthier eating and greater levels of physical activity could have considerable benefits for these individuals. While research has investigated cancer survivors' perspective on their challenges in meeting the nutrition and physical guidelines, little research has examined how health professionals may assist their patients meet these guidelines. Cancer nurses are ideally placed to promote healthy behaviours to their patients, especially if access to dieticians or dietary resources is limited. However, little is known about cancer nurses' healthy eating promotion practices to their patients. The primary aim of this study was to examine current healthy eating promotion practices, beliefs and barriers of cancer nurses in Australia and New Zealand. A secondary aim was to gain insight into whether these practices, beliefs and barriers were influenced by the nurses' hospital or years of work experience. Patients and Methods. An online questionnaire was used to obtain data. Sub-group cancer nurse comparisons were performed on hospital location (metropolitan vs regional and rural) and years of experience (eating prior (62.6%), during (74.8%) and post treatment (64.2%). Most cancer nurses felt that healthy eating had positive effects on the cancer patients' quality of life (85.4%), weight management (82.9%), mental health (80.5%), activities of daily living (79.7%) and risk of other chronic diseases (79.7%), although only 75.5% agreed or strongly agreed that this is due to a strong evidence base. Lack of time (25.8%), adequate support structures (17.3%) nutrition expertise (12.2%) were cited by the cancer nurses as the most common barriers to promoting healthy eating to their patients. Comparisons based on their hospital location and years of experience, revealed very few significant differences, indicating that cancer nurses' healthy eating promotion practices

  16. TP53 mutations as biomarkers for cancer epidemiology in Latin America: current knowledge and perspectives.

    Science.gov (United States)

    de Moura Gallo, Claudia Vitória; Azevedo E Silva Mendonça, Gulnar; de Moraes, Emanuela; Olivier, Magali; Hainaut, Pierre

    2005-05-01

    Due to particular social and economical development, and to the impact of globalization of lifestyles, Latin America shows a superposition of cancers that are frequent in low resource countries (gastric, oesophageal squamous cell and cervical cancers) and high resource countries (cancers of breast, colon and rectum, lung and prostate). Latin America thus offers opportunities for investigating the impact on changing lifestyle patterns on the occurrence of cancer. At the molecular level, mutations in the tumor suppressor gene TP53 are common in many cancers and their distribution can be informative of the nature of the mutagenic mechanisms, thus giving clues to cancer etiology and molecular pathogenesis. However most of the data available are derived from studies in industrialized countries. In this review, we discuss current trends on cancer occurrence in Latin American countries, and we review the literature available on TP53 mutations and polymorphisms in patients from Latin America. Overall, a total of 285 mutations have been described in 1213 patients in 20 publications, representing 1.5% of the total number of mutations reported world-wide. Except for hematological cancers, TP53 mutation frequencies are similar to those reported in other regions of the world. The only tumor site presenting significant differences in mutation pattern as compared to other parts of the world is colon and rectum. However, this difference is based on a single study with 35 patients. Recently, a characteristic TP53 mutation at codon 337 (R337H) has been identified in the germline of children with adrenocortical carcinoma in Southern Brazil. Further and better focused analyses of TP53 mutation patterns in the context of epidemiological studies, should help to improve our understanding of cancer etiology in order to develop appropriate health policies and public health programs in Latin America. PMID:15878142

  17. What is the most accurate whole-body imaging modality for assessment of local and distant recurrent disease in colorectal cancer? A meta-analysis. Imaging for recurrent colorectal cancer

    International Nuclear Information System (INIS)

    The objective of this study was to compare the diagnostic performance of positron emission tomography (PET), PET/CT, CT and MRI as whole-body imaging modalities for the detection of local and/or distant recurrent disease in colorectal cancer (CRC) patients who have a (high) suspicion of recurrent disease, based on clinical findings or rise in carcinoembryonic antigen (CEA). A meta-analysis was undertaken. PubMed and Embase were searched for studies on the accuracy of whole-body imaging for patients with suspected local and/or distant recurrence of their CRC. Additionally, studies had to have included at least 20 patients with CRC and 2 x 2 contingency tables had to be provided or derivable. Articles evaluating only local recurrence or liver metastasis were excluded. Summary receiver-operating characteristic (ROC) curves were constructed from the data on sensitivity and specificity of individual studies and pooled estimates of diagnostic odds ratios (DORs) and areas under the ROC curve (AUCs) were calculated. To test for heterogeneity the Cochran Q test was used. Fourteen observational studies were included which evaluated PET, PET/CT, CT and/or MRI. Study results were available in 12 studies for PET, in 5 studies for CT, in 5 studies for PET/CT and in 1 study for MRI. AUCs for PET, PET/CT and CT were 0.94 (0.90-0.97), 0.94 (0.87-0.98) and 0.83 (0.72-0.90), respectively. In patient based analyses PET/CT had a higher diagnostic performance than PET with an AUC of 0.95 (0.89-0.97) for PET/CT vs 0.92 (0.86-0.96) for PET. Both whole-body PET and PET/CT are very accurate for the detection of local and/or distant recurrent disease in CRC patients with a (high) suspicion of recurrent disease. CT has the lowest diagnostic performance. This difference is probably mainly due to the lower accuracy of CT for detection of extrahepatic metastases (including local recurrence). For clinical practice PET/CT might be the modality of choice when evaluating patients with a (high

  18. Prevalence, putative mechanisms, and current management of sleep problems during chemotherapy for cancer

    Directory of Open Access Journals (Sweden)

    Palesh O

    2012-12-01

    Full Text Available Oxana Palesh,1 Luke Peppone,2 Pasquale F Innominato,3–5 Michelle Janelsins,2 Monica Jeong,1 Lisa Sprod,7 Josee Savard,6 Max Rotatori,1 Shelli Kesler,1 Melinda Telli,1 Karen Mustian21Stanford University School of Medicine, Stanford, CA, USA; 2University of Rochester School of Medicine and Dentistry, Rochester, NY, USA; 3INSERM, UMRS 776, Biological Rhythms and Cancers, Villejuif, France; 4Faculty of Medicine, Universite Paris Sud, le Kremlin-Bicêtre, France; 5APHP, Chronotherapy Unit, Department of Oncology, Paul Brousse Hospital, Villejuif, France; 6Laval University, Quebec, Canada; 7University of North Carolina, Wilmington, NC, USAAbstract: Sleep problems are highly prevalent in cancer patients undergoing chemotherapy. This article reviews existing evidence on etiology, associated symptoms, and management of sleep problems associated with chemotherapy treatment during cancer. It also discusses limitations and methodological issues of current research. The existing literature suggests that subjectively and objectively measured sleep problems are the highest during the chemotherapy phase of cancer treatments. A possibly involved mechanism reviewed here includes the rise in the circulating proinflammatory cytokines and the associated disruption in circadian rhythm in the development and maintenance of sleep dysregulation in cancer patients during chemotherapy. Various approaches to the management of sleep problems during chemotherapy are discussed with behavioral intervention showing promise. Exercise, including yoga, also appear to be effective and safe at least for subclinical levels of sleep problems in cancer patients. Numerous challenges are associated with conducting research on sleep in cancer patients during chemotherapy treatments and they are discussed in this review. Dedicated intervention trials, methodologically sound and sufficiently powered, are needed to test current and novel treatments of sleep problems in cancer patients

  19. Modality-dependent dose requirements in the Austrian breast cancer early detection program. First results from technical quality assurance; Geraeteabhaengiger Dosisbedarf im Oesterreichischen Brustkrebsfrueherkennungsprogramm. Erste Ergebnisse aus der technischen Qualitaetssicherung

    Energy Technology Data Exchange (ETDEWEB)

    Osanna-Elliott, A.; Semturs, F.; Menhart, S.; Schloegl, C.; Wildner, S.; Zwettler, G. [AGES, Wien (Austria). Referenzzentrum fuer technische Qualitaetssicherung im Brustkrebsfrueherkennungsprogramm

    2015-07-01

    The Austrian Breast Cancer Early Detection Program (BKFP) has officially started in January 2014. In order to ensure that all participating women can rely on a sufficient cancer detection rate while at the same time the required dose is as low as reasonably achievable, all participating radiology institutes (approx. 200) have to fulfill strict quality assurance requirements. The control and certification is performed by the Reference Center for Technical Quality Assurance (RefZQS), which has been developing the methods and tolerances in a pilot project since 2007. The limits are defined in the EUREF-Oeprotocol which is based on the European EPQC guidelines. From the requirement for optimized image quality while simultaneously following the ALARA principle, we found modality-dependent dose requirements, which we had expected but which have now been compiled for the first time for Austria.

  20. Human Papillomavirus: Current and Future RNAi Therapeutic Strategies for Cervical Cancer

    Directory of Open Access Journals (Sweden)

    Hun Soon Jung

    2015-05-01

    Full Text Available Human papillomaviruses (HPVs are small DNA viruses; some oncogenic ones can cause different types of cancer, in particular cervical cancer. HPV-associated carcinogenesis provides a classical model system for RNA interference (RNAi based cancer therapies, because the viral oncogenes E6 and E7 that cause cervical cancer are expressed only in cancerous cells. Previous studies on the development of therapeutic RNAi facilitated the advancement of therapeutic siRNAs and demonstrated its versatility by siRNA-mediated depletion of single or multiple cellular/viral targets. Sequence-specific gene silencing using RNAi shows promise as a novel therapeutic approach for the treatment of a variety of diseases that currently lack effective treatments. However, siRNA-based targeting requires further validation of its efficacy in vitro and in vivo, for its potential off-target effects, and of the design of conventional therapies to be used in combination with siRNAs and their drug delivery vehicles. In this review we discuss what is currently known about HPV-associated carcinogenesis and the potential for combining siRNA with other treatment strategies for the development of future therapies. Finally, we present our assessment of the most promising path to the development of RNAi therapeutic strategies for clinical settings.

  1. Current status and prospects of clinical proteomics studies on detection of colorectal cancer: Hopes and fears

    Institute of Scientific and Technical Information of China (English)

    ME de Noo; RAEM Tollenaar; AM Deelder; LH Bouwman

    2006-01-01

    Colorectal adenocarcinoma (CRC) is the third most common type of cancer and the fourth most frequent cause of death due to cancer worldwide. Given the natural history of CRC, early diagnosis appears to be the most appropriate tool to reduce disease-related mortality. A field of recent interest is clinical proteomics, which was reported to lead to high sensitivity and specificities for early detection of several solid tumors. This emerging field uses mass spectrometry-based protein profiles/patterns of easy accessible body fluids to distinguish cancer from non-cancer patients. These discrepancies may be a result of: (1) proteins being abnormally produced or shed and added to the serum proteome, (2) proteins clipped or modified as a consequence of the disease process, or (3) proteins subtracted from the proteome owing to disease-related proteolytic degradation pathways. Therefore, protein pattern diagnostics would provide easy and reliable tools for detection of cancer. This paper focuses on the current status of clinical proteomics research in oncology and in colorectal cancer especially,and will reflect on pitfalls and fears in this relatively new area of clinical medicine, which are reproducibility issues and pre-analytical factors, statistical issues, and identification and nature of discriminating proteins/peptides.

  2. Current Challenges in Volatile Organic Compounds Analysis as Potential Biomarkers of Cancer

    Directory of Open Access Journals (Sweden)

    Kamila Schmidt

    2015-01-01

    Full Text Available An early diagnosis and appropriate treatment are crucial in reducing mortality among people suffering from cancer. There is a lack of characteristic early clinical symptoms in most forms of cancer, which highlights the importance of investigating new methods for its early detection. One of the most promising methods is the analysis of volatile organic compounds (VOCs. VOCs are a diverse group of carbon-based chemicals that are present in exhaled breath and biofluids and may be collected from the headspace of these matrices. Different patterns of VOCs have been correlated with various diseases, cancer among them. Studies have also shown that cancer cells in vitro produce or consume specific VOCs that can serve as potential biomarkers that differentiate them from noncancerous cells. This review identifies the current challenges in the investigation of VOCs as potential cancer biomarkers, by the critical evaluation of available matrices for the in vivo and in vitro approaches in this field and by comparison of the main extraction and detection techniques that have been applied to date in this area of study. It also summarises complementary in vivo, ex vivo, and in vitro studies conducted to date in order to try to identify volatile biomarkers of cancer.

  3. Lessons learned from modal testing of aerospace structures

    Science.gov (United States)

    Hunt, David L.; Brillhart, Ralph D.

    1993-02-01

    The primary factors affecting the accuracy and the time required to perform modal tests on aerospace structures are discussed, and the lessons learned from modal tests performed over the past 15 yrs are examined. Case histories of modal testing on aerospace structures are reviewed, including the Galileo satellite and the Space Shuttle solid rocket motor and test stand. Currently recommended approaches to the modal testing are addressed.

  4. Electrical impedance scanning as a new imaging modality in breast cancer detection—a short review of clinical value on breast application, limitations and perspectives

    Science.gov (United States)

    Malich, A.; Böhm, T.; Facius, M.; Kleinteich, I.; Fleck, M.; Sauner, D.; Anderson, R.; Kaiser, W. A.

    2003-01-01

    Objective. Cancer cells exhibit altered local dielectric properties compared to normal cells, measurable as different electrical conductance and capacitance using electrical impedance scanning (EIS). Therefore, active biocompatible current is applied to the patient for calculation of both parameters taking into account frequency, voltage and current flow. Subjects and methods. 240 women with 280 sonographically and/or mammographically suspicious findings were examined using EIS. All lesions were histologically proven. A lesion was scored as positive, when a focal increased conductance and/or capacitance was measurable using EIS. The lesion was visible as a bright area in a 256 grey-scale computer output. Due to system limitations patients having a pacemaker or pregnant had to be excluded from the study. Results. 91/113 malignant and 108/167 benign lesions were correctly identified using EIS (80.5% sensitivity, 64.7% specificity). NPV and PPV of 83.1% and 60.7% were observed, respectively. Accuracy was 0.73. A wide range of factors can induce false positive results, although by an experienced observer a number of these findings can be detected such as scars, skin alterations, contact artefacts, air bubbles and naevi, hairs and interfering bone. Based upon visibility on ultrasound (194 lesions visible, 86 not visible) significant differences in the detection rate occurred. Histology-dependent detectability rate varied significantly with lowest rate in CIS-cases (50%). Specificity values varied histology-depending, too; probably depending on the rate of proliferation between 75% (inflammatory lesions) and papillomata (50%). Best detectability was observed in malignant lesions with a size between 20 and 30 mm. Further possible applications will be discussed regarding the currently available literature (lymph nodes, salivary glands, mathematical and animal based models). Conclusion. EIS appears to be a promising new additional technology providing a rather high

  5. Electrical impedance scanning as a new imaging modality in breast cancer detection - a short review of clinical value on breast application, limitations and perspectives

    International Nuclear Information System (INIS)

    Objective. Cancer cells exhibit altered local dielectric properties compared to normal cells, measurable as different electrical conductance and capacitance using electrical impedance scanning (EIS). Therefore, active biocompatible current is applied to the patient for calculation of both parameters taking into account frequency, voltage and current flow. Subjects and methods. 240 women with 280 sonographically and/or mammographically suspicious findings were examined using EIS. All lesions were histologically proven. A lesion was scored as positive, when a focal increased conductance and/or capacitance was measurable using EIS. The lesion was visible as a bright area in a 256 grey-scale computer output. Due to system limitations patients having a pacemaker or pregnant had to be excluded from the study. Results. 91/113 malignant and 108/167 benign lesions were correctly identified using EIS (80.5% sensitivity, 64.7% specificity). NPV and PPV of 83.1% and 60.7% were observed, respectively. Accuracy was 0.73. A wide range of factors can induce false positive results, although by an experienced observer a number of these findings can be detected such as scars, skin alterations, contact artefacts, air bubbles and naevi, hairs and interfering bone. Based upon visibility on ultrasound (194 lesions visible, 86 not visible) significant differences in the detection rate occurred. Histology-dependent detectability rate varied significantly with lowest rate in CIS-cases (50%). Specificity values varied histology-depending, too; probably depending on the rate of proliferation between 75% (inflammatory lesions) and papillomata (50%). Best detectability was observed in malignant lesions with a size between 20 and 30 mm. Further possible applications will be discussed regarding the currently available literature (lymph nodes, salivary glands, mathematical and animal based models). Conclusion. EIS appears to be a promising new additional technology providing a rather high

  6. Does ductal lavage assert its role as a noninvasive diagnostic modality to identify women at low risk of breast cancer development?

    OpenAIRE

    Konstandiadou, Ioanna; Mastoraki, Aikaterini; Kotsilianou, Olympia; Karakitsos, Petros; Athanasas, George; Smyrniotis, Vasilios; Arkadopoulos, Nikolaos

    2012-01-01

    Objective Ductal lavage (DL) involves evaluation of the ductal system of the breast for detection of intra-ductal carcinomas and precursor lesions by collecting breast epithelial cells using a small-gauge catheter inserted into a ductal orifice on the nipple. The aim of this survey was to analyze cytologic features of samples obtained from low-risk women with DL and to elucidate the efficacy of this diagnostic modality in evaluating fluid production, cannulating and determining atypical breas...

  7. Embolisation of cancer: what is the evidence?

    OpenAIRE

    Goode, J A; Matson, M B

    2004-01-01

    Embolisation has become an accepted modality of cancer treatment in patients with a variety of clinical scenarios. It is commonly used in clinical practice in the treatment of hepatocellular carcinoma, hepatic metastases from colorectal cancer and neuroendocrine tumours, and renal cell carcinoma. This review summarizes the current evidence for the efficacy of embolotherapy in these clinical settings, together with the associated complications.

  8. Current status of methodology research on nuclear medicine on sentinel lymph node biopsy in breast cancer

    International Nuclear Information System (INIS)

    Breast cancer is the most common malignancy of the female,and axillary lymph node dissection has been considered as the basic method in breast cancer surgery. Sentinel lymph node biopsy (SLNB) in recent years is accepted gradually both at home and abroad because it not only can avoid complications but also has the advantages of safe and simple operation, high accuracy, and slight trauma. It has taken the place of axillary lymph node dissection in the treatment of axillary node-negative patients. Nuclear medicine inspection has played a crucial role in SLNB, and radiotracers, injecting techniques,detecting methods and standards have great influence upon the accuracy and false-negative rate of axillary lymph nodes and internal mammary lymph nodes detection. In this review, the current methodology status of nuclear medicine is summarized on SLNB in breast cancer at home and abroad. (authors)

  9. Pegylated liposomal doxorubicin: appraisal of its current role in the management of epithelial ovarian cancer

    Directory of Open Access Journals (Sweden)

    Markman M

    2011-06-01

    Full Text Available Maurie MarkmanCancer Treatment Centers of America, Eastern Regional Medical Center, Philadelphia, PA, USAAbstract: Pegylated liposomal doxorubicin (PLD has become a major component in the routine management of epithelial ovarian cancer. The drug is frequently employed as a single agent in the platinum-resistant setting, and recently reported data reveal the superiority of the combination of PLD plus carboplatin, compared with the platinum drug plus paclitaxel, in delaying the time to disease progression in women with recurrent (potentially platinum-sensitive disease. Current research efforts involving PLD in ovarian cancer are focusing on adding novel targeted drugs to this cytotoxic agent. The utility of such approaches in the platinum-resistant population, compared with the sequential administration of single agents active in this setting, remains to be determined.Keywords: PLD, carboplatin, paclitaxel, platinum-sensitive, platinum-resistant

  10. Generalized Modal Satisfiability

    OpenAIRE

    Hemaspaandra, Edith; Schnoor, Henning; Schnoor, Ilka

    2008-01-01

    It is well known that modal satisfiability is PSPACE-complete (Ladner 1977). However, the complexity may decrease if we restrict the set of propositional operators used. Note that there exist an infinite number of propositional operators, since a propositional operator is simply a Boolean function. We completely classify the complexity of modal satisfiability for every finite set of propositional operators, i.e., in contrast to previous work, we classify an infinite number of problems. We sho...

  11. Concurrent chemo-radiotherapy in the treatment of early breast cancer: Current status

    Directory of Open Access Journals (Sweden)

    Nabil Ismaili

    2013-01-01

    Full Text Available Concurrent chemo-radiotherapy (CCRT in early breast cancer was investigated by few authors and remains controversial. This treatment is more commonly used for locally advanced breast cancer and showed high rate of complete pathological response. A search of articles published in English literature, between 1980 and November 2012, was conducted on Medline using the following terms: "breast cancer", "chemotherapy", "concurrent radiotherapy", and "Trastuzumab". We identified five phase I/II trials and three randomized phase three trials evaluating concurrent chemoradiotherapy in the adjuvant of breast cancer. In patients with early breast cancer having positive lymph nodes, phases III clinical trials showed that CCRT improved local control after conservative breast surgery. However, these randomized trials used non-standard regimen: Cyclophosphamide, methotrexate and fluorouracil (CMF or fluorouracil, mitoxantrone and cyclophosphamide (FNC. In addition, in phases II clinical trials, concurrent use of taxanes and anthracycline with standard whole-breast irradiation showed high rate of toxicity: Pulmonary toxicity with taxane; and cardiac and skin toxicity with anthracycline. Consequentely, CCRT is not be used in practice because of concerns of toxicity with the standard drugs (anthracyclines and taxanes and radiation. Anthracyclines with partial breast irradiation (PBI was feasible according to one phase I clinical trial, and should be investigated in randomized clinical trials. Concurrent Trastuzumab plus radiotherapy is safe and can be used in HER2-positive breast cancer; in this case, cardiac volume sparing and patient selections for internal mammary chain irradiation are highly recommended. The present paper aimed to review the current data evaluating the efficacy and safety of CCRT in early breast cancer.

  12. Current evidence linking polyunsaturated fatty acids (PUFAs with cancer risk and progression

    Directory of Open Access Journals (Sweden)

    MariaAzrad

    2013-09-01

    Full Text Available There is increasing evidence that polyunsaturated fatty acids (PUFAs play a role in cancer risk and progression. The n-3 family of PUFAs includes alpha-linolenic acid (ALA, eicosapentaenoic acid (EPA and docosahexaenoic acid (DHA while the n-6 family includes linolenic acid (LA and arachidonic acid (AA. EPA and DHA are precursors for anti-inflammatory lipid mediators while AA is a precursor for pro-inflammatory lipid mediators. Collectively, PUFAs play crucial roles in maintaining cellular homeostasis, and perturbations in dietary intake or PUFA metabolism could result in cellular dysfunction and contribute to cancer risk and progression. Epidemiologic studies provide an inconsistent picture of the associations between dietary PUFAs and cancer. This discrepancy may reflect the difficulties in collecting accurate dietary data; however, it also may reflect genetic variation in PUFA metabolism which has been shown to modify physiological levels of PUFAs and cancer risk. Also, host-specific mutations as a result of cellular transformation could modify metabolism of PUFAs in the target-tissue. Clinical trials have shown that supplementation with PUFAs or foods high in PUFAs can affect markers of inflammation, immune function, tumor biology and prognosis. Preclinical investigations have begun to elucidate how PUFAs may mediate cell proliferation, apoptosis and angiogenesis and the signaling pathways involved in these processes. The purpose of this review is to summarize the current evidence linking PUFAs and their metabolites with cancer and the molecular mechanisms that underlie this association. Identifying the molecular mechanism(s through which PUFAs affect cancer risk and progression will provide an opportunity to pursue focused dietary interventions that could translate into the development of personalized diets for cancer control.

  13. Current dichotomy between traditional molecular biological and omic research in cancer biology and pharmacology.

    Science.gov (United States)

    Reinhold, William C

    2015-12-10

    There is currently a split within the cancer research community between traditional molecular biological hypothesis-driven and the more recent "omic" forms or research. While the molecular biological approach employs the tried and true single alteration-single response formulations of experimentation, the omic employs broad-based assay or sample collection approaches that generate large volumes of data. How to integrate the benefits of these two approaches in an efficient and productive fashion remains an outstanding issue. Ideally, one would merge the understandability, exactness, simplicity, and testability of the molecular biological approach, with the larger amounts of data, simultaneous consideration of multiple alterations, consideration of genes both of known interest along with the novel, cross-sample comparisons among cell lines and patient samples, and consideration of directed questions while simultaneously gaining exposure to the novel provided by the omic approach. While at the current time integration of the two disciplines remains problematic, attempts to do so are ongoing, and will be necessary for the understanding of the large cell line screens including the Developmental Therapeutics Program's NCI-60, the Broad Institute's Cancer Cell Line Encyclopedia, and the Wellcome Trust Sanger Institute's Cancer Genome Project, as well as the the Cancer Genome Atlas clinical samples project. Going forward there is significant benefit to be had from the integration of the molecular biological and the omic forms or research, with the desired goal being improved translational understanding and application. PMID:26677427

  14. Targeted therapies with companion diagnostics in the management of breast cancer: current perspectives

    Directory of Open Access Journals (Sweden)

    Myers MB

    2016-01-01

    Full Text Available Meagan B Myers Division of Genetic and Molecular Toxicology, National Center for Toxicological Research, US Food and Drug Administration, Jefferson, AR, USA Abstract: Breast cancer is a multifaceted disease exhibiting both intertumoral and intratumoral heterogeneity as well as variable disease course. Over 2 decades of research has advanced the understanding of the molecular substructure of breast cancer, directing the development of new therapeutic strategies against these actionable targets. In vitro diagnostics, and specifically companion diagnostics, have been integral in the successful development and implementation of these targeted therapies, such as those directed against the human epidermal growth factor receptor 2. Lately, there has been a surge in the development, commercialization, and marketing of diagnostic assays to assist in breast cancer patient care. More recently, multigene signature assays, such as Oncotype DX, MammaPrint, and Prosigna, have been integrated in the clinical setting in order to tailor decisions on adjuvant endocrine and chemotherapy treatment. This review provides an overview of the current state of breast cancer management and the use of companion diagnostics to direct personalized approaches in the treatment of breast cancer. Keywords: HER2, precision medicine, in vitro diagnostics, estrogen receptor, multigene assay

  15. Modal survey of the Brazilian launch vehicle

    Science.gov (United States)

    Carneiro, S. H. S.; Teixeira, H. S., Jr.; Pirk, R.; Arruda, J. R. F.

    This paper describes the Brazilian satellite launch vehicle modal analysis program being currently performed. A full scale mock-up of the solid propellant four-stage launcher will be tested in five different configurations. To simulate free-free boundary conditions, a pneumatic suspension system was developed, and its influence in the mock-up dynamic behavior was investigated. The theoretical FEM models and preliminary results of the modal test are shown, along with theoretical/experimental correlation discussions.

  16. Current developments of coumarin-based anti-cancer agents in medicinal chemistry.

    Science.gov (United States)

    Emami, Saeed; Dadashpour, Sakineh

    2015-09-18

    Cancer is one of the leading health hazards and the prominent cause of death in the world. A number of anticancer agents are currently in clinical practice and used for treatment of various kinds of cancers. There is no doubt that the existing arsenal of anticancer agents is insufficient due to the high incidence of side effects and multidrug resistance. In the efforts to develop suitable anticancer drugs, medicinal chemists have focused on coumarin derivatives. Coumarin is a naturally occurring compound and a versatile synthetic scaffold possessing wide spectrum of biological effects including potential anticancer activity. This review article covers the current developments of coumarin-based anticancer agents and also discusses the structure-activity relationship of the most potent compounds. PMID:26318068

  17. Toward predicate approaches to modality

    CERN Document Server

    Stern, Johannes

    2016-01-01

    In this volume, the author investigates and argues for, a particular answer to the question: What is the right way to logically analyze modalities from natural language within formal languages? The answer is: by formalizing modal expressions in terms of predicates. But, as in the case of truth, the most intuitive modal principles lead to paradox once the modal notions are conceived as predicates. The book discusses the philosophical interpretation of these modal paradoxes and argues that any satisfactory approach to modality will have to face the paradoxes independently of the grammatical category of the modal notion. By systematizing modal principles with respect to their joint consistency and inconsistency, Stern provides an overview of the options and limitations of the predicate approach to modality that may serve as a useful starting point for future work on predicate approaches to modality. Stern also develops a general strategy for constructing philosophically attractive theories of modal notions conce...

  18. Current status of boron neutron capture therapy of high grade gliomas and recurrent head and neck cancer

    Directory of Open Access Journals (Sweden)

    Barth Rolf F

    2012-08-01

    Full Text Available Abstract Boron neutron capture therapy (BNCT is a biochemically targeted radiotherapy based on the nuclear capture and fission reactions that occur when non-radioactive boron-10, which is a constituent of natural elemental boron, is irradiated with low energy thermal neutrons to yield high linear energy transfer alpha particles and recoiling lithium-7 nuclei. Clinical interest in BNCT has focused primarily on the treatment of high grade gliomas, recurrent cancers of the head and neck region and either primary or metastatic melanoma. Neutron sources for BNCT currently have been limited to specially modified nuclear reactors, which are or until the recent Japanese natural disaster, were available in Japan, United States, Finland and several other European countries, Argentina and Taiwan. Accelerators producing epithermal neutron beams also could be used for BNCT and these are being developed in several countries. It is anticipated that the first Japanese accelerator will be available for therapeutic use in 2013. The major hurdle for the design and synthesis of boron delivery agents has been the requirement for selective tumor targeting to achieve boron concentrations in the range of 20 μg/g. This would be sufficient to deliver therapeutic doses of radiation with minimal normal tissue toxicity. Two boron drugs have been used clinically, a dihydroxyboryl derivative of phenylalanine, referred to as boronophenylalanine or “BPA”, and sodium borocaptate or “BSH” (Na2B12H11SH. In this report we will provide an overview of other boron delivery agents that currently are under evaluation, neutron sources in use or under development for BNCT, clinical dosimetry, treatment planning, and finally a summary of previous and on-going clinical studies for high grade gliomas and recurrent tumors of the head and neck region. Promising results have been obtained with both groups of patients but these outcomes must be more rigorously evaluated in larger

  19. Current status of boron neutron capture therapy of high grade gliomas and recurrent head and neck cancer

    International Nuclear Information System (INIS)

    Boron neutron capture therapy (BNCT) is a biochemically targeted radiotherapy based on the nuclear capture and fission reactions that occur when non-radioactive boron-10, which is a constituent of natural elemental boron, is irradiated with low energy thermal neutrons to yield high linear energy transfer alpha particles and recoiling lithium-7 nuclei. Clinical interest in BNCT has focused primarily on the treatment of high grade gliomas, recurrent cancers of the head and neck region and either primary or metastatic melanoma. Neutron sources for BNCT currently have been limited to specially modified nuclear reactors, which are or until the recent Japanese natural disaster, were available in Japan, the United States, Finland and several other European countries, Argentina and Taiwan. Accelerators producing epithermal neutron beams also could be used for BNCT and these are being developed in several countries. It is anticipated that the first Japanese accelerator will be available for therapeutic use in 2013. The major hurdle for the design and synthesis of boron delivery agents has been the requirement for selective tumor targeting to achieve boron concentrations in the range of 20 μg/g. This would be sufficient to deliver therapeutic doses of radiation with minimal normal tissue toxicity. Two boron drugs have been used clinically, a dihydroxyboryl derivative of phenylalanine, referred to as boronophenylalanine or “BPA”, and sodium borocaptate or “BSH” (Na2B12H11SH). In this report we will provide an overview of other boron delivery agents that currently are under evaluation, neutron sources in use or under development for BNCT, clinical dosimetry, treatment planning, and finally a summary of previous and on-going clinical studies for high grade gliomas and recurrent tumors of the head and neck region. Promising results have been obtained with both groups of patients but these outcomes must be more rigorously evaluated in larger, possibly randomized clinical

  20. Testosterone Substitution: Current Modalities and Perspectives

    OpenAIRE

    Zitzmann M; Nieschlag E

    2006-01-01

    The clinical picture of male hypogonadism is associated with typical symptoms, such as disturbances of mood and cognitive abilities as well as sexual functions; furtheron, a decrease in muscle mass and strength, an accumulation of body fat and osteopenia/osteoporosis are observed. There are indications that insulin sensitivity is mitigated in a state of androgen depletion. In older men, symptoms of androgen deficiency (late-onset hypogonadism) may exhibit a differential profile due to accompa...

  1. Immunotherapy in gastrointestinal cancer: Recent results, current studies and future perspectives.

    Science.gov (United States)

    Moehler, Markus; Delic, Maike; Goepfert, Katrin; Aust, Daniela; Grabsch, Heike I; Halama, Niels; Heinrich, Bernd; Julie, Catherine; Lordick, Florian; Lutz, Manfred P; Mauer, Murielle; Alsina Maqueda, Maria; Schild, Hansjoerg; Schimanski, Carl C; Wagner, Anna-Dorothea; Roth, Arnaud; Ducreux, Michel

    2016-05-01

    The new therapeutic approach of using immune checkpoint inhibitors as anticancer agents is a landmark innovation. Early studies suggest that immune checkpoint inhibition might also be effective in patients with gastrointestinal cancer. To improve the efficacy of immunotherapy, different strategies are currently under evaluation. This review summarises the discussion during the European Organisation for Research and Treatment of Cancer Gastrointestinal Tract Cancer Translational Research Meeting in Mainz in November 2014 and provides an update on the most recent results of immune therapy in gastrointestinal cancers. Knowledge of potential relationships between tumour cells and their microenvironment including the immune system will be essential in gastrointestinal malignancies. In this context, the density of T cell infiltration within colorectal cancer metastases has been associated with response to chemotherapy, and a high expression of programmed cell death ligand 1 (PD-L1) in advanced gastric cancer has been related with poor prognosis. Effective targets might include neo-antigens encoded from genes carrying tumour-specific somatic mutations. Tailored immunotherapy based on such mutations could enable the effective targeting of an individual patient's tumour with vaccines produced on demand. Other strategies considering checkpoint inhibitors have shown efficacy by targeting cytotoxic T-lymphocyte-associated protein 4 and PD-1 or PD-L1. DNA mismatch repair-deficient tumours appear to be potentially the best candidates for these therapies. Finally, the combination of oncolytic viruses with immunotherapy might boost antitumour activity as well. Further evaluation of these promising immunological therapeutic approaches will require large prospective clinical studies. PMID:27039171

  2. Current status of PET imaging of differentiated thyroid cancer with second generation radiopharmaceuticals

    International Nuclear Information System (INIS)

    Although the prognosis of differentiated thyroid cancer (DTC) is favorable, some histotypes show worst clinical outcome and higher risk of recurrence. Serum thyroglobulin (Tg) levels and 131I-whole-body-scan (WBS), together with neck ultrasound (US), represent the golden standard for DTC follow-up. Nevertheless, the relatively high frequency of patients with high Tg levels and negative WBS requires further investigations by using new imaging modalities. The availability of whole body positron emission tomography (PET) methods, in parallel with the advances in radiochemistry, offer a wide substrate for many solutions. To this day 18F-fluoro-deoxy-glucose (18F-FDG) PET/CT still represents the imaging of choice in follow-up of patients with high serum Tg and negative 131I-WBS but in the last decades the research has focused on finding “second generation” radiopharmaceuticals for PET imaging, with both diagnostic and prognostic purposes, aiming to change the way to image thyroid cancer. Moreover, the use of various PET radiopharmaceuticals, that offer the possibility to explore different pathways involved in thyroid cancer, could find important applications in the near future for clinical decision making in order to program tailored treatments and follow-up. It would be desirable to use the same radiopharmaceutical for both imaging and dosimetric purpose to achieve a tailored therapy. Many efforts are focused in this direction and 124I-PET/CT is now emerging as a valid tool in restaging and therapy management of DTC with promising results. Although the preliminary data available in literature require a confirmation in larger studies with longer follow-up, we think that in next future 124-PET/CT could gain an important role for management of DTC. The aim of this review was to perform a systematic analysis of literature describing the state of art of “second generation” PET-radiopharmaceuticals for imaging DTC. Discussion is focused on the utility of 124I

  3. Current therapeutic strategies for advanced pancreatic cancer: A review for clinicians.

    Science.gov (United States)

    Spadi, Rosella; Brusa, Federica; Ponzetti, Agostino; Chiappino, Isabella; Birocco, Nadia; Ciuffreda, Libero; Satolli, Maria Antonietta

    2016-02-10

    Pancreatic cancer (PC) would become the second leading cause of cancer death in the near future, despite representing only 3% of new cancer diagnosis. Survival improvement will come from a better knowledge of risk factors, earlier diagnosis, better integration of locoregional and systemic therapies, as well as the development of more efficacious drugs rising from a deeper understanding of disease biology. For patients with unresectable, non-metastatic disease, combined strategies encompassing primary chemotherapy and radiation seems to be promising. In fit patients, new polychemotherapy regimens can lead to better outcomes in terms of slight but significant survival improvement associated with a positive impact on quality of life. The upfront use of these regimes can also increase the rate of radical resections in borderline resectable and locally advanced PC. Second line treatments showed to positively affect both overall survival and quality of life in fit patients affected by metastatic disease. At present, oxaliplatin-based regimens are the most extensively studied. Nonetheless, other promising drugs are currently under evaluation. Presently, in addition to surgery and conventional radiation therapy, new locoregional treatment techniques are emerging as alternative options in the multimodal approach to patients or diseases not suitable for radical surgery. As of today, in contrast with other types of cancer, targeted therapies failed to show relevant activity either alone or in combination with chemotherapy and, thus, current clinical practice does not include them. Up to now, despite the fact of extremely promising results in different tumors, also immunotherapy is not in the actual therapeutic armamentarium for PC. In the present paper, we provide a comprehensive review of the current state of the art of clinical practice and research in PC aiming to offer a guide for clinicians on the most relevant topics in the management of this disease. PMID:26862489

  4. Characterization of apolipoprotein and apolipoprotein precursors in pancreatic cancer serum samples via two-dimensional liquid chromatography and mass spectrometry

    OpenAIRE

    Chen, Jianzhong; Anderson, Michelle; Misek, David E.; Simeone, Diane M.; Lubman, David M.

    2007-01-01

    Major advances in cancer control depend upon early detection, early diagnosis and efficacious treatment modalities. Current existing markers of pancreatic ductal adenocarcinoma, generally incurable by available treatment modalities, are inadequate for early diagnosis or for distinguishing between pancreatic cancer and chronic pancreatitis. We have used a proteomic approach to identify proteins that are differentially expressed in sera from pancreatic cancer patients, as compared to control. N...

  5. Current impediments to acceptance of the ultraviolet-B-vitamin D-cancer hypothesis.

    Science.gov (United States)

    Grant, William B; Boucher, Barbara J

    2009-09-01

    The ultraviolet-B (UVB)-vitamin D-cancer hypothesis was proposed in 1980. There have been numerous ecological, observational and other studies of the hypothesis. There are about 14 types of cancer for which it seems to apply: bladder, breast, colon, endometrial, esophageal, gallbladder, gastric, ovarian, pancreatic, rectal, renal and vulvar cancer and both Hodgkin's and non-Hodgkin's lymphoma. Nonetheless, the hypothesis has not yet been accepted by public health agencies. Some of the reasons for this include a distrust of ecological studies, some mistrust of observational studies, and the existence of just one positive randomized controlled trial, an analysis of a vitamin D and calcium supplementation study involving post-menopausal women in Nebraska. Paradigm shifts such as this generally take time, in part due to opposition from those content with the status quo. In this paper, results of ecological studies in the United States using summertime solar UVB as the index of vitamin D production, which is highly asymmetrical with respect to latitude, and indices for other cancer risk-modifying factors (air pollution, alcohol consumption, dietary iron and zinc, ethnic background, socioeconomic status, smoking and urban/rural residence) are discussed in terms of supporting the hypothesis. These studies were not considered while other ecological studies were examined in recent critiques of the hypothesis. While additional randomized controlled trials would, of course, be helpful, the current evidence seems to satisfy the criteria for causality as outlined by A. Bradford Hill. PMID:19667154

  6. Conceptual structure within and between modalities

    Directory of Open Access Journals (Sweden)

    Katia eDilkina

    2013-01-01

    Full Text Available Current views of semantic memory share the assumption that conceptual representations are based on multi-modal experience, which activates distinct modality-specific brain regions. This proposition is widely accepted, yet little is known about how each modality contributes to conceptual knowledge and how the structure of this contribution varies across these multiple information sources. We used verbal feature lists, features from drawings and verbal co-occurrence statistics from latent semantic analysis to examine the informational structure in four domains of knowledge: perceptual, functional, encyclopedic and verbal. The goals of the analysis were three-fold: (1 to assess the structure within individual modalities; (2 to compare structures between modalities; and (3 to assess the degree to which concepts organize categorically or randomly.Our results indicated significant and unique structure in all four modalities: perceptually, concepts organize based on prominent features such as shape, size, color and parts; functionally, they group based on use and interaction; encyclopedically, they arrange based on commonality in location or behavior; and verbally, they group associatively or relationally. Visual/perceptual knowledge gives rise to the strongest hierarchical organization and is closest to classic taxonomic structure. Information is organized somewhat similarly in the perceptual and encyclopedic domains, which differs significantly from the structure in the functional and verbal domains. Notably, the verbal modality has the most unique organization, which is not at all categorical but also not random. The idiosyncrasy and complexity of conceptual structure across modalities begs the question of how all of these modality-specific experiences are fused together into coherent, multi-faceted yet unified concepts. Accordingly, both methodological and theoretical implications of the present findings are discussed.

  7. Targeting PD-1/PD-L1 in lung cancer: current perspectives

    Directory of Open Access Journals (Sweden)

    González-Cao M

    2015-07-01

    Full Text Available María González-Cao,1 Niki Karachaliou,1 Santiago Viteri,1 Daniela Morales-Espinosa,1 Cristina Teixidó,2 Jesús Sánchez Ruiz,3 Miquel Ángel Molina-Vila,2 Mariacarmela Santarpia,4 Rafael Rosell1,2,5,61Translational Cancer Research Unit, Instituto Oncológico Dr Rosell, Quirón Dexeus University Hospital, Barcelona, Spain; 2Pangaea Biotech SL, Barcelona, Spain; 3Centro Nacional de Investigación Oncología (CNIO, Madrid, Spain; 4Medical Oncology Unit, Human Pathology Department, University of Messina, Messina, Italy; 5Cancer Biology and Precision Medicine Program, Catalan Institute of Oncology, Germans Trias i Pujol Health Sciences Institute and Hospital, Campus Can Ruti, Badalona, Barcelona, Spain; 6Fundación Molecular Oncology Research, Barcelona, SpainAbstract: Increased understanding of tumor immunology has led to the development of effective immunotherapy treatments. One of the most important advances in this field has been due to pharmacological design of antibodies against immune checkpoint inhibitors. Anti-PD-1/PD-L1 antibodies are currently in advanced phases of clinical development for several tumors, including lung cancer. Results from Phase I–III trials with anti-PD-1/PD-L1 antibodies in non-small-cell lung cancer have demonstrated response rates of around 20% (range, 16%–50%. More importantly, responses are long-lasting (median duration of response, 18 months and fast (50% of responses are detected at time of first tumor evaluation with very low grade 3–4 toxicity (less than 5%. Recently, the anti-PD-1 antibody pembrolizumab received US Food and Drug Administration (FDA breakthrough therapy designation for treatment of non-small-cell lung cancer, supported by data from a Phase Ib trial. Another anti-PD-1 antibody, nivolumab, has also been approved for lung cancer based on survival advantage demonstrated in recently released data from a Phase III trial in squamous cell lung cancer.Keywords: immunotherapy, immunoncology

  8. Intratumoral chemotherapy for lung cancer: re-challenge current targeted therapies

    Directory of Open Access Journals (Sweden)

    Hohenforst-Schmidt W

    2013-07-01

    through passive transport within the tumor. Recent advances have enhanced the diffusion of pharmaceuticals through active transport by using pharmaceuticals designed to target the genome of tumors. In the present study, five patients with non-small cell lung cancer epidermal growth factor receptor (EGFR negative stage IIIa–IV International Union Against Cancer 7 (UICC-7, and with Eastern Cooperative Oncology Group (ECOG 2 scores were administered platinum-based doublet chemotherapy using combined intratumoral-regional and intravenous route of administration. Cisplatin analogues were injected at 0.5%–1% concentration within the tumor lesion and proven malignant lymph nodes according to pretreatment histological/cytological results and the concentration of systemic infusion was decreased to 70% of a standard protocol. This combined intravenous plus intratumoral-regional chemotherapy is used as a first line therapy on this short series of patients. To the best of our knowledge this is the first report of direct treatment of involved lymph nodes with cisplatin by endobronchial ultrasound drug delivery with a needle without any adverse effects. The initial overall survival and local response are suggestive of a better efficacy compared to established doublet cisplatin–based systemic chemotherapy in (higher standard concentrations alone according to the UICC 7 database expected survival. An extensive search of the literature was performed to gather information of previously published literature of intratumoral chemo-drug administration and formulation for this treatment modality. Our study shows a favorable local response, more than a 50% reduction, for a massive tumor mass after administration of five sessions of intratumoral chemotherapy plus two cycles of low-dose intravenous chemotherapy according to our protocol. These encouraging results (even in very sick ECOG 2 patients with central obstructive non-small cell lung cancer having a worse prognosis and quality of

  9. Philosophical Insight and Modal Cognition

    OpenAIRE

    Gerken, Mikkel

    2015-01-01

    Modal rationalists uphold a strong constitutive relationship between a priori cognition and modal cognition. Since both a priori cognition and modal cognition have been taken to be characteristic of philosophical insights, I will critically assess an ambitious modal rationalism and an associated ambitious methodological rationalism. I begin by examining Kripkean cases of the necessary a posteriori in order to characterize the ambitious modal rationalism that will be the focus of my criticism....

  10. Proton therapy for head and neck cancer: Rationale, potential indications, practical considerations, and current clinical evidence

    International Nuclear Information System (INIS)

    There is a strong rationale for potential benefits from proton therapy (PT) for selected cancers of the head and neck because of the opportunity to improve the therapeutic ratio by improving radiation dose distributions and because of the significant differences in radiation dose distribution achievable with x-ray-based radiation therapy (RT) and PT. Comparisons of dose distributions between x-ray-based and PT plans in selected cases show specific benefits in dose distribution likely to translate into improved clinical outcomes. However, the use of PT in head and neck cancers requires special considerations in the simulation and treatment planning process, and currently available PT technology may not permit realization of the maximum potential benefits of PT. To date, few clinical data are available, but early clinical experiences in sinonasal tumors in particular suggest significant improvements in both disease control and radiation-related toxicity

  11. Understanding the cancer cell phenotype beyond the limitations of current omics analyses.

    Science.gov (United States)

    Moreno-Sánchez, Rafael; Saavedra, Emma; Gallardo-Pérez, Juan Carlos; Rumjanek, Franklin D; Rodríguez-Enríquez, Sara

    2016-01-01

    Efforts to understand the mechanistic principles driving cancer metabolism and proliferation have been lately governed by genomic, transcriptomic and proteomic studies. This paper analyzes the caveats of these approaches. As molecular biology's central dogma proposes a unidirectional flux of information from genes to mRNA to proteins, it has frequently been assumed that monitoring the changes in the gene sequences and in mRNA and protein contents is sufficient to explain complex cellular processes. Such a stance commonly disregards that post-translational modifications can alter the protein function/activity and also that regulatory mechanisms enter into action, to coordinate the protein activities of pathways/cellular processes, in order to keep the cellular homeostasis. Hence, the actual protein activities (as enzymes/transporters/receptors) and their regulatory mechanisms ultimately dictate the final outcomes of a pathway/cellular process. In this regard, it is here documented that the mRNA levels of many metabolic enzymes and transcriptional factors have no correlation with the respective protein contents and activities. The validity of current clinical mRNA-based tests and proposed metabolite biomarkers for cancer detection/prognosis is also discussed. Therefore, it is proposed that, to achieve a thorough understanding of the modifications undergone by proliferating cancer cells, it is mandatory to experimentally analyze the cellular processes at the functional level. This could be achieved (a) locally, by examining the actual protein activities in the cell and their kinetic properties (or at least kinetically characterize the most controlling steps of the pathway/cellular process); (b) systemically, by analyzing the main fluxes of the pathway/cellular process, and how they are modulated by metabolites, all which should contribute to comprehending the regulatory mechanisms that have been altered in cancer cells. By adopting a more holistic approach it may

  12. Individuals, Worlds, and Modalities

    Czech Academy of Sciences Publication Activity Database

    Svoboda, Vladimír

    Frankfurt a.M. : Ontos Verlag, 2003 - (Rott, H.; Horák, V.), s. 149-167 ISBN 3-937202-24-2. - (Studien zur Logik, Sprachphilosophie und Metaphysik. 4) Institutional research plan: CEZ:AV0Z9009908 Keywords : modality * possible world semantics * intensional logic Subject RIV: AA - Philosophy ; Religion

  13. Current status of radiation therapy. Evidence-based medicine (EBM) of radiation therapy. Current management of patients with esophageal cancer

    International Nuclear Information System (INIS)

    The best management for small mucosal esophageal cancer is generally endoscopic mucosal resection. However, for submucosal cancer and extensive mucosal caner, either radical surgery or radiation seems to be an equally efficacious option. Radiation therapy concurrent with chemotherapy is more effective than radiation therapy alone for patients with unresectable esophageal cancer. The key drugs are cisplatin and 5-fluorouracil. However, for patients with poor performance status or for aged patients, radiation therapy alone is still a choice of treatment. Surgery has generally been indicated for patients with resectable esophageal cancer. However, outcomes of concurrent chemoradiation therapy may be comparable with those of surgery. Therefore, a prospective randomized study should be performed to determine the best management for patients with resectable esophageal cancer. The usefulness of intra-cavitary irradiation for esophageal cancer has not been clarified. A prospective randomized trial with a large number of patients is necessary to determine the effectiveness of intra-cavitary irradiation. The best management for patients with loco-regionally recurrent esophageal cancer after surgery has not been determined. Intensive therapy should be considered if the site of recurrence is limited and the time interval from surgery to recurrence is long. Chemotherapy is essential in the management of patients with small cell esophageal cancer. However, the best local therapy has not been determined. (author)

  14. The National Cancer Institute's PREVENT Cancer Preclinical Drug Development Program: overview, current projects, animal models, agent development strategies, and molecular targets.

    Science.gov (United States)

    Shoemaker, Robert H; Suen, Chen S; Holmes, Cathy A; Fay, Judith R; Steele, Vernon E

    2016-02-01

    The PREVENT Cancer Preclinical Drug Development Program (PREVENT) is a National Cancer Institute, Division of Cancer Prevention (NCI, DCP)-supported program whose primary goal is to bring new cancer preventive interventions (small molecules and vaccines) and biomarkers through preclinical development towards clinical trials by creating partnerships between the public sector (eg, academia, industry) and DCP. PREVENT has a formalized structure for moving interventions forward in the prevention pipeline using a stage-gate process with go/no go decision points along the critical path for development. This review describes the structure of the program, its focus areas, and provides examples of projects currently in the pipeline. PMID:26970137

  15. MODAL MANUSIA DAN PRODUKTIVITAS

    Directory of Open Access Journals (Sweden)

    Erlinda Puspita Sari

    2014-03-01

    Full Text Available Modal manusia dianggap sebagai salah satu faktor penentu produktivitas. Modal manusia merupakan dimensi kualitatif dari sumberdaya manusia, seperti keahlian dan keterampilan, yang akan memengaruhi kemampuan produktif manusia tersebut. Dimensi kualitatif tersebut diperoleh melalui pendidikan, pelatihan dan kesehatan. Penelitian ini bertujuan untuk menganaliss efek dari modal manusia terhadap tingkat produktivitas di provinsi-provinsi di Indonesia. Dalam penelitian ini, tingkat pendidikan diukur dengan beberapa indikator, yaitu; angka melek huruf dan angka partisipasi murni tingkat SD, SMP maupun SMA. Tingkat kesehatan diukur dengan angka kematian bayi. Data yang digunakan adalah data panel dari 25 provinsi di Indonesia selama perioede 1996-2010 yang dianalisis dengan menggunakan Model Panel Data Fixed Effect. Hasil analisis menunjukkan bahwa modal manusia yang diukur dari tingkat pendidikan (APM dan tingkat kesehatan (AKB merupakan faktor yang berpengaruh dan signifikan untuk menjelaskan variasi produktivitas meskipun magnitude-nya lebih kecil dibandingkan dengan modal fisik. Hasil analisis juga menunjukkan bahwa variabel pendidikan memiliki magnitude yang lebih besar dibandingkan dengan variabel kesehatan. Human capital is regarded as one of the determining factors of productivity. Human capital is qualitative dimension of human resource which includes skills and knowledge. These qualitative dimensions are internalized through education, training and health. This study aimed to analyze the effect of human capital on productivity level across provinces in Indonesia. In this study, the level of education was measured by literacy and school enrollment rate (in primary, secondary and high school. The level of health was measured by infant mortality rate. The study employed a panel data of 25 provinces in Indonesia during the period of 1996-2010. Using fixed effect method, the result showed that secondary school enrollment rate and infant mortality

  16. Targeted therapy for advanced gastric cancer: A review of current status and future prospects

    Institute of Scientific and Technical Information of China (English)

    Ozkan; Kanat; Bert; O’Neil; Safi; Shahda

    2015-01-01

    In the West in particular, the vast majority of gastric cancer(GC) patients present with advanced-stage disease. Although combination chemotherapy is stillthe most important component of treatment for these patients, it confers a modest survival advantage. Recently, increased knowledge of the key molecular signaling pathways involved in gastric carcinogenesis has led to the discovery of specific molecular-targeted therapeutic agents. Some of these agents such as trastuzumab and ramucirumab have changed the treatment paradigm for this disease. In this paper, we will summarize the current clinical status of targeted drug therapy in the management of GC.

  17. Current status of immunotherapy for non-small-cell lung cancer.

    Science.gov (United States)

    Imbimbo, Martina; Lo Russo, Giuseppe; Blackhall, Fiona

    2016-08-01

    In the last few years, the introduction of novel immunotherapeutic agents has represented a treatment shift for a subset of patients with non-small-cell lung cancer (NSCLC). Checkpoint inhibitors have been demonstrated to improve survival in advanced stage disease with very good tolerability. This success follows many years of scientific effort to manipulate the human immune system to attack cancer cells. With a variety of approaches ranging from vaccines to administration of interleukin or interferon-γ, the results in NSCLC were unsuccessful, with the view that it is a scarcely immunogenic cancer, unlike melanoma or renal cell carcinoma. The step change has come from understanding of immune checkpoints-cell surface molecules that regulate immune system activation and mediate coinhibitory signaling pathways that physiologically protect the body from autoimmunity. These pathways play an important role in tumors, including NSCLC, and are a mechanism of escape from immune surveillance. Several monoclonal antibodies have been developed in order to inhibit these molecules and unleash the brakes of the immune system. Currently in NSCLC, 7 different checkpoint inhibitors are under investigation: 2 anti-cytotoxic T-lymphocyte-associated antigen 4, 2 anti-programmed death (PD)-1, and 3 anti-PD-ligand 1 antibodies. Here we review the progress to date in developing immunotherapy for NSCLC, summarize results from published trials, highlight ongoing trials, and discuss progress in the question of how best to select patients for this treatment. PMID:27443896

  18. Current status of transrectal ultrasound-guided prostate biopsy in the diagnosis of prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Raja, J. [Department of Radiology, St George' s Hospital, Tooting, London (United Kingdom)]. E-mail: jowadraja@gmail.com; Ramachandran, N. [Department of Radiology, St George' s Hospital, Tooting, London (United Kingdom); Munneke, G. [Department of Radiology, St George' s Hospital, Tooting, London (United Kingdom); Patel, U. [Department of Radiology, St George' s Hospital, Tooting, London (United Kingdom)

    2006-02-15

    In contemporary practice, most prostate cancers are either invisible on ultrasound or indistinguishable from concurrent benign prostatic hyperplasia. Diagnosis therefore rests on prostate biopsy. Biopsies are not simply directed at ultrasonically visible lesions, as these would miss many cancers; rather the whole gland is sampled. The sampling itself is systematic, using patterns based on prostate zonal anatomy and the geographical distribution and frequency of cancer. This review explains the evolution of the prostate biopsy technique, from the classical sextant biopsy method to the more recent extended biopsy protocols (8, 10, 12, >12 and saturation biopsy protocols). Extended protocols are increasingly being used to improve diagnostic accuracy, especially in those patients who require repeat biopsy. This trend has been facilitated by the ongoing improvement in safety and acceptability of the procedure, particularly with the use of antibiotic prophylaxis and local anaesthesia. The technical details of these extended protocols are discussed, as are the current data regarding procedure-related morbidity and how this may be minimized.

  19. Clinical proteomics in cancer research-promises and limitations of current two-dimensional gel electrophoresis.

    Science.gov (United States)

    Iwadate, Yasuo

    2008-01-01

    Cancer can be defined as a deviated protein network system toward dysregulated cellular proliferation. Alteration in the content and functional state of the proteins with many linkages may shift the equilibrium state of the protein signaling network to enhance a survival advantage of the affected cells. Searching for such hub proteins is the main purpose of the cancer proteomics. Although the progression in the vanguard proteomic technologies would largely contribute to cancer diagnosis and treatment in the future, the technology most frequently used for the analysis of clinical tissue samples is the two-dimensional gel electrophoresis (2DE) combined with matrix assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS). Accumulation of 2DE data has generated many candidate biomarkers with potential clinical value. The identified proteins are restricted to a subset of the predicted human proteome, and ubiquitously exist in all normal cells taking important roles in the basic biological functions. Although these proteins can be used as valuable prognostic markers, the low-abundance proteins which is tissue-specific and useful as diagnostic markers could not easily be found by the standard 2DE technology alone. None of the current proteomic technologies can identify the whole proteome by themselves. Adequate combinations of different approaches not only in proteomics but in immunological methods would be necessary for the tissue specific markers. PMID:18855668

  20. Current Role and Future Perspectives of Magnetic Resonance Spectroscopy in Radiation Oncology for Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Aleksandra Zapotoczna

    2007-06-01

    Full Text Available Prostatic neoplasms are not uniformly distributed within the prostate volume. With recent developments in three-dimensional intensity-modulated and imageguided radiation therapy, it is possible to treat different volumes within the prostate to different thresholds of doses. This approach has the potential to adapt the dose to the biologic aggressiveness of various clusters of tumor cells within the gland. The definition of tumor burden volume in prostate cancer can be facilitated by the use of magnetic resonance spectroscopy (MRS. The increasing sensitivity and specificity of MRS to the prostate is causing new interest in its potential role in the definition of target subvolumes at higher risk of failure following radical radiotherapy. Prostate MRS might also play a role as a noninvasive predictive factor for tumor response and treatment outcome. We review the use of MRS in radiation therapy for prostate cancer by evaluating its accuracy in the classification of aggressive cancer regions and target definition; its current role in the radiotherapy planning process, with special interest in technical issues behind the successful inclusion of MRS in clinical use; and available early experiences as a prognostic tool.

  1. Garcinol: Current status of its anti-oxidative, anti-inflammatory and anti-cancer effects.

    Science.gov (United States)

    Liu, Chaoqun; Ho, Paul Chi-Lui; Wong, Fang Cheng; Sethi, Gautam; Wang, Ling Zhi; Goh, Boon Cher

    2015-06-28

    Garcinol is the main medicinal component of the dried fruit rind of Garcinia indica (G. indica), which has traditionally been extensively used to treat gastric ailments and skin irritation. In vitro studies of garcinol revealed its potential therapeutic effects, such as its anti-oxidative, anti-inflammatory and anti-cancer properties. Similarly, in vivo studies in animal models also demonstrated the efficacy of garcinol for the treatment of various inflammatory and cancerous conditions. Despite being well tolerated in preclinical studies, the toxicological profile of garcinol remains elusive. More importantly, systematic pharmacokinetics (PK) studies of garcinol to establish an appropriate route of administration and its effective concentration range under physiological conditions have not yet been performed. PK studies play an essential role in translating the preclinical findings of garcinol from cell line models and animal species to humans, thereby facilitating dose selection, the characterization of the therapeutic index, identification of a metabolic pathway, and the determination of garcinol's potency and tolerability. This paper reviews the current studies of garcinol as a potential anti-oxidant, anti-inflammatory and anti-cancer agent and highlights the importance of performing preclinical PK and toxicological studies on garcinol for its development pipeline. PMID:25796441

  2. Current status and evolution of preclinical drug development models of epithelial ovarian cancer

    Directory of Open Access Journals (Sweden)

    Panagiotis A Konstantinopoulos

    2013-12-01

    Full Text Available Epithelial ovarian cancer (EOC is the most lethal gynecologic malignancy and the fifth most common cause of female cancer death in the United States. Although important advances in surgical and chemotherapeutic strategies over the last three decades have significantly improved the median survival of EOC patients, the plateau of the survival curve has not changed appreciably. Given that EOC is a genetically and biologically heterogeneous disease, identification of specific molecular abnormalities that can be targeted in each individual ovarian cancer on the basis of predictive biomarkers promises to be an effective strategy to improve outcome in this disease. However, for this promise to materialize, appropriate preclinical experimental platforms that recapitulate the complexity of these neoplasms and reliably predict antitumor activity in the clinic are critically important. In this review, we will present the current status and evolution of preclinical models of EOC, including cell lines, immortalized normal cells, xenograft models, patient-derived xenografts and animal models, and will discuss their potential for oncology drug development.

  3. Stem Cell Based Gene Therapy in Prostate Cancer

    OpenAIRE

    Jae Heon Kim; Hong Jun Lee; Yun Seob Song

    2014-01-01

    Current prostate cancer treatment, especially hormone refractory cancer, may create profound iatrogenic outcomes because of the adverse effects of cytotoxic agents. Suicide gene therapy has been investigated for the substitute modality for current chemotherapy because it enables the treatment targeting the cancer cells. However the classic suicide gene therapy has several profound side effects, including immune-compromised due to viral vector. Recently, stem cells have been regarded as a new ...

  4. Facile preparation of uniform FeSe2 nanoparticles for PA/MR dual-modal imaging and photothermal cancer therapy

    Science.gov (United States)

    Fu, Tingting; Chen, Yuyan; Hao, Jiali; Wang, Xiaoyong; Liu, Gang; Li, Yonggang; Liu, Zhuang; Cheng, Liang

    2015-12-01

    Recently, magnetic photothermal nanomaterials have emerged as a new class of bio-nanomaterials for application in cancer diagnosis and therapy. Hence, we developed a new kind of magnetic nanomaterials, iron diselenide (FeSe2) nanoparticles, for multimodal imaging-guided photothermal therapy (PTT) to improve the efficacy of cancer treatment. By controlling the reaction time and temperature, FeSe2 nanoparticles were synthesized by a simple solution-phase method. After modification with polyethylene glycol (PEG), the obtained FeSe2-PEG nanoparticles showed high stability under various physiological conditions. FeSe2-PEG could serve as a T2-weighted magnetic resonance (MR) imaging contrast agent because of its strong superparamagnetic properties, with its r2 relaxivity determined to be 133.38 mM-1 S-1, a value higher than that of the clinically used Feridex. On the other hand, with high absorbance in the near-infrared (NIR) region, FeSe2-PEG also appeared to be a useful contrast agent for photoacoustic imaging (PA) as well as an effective photothermal agent for PTT cancer treatment, as demonstrated in our animal tumor model experiments. Moreover, long-term toxicity tests have proven that FeSe2-PEG nanoparticles after systematic administration rendered no appreciable toxicity to the treated animals, and could be gradually excreted from the major organs of mice. Our work indicates that FeSe2-PEG nanoparticles would be a new class of theranostic agents promising for application in bioimaging and cancer therapy.Recently, magnetic photothermal nanomaterials have emerged as a new class of bio-nanomaterials for application in cancer diagnosis and therapy. Hence, we developed a new kind of magnetic nanomaterials, iron diselenide (FeSe2) nanoparticles, for multimodal imaging-guided photothermal therapy (PTT) to improve the efficacy of cancer treatment. By controlling the reaction time and temperature, FeSe2 nanoparticles were synthesized by a simple solution-phase method. After

  5. Multi-modal Imaging of Angiogenesis in a Nude Rat Model of Breast Cancer Bone Metastasis Using Magnetic Resonance Imaging, Volumetric Computed Tomography and Ultrasound

    OpenAIRE

    Bäuerle, Tobias; Komljenovic, Dorde; Martin R. Berger; Semmler, Wolfhard

    2012-01-01

    Angiogenesis is an essential feature of cancer growth and metastasis formation. In bone metastasis, angiogenic factors are pivotal for tumor cell proliferation in the bone marrow cavity as well as for interaction of tumor and bone cells resulting in local bone destruction. Our aim was to develop a model of experimental bone metastasis that allows in vivo assessment of angiogenesis in skeletal lesions using non-invasive imaging techniques.

  6. 早期鼻腔NK/T细胞淋巴瘤放疗模式的研究现状%Current study status of radiotherapy modality on early stage nasal NK/T cell lymphoma

    Institute of Scientific and Technical Information of China (English)

    韩宝林

    2012-01-01

    鼻腔NK/T细胞淋巴瘤属于结外非霍奇金淋巴瘤的一种少见特殊类型,目前研究已经确立了放疗在其治疗中的地位和作用,但对于具体的放疗模式,如适宜的放疗靶区、放疗剂量以及颈部预防照射等问题仍存在着较大的争议.多数研究表明扩大野放疗和较高的放疗剂量是取得较好放疗疗效的关键;局限期病例多不主张颈部预防照射,但对于病变范围广泛者仍有较大争论.%Nasal NK/T cell lymphoma is a rare and distinct type of extranodal Non-Hodgkin' s lymphoma. Current study has proved that Radiotherapy is the most effective treatment method in the early stage nasal NK/T cell lymphoma, but there is no universal standard for concrete radiotherapy modality, such as the radiation target, the radiation dose and preventive neck radiation. Most studies have proved that radiotherapy of extended field and higher dose achieved good effect in early stage nasal NK/T cell lymphoma.And the studies also do not suggested preventive neck radiation in local stage patients, but it need further study in the extensive stage patients.

  7. Targeting Bone Metabolism in Patients with Advanced Prostate Cancer: Current Options and Controversies

    Directory of Open Access Journals (Sweden)

    Tilman Todenhöfer

    2015-01-01

    Full Text Available Maintaining bone health remains a clinical challenge in patients with prostate cancer (PC who are at risk of developing metastatic bone disease and increased bone loss due to hormone ablation therapy. In patients with cancer-treatment induced bone loss (CTIBL, antiresorptive agents have been shown to improve bone mineral density (BMD and to reduce the risk of fractures. For patients with bone metastases, both zoledronic acid and denosumab delay skeletal related events (SREs in the castration resistant stage of disease. Novel agents targeting the Wnt inhibitors dickkopf-1 and sclerostin are currently under investigation for the treatment of osteoporosis and malignant bone disease. New antineoplastic drugs such as abiraterone, enzalutamide, and Radium-223 are capable of further delaying SREs in patients with advanced PC. The benefit of antiresorptive treatment for patients with castration sensitive PC appears to be limited. Recent trials on the use of zoledronic acid for the prevention of bone metastases failed to be successful, whereas denosumab delayed the occurrence of bone metastases by a median of 4.1 months. Currently, the use of antiresorptive drugs to prevent bone metastases still remains a field of controversies and further trials are needed to identify patient subgroups that may profit from early therapy.

  8. Targeting bone metabolism in patients with advanced prostate cancer: current options and controversies.

    Science.gov (United States)

    Todenhöfer, Tilman; Stenzl, Arnulf; Hofbauer, Lorenz C; Rachner, Tilman D

    2015-01-01

    Maintaining bone health remains a clinical challenge in patients with prostate cancer (PC) who are at risk of developing metastatic bone disease and increased bone loss due to hormone ablation therapy. In patients with cancer-treatment induced bone loss (CTIBL), antiresorptive agents have been shown to improve bone mineral density (BMD) and to reduce the risk of fractures. For patients with bone metastases, both zoledronic acid and denosumab delay skeletal related events (SREs) in the castration resistant stage of disease. Novel agents targeting the Wnt inhibitors dickkopf-1 and sclerostin are currently under investigation for the treatment of osteoporosis and malignant bone disease. New antineoplastic drugs such as abiraterone, enzalutamide, and Radium-223 are capable of further delaying SREs in patients with advanced PC. The benefit of antiresorptive treatment for patients with castration sensitive PC appears to be limited. Recent trials on the use of zoledronic acid for the prevention of bone metastases failed to be successful, whereas denosumab delayed the occurrence of bone metastases by a median of 4.1 months. Currently, the use of antiresorptive drugs to prevent bone metastases still remains a field of controversies and further trials are needed to identify patient subgroups that may profit from early therapy. PMID:25802521

  9. Volumetric intensity modulated arc therapy in lung cancer: Current literature review

    Directory of Open Access Journals (Sweden)

    Suresh B Rana

    2013-01-01

    Full Text Available The volumetric intensity modulated arc therapy (VMAT is a novel radiation technique that delivers a highly conformal radiation dose to the target by allowing the simultaneous variation of gantry rotation speed, dose rate and multiple-leaf collimators leaf positions. The aim of this study was to review the current literature on two VMAT systems, RapidArc and SmartArc with main focus on planning studies of lung cancer. A systematic review of available data was conducted using MEDLINE/PubMed with the keywords ′′lung′′ and "VMAT". The published data show that VMAT techniques have clear superiority over three-dimensional conformal radiation therapy with regard to improving dose conformity and sparing of organs at risks (OARs. The data indicates that for lung tumor VMAT and intensity modulated radiation therapy (IMRT provide equivalent dose homogeneity, dose conformity and target volume coverage; however, contradictory results were obtained in terms of OARs sparing. The major advantages of VMAT over IMRT are the reduction in the number of monitor units and faster treatment delivery times without compromising the quality of the treatment plans. Moreover, faster delivery time is more patient-friendly and it minimizes intra-fractional patient motion allowing treatment volumes stay within their respective treatment margins. Current literature data shows that VMAT can be a good option to treat lung cancer; however, data on clinical trials are still lacking. The clinical trials are essential to confirm the safety and efficacy of VMAT techniques.

  10. Testing for her2 in breast cancer: current pathology challenges faced in Canada.

    Science.gov (United States)

    Hanna, W; Barnes, P; Berendt, R; Chang, M; Magliocco, A; Mulligan, A M; Rees, H; Miller, N; Elavathil, L; Gilks, B; Pettigrew, N; Pilavdzic, D; Sengupta, S

    2012-12-01

    This review is designed to highlight several key challenges in the diagnosis of human epidermal growth factor receptor 2 (her2)-positive breast cancer currently faced by pathologists in Canada: Pre-analysis issues affecting the accuracy of her2 testing in non-excision sample types: core-needle biopsies, effusion samples, fine-needle aspirates, and bone metastasesher2 testing of core-needle biopsies compared with surgical specimensCriteria for retesting her2 status upon disease recurrenceLiterature searches for each topic were carried out using the medline, Embase, International Pharmaceutical Abstracts, and biosis databases. In addition, the congress databases of the American Society of Clinical Oncology (2005-2011) and the San Antonio Breast Cancer Symposium (2007-2011) were searched for relevant abstracts.All authors are expert breast pathologists with extensive experience of her2 testing, and several participated in the development of Canadian her2 testing guidelines. For each topic, the authors present an evaluation of the current data available for the guidance of pathology practice, with recommendations for the optimization or improvement of her2 testing practice. PMID:23300357

  11. Clinical relevance of autophagic therapy in cancer: Investigating the current trends, challenges, and future prospects.

    Science.gov (United States)

    Mukhopadhyay, Subhadip; Sinha, Niharika; Das, Durgesh Nandini; Panda, Prashanta Kumar; Naik, Prajna Paramita; Bhutia, Sujit Kumar

    2016-08-01

    Oncophagy (cancer-related autophagy) has a complex dual character at different stages of tumor progression. It remains an important clinical problem to unravel the reasons that propel the shift in the role of oncophagy from tumor inhibition to a protective mechanism that shields full-blown malignancy. Most treatment strategies emphasize curbing protective oncophagy while triggering the oncophagy that is lethal to tumor cells. In this review, we focus on the trends in current therapeutics as well as various challenges in clinical trials to address the oncophagic dilemma and evaluate the potential of these developing therapies. A detailed analysis of the clinical and pre-clinical scenario of the anticancer medicines highlights the various inducers and inhibitors of autophagy. The ways in which tumor stage, the microenvironment and combination drug treatment continue to play an important tactical role are discussed. Moreover, autophagy targets also play a crucial role in developing the best possible solution to this oncophagy paradox. In this review, we provide a comprehensive update on the current clinical impact of autophagy-based cancer therapeutic drugs and try to lessen the gap between translational medicine and clinical science. PMID:26743568

  12. Predicting Pelvic Lymph Node Involvement in Current-Era Prostate Cancer

    International Nuclear Information System (INIS)

    Purpose: The Roach formula [2/3 × prostate-specific antigen + (Gleason score – 6) × 10], derived in 1993 during the early prostate specific antigen (PSA) screening era, has been used to predict the risk of pelvic lymph node involvement in patients with prostate cancer. In the current era of widespread PSA screening with a shift to earlier disease stages, there is evidence to suggest that the Roach score overestimates risk of nodal metastasis. This study retrospectively reviews the validity of this formula as a prediction tool. Methods and Materials: We conducted a retrospective institutional review including men with clinical T1c–T3 prostate cancer, with baseline PSA levels and biopsy-obtained Gleason scores who underwent radical prostatectomy with pelvic node dissection from 2001 through 2009 (N = 1,022). The predicted risk of nodal involvement was calculated for each patient using the Roach formula and then compared with actual rates following surgery. Results: The study included 1,022 patients; 99.6% had clinical T1c/T2 disease, with a mean of 10.3 lymph nodes surgically evaluated. Overall, 42 patients (4.1%) had nodal metastasis. For every range of scores, the Roach formula overestimates the risk of nodal involvement. Observed nodal positivity was 1%, 6.3%, 10%, 15.2%, and 16.7% for Roach scores ≤10%, >10%–20%, >20%–30%, >30%–40%, and >40%, respectively. The Roach score overestimates the risk by approximately 4.5-fold in patients with scores ≤10%, by 2.5-fold for all scores between 10% and 40%, and by 4-fold for scores >40%. Conclusion: The Roach formula overpredicts the risk of pelvic nodal involvement in current-era prostate cancer patients undergoing regular PSA screening and with mainly T1c/T2 disease. Contemporary patients are much less likely to have nodal involvement for a given PSA and Gleason score.

  13. Modal Analysis of Exhaust System

    OpenAIRE

    Myrén, Marcus; Olsson, Jörgen

    1999-01-01

    A modal analysis is performed on an exhaust system for cars. Natural frequencies and mode shapes are correlated between experimental and finite element models. MAC-values are calculated. Theories and guidelines for modal analyses of exhaust systems are discussed.

  14. Real-time sonoelastography compared to magnetic resonance imaging using four different modalities at 3.0 T in the detection of prostate cancer: Strength and weaknesses

    Energy Technology Data Exchange (ETDEWEB)

    Pelzer, Alexandre E., E-mail: alexandre.pelzer@gmail.com [Department of Urology, Klinikum Ingolstadt, Krumenauerstr. 25, 85049 Ingolstadt (Germany); Heinzelbecker, Julia, E-mail: julia.heinzelbecker@umm.de [Department of Urology, University Medical Centre Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Weiß, Christel, E-mail: christel.weiss@urz.uni-heidelberg.de [Institute of Medical Statistics and Biometry, Medical Faculty Mannheim, Ludolf-Krehl-Straße 13-17, 68167 Mannheim (Germany); Frühbauer, Dominik, E-mail: dominik.j.fruehbauer@googlemail.com [Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Weidner, Anja M., E-mail: anja.weidner@umm.de [Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Kirchner, Matthias, E-mail: kirchner@patho-nordhessen.de [Institute of Pathology Nordhessen, Germaniastr. 7, 34119 Kassel (Germany); Stroebel, Philipp, E-mail: philipp.stroebel@umm.de [Institute of Pathology, University Medical Centre Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Schoenberg, Stephan O., E-mail: stefan.schoenberg@umm.de [Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Dinter, Dietmar J., E-mail: dietmar.dinter@umm.de [Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany)

    2013-05-15

    Objective: To compare the results of RTE with four different modalities at 3.0 T using endorectal and body phased array coil in the detection of PC. Patients and methods: Between May 2009 and July 2010, 50 patients with biopsy proven PC scheduled for radical prostatectomy (RP) were examined. All patients underwent RTE of the prostate and 3.0 T endorectal MRI. The investigators were unaware of the clinical data and of each others results. Results: RTE detected PC in 46 (92%) and MRI in 42 (84%) of the patients. Depending on the analysis sensitivity was 44.1–58.9% for RTE and 36.7–43.1% for MRI. Specificity was 83.0–74.8% for RTE and 85.9–79.8% for MRI. Sensitivity was significantly higher for RTE (16-sectors: p = 0.0348; 8-sectors: p = 0.0002) and showed better results in the dorsal (RTE: 51.9%; MRT: 37.7%) and apical to middle (RTE: 66.7%-80.0%; MRI: 41.7%-60.0%) parts of the prostate. MRI showed better results in the base (MRI: 19.4%; RTE: 14.9%) and transitional zone (TZ) (MRI: 34.7%; RTE: 29.6%). Concerning capsular involvement the results were comparable with sensitivity and specificity of RTE being 79.2% and 80.0% compared to 80.8% and 70.0% of MRI. Conclusions: Concerning sensitivity RTE showed advantages in apical and middle parts whereas MRI may provide advantages in the glands’ base and TZ. Both RTE and MRI have limitations particularly in basal and ventral parts. Most of the undetected tumours were of low tumour volume and Gleason Score. Considering capsular involvement both techniques showed comparable results.

  15. Does ductal lavage assert its role as a noninvasive diagnostic modality to identify women at low risk of breast cancer development?

    Science.gov (United States)

    Konstandiadou, Ioanna; Kotsilianou, Olympia; Karakitsos, Petros; Athanasas, George; Smyrniotis, Vasilios; Arkadopoulos, Nikolaos

    2012-01-01

    Objective Ductal lavage (DL) involves evaluation of the ductal system of the breast for detection of intra-ductal carcinomas and precursor lesions by collecting breast epithelial cells using a small-gauge catheter inserted into a ductal orifice on the nipple. The aim of this survey was to analyze cytologic features of samples obtained from low-risk women with DL and to elucidate the efficacy of this diagnostic modality in evaluating fluid production, cannulating and determining atypical breast epithelial cells. Methods Into this prospective study were consecutively registered 80 women between ages 28 to 67. Nipple aspiration was performed to identify all fluid-yielding ducts. According to the grading of specific features the interpretation of the sample included: normal/benign (category, 0), mild atypical (category, I), markedly atypical (category, II) or malignant (category, III) disorders. Results Ninety five percent (316/334) of the nipple aspirate fluid samples were classified as category 0, 4.8% (16/334) as category I and 0.2% (2/334) as category II changes. Category III disorders were not detected. Therefore, in 80% of the women examined results were within normal limits while 17.5% of the participants presented mild atypical and 2.5% markedly atypical rates. Conclusion DL collection procedure proved to be rapid as well as acceptable by the women studied. It retains the advantage over other methods of nipple aspirate fluid in that it is easy to perform, thereby removing most clinician variability. It also helped low risk women to discriminate those with breast disorders that require additional investigation, further follow-up or administration of preventive medication. PMID:22523627

  16. Malignant and borderline phyllodes tumor of breast treated with a multi-modality approach in a tertiary cancer care centre in North India

    Directory of Open Access Journals (Sweden)

    Supriya Mallick

    2016-01-01

    Full Text Available Background: Phyllodes tumor (PT of the breast can be categorized into benign, borderline and malignant subgroups depending on various histopathological factors. Although malignant PTs may be indolent and controlled by local excision, they frequently show local and distant relapses. Literature reveals local recurrence to be the predominant pattern of failure and thus emphasizes the importance of adjuvant radiation in these tumors. The role of systemic chemotherapy has remained doubtful. Materials and Methods: We have analyzed details of all patients of PT (n = 33 treated with adjuvant multi-modality approach in our institute since 1994–2009. The demographic data, treatment details, recurrence patterns and salvage treatment options were documented. Results: All patients received adjuvant radiation. Seven patients received adjuvant chemotherapy. The mean survival of the entire cohort was 150.618 months. There was a trend for better overall survival with borderline grade (193.6 vs. 160.2 months; P = 0.08, log rank. The disease free survival (DFS favored borderline grade (193.6 months vs. 82.9 months for high grade; P = 0.02, log rank. The DFS was significantly better in tumors having negative margins on postoperative histopathological examination (DFS rate at 5 years being 100% vs. 69.2% for positive or close margins; P = 0.015. The mode of surgery did not have any impact on survival. Conclusion: Adjuvant Radiation should be discussed taking into account surgical margins, size and various pathological factors of the primary. Adjuvant radiation may be utilized in high risk patients to enhance loco-regional control. Systemic chemotherapy is an option, worth exploring, in cases of systemic failure.

  17. Real-time sonoelastography compared to magnetic resonance imaging using four different modalities at 3.0 T in the detection of prostate cancer: Strength and weaknesses

    International Nuclear Information System (INIS)

    Objective: To compare the results of RTE with four different modalities at 3.0 T using endorectal and body phased array coil in the detection of PC. Patients and methods: Between May 2009 and July 2010, 50 patients with biopsy proven PC scheduled for radical prostatectomy (RP) were examined. All patients underwent RTE of the prostate and 3.0 T endorectal MRI. The investigators were unaware of the clinical data and of each others results. Results: RTE detected PC in 46 (92%) and MRI in 42 (84%) of the patients. Depending on the analysis sensitivity was 44.1–58.9% for RTE and 36.7–43.1% for MRI. Specificity was 83.0–74.8% for RTE and 85.9–79.8% for MRI. Sensitivity was significantly higher for RTE (16-sectors: p = 0.0348; 8-sectors: p = 0.0002) and showed better results in the dorsal (RTE: 51.9%; MRT: 37.7%) and apical to middle (RTE: 66.7%-80.0%; MRI: 41.7%-60.0%) parts of the prostate. MRI showed better results in the base (MRI: 19.4%; RTE: 14.9%) and transitional zone (TZ) (MRI: 34.7%; RTE: 29.6%). Concerning capsular involvement the results were comparable with sensitivity and specificity of RTE being 79.2% and 80.0% compared to 80.8% and 70.0% of MRI. Conclusions: Concerning sensitivity RTE showed advantages in apical and middle parts whereas MRI may provide advantages in the glands’ base and TZ. Both RTE and MRI have limitations particularly in basal and ventral parts. Most of the undetected tumours were of low tumour volume and Gleason Score. Considering capsular involvement both techniques showed comparable results

  18. Nutrition support and dietary interventions for patients with lung cancer: current insights

    OpenAIRE

    Kiss N

    2016-01-01

    Nicole Kiss1,2 1Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia; 2Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia Abstract: Malnutrition and weight loss are prevalent in patients with lung cancer. The impact of malnutrition on patients with cancer, and specifically in patients with lung cancer, has been demonstrated in a large number of studies. Malnutrition has been shown to neg...

  19. Refinement Checking on Parametric Modal Transition Systems

    DEFF Research Database (Denmark)

    Benes, Nikola; Kretínsky, Jan; Larsen, Kim Guldstrand;

    2015-01-01

    Modal transition systems (MTS) is a well-studied specification formalism of reactive systems supporting a step-wise refinement methodology. Despite its many advantages, the formalism as well as its currently known extensions are incapable of expressing some practically needed aspects in the refin...

  20. An application of operational modal analysis in modal filtering

    Energy Technology Data Exchange (ETDEWEB)

    Kurowski, Piotr; Mendrok, Krzysztof; Uhl, Tadeusz, E-mail: mendrok@agh.edu.pl [AGH University of Science and Technology in Krakow, Al. Mickiewicza 30, 30-059, Krakow (Poland)

    2011-07-19

    Modal filtration in the field of damage detection has many advantages, including: its autonomous operation (without the interaction of qualified staff), low computational cost and low sensitivity to changes in external conditions. However, the main drawback of this group of damage detection methods is its limited applicability to operational data. In this paper a method of modal filter formulation from the in-operational data is described. The basis for this approach is FRFs synthesis using knowledge of the operational modal model. For that purpose a method of operational mode shape scaling is described. This is based on the measurements of several FRFs of the object. The method is then applied to the construction of modal filters and modal filtration. Additionally, the study presents verification of the method using data obtained from simulation and laboratory experiments. Verification consisted of comparing the results of modal filtering based on classical experimental modal analysis with the results of the approach proposed in the work.

  1. TRWG developmental pathway for biospecimen-based assessment modalities

    Energy Technology Data Exchange (ETDEWEB)

    Translational Research Working Group; Srivastava, Sudhir; Gray, Joe W.; Reid, Brian J.; Grad, Oren; Greenwood, Addison; Hawk, Ernest T.

    2008-09-03

    The Translational Research Working Group (TRWG) was created as a national initiative to evaluate the current status of NCI's investment in translational research and envision its future. The TRWG conceptualized translational research as a set of six developmental processes or pathways focused on various clinical goals. One of those pathways describes the development of biospecimen-based assays that utilize biomarkers for the detection, diagnosis, prognosis, and assessment of response to cancer treatment. The biospecimen-based assessment modality (BM) pathway was conceived not as comprehensive description of the corresponding real-world processes, but rather as a tool designed to facilitate movement of a candidate assay through the translational process to the point where it can be handed off for definitive clinical testing. This paper introduces the pathway in the context of prior work and discusses key challenges associated with the biomarker development process in light of the pathway.

  2. Dorsal and ventral streams across sensory modalities

    Institute of Scientific and Technical Information of China (English)

    Anna Sedda; Federica Scarpina

    2012-01-01

    In this review,we describe the current models of dorsal and ventral streams in vision,audition and touch.Available theories take their first steps from the model of Milner and Goodale,which was developed to explain how human actions can be efficiently carried out using visual information.Since then,similar concepts have also been applied to other sensory modalities.We propose that advances in the knowledge of brain functioning can be achieved through models explaining action and perception patterns independently from sensory modalities.

  3. Treatment, therapy results and survival for non-small cell lung cancer in a period of new therapeutic modalities and cytotoxic substances

    International Nuclear Information System (INIS)

    During the last years considerable changes have been made in the treatment of non-small cell lung cancer. This retrospective study analyzed besides the common characteristics the treatment, response rates and overall survival of patients with non-small cell lung cancer in a central internistical and oncological outpatient department. 328 patients treated at the haematology-oncology outpatient department were included in this study. Requirements have been patients with histologically or cytologically verified non-small cell lung cancer, diagnosis between 1989 and 2001 and comprehensible courses of disease and treatment. Results: Most of the patients were men (72 %) and only 28 % were women. Median age at diagnosis was 61 years; 8.8 % of the patients were aged under 45 years. Adenocarcinoma (46 %) and squamous cell carcinoma (36 %) were the most frequent histologic types. At time of diagnosis 68 % of the patients have been in an already advanced stage IIIB or IV. Surprisingly the diagnosis resulted for 25 % of the patients by chance, 75 % of the patients were diagnosed due to symptoms. Only 8 % of the patients did not receive a specific therapy (surgery, radiation therapy, chemotherapy) due to their advanced disease. 21 patients were treated in a neoadjuvant setting and for 10 (48 %) surgery with curative intention could be performed. The most frequently given chemotherapy in the first-line palliative therapy were Cis-, Carboplatin/VP 16 (40 %) and Cis-, Carboplatin/Navelbine (27 %). The response rate was poor - six complete responses (2.5 %) and 34 (14.3 %) partial responses. 107 patients received a second-line chemotherapy. The overall median survival of all patients was 13.5 months. The stage at time of diagnosis was the most important prognostic factor. Interestingly enough also a survival benefit for women could be demonstrated (15.5 months vs. 13 months). The common characteristics of the analyzed patients correspond to the typical collective of patients in a

  4. [Cancer].

    Science.gov (United States)

    de la Peña-López, Roberto; Remolina-Bonilla, Yuly Andrea

    2016-09-01

    Cancer is a group of diseases which represents a significant public health problem in Mexico and worldwide. In Mexico neoplasms are the second leading cause of death. An increased morbidity and mortality are expected in the next decades. Several preventable risk factors for cancer development have been identified, the most relevant including tobacco use, which accounts for 30% of the cancer cases; and obesity, associated to another 30%. These factors, in turn, are related to sedentarism, alcohol abuse and imbalanced diets. Some agents are well knokn to cause cancer such as ionizing radiation, viruses such as the papilloma virus (HPV) and hepatitis virus (B and C), and more recently environmental pollution exposure and red meat consumption have been pointed out as carcinogens by the International Agency for Research in Cancer (IARC). The scientific evidence currently available is insufficient to consider milk either as a risk factor or protective factor against different types of cancer. PMID:27603890

  5. Converting from CT- to MRI-only-based target definition in radiotherapy of localized prostate cancer. A comparison between two modalities

    International Nuclear Information System (INIS)

    To investigate the conversion of prostate cancer radiotherapy (RT) target definition from CT-based planning into an MRI-only-based planning procedure. Using the CT- and MRI-only-based RT planning protocols, 30 prostate cancer patients were imaged in the RT fixation position. Two physicians delineated the prostate in both CT and T2-weighted MRI images. The CT and MRI images were coregistered based on gold seeds and anatomic borders of the prostate. The uncertainty of the coregistration, as well as differences in target volumes and uncertainty of contour delineation were investigated. Conversion of margins and dose constraints from CT- to MRI-only-based treatment planning was assessed. On average, the uncertainty of image coregistration was 0.4 ± 0.5 mm (one standard deviation, SD), 0.9 ± 0.8 mm and 0.9 ± 0.9 mm in the lateral, anterior-posterior and base-apex direction, respectively. The average ratio of the prostate volume between CT and MRI was 1.20 ± 0.15 (one SD). Compared to the CT-based contours, the MRI-based contours were on average 2-7 mm smaller in the apex, 0-1 mm smaller in the rectal direction and 1-4 mm smaller elsewhere. When converting from a CT-based planning procedure to an MRI-based one, the overall planning target volumes (PTV) are prominently reduced only in the apex. The prostate margins and dose constraints can be retained by this conversion. (orig.)

  6. Breast Cancer Screening in Women with Learning Disabilities: Current Knowledge and Considerations

    Science.gov (United States)

    Willis, Diane S.; Kennedy, Catriona M.; Kilbride, Lynn

    2008-01-01

    As people with learning disabilities now live longer, they will experience the same age-related illnesses as the general population and cancer is a prime example of this. In women, cancer screening is used to detect early on-set of cancer of the breast and abnormalities of the cervix which might, if left untreated, develop into cancer.…

  7. Modal Interfaces in Hawaii

    Science.gov (United States)

    Wright, E. Alvey

    1974-01-01

    Hawaii, an archipelago where transportation distances are short but the interfaces are many, seeks elimination of modal changes by totally-submerged hydrofoil craft operating at the water surface directly between tourist resort destinations, by dual mode rapid transit vehicles operating directly between the deplaning bridges at Honolulu International Airport and hotel porte-cochere at Waikiki, by demand responsive vehicles for collection and distribution operating on fixed guideways for line haul, and by roll-on/roll-off inter-island ferries for all models of manually operated ground vehicles. The paper also describes facilitation of unavoidable interfaces by innovative sub-systems.

  8. RF modal quantity gaging

    Science.gov (United States)

    Vanleuven, K.

    1989-05-01

    The primary objective is to provide a concept of a radio frequency (RF) modal resonance technique which is being investigated as a method for gaging the quantities of subcritical cryogenic propellants in metallic tanks. Of special interest are the potential applications of the technique to microgravity propellant gaging situations. The results of concept testing using cryogenic oxygen, hydrogen, and nitrogen, as well as paraffin simulations of microgravity fluid orientations, are reported. These test results were positive and showed that the gaging concept was viable.

  9. An overview of synthetic strategies and current applications of gold nanorods in cancer treatment

    Science.gov (United States)

    Manish Lakhani, Prit; Vishnu Kiran Rompicharla, Sri; Ghosh, Balaram; Biswas, Swati

    2015-10-01

    Photothermal therapy, also referred to as optical hyperthermia or photothermal ablation, is an emerging strategy for treating solid tumours. Colloidal gold converts the absorbed light into localized heat via a non-radiative mechanism, surface plasmon resonance, which ablates the solid tumours. Several plasmon resonating nanostructures, including gold nanoparticles (AuNPs), gold nanorods (AuNRs), gold nanoshells, gold nanocages, copper sulphide and carbon nanotubes, have shown potential for photo-activated cancer therapy. Generally, spherical AuNPs display absorption maxima between 500-550 nm, making them inefficient due to low tissue penetration. On the other hand, AuNRs absorb light in the near-infrared (NIR) region that penetrates deeper with higher spatial precision, and causes no damage to the surrounding healthy tissues due to the low energy absorption of NIR light by normal tissue. Moreover, the absorption range of light can be fine-tuned to the NIR region by adjusting the aspect ratios of AuNRs. However, large-scale synthesis and stability of this colloidal system still poses challenges for clinical translation. In this review, we discuss various strategies applied up to now for the synthesis of AuNRs. Current trends in the pre-clinical development of multifunctional AuNRs with emphasis on preparation and application strategies in cancer therapy have been delineated.

  10. Use of Modal Synthesis for Composite Structures

    Directory of Open Access Journals (Sweden)

    Musil Miloš

    2014-12-01

    Full Text Available A common occurrence in engineering practice is undesirable levels of vibration in the structures of machinery, which decrease their functionality, safety, reliability and service life. Current trends in the dynamic operation of machinery inherently generate such undesirable effects. That is to say, increasing the operational capacity of a machine (higher speeds, higher loads, more changes in operational regimes, etc... is financially counterproductive to any desired savings in the material/technological realization of such structures. One possible approach to modify the dynamic properties of the structure is through modal synthesis. This approach combines the modal properties of the real structure obtained through measurements with the modal properties of additional components obtained computationally. This approach is particularly effective if the computational model of the built structure is incorrect.

  11. Current Status of Poly(ADP-ribose Polymerase Inhibitors as Novel Therapeutic Agents for Triple-Negative Breast Cancer

    Directory of Open Access Journals (Sweden)

    David J. Hiller

    2012-01-01

    Full Text Available Triple-negative breast cancer (TNBC is an aggressive type of breast cancer that is clinically defined as lacking estrogen and progesterone receptors, as well as being ERBB2 (HER-2 negative. Without specific therapeutic targets, TNBC carries a worse prognosis than other types of breast cancer in the absence of therapy. Research has now further differentiated breast cancer into subtypes based on genetic expression patterns. One of these subtypes, basal-like, frequently overlaps with the clinical picture of TNBC. Additionally, both TNBC and basal-like breast cancer link to BRCA mutations. Recent pharmaceutical advances have created a class of drugs, poly(ADP-ribose polymerase (PARP inhibitors, which are showing potential to effectively treat these patients. The aim of this paper is to summarize the basis behind PARP inhibitors and update the current status of their development in clinical trials for the treatment of TNBC.

  12. Current Perspectives on Novel Drug Delivery Systems and Approaches for Management of Cervical Cancer: A Comprehensive Review.

    Science.gov (United States)

    Hani, Umme; Osmani, Riyaz Ali M; Bhosale, Rohit R; Shivakumar, Hosakote Gurumallappa; Kulkarni, Parthasarathi K

    2016-01-01

    Cervical cancer is uterine cervix carcinoma, the second deadly cancer and has a high incidence and mortality rate. In the developing world conventional treatment strategies such as surgical intervention and chemoradiotherapy are less widely available. Currently cancer research focuses on improving treatment of cervical cancer using various therapies such as gene therapy, recombinant protein therapy, photodynamic therapy, photothermal therapy and delivery of chemotherapeutic agents using nanoparticles, hydrogel and liposomal based delivery systems and also localized delivery systems which exist in a variety of forms such as intravaginal rings, intravaginal patches, intravaginal films, etc. in order to improve the drug delivery in a controlled manner to the diseased site thereby reducing systemic side effects. The present review encloses existing diverse delivery systems and approaches intended for treatment of cervical cancer. PMID:25944014

  13. Current Issues of Targeted Therapy in Metastatic Triple-Negative Breast Cancer

    OpenAIRE

    Liedtke, Cornelia; Kiesel, Ludwig

    2011-01-01

    Patients with triple-negative breast cancer are characterized by a poor prognosis compared with patients with other breast cancer subtypes. The angiogenesis inhibitor bevacizumab is effective in the palliative treatment of patients with triple-negative breast cancer as well as in other breast cancer subtypes. PARP inhibitors represent the first group of targeted agents to be developed under the particular aspect of treating patients with hereditary and triple-negative breast cancer. In additi...

  14. Mammography - importance, possibilities, current screening situation of the breast cancer and further expansion possibilities

    International Nuclear Information System (INIS)

    Breast cancer still remains the most frequent cancer in women population. Incidence of breast cancer is increasing, but mortality is decreasing. The most important for decreasing of breast cancer mortality is early diagnostic, especially screening. Screening is a form of secondary prevention. Although many screening studies have shown that mammography decreases of the breast cancer death, there are still many controversies. The published recommendations for the breast screening are sometimes very different. (author)

  15. Application of Quantum Dots-Based Biotechnology in Cancer Diagnosis: Current Status and Future Perspectives

    OpenAIRE

    Chun-Wei Peng; Yan Li

    2010-01-01

    The semiconductor nanocrystal quantum dots (QDs) have excellent photo-physical properties, and the QDs-based probes have achieved encouraging developments in cellular and in vivo molecular imaging. More and more researches showed that QDs-based technology may become a promising approach in cancer research. In this review, we focus on recent application of QDs in cancer diagnosis and treatment, including early detection of primary tumor such as ovarian cancer, breast cancer, prostate cancer an...

  16. Current Good Manufacturing Practice Production of an Oncolytic Recombinant Vesicular Stomatitis Viral Vector for Cancer Treatment

    Science.gov (United States)

    Meseck, M.; Derecho, I.; Lopez, P.; Knoblauch, C.; McMahon, R.; Anderson, J.; Dunphy, N.; Quezada, V.; Khan, R.; Huang, P.; Dang, W.; Luo, M.; Hsu, D.; Woo, S.L.C.; Couture, L.

    2011-01-01

    Abstract Vesicular stomatitis virus (VSV) is an oncolytic virus currently being investigated as a promising tool to treat cancer because of its ability to selectively replicate in cancer cells. To enhance the oncolytic property of the nonpathologic laboratory strain of VSV, we generated a recombinant vector [rVSV(MΔ51)-M3] expressing murine gammaherpesvirus M3, a secreted viral chemokine-binding protein that binds to a broad range of mammalian chemokines with high affinity. As previously reported, when rVSV(MΔ51)-M3 was used in an orthotopic model of hepatocellular carcinoma (HCC) in rats, it suppressed inflammatory cell migration to the virus-infected tumor site, which allowed for enhanced intratumoral virus replication leading to increased tumor necrosis and substantially prolonged survival. These encouraging results led to the development of this vector for clinical translation in patients with HCC. However, a scalable current Good Manufacturing Practice (cGMP)-compliant manufacturing process has not been described for this vector. To produce the quantities of high-titer virus required for clinical trials, a process that is amenable to GMP manufacturing and scale-up was developed. We describe here a large-scale (50-liter) vector production process capable of achieving crude titers on the order of 109 plaque-forming units (PFU)/ml under cGMP. This process was used to generate a master virus seed stock and a clinical lot of the clinical trial agent under cGMP with an infectious viral titer of approximately 2 × 1010 PFU/ml (total yield, 1 × 1013 PFU). The lot has passed all U.S. Food and Drug Administration-mandated release testing and will be used in a phase 1 clinical translational trial in patients with advanced HCC. PMID:21083425

  17. Optimizing therapy for radioactive iodine-refractory differentiated thyroid cancer: Current state of the art and future directions

    OpenAIRE

    Dadu, R.; Cabanillas, M.E.

    2012-01-01

    The majority of patients with differentiated thyroid cancer are cured with standard primary treatments including surgery, radioactive iodine and TSH suppression. A small proportion of patients who develop radioactive iodine-refractory metastatic disease have few treatment options. Recent discovery of the molecular mechanisms that contribute to thyroid cancer tumorigenesis and its progression have revealed key targets that are currently being evaluated in clinical trials. In the last decade se...

  18. A retrospective cohort study on combined modality therapy with or without surgery for clinical stage I and II small cell lung cancer

    International Nuclear Information System (INIS)

    Objective: To evaluate the treatment effects of surgery plus chemotherapy (± radio- therapy) compared with combined chemotherapy and radiotherapy for clinical staged I and II small cell lung cancer (SCLC). Methods: Out of 358 patients with limited small cell lung cancer, proved cyto-pathologicaily, 89 patients with clinical stage I or II disease made up the material of this paper. Fifty-five patients received surgery and adjuvant chemotherapy with or without radiotherapy ( surgery group). Thirty-four patients were treated by non-surgery method: ie combined chemotherapy and radiotherapy (non-surgery group). The chemotherapy regimen included PE (or CE), CAP or CAV for 4-6 cycles. Irradiation treatment covering the primary tumor, the ipsilateral hilar nodes and mediastinum was delivered once-daily with 6 megavoltage X-ray beam to a median irradiation dose of 58 Gy (56-60 Gy) was given in 5-6 weeks. Results: The overall median survival time (MST) was 48 months. The 1-, 2-, 3-, and 5-year overall survival rates were 95%, 71%, 57%, and 48%. In the surgery group, the median survival time (MST) was 50 months. The 1-, 2-, 3-, and 5-year survival rates were 96%, 70%, 58%, and 52%. Failure in the surgical group included local recurrence (4%), distant metastasis (31%), both local and distant failure (9%), and brain metastasis (18%). In the non-surgery group, the MST was 40 months. The 1-, 2-, 3-, and 5-year survival rates were 94%, 74%, 55%, and 40%. Failure included local recurrence (12%), distant metastasis (44%), both local and distant failure (6%), and brain metastasis (29%). There was no significant difference in the overall survival rates between the two groups (χ2=0.70, P=0.404). Cox regression analysis showed that brain metastasis was an influential factor of prognosis (P=0.001 ). Conclusions: For clinical stage I and II SCLC, both surgery plus chemotherapy (or radiotherapy) or combined chemotherapy and radiotgherapy without surgery could achieve a satisfactory

  19. Long-term results from a randomized phase II trial of neoadjuvant combined-modality therapy for locally advanced rectal cancer

    International Nuclear Information System (INIS)

    This study evaluated the effectiveness and safety of preoperative chemoradiotherapy with capecitabine in patients with locally advanced resectable rectal cancer. This report summarizes the results of the phase II study together with long-term (5-year) follow-up. Between June 2004 and January 2005, 57 patients with operable, clinical stage II-III adenocarcinoma of the rectum entered the study. Radiation dose was 45 Gy delivered as 25 fractions of 1.8 Gy. Concurrent chemotherapy with oral capecitabine 825 mg/m2 twice daily was administered during radiotherapy and at weekends. Surgery was scheduled 6 weeks after the completion of the chemoradiotherapy. Patients received four cycles of postoperative chemotherapy comprising either capecitabine 1250 mg/m2 bid days 1-14 every 3 weeks or bolus i.v. 5-fluorouracil 425 mg/m2/day and leucovorin 20 mg/m2/day days 1-5 every 4 weeks (choice was at the oncologist's discretion). Study endpoints included complete pathological remission, proportion of R0 resections and sphincter-sparing procedures, toxicity, survival parameters and long-term (5-year) rectal and urogenital morbidity assessment. One patient died after receiving 27 Gy because of a pulmonary embolism. Fifty-six patients completed radiochemotherapy and had surgery. Median follow-up time was 62 months. No patients were lost to follow-up. R0 resection was achieved in 55 patients. A complete pathological response was observed in 5 patients (9.1%); T-, N- and overall downstaging rates were 40%, 52.9% and 49.1%, respectively. The 5-year overall survival rate, recurrence-free survival, and local control was 61.4% (95% CI: 48.9-73.9%), 52.4% (95% CI: 39.3-65.5%), and 87.4% (95% CI: 75.0-99.8%), respectively. In 5 patients local relapse has occurred; dissemination was observed in 19 patients and secondary malignancies have occurred in 2 patients. The most frequent side-effect of the preoperative combined therapy was dermatitis (grade 3 in 19 patients). The proportion of

  20. Radiolabeled cyclic arginine-glycine-aspartic (RGD)-conjugated iron oxide nanoparticles as single-photon emission computed tomography (SPECT) and magnetic resonance imaging (MRI) dual-modality agents for imaging of breast cancer

    International Nuclear Information System (INIS)

    Ultrasmall superparamagnetic iron oxide nanoparticles (USPIOs) modified with a novel cyclic arginine-glycine-aspartate (RGD) peptide were made and radiolabeled as single-photon emission computed tomography (SPECT) and magnetic resonance imaging (MRI) dual-modality agents for imaging of breast cancer. The probe was tested both in vitro and in vivo to determine its receptor targeting efficacy and feasibility for SPECT and MRI. The radiochemical syntheses of 125I-cRGD-USPIO were accomplished with a radiochemical purity of 96.05 ± 0.33 %. High radiochemical stability was found in fresh human serum and in phosphate-buffered saline. The average hydrodynamic size of 125I-cRGD-USPIO determined by dynamic light scattering was 51.3 nm. Results of in vitro experiments verified the specificity of the radiolabeled nanoparticles to tumor cells. Preliminary biodistribution studies of 125I-radiolabeled cRGD-USPIO in Bcap37-bearing nude mice showed that it had long circulation half-life, high tumor uptake, and high initial blood retention with moderate liver uptake. In vivo tumor targeting and uptake of the radiolabeled nanoparticles in mice model were visualized by SPECT and MRI collected at different time points. Our results strongly indicated that the 125I-cRGD-USPIO could be used as a promising bifunctional radiotracer for early clinical tumor detection with high sensitivity and high spatial resolution by SPECT and MRI

  1. Radiolabeled cyclic arginine-glycine-aspartic (RGD)-conjugated iron oxide nanoparticles as single-photon emission computed tomography (SPECT) and magnetic resonance imaging (MRI) dual-modality agents for imaging of breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Deng, Shengming; Zhang, Wei; Zhang, Bin, E-mail: zbnuclmd@126.com [The First Affiliated Hospital of Soochow University, Department of Nuclear Medicine (China); Hong, Ruoyu [Soochow University, College of Chemistry, Chemical Engineering and Materials Science & Key Laboratory of Organic Synthesis of Jiangsu Province (China); Chen, Qing; Dong, Jiajia [The First Affiliated Hospital of Soochow University, Department of Nuclear Medicine (China); Chen, Yinyiin [The First Affiliated Hospital of Soochow University, Department of Radiology (China); Chen, Zhiqiang; Wu, Yiwei, E-mail: wuyiwei3988@gmail.com [The First Affiliated Hospital of Soochow University, Department of Nuclear Medicine (China)

    2015-01-15

    Ultrasmall superparamagnetic iron oxide nanoparticles (USPIOs) modified with a novel cyclic arginine-glycine-aspartate (RGD) peptide were made and radiolabeled as single-photon emission computed tomography (SPECT) and magnetic resonance imaging (MRI) dual-modality agents for imaging of breast cancer. The probe was tested both in vitro and in vivo to determine its receptor targeting efficacy and feasibility for SPECT and MRI. The radiochemical syntheses of {sup 125}I-cRGD-USPIO were accomplished with a radiochemical purity of 96.05 ± 0.33 %. High radiochemical stability was found in fresh human serum and in phosphate-buffered saline. The average hydrodynamic size of {sup 125}I-cRGD-USPIO determined by dynamic light scattering was 51.3 nm. Results of in vitro experiments verified the specificity of the radiolabeled nanoparticles to tumor cells. Preliminary biodistribution studies of {sup 125}I-radiolabeled cRGD-USPIO in Bcap37-bearing nude mice showed that it had long circulation half-life, high tumor uptake, and high initial blood retention with moderate liver uptake. In vivo tumor targeting and uptake of the radiolabeled nanoparticles in mice model were visualized by SPECT and MRI collected at different time points. Our results strongly indicated that the {sup 125}I-cRGD-USPIO could be used as a promising bifunctional radiotracer for early clinical tumor detection with high sensitivity and high spatial resolution by SPECT and MRI.

  2. Genotoxicity of tobacco smoke-derived aromatic amines and bladder cancer: current state of knowledge and future research directions.

    Science.gov (United States)

    Besaratinia, Ahmad; Tommasi, Stella

    2013-06-01

    Bladder cancer is a significant public health problem, worldwide. In the United States, bladder cancer is the fourth most common cancer in men, and its recurrence rate is the highest among all malignancies. Tobacco smoking is the leading risk factor for bladder cancer. The risk of bladder cancer is directly related to the intensity and duration of smoking, while quitting smoking reduces this risk. The increased risk of smokers for developing bladder cancer is attributable to their exposure to aromatic amines, which constitute a family of known bladder carcinogens present in tobacco smoke. The underlying mechanism of action of aromatic amines in the genesis of bladder cancer is not, however, fully delineated. Research has identified a genotoxic mode of action, specifically DNA adduction and mutagenicity, for aromatic amines, which may account for their carcinogenicity. The present review summarizes our current knowledge on the DNA adduction and mutagenicity of aromatic amines in relation to smoking-associated bladder cancer. For illustrative purposes, representative results from published research on aromatic amine-induced DNA adduction and mutagenesis are discussed. The direction of future research on the underlying mechanisms of tobacco smoke-associated bladder carcinogenesis is also outlined. Understanding the molecular mechanisms of bladder carcinogenesis is essential for improving future strategies for prevention, early detection, treatment, and prognosis of this malignancy. PMID:23449930

  3. Converting from CT- to MRI-only-based target definition in radiotherapy of localized prostate cancer. A comparison between two modalities

    Energy Technology Data Exchange (ETDEWEB)

    Seppaelae, Tiina; Visapaeae, Harri; Collan, Juhani; Kapanen, Mika; Kouri, Mauri; Tenhunen, Mikko; Saarilahti, Kauko [University of Helsinki and Helsinki University Hospital, Comprehensive Cancer Center, POB 180, Helsinki (Finland); Beule, Annette [University of Helsinki and Helsinki University Hospital, HUS Medical Imaging Center, Radiology, POB 180, Helsinki (Finland)

    2015-11-15

    To investigate the conversion of prostate cancer radiotherapy (RT) target definition from CT-based planning into an MRI-only-based planning procedure. Using the CT- and MRI-only-based RT planning protocols, 30 prostate cancer patients were imaged in the RT fixation position. Two physicians delineated the prostate in both CT and T2-weighted MRI images. The CT and MRI images were coregistered based on gold seeds and anatomic borders of the prostate. The uncertainty of the coregistration, as well as differences in target volumes and uncertainty of contour delineation were investigated. Conversion of margins and dose constraints from CT- to MRI-only-based treatment planning was assessed. On average, the uncertainty of image coregistration was 0.4 ± 0.5 mm (one standard deviation, SD), 0.9 ± 0.8 mm and 0.9 ± 0.9 mm in the lateral, anterior-posterior and base-apex direction, respectively. The average ratio of the prostate volume between CT and MRI was 1.20 ± 0.15 (one SD). Compared to the CT-based contours, the MRI-based contours were on average 2-7 mm smaller in the apex, 0-1 mm smaller in the rectal direction and 1-4 mm smaller elsewhere. When converting from a CT-based planning procedure to an MRI-based one, the overall planning target volumes (PTV) are prominently reduced only in the apex. The prostate margins and dose constraints can be retained by this conversion. (orig.) [German] Ziel unserer Studie war es, die Umstellung der Strahlentherapieplanung des Prostatakarzinoms von CT-gestuetzter in ausschliesslich MR-gestuetzte Zieldefinition zu untersuchen. Bei 30 Patienten mit Prostatakarzinom wurden eine CT und eine MRT unter Planungsbedingungen durchgefuehrt. Zwei Untersucher konturierten die Prostata in CT- und T2-gewichteten MR-Bildern. Mit Hilfe der Position von Goldstiften und der anatomischen Grenzen der Prostata wurden die CT- und MR-Bilder koregistriert. Es wurden die Genauigkeit der Koregistrierung sowie die Unterschiede der Zielvolumina und der

  4. Current Status of Targeted Therapy for Anaplastic Lymphoma Kinase in Non-small Cell Lung Cancer

    Directory of Open Access Journals (Sweden)

    Li MA

    2014-12-01

    Full Text Available The rate of the anaplastic lymphoma kinase (ALK gene rearrangements in non-small cell lung cancer (NSCLC tissues is 3%-5%. The first-in-class ALK tyrosine kinase inhibitor, crizotinib, can effectively target these tumors represent a significant advance in the evolution of personalized medicine for NSCLC. A randomized phase III clinical trial in which superiority of crizotinib over chemotherapy was seen in previously treated ALK-positive NSCLC patients demonstrated durable responses and well tolerance in the majority of ALK-positive NSCLC patients treated with crizotinib. However, despite the initial responses, most patients develop acquired resistance to crizotinib. Several novel therapeutic approaches targeting ALK-positive NSCLC are currently under evaluation in clinical trials, including second-generation ALK inhibitors, such as LDK378, CH5424802 (RO5424802, and AP26113, and new agents shock protein 90 inhibitors. This review aims to present the current knowledge on this fusion gene, the treatment advances, and novel drug clinical trials in ALK rearranged NSCLC.

  5. Current paradigms and evolving concepts in metastatic castration-resistant prostate cancer

    Institute of Scientific and Technical Information of China (English)

    Snmanta Krnmar Pal; Oliver Sartor

    2011-01-01

    @@ Until recently,docetaxel-based therapy represented the only therapy shown to prolong survival in patients with metastatic castration-resistant prostate cancer (mCRPC).The past year and a half has been marked by unprecedented progress in treatments for this disease.Three positive phase III clinical trials have emerged,each evaluating agents (sipuleucel-T,cabazitaxel and abiraterone)with distinct mechanisms of action.Herein,the three pivotal trials are described alongside both past and current large phase III studies conducted in this mCRPC.The overall survival for patients with mCRPC treated in current clinical trials is considerably longer than noted in the past.We note that more recent trials with older agents have also shown improved survival and discuss potential non-therapeutic biases that influence this critical measure of outcome.The necessity for utilizing randomized trials when evaluating new therapeutics is emphasized given the changing prognosis in this mCRPC.

  6. Metastatic non-small cell lung cancer Current treatment based on evidence (ONCOL Group)

    International Nuclear Information System (INIS)

    to perform a review of evidence about the treatment of non-small cell lung cancer (NSCLC). Source of data: the information was obtained from searches conducted in Medline, CCTR, Biosis, Embase, Lilacs and CINHAL. We also collected the most representative references presented during the last five years at Asco, ESMO and IASLC. Data extraction: data were extracted by associate members to the ONCOL Group. The collection of information did not follow a uniform strategy. Results of data synthesis: therapy for NSCLC can prolong survival and improve quality of life, but the majority of advanced stage patients dies due to disease progression within 2 years, meaning that there is room for improvement. The standard chemotherapy for NSCLC involves one of a number of platinum-based doublets that have been shown to improve survival when compared with single agents or best supportive care. These doublets are generally comparable in terms of efficacy, differing primarily in their toxicity profiles. However, encouraging new options may be approaching, including therapies targeted to specific patient subpopulations, and the use of combinations of current and new drugs to produce synergistic effects. This review present a detailed analysis of current evidence regarding the treatment of NSCLC based on a representative case series. This review didn't conduct a systematic evaluation of the evidence. Conclusion: medical therapy for NSCLC produces positive changes in main outcomes, including quality of life

  7. [Prostate cancer. Current and practice-relevant news from urology in 2011].

    Science.gov (United States)

    Wirth, M; Zastrow, S

    2011-09-01

    The effect of 5α reductase inhibitors in prostate cancer has been extensively investigated. The studies determined that finasteride and also dutasteride reduced the risk of prostate cancer; however, particularly high-grade cancer was not reduced and may possibly even have been increased. This is appropriately reflected in the S3 guideline on prostate cancer. New data on early recognition show that after longer term observation prostate cancer-specific mortality can be more effectively reduced by screening than was initially shown by the original data from the ERSPC study. Active surveillance is becoming more important for the therapy of early prostate cancer. Other new publications have shown good results for patients who underwent surgery for high risk prostate cancer. For metastasized prostate cancer new immunotherapeutic, chemotherapeutic and hormonal options are now available or will soon be approved. PMID:21842194

  8. Radiofrequency interstitial tumor ablation (RITA) is a possible new modality for treatment of renal cancer: ex vivo and in vivo experience.

    Science.gov (United States)

    Zlotta, A R; Wildschutz, T; Raviv, G; Peny, M O; van Gansbeke, D; Noel, J C; Schulman, C C

    1997-08-01

    Small renal tumors are increasingly diagnosed and are frequently treated by nephron-sparing surgery. Tumors can be ablated by radiofrequency (RF) energy, which allows the operator to create very localized necrotic lesions. Radiofrequency interstitial tumor ablation (RITA) has been used in human kidneys in an ex vivo experiment to assess the necrotic lesions produced in a model close to physiologic conditions and then in three patients with localized renal cancer prior to radical nephrectomy. In the ex vivo model, four freshly removed kidneys were treated. Bipolar RF energy was delivered by a generator connected to two needles introduced parallel to each other into the renal parenchyma. A thermocouple was inserted between the two active electrodes. The renal artery at physiologic conditions was maintained at a constant temperature of perfusion of 37 degrees C by a computer-assisted Hot-line monitor. Two lesions were produced in each pole of each kidney including the cortex and the medulla. In an initial human study focusing on safety, feasibility, and pathology, three patients were treated by RITA with bipolar and monopolar energy. One patient with a peripheral 2-cm upper-pole tumor was treated percutaneously under ultrasound guidance with local anesthesia only 1 week prior to surgery. The other patients, with 3- and 5-cm tumors, were treated during surgery under general anesthesia just before nephrectomy. Ex vivo, the maximum temperature at the active needles ranged from 84 degrees C to 130 degrees C with 10 to 14 W applied during 10 to 14 minutes. Lesions were on average 2.2 x 3 x 2.5 cm.3 Microscopic examination showed stromal edema with intensive pyknosis. No damage was seen to adjacent untreated tissue. In the in vivo procedure, tolerance of RTA as an anesthesia-free procedure was excellent. The size of the observed lesions was comparable to the forecast size depending on the needle deployment. No side effects were noted, and no adjacent structures were

  9. Current knowledge, attitudes and practices of women on breast cancer and mammography at Mulago Hospital

    OpenAIRE

    Michael, Kawooya G; Nakatudde Rebecca; Rosemary, Byanyima K; Muyinda Zeridah; Mubuuke A. Gonzaga; Businge Francis; Kiguli-Malwadde Elsie

    2010-01-01

    BACKGROUND: Breast cancer is the third commonest cancer in Ugandan women. Women present late for breast cancer management which leads to high mortality rates. The objective of the study was to assess the knowledge, attitudes and practices of Ugandan women concerning breast cancer and mammography.METHODS: This was a descriptive cross-sectional study where 100 women reporting to the Radiology department were interviewed. We used consecutive sampling. Interviewer-administered questionnaires were...

  10. Proton Beam Therapy for Non-Small Cell Lung Cancer: Current Clinical Evidence and Future Directions

    OpenAIRE

    Berman, Abigail T.; Sara St. James; Ramesh Rengan

    2015-01-01

    Lung cancer is the leading cancer cause of death in the United States. Radiotherapy is an essential component of the definitive treatment of early-stage and locally-advanced lung cancer, and the palliative treatment of metastatic lung cancer. Proton beam therapy (PBT), through its characteristic Bragg peak, has the potential to decrease the toxicity of radiotherapy, and, subsequently improve the therapeutic ratio. Herein, we provide a primer on the physics of proton beam therapy for lung canc...

  11. Current relevance of cervical ultrasonography in staging cancer of the esophagus and gastroesophageal junction

    International Nuclear Information System (INIS)

    Purpose: To evaluate the value of external ultrasonography (US) of the neck in current dedicated preoperative staging of patients with cancer of the esophagus and gastroesophageal junction (GEJ). Materials and methods: We analyzed 180 consecutive patients (154 men, 26 women, and mean age 63 (38-84) years) without palpable cervical lymphadenopathy, treated between January 2001 and March 2006. Suspicious lesions were confirmed by cytological examination. All first 125 consecutive patients (group A) were staged by standard endoscopic ultrasonography (EUS), multidetector computed tomography (md-CT), positron emission tomography with 18F-fluorodeoxyglucose (FDG-PET) and external US. The other 55 patients (group B) were prospectively staged according to a revised protocol consisting of routine EUS and md-CT, while PET was only performed in subjects with T3-T4 and/or N1 disease and external US solely on indication. Results: Cervical metastases were found in seven patients from group A (6%) and in five from group B (9%). Twenty percent (4/20) of the tumors above the carina and 5% (8/160) of the distal tumors presented with cervical metastases. All were diagnosed as T3 and T4 tumors on EUS. Eleven of these metastases were detected by external US and nine on md-CT. All nodal metastases were detected by the combination of PET and md-CT. No cervical metastases were missed by the diagnostic algorithm in group B. Conclusion: In present staging procedures for esophageal cancer, routine external US seems to have no additional value in detecting cervical metastases. It is still indicated to obtain cytological proof of suspected cervical lesions

  12. Current relevance of cervical ultrasonography in staging cancer of the esophagus and gastroesophageal junction

    Energy Technology Data Exchange (ETDEWEB)

    Schreurs, Liesbeth M.A. [Department of Surgical Oncology/Abdominal Surgery, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB Groningen (Netherlands)], E-mail: l.m.a.schreurs@chir.umcg.nl; Verhoef, Christian C.P.M. [Department of Surgical Oncology/Abdominal Surgery, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB Groningen (Netherlands)], E-mail: c.c.p.m.verhoef@chir.umcg.nl; Jagt, Erik J. van der [Department of Radiology, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB Groningen (Netherlands)], E-mail: e.j.van.der.jagt@rad.umcg.nl; Dam, Gooitzen M. van [Department of Surgical Oncology/Abdominal Surgery, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB Groningen (Netherlands)], E-mail: g.m.van.dam@chir.umcg.nl; Groen, Henk [Department of Epidemiology, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB Groningen (Netherlands)], E-mail: h.groen@mta.umcg.nl; Plukker, John Th.M. [Department of Surgical Oncology/Abdominal Surgery, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB Groningen (Netherlands)], E-mail: j.th.plukker@chir.umcg.nl

    2008-07-15

    Purpose: To evaluate the value of external ultrasonography (US) of the neck in current dedicated preoperative staging of patients with cancer of the esophagus and gastroesophageal junction (GEJ). Materials and methods: We analyzed 180 consecutive patients (154 men, 26 women, and mean age 63 (38-84) years) without palpable cervical lymphadenopathy, treated between January 2001 and March 2006. Suspicious lesions were confirmed by cytological examination. All first 125 consecutive patients (group A) were staged by standard endoscopic ultrasonography (EUS), multidetector computed tomography (md-CT), positron emission tomography with {sup 18}F-fluorodeoxyglucose (FDG-PET) and external US. The other 55 patients (group B) were prospectively staged according to a revised protocol consisting of routine EUS and md-CT, while PET was only performed in subjects with T3-T4 and/or N1 disease and external US solely on indication. Results: Cervical metastases were found in seven patients from group A (6%) and in five from group B (9%). Twenty percent (4/20) of the tumors above the carina and 5% (8/160) of the distal tumors presented with cervical metastases. All were diagnosed as T3 and T4 tumors on EUS. Eleven of these metastases were detected by external US and nine on md-CT. All nodal metastases were detected by the combination of PET and md-CT. No cervical metastases were missed by the diagnostic algorithm in group B. Conclusion: In present staging procedures for esophageal cancer, routine external US seems to have no additional value in detecting cervical metastases. It is still indicated to obtain cytological proof of suspected cervical lesions.

  13. Fentanyl transmucosal tablets: current status in the management of cancer-related breakthrough pain

    Directory of Open Access Journals (Sweden)

    Prommer E

    2012-06-01

    Full Text Available Eric Prommer, Brandy FicekDivision of Hematology/Oncology, Mayo Clinic College of Medicine, Mayo Clinic Hospital, Scottsdale, AZ, USAAbstract: Breakthrough pain is a newly recognized pain category that was first described by Portenoy and Hagen in 1990. The term describes pain that increases in intensity to “break through” chronic pain that is being controlled by a scheduled opioid regimen. The development of fluctuations in pain intensity is challenging due to their unpredictable nature, rapid onset, and need for rapid treatment intervention. Breakthrough pain has been treated by using an extra opioid dose in addition to the scheduled opioid being used for pain. Recommendations for dose and frequency are based on expert opinion only, and have included dosing based on a percentage of the total opioid dose. Other recommendations include increasing the regularly scheduled opioid dose. Clinical trials have now focused on delivery of opioids that have both potency and a rapid onset of action. Lipophilic opioids have received a substantial amount of study due to their quick absorption and rapid onset of analgesia. Lipophilic opioids that have been studied to date include transmucosal fentanyl, sublingual fentanyl, intranasal sufentanil, and oral and sublingual methadone. Initial clinical trials have established the superiority of transmucosal fentanyl as a breakthrough analgesic when compared with immediate-release oral opioid formulations. Problems with bioavailability have led to a search for newer formulations of transmucosal delivery. Newer formulations, such as fentanyl transmucosal tablets, have been developed to ensure superior delivery for the patient suffering from breakthrough pain. The purpose of this paper is to discuss the current status of transmucosal tablet formulations for cancer breakthrough pain.Keywords: fentanyl, transmucosal, tablets, pain, breakthrough, cancer

  14. New Ultrasound Modalities in Rheumatology.

    Science.gov (United States)

    Gutierrez, Marwin; Okano, Tadashi; Reginato, Anthony M; Cazenave, Tomas; Ventura-Rios, Lucio; Bertolazzi, Chiara; Pineda, Carlos

    2015-12-01

    Over the years, ultrasound (US) has accumulated important evidence supporting its relevant role for the assessment of inflammatory processes of different rheumatologic diseases, as well as in the follow-up in assessing the response to different therapeutic approaches. This has been possible because of the increase in training, competency, and knowledge, as well as the rapid progress in the US technologies.Currently, some US machines can be equipped by sophisticated software modalities (i.e., 3-dimensional US, elastosonography, automated cardiovascular software, and fusion imaging) that can augment US traditional role as a safe, fast, and easy-to-perform modality and giving it new life and increased relevance in rheumatology. In this article, we evaluated the US developments, from conventional B-mode to more sophisticated technologies, and their potential clinical impact in the field of rheumatology.Three-dimensional US can improve the accuracy of the assessment of bone erosions and the quantification of power Doppler because of its multiplanar view including coronal, axial and sagital view. Elastosonography is still looking for its role in rheumatology. Preliminary works induce us to consider it as a promise tool for the assessment of tendon pathology and skin of patients with connective tissue disorders. The automated method for the measurement of carotid intima-media thickness permits a rapid and accurate assessment. The preliminary published data showed that it is reliable, and valid compared to the traditional method; they also support the future of rheumatologists as the direct operators in evaluating the cardiovascular risk in daily practice. Fusion imaging increases the diagnostic power of US, displaying simultaneously in the monitor, the US image, and the corresponding computed tomography/magnetic resonance imaging image. However, there are no sufficient data supporting its application in daily rheumatologic practice. PMID:26587854

  15. A brief history of cancer: age-old milestones underlying our current knowledge database.

    Science.gov (United States)

    Faguet, Guy B

    2015-05-01

    This mini-review chronicles the history of cancer ranging from cancerous growths discovered in dinosaur fossils, suggestions of cancer in Ancient Egyptian papyri written in 1500-1600 BC, and the first documented case of human cancer 2,700 years ago, to contributions by pioneers beginning with Hippocrates and ending with the originators of radiation and medical oncology. Fanciful notions that soon fell into oblivion are mentioned such as Paracelsus and van Helmont substituting Galen's black bile by mysterious ens or archeus systems. Likewise, unfortunate episodes such as Virchow claiming Remak's hypotheses as his own remind us that human shortcomings can affect otherwise excellent scientists. However, age-old benchmark observations, hypotheses, and practices of historic and scientific interest are underscored, excerpts included, as precursors of recent discoveries that shaped modern medicine. Examples include: Petit's total mastectomy with excision of axillary glands for breast cancer; a now routine practice, Peyrilhe's ichorous matter a cancer-causing factor he tested for transmissibility one century before Rous confirmed the virus-cancer link, Hill's warning of the dangers of tobacco snuff; heralding today's cancer pandemic caused by smoking, Pott reporting scrotum cancer in chimney sweepers; the first proven occupational cancer, Velpeau's remarkable foresight that a yet unknown subcellular element would have to be discovered in order to define the nature of cancer; a view confirmed by cancer genetics two centuries later, ending with Röntgen and the Curies, and Gilman et al. ushering radiation (1896, 1919) and medical oncology (1942), respectively. PMID:25113657

  16. Modal abstractions of concurrent behavior

    DEFF Research Database (Denmark)

    Nielson, Flemming; Nanz, Sebastian; Nielson, Hanne Riis

    2011-01-01

    We present an effective algorithm for the automatic construction of finite modal transition systems as abstractions of potentially infinite concurrent processes. Modal transition systems are recognized as valuable abstractions for model checking because they allow for the validation as well as...... supports the definition of a 3-valued modal logic for validating as well as refuting properties of systems. The construction is illustrated on a few examples, including the Ingemarsson-Tang-Wong key agreement protocol. © 2011 ACM....

  17. Increased survival and decreased metastasis rates with early thoracic radiotherapy and prophylactic cranial irradiation in combined-modality treatment of limited-stage small cell lung cancer

    International Nuclear Information System (INIS)

    Purpose/Objective: To evaluate the relative efficacy of concurrent vs. sequential timing of thoracic radiotherapy (RT) and chemotherapy consisting of cisplatin and etoposide (VP-16) with respect to absolute survival, freedom from relapse, control of thoracic disease, and frequency and distribution of distant metastases. The role of prophylactic cranial irradiation (PCI) in preventing CNS metastasis was also assessed. Materials and Methods: Forty-eight patients with limited-stage small cell lung cancer were treated either concurrently (29 patients) or sequentially (19 patients) with thoracic RT and chemotherapy consisting of cisplatin and etoposide. Thirty-four patients (71%) received thoracic irradiation to a dose of 45 Gy in 25 fractions (range, 30-55 Gy). Number of chemotherapy cycles ranged from 3 to 8; either 4 or 6 cycles were given to 36 patients (75%). Of 27 patients with a complete response at the completion of chemotherapy, 21 patients received PCI. Median follow-up was 29.3 months (range, 12-98 months). No patients were lost to follow-up. Potential prognostic variables were evaluated by both univariate and multivariate analysis. Results: The absolute survival rate for all patients was 42% at 2 years and 32% at 5 years. The relapse-free survival rate was 35% at 2 years and 31% at 5 years. Thirty-six sites of failure were observed in 27 patients. Thoracic recurrence occurred in 9 patients (all within the RT field). The CNS was the most common site of relapse (15 patients). Multivariate analysis revealed that (1) concurrent RT and chemotherapy vs. sequential chemotherapy followed by RT and (2) disease volume were variables significantly predictive for survival. Absolute survival was 41% for patients who had early concurrent RT, beginning with either cycle 1 or 2 of chemotherapy, vs. 25% for those who had sequential treatment (p=.036). Patients having a disease volume less than one third of the thoracic width had a survival rate of 41% vs. 23% for those with

  18. Evaluation of modal testing methods

    Science.gov (United States)

    Chen, J.-C.

    1984-01-01

    Modal tests are playing an increasingly important role in structural dynamics efforts which are in need of analytical model verification or trouble shootings. In the meantime, the existing modal testing methods are undergoing great changes as well as new methods are being created. Although devoted advocates of each method can be found to argue the relative advantages and disadvantages, the general superiority, if any, of one or the other is not yet evident. The Galileo spacecraft, a realistic, complex structural system, will be used as a test article for performing modal tests by various methods. The results will be used to evaluate the relative merits of the various modal testing methods.

  19. Hahn Sequence Space of Modals

    OpenAIRE

    Balasubramanian, T.; Zion Chella Ruth, S.

    2014-01-01

    The history of modal intervals goes back to the very first publications on the topic of interval calculus. The modal interval analysis is used in Computer graphics and Computer Aided Design (CAD), namely, the computation of narrow bounds on Bezier and B-Spline curves. Since modal intervals are used in many fields, we introduce a new sequence space h(gI) called the Hahn sequence space of modal intervals. We have given some new definitions and theorems. Some inclusion relation and some topologi...

  20. Load Estimation from Modal Parameters

    DEFF Research Database (Denmark)

    Aenlle, Manuel López; Brincker, Rune; Fernández, Pelayo Fernández; Canteli, Alfonso Fernández

    In Natural Input Modal Analysis the modal parameters are estimated just from the responses while the loading is not recorded. However, engineers are sometimes interested in knowing some features of the loading acting on a structure. In this paper, a procedure to determine the loading from a FRF...... matrix assembled from modal parameters and the experimental responses recorded using standard sensors, is presented. The method implies the inversion of the FRF which, in general, is not full rank matrix due to the truncation of the modal space. Furthermore, some ecommendations are included to improve...

  1. HPV infection, anal intra-epithelial neoplasia (AIN) and anal cancer: current issues

    OpenAIRE

    Stanley Margaret A; Winder David M; Sterling Jane C; Goon Peter KC

    2012-01-01

    Abstract Background Human papillomavirus (HPV) is well known as the major etiological agent for ano-genital cancer. In contrast to cervical cancer, anal cancer is uncommon, but is increasing steadily in the community over the last few decades. However, it has undergone an exponential rise in the men who have sex with men (MSM) and HIV + groups. HIV + MSM in particular, have anal cancer incidences about three times that of the highest worldwide reported cervical cancer incidences. Discussion T...

  2. The Current and Evolving Role of PET in Personalized Management of Lung Cancer.

    Science.gov (United States)

    Mena, Esther; Yanamadala, Anusha; Cheng, Gang; Subramaniam, Rathan M

    2016-07-01

    Using tumor genomic profiling information has revolutionized the landscape of personalized treatment of lung cancer. The management of lung cancer and non-small cell lung cancer particularly is influenced by discoveries of activating mutations in epidermal growth factor receptor and targeted therapies with tyrosine kinase inhibitors, fusion genes involving anaplastic lymphoma kinase, and targeted therapies for Kristen-Rat-Sarcoma and MET protooncogenes. PET imaging plays an important role in assessing the biologic behavior of lung cancer and defining response to therapy. This review summarizes genomic discoveries in lung cancer and their implications for functional PET imaging. PMID:27321029

  3. Predictive assays and their role in selection of radiation as the therapeutic modality

    International Nuclear Information System (INIS)

    Radiation therapy is a modality to treat cancer patients using ionising radiation. Ionising radiation kills cancer (or malignant tumour) cells and hopefully cures the patient. If some cancer cells survive the treatment, those cells would ultimately multiply again and eventually kill the patient. Although radiation is intended to focus on the cancer, irradiation of the normal tissues is unavoidable. The higher the radiation dose given to the cancer, the greater the chance of eradicating it. On the other hand, the greater the radiation dose, the greater the probability of severe morbidity or side effects. Thus, optimising the dose for the patients is crucial. Human cancers have variable radiation sensitivities. Many factors influence the sensitivity. These factors include simple parameters such as tumour size, cellular sensitivity, such as repair capacity, and tumour environment, such as oxygen content. If we can predict the radiation sensitivity of the individual tumours prior to radiation therapy, or even during the radiation therapy, it would give us valuable information with regard to determining the optimal dose. Such an approach has led to the search for predictive assays. Recent advances in molecular technology and equipment have facilitated progress in this field. Some of the studies relied on tumour tissues taken by biopsy, while others focused on cell cycle parameters, which could suggest optimal fractionation schedules. The IAEA's sub-programme on Applied Radiation Biology and Radiotherapy aims to assist Member States in establishing or upgrading radiotherapy facilities to contribute effectively to cancer treatment for palliative or curative purposes and to provide assistance towards the enhancement of radiation-induced therapeutic gain. The Co-ordinated Research Project (CRP) on Radiation Responsiveness Criteria for Human Tumours as Determinant for Therapeutic Modality Planning was initiated in 1992 to address this problem. This publication was assembled

  4. Proton Beam Therapy for Non-Small Cell Lung Cancer: Current Clinical Evidence and Future Directions

    Energy Technology Data Exchange (ETDEWEB)

    Berman, Abigail T., E-mail: abigail.berman@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104 (United States); James, Sara St.; Rengan, Ramesh [Department of Radiation Oncology, University of Washington Medical Center, Seattle, WA 98195 (United States)

    2015-07-02

    Lung cancer is the leading cancer cause of death in the United States. Radiotherapy is an essential component of the definitive treatment of early-stage and locally-advanced lung cancer, and the palliative treatment of metastatic lung cancer. Proton beam therapy (PBT), through its characteristic Bragg peak, has the potential to decrease the toxicity of radiotherapy, and, subsequently improve the therapeutic ratio. Herein, we provide a primer on the physics of proton beam therapy for lung cancer, present the existing data in early-stage and locally-advanced non-small cell lung cancer (NSCLC), as well as in special situations such as re-irradiation and post-operative radiation therapy. We then present the technical challenges, such as anatomic changes and motion management, and future directions for PBT in lung cancer, including pencil beam scanning.

  5. Proton Beam Therapy for Non-Small Cell Lung Cancer: Current Clinical Evidence and Future Directions

    International Nuclear Information System (INIS)

    Lung cancer is the leading cancer cause of death in the United States. Radiotherapy is an essential component of the definitive treatment of early-stage and locally-advanced lung cancer, and the palliative treatment of metastatic lung cancer. Proton beam therapy (PBT), through its characteristic Bragg peak, has the potential to decrease the toxicity of radiotherapy, and, subsequently improve the therapeutic ratio. Herein, we provide a primer on the physics of proton beam therapy for lung cancer, present the existing data in early-stage and locally-advanced non-small cell lung cancer (NSCLC), as well as in special situations such as re-irradiation and post-operative radiation therapy. We then present the technical challenges, such as anatomic changes and motion management, and future directions for PBT in lung cancer, including pencil beam scanning

  6. Proton Beam Therapy for Non-Small Cell Lung Cancer: Current Clinical Evidence and Future Directions

    Directory of Open Access Journals (Sweden)

    Abigail T. Berman

    2015-07-01

    Full Text Available Lung cancer is the leading cancer cause of death in the United States. Radiotherapy is an essential component of the definitive treatment of early-stage and locally-advanced lung cancer, and the palliative treatment of metastatic lung cancer. Proton beam therapy (PBT, through its characteristic Bragg peak, has the potential to decrease the toxicity of radiotherapy, and, subsequently improve the therapeutic ratio. Herein, we provide a primer on the physics of proton beam therapy for lung cancer, present the existing data in early-stage and locally-advanced non-small cell lung cancer (NSCLC, as well as in special situations such as re-irradiation and post-operative radiation therapy. We then present the technical challenges, such as anatomic changes and motion management, and future directions for PBT in lung cancer, including pencil beam scanning.

  7. Multi-centre European study of breakthrough cancer pain: pain characteristics and patient perceptions of current and potential management strategies

    DEFF Research Database (Denmark)

    Davies, Andrew; Zeppetella, Giovambattista; Andersen, Steen;

    2011-01-01

    This study involved 320 cancer patients from four Northern European countries. Patients with breakthrough pain were questioned about the characteristics of their pain, the current management of their pain, and the acceptability/utility of alternative routes of administration. The median number...

  8. Nutrition support and dietary interventions for patients with lung cancer: current insights

    Directory of Open Access Journals (Sweden)

    Kiss N

    2016-01-01

    Full Text Available Nicole Kiss1,2 1Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia; 2Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia Abstract: Malnutrition and weight loss are prevalent in patients with lung cancer. The impact of malnutrition on patients with cancer, and specifically in patients with lung cancer, has been demonstrated in a large number of studies. Malnutrition has been shown to negatively affect treatment completion, survival, quality of life, physical function, and health care costs. Emerging evidence is providing some insight into which lung cancer patients are at higher nutritional risk. In lung cancer patients treated with radiotherapy, stage III or more disease, treatment with concurrent chemotherapy and the extent of radiotherapy delivered to the esophagus appear to confer a higher risk of weight loss during and post-treatment. Studies investigating nutrition interventions for lung cancer patients have examined intensive dietary counseling, supplementation with fish oils, and interdisciplinary models of nutrition and exercise interventions and show promise for improved outcomes from these interventions. However, further research utilizing these interventions in large clinical trials is required to definitively establish effective interventions in this patient group. Keywords: lung cancer, nutrition, malnutrition

  9. Lynch syndrome (hereditary non-polyposis colorectal cancer): current concepts and approaches to management.

    Science.gov (United States)

    Ricciardiello, Luigi; Boland, C Richard

    2005-10-01

    Colorectal cancer is among the most frequent causes of cancer death worldwide. An inherited predisposition to cancer of the colon and other organs, Lynch syndrome-- also called hereditary non-polyposis colorectal cancer--is probably the most frequent cause of hereditary cancer and is often found in a colon cancer patient and traced through other family members. However, this syndrome is not only characterized by the early onset of colon cancers but also by a predisposition to a constellation of extraintestinal cancers that tend to be misdiagnosed. With new diagnostic technologies, the incidence of familial/inherited versus sporadic cases may appear to increase, due to the recognition of cancers in families that do not fulfill clinical guidelines developed prior to knowledge of the genetic basis of this disease. We now have the ability and the responsibility to detect and prevent this disease, and equally important, to direct patients to specifically targeted treatment. Specialists should be aware of the significance of inherited colon cancer and should become familiar with the molecular diagnostic tests now widely available. PMID:16168241

  10. HPV infection, anal intra-epithelial neoplasia (AIN and anal cancer: current issues

    Directory of Open Access Journals (Sweden)

    Stanley Margaret A

    2012-09-01

    Full Text Available Abstract Background Human papillomavirus (HPV is well known as the major etiological agent for ano-genital cancer. In contrast to cervical cancer, anal cancer is uncommon, but is increasing steadily in the community over the last few decades. However, it has undergone an exponential rise in the men who have sex with men (MSM and HIV + groups. HIV + MSM in particular, have anal cancer incidences about three times that of the highest worldwide reported cervical cancer incidences. Discussion There has therefore traditionally been a lack of data from studies focused on heterosexual men and non-HIV + women. There is also less evidence reporting on the putative precursor lesion to anal cancer (AIN – anal intraepithelial neoplasia, when compared to cervical cancer and CIN (cervical intraepithelial neoplasia. This review summarises the available biological and epidemiological evidence for HPV in the anal site and the pathogenesis of AIN and anal cancer amongst traditionally non-high risk groups. Summary There is strong evidence to conclude that high-grade AIN is a precursor to anal cancer, and some data on the progression of AIN to invasive cancer.

  11. Current situation of high-dose-rate brachytherapy for cervical cancer in Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Rogerio Matias Vidal da; Souza, Divanizia do Nascimento, E-mail: rmv.fisica@gmail.com [Universidade Federal de Sergipe (UFS), Sao Cristovao, SE (Brazil); Pinezi, Juliana Castro Dourado [Pontificia Universidade Catolica de Goias (PUC-Goias), Goiania, GO (Brazil); Macedo, Luiz Eduardo Andrade [Hospital Chama, Arapiraca, AL (Brazil)

    2014-05-15

    To assess the current situation of high-dose-rate (HDR) brachytherapy for cancer of the cervix in Brazil, regarding apparatuses, planning methods, prescription, fractionation schedule and evaluation of dose in organs at risk. Materials and methods: in the period between March/2012 and May/2013, a multiple choice questionnaire was developed and sent to 89 Brazilian hospitals which perform HDR brachytherapy. Results: sixty-one services answered the questionnaire. All regions of the country experienced a sharp increase in the number of HDR brachytherapy services in the period from 2001 to 2013. As regards planning, although a three-dimensional planning software was available in 91% of the centers, conventional radiography was mentioned by 92% of the respondents as their routine imaging method for such a purpose. Approximately 35% of respondents said that brachytherapy sessions are performed after teletherapy. The scheme of four 7 Gy intracavitary insertions was mentioned as the most frequently practiced. Conclusion: the authors observed that professionals have difficulty accessing adjuvant three-dimensional planning tools such as computed tomography and magnetic resonance imaging. (author)

  12. Current measures of metabolic heterogeneity within cervical cancer do not predict disease outcome

    Directory of Open Access Journals (Sweden)

    Brooks Frank J

    2011-06-01

    Full Text Available Abstract Background A previous study evaluated the intra-tumoral heterogeneity observed in the uptake of F-18 fluorodeoxyglucose (FDG in pre-treatment positron emission tomography (PET scans of cancers of the uterine cervix as an indicator of disease outcome. This was done via a novel statistic which ostensibly measured the spatial variations in intra-tumoral metabolic activity. In this work, we argue that statistic is intrinsically non-spatial, and that the apparent delineation between unsuccessfully- and successfully-treated patient groups via that statistic is spurious. Methods We first offer a straightforward mathematical demonstration of our argument. Next, we recapitulate an assiduous re-analysis of the originally published data which was derived from FDG-PET imagery. Finally, we present the results of a principal component analysis of FDG-PET images similar to those previously analyzed. Results We find that the previously published measure of intra-tumoral heterogeneity is intrinsically non-spatial, and actually is only a surrogate for tumor volume. We also find that an optimized linear combination of more canonical heterogeneity quantifiers does not predict disease outcome. Conclusions Current measures of intra-tumoral metabolic activity are not predictive of disease outcome as has been claimed previously. The implications of this finding are: clinical categorization of patients based upon these statistics is invalid; more sophisticated, and perhaps innately-geometric, quantifications of metabolic activity are required for predicting disease outcome.

  13. Current situation of high-dose-rate brachytherapy for cervical cancer in Brazil

    International Nuclear Information System (INIS)

    To assess the current situation of high-dose-rate (HDR) brachytherapy for cancer of the cervix in Brazil, regarding apparatuses, planning methods, prescription, fractionation schedule and evaluation of dose in organs at risk. Materials and methods: in the period between March/2012 and May/2013, a multiple choice questionnaire was developed and sent to 89 Brazilian hospitals which perform HDR brachytherapy. Results: sixty-one services answered the questionnaire. All regions of the country experienced a sharp increase in the number of HDR brachytherapy services in the period from 2001 to 2013. As regards planning, although a three-dimensional planning software was available in 91% of the centers, conventional radiography was mentioned by 92% of the respondents as their routine imaging method for such a purpose. Approximately 35% of respondents said that brachytherapy sessions are performed after teletherapy. The scheme of four 7 Gy intracavitary insertions was mentioned as the most frequently practiced. Conclusion: the authors observed that professionals have difficulty accessing adjuvant three-dimensional planning tools such as computed tomography and magnetic resonance imaging. (author)

  14. [Current status and prospect of perioperative thrombus management in gastrointestinal cancer].

    Science.gov (United States)

    Qin, X Y

    2016-03-01

    Thanks to the progress of surgical theory and skills, as well as the application of modern medical devices in general surgery, both the occurrence of perioperative complications and mortality of gastrointestinal surgery have significantly reduced recently. However, it is still far from optimal in terms of the perioperative venous thromboembolism (VTE) management in gastrointestinal cancer, and what is responsible for that? This paper aims at finding out the reasons contributing to the current status, giving suggestions for how to make improvement at both disease level and hospital management level. At the same time, while paying attention for the prophylaxis of VTE, there have been more and more patients receiving antithrombotic treatment require elective or emergent surgery in clinical practice, due to aging and increased incidence of cardiovascular disease year by year. How to balance the bleeding and thrombosis risk for these patients during perioperative periods is also a question we are going to discuss. In conclusion, as to the issue of the management of perioperative thrombosis, there will be a long way for Chinese doctors to go. Our peers should pay more attention to this problem and take more efforts, so that the thrombotic complications in surgical patients can be reduced. PMID:26932880

  15. Current status on microRNAs as biomarkers for ovarian cancer.

    Science.gov (United States)

    Prahm, Kira Philipsen; Novotny, Guy Wayne; Høgdall, Claus; Høgdall, Estrid

    2016-05-01

    Ovarian cancer (OC) is the most lethal gynecological malignancy in the Western world, and has a very poor prognosis, often due to late diagnosis and emergence of chemotherapy resistance. Therefore, there is an essential need for new diagnostic and prognostic markers that can improve and initiate more personalized treatment, eventually improving survival of the patients. MicroRNAs are small, non-coding RNA molecules, that post-transcriptionally regulate gene expression. Several studies have within the last decade shown that microRNAs are deregulated in OC and have potential as diagnostic and prognostic biomarkers for OC. Recently studies have also focused on microRNAs as predictors of chemotherapy responses and their potential as therapeutic targets. However, many of the published studies are difficult to interpret as a whole due to various methods of analysis. Future focus should be aimed at developing a general standardized analytical method, which can limit differences between studies thus allowing easier comparison across them. In addition, validation of studies in independent series that ideally should be histotype-specific is essential to determine the clinical role of microRNAs in different types of OC. In this review we summarize the current knowledge of microRNAs as potential biomarkers for OC, with focus on their clinical relevance. PMID:26809719

  16. Neoadjuvant Chemotherapy Use in Bladder Cancer: A Survey of Current Practice and Opinions

    Directory of Open Access Journals (Sweden)

    N. G. Cowan

    2014-01-01

    Full Text Available Objectives. Level 1 evidence supports the use of neoadjuvant chemotherapy (NAC to improve overall survival in muscle invasive bladder cancer; however utilization rates remain low. The aims of our study were to determine factors associated with NAC use, to more clearly define reasons for low utilization, and to determine the current rate of NAC use among urologic oncologists. Materials and Methods. Active members of the Society for Urologic Oncology were provided a 20-question survey. Descriptive statistical analysis was conducted for each question and univariate analysis was performed. Results. We achieved a response rate of 21%. Clinical T3/T4 disease was the most often selected reason for recommending NAC (87%. Concerns with recommending NAC were age and comorbidities (54% followed by delay in surgery (35%. An association was identified between urologic oncologists who discussed NAC with >90% of their patients and medical oncologists “always” recommending NAC (P=0.0009. NAC utilization rate was between 30 and 57%. Conclusions. Amongst this highly specialized group of respondents, clinical T3-T4 disease was the most common reason for implementation of NAC. Respondents who frequently discussed NAC were more likely to report their medical oncologist always recommending NAC. Reported NAC use was higher in this surveyed group (30–57% compared with recently published rates.

  17. The current G-CSF use in cancer patients with chemotherapy

    Institute of Scientific and Technical Information of China (English)

    Jing Zhang; Shiying Yu

    2014-01-01

    Objective:The purpose of the study was to survey current G-CSF use in cancer patients, investigate whether the use of granulocyte colony-stimulating factor (G-CSF) is standardized. Methods:From July 2012 to October 2012, patients in a third-grade class-A hospital were investigated by self-designed questionnaires, according to ASCO’s recommendations for white blood cellgrowth factors in 2006 and NCCN myeloid growth factors guideline in 2012. Results:Two hundred and twenty-two patients treated with 724 courses of chemotherapy were included. In prophylactic use, 259 (35.8%) cases used G-CSF that the guideline doesn’t recommend, which belonged to excessive use, the dose were 274 700 µg, accounting for 59.7%of the totle prophylactic use;105 (14.5%) didn’t use while the guideline recommend, belonging to lack of use. 89.0%of the prophylactic use were 24-72 h after chemotherapy, only a few (5.4%) on the day of chemotherapy. In therapeutic use, only 3.1%were standardized, with the dose of 23 000 µg, accounting for 7.4%of the total. So 92.6%were excessive. 14.2%of the therapeutic use were 24-72 h after chemotherapy, 21.2%on the day of chemotherapy. Conclusion:More than 50%use of G-CSF weren’t standardized, especial y the excessive use.

  18. Biologic therapies in the metastatic colorectal cancer treatment continuum--applying current evidence to clinical practice.

    Science.gov (United States)

    Peeters, Marc; Price, Timothy

    2012-08-01

    More therapeutic options are now available than ever before for patients with metastatic colorectal cancer (mCRC) and, as such, treatment decisions have become more complex. A multidisciplinary approach is, therefore, required to effectively manage these patients. In the past few years, many trials have reported on the value of combining biological agents, such as those targeting vascular endothelial growth factor A and epidermal growth factor receptors, with chemotherapy. However, despite the plethora of information now available, the optimal treatment strategy for patients with mCRC remains unclear. Indeed, the propensity of investigators to conduct clinical trials utilising a variety of chemotherapy backbones combined with the increased complexity of retrospectively incorporating analyses of genetic mutation status (e.g. KRAS and BRAF) have led to conflicting results for seemingly similar endpoints, particularly overall survival. As a result, guidelines that have been developed, whilst having some similarities, have distinct differences in terms of suggested therapeutic combinations. Therefore, here, we review and distil the currently available data reported from phase III trials of biologic agents in the first-, second- and third-line mCRC settings. PMID:21899955

  19. [Infection therapeutic modalities in human papillomavirus].

    Science.gov (United States)

    Carrillo Pacheco, Adia; Hernández Valencia, Marcelino; Hernández Quijano, Tomás; Zárate, Arturo

    2012-11-01

    Human papillomavirus (HPV) genital it can infect any mucous of the body and to cause cancer of the uterine cervix. Until recently specific treatments did not exist on this infection, for what had to destroy or to remove the injured tissue by diverse procedures, what could have obstetric repercussions in young women. Recently some surgical modalities and topical drugs have arisen, as well as of systemic employment that allow to arrive to the lesions difficult to approach, and have demonstrated good effectiveness to cure the infection for HPV, for what an analysis of the medical treatment of this infection type is made. PMID:23427640

  20. Mimicry for all modalities.

    Science.gov (United States)

    Dalziell, Anastasia H; Welbergen, Justin A

    2016-06-01

    Mimicry is a canonical example of adaptive signal design. In principle, what constitutes mimicry is independent of the taxonomic identity of the mimic, the ecological context in which it operates, and the sensory modality through which it is expressed. However, in practice the study of mimicry is inconsistent across research fields, with theoretical and empirical advances often failing to cross taxonomic and sensory divides. We propose a novel conceptual framework whereby mimicry evolves if a receiver perceives the similarity between a mimic and a model and as a result confers a selective benefit onto the mimic. Here, misidentification and/or deception are no longer formal requirements, and mimicry can evolve irrespective of the underlying proximate mechanisms. The centrality of receiver perception in this framework enables us to formally distinguish mimicry from perceptual exploitation and integrate mimicry and multicomponent signalling theory for the first time. In addition, it resolves inconsistencies in our understanding of the role of learning in mimicry evolution, and shows that imperfect mimicry is expected to be the norm. Mimicry remains a key model for understanding signal evolution and cognition, and we recommend the adoption of a unified approach to stimulate future interdisciplinary developments in this fascinating area of research. PMID:27117779

  1. Studi Tentang Kemunculan Modal Sosial

    Directory of Open Access Journals (Sweden)

    Retno Widayani

    2013-11-01

    Full Text Available Naskah ini merupakan hasil penelitian tentang kemunculan modal sosial di masyarakat dengan mengambil studi kasus masyarakat RW 13 Kelurahan Subangjaya Kecamatan Cikole Kota Sukabumi. Selain itu, penelitian ini juga mendeskripsikan penyebab kemunculan modal sosial dan mendeskripsikan bagaimana modal sosial dapat berfungsi dalam mengatasi persoalan masyarakat yang tidak dipecahkan sepenuhnya oleh pemerintah. Berdasarkan hasil penelitian di lapangan dapat disimpulkan bahwa masyarakat RW 13 Kelurahan Subangjaya Kota Sukabumi telah memiliki semangat modal sosial yang cukup kuat dan telah ada secara alamiah sejak dulu dan telah turun temurun, sehingga sangat mudah untuk digerakkan. Kekuatan modal sosial di RW 13 lebih dipengaruhi oleh tingkat homogenitas masyakarat RW 13 yang masih kental. Selain itu, kepemimpinan juga berkorelasi positif terhadap kemunculan modal sisual di RW 13. Konsep keteladanan dalam eksistensi modal sosial hanya efektif jika diterapkan pada masyarakat dengan relasi primer di unit sosial yang kecil dan terbatas (primary social relation seperti di tingkat RW dan RT dan akan menemui kesulitan jika diterapkan pada komunitas yang lebih besar. Di sisi lain, kepemimpinan yang baik membawa efek negatif, di mana kualitas modal sosial masyakarat menjadi tergantung pada kualitas pemimpin dalam aksi kolektifnya

  2. Modal Logics for Cryptographic Processes

    DEFF Research Database (Denmark)

    Frendrup, U.; Huttel, Hans; Jensen, N. J.

    2002-01-01

    We present three modal logics for the spi-calculus and show that they capture strong versions of the environment sensitive bisimulation introduced by Boreale et al. Our logics differ from conventional modal logics for process calculi in that they allow us to describe the knowledge of an attacker...

  3. Polygenic susceptibility to breast cancer: current state-of-the-art

    Science.gov (United States)

    Ghoussaini, Maya; Pharoah, Paul DP

    2016-01-01

    Breast cancer is the most commonly occurring invasive cancer among women and its estimated incidence rate worldwide is approximately 1 million cases annually. Although several breast cancer susceptibility genes have been identified over the past two decades, it is likely that many genes with modest effects are yet to be found. In this review, we discuss the progress that has been recently made with the emergence of empirical genome-wide association studies for breast cancer and the identification of several common, low-penetrance disease alleles at loci that had not been previously implicated as candidates for breast cancer susceptibility. We also discuss the implications of these recent findings for risk prediction, targeted screening and public health interventions, and conclude by discussing the strengths and weaknesses of these studies, and the strategies required to identify additional risk factors for breast cancer. PMID:19519208

  4. Application of Quantum Dots-Based Biotechnology in Cancer Diagnosis: Current Status and Future Perspectives

    Directory of Open Access Journals (Sweden)

    Chun-Wei Peng

    2010-01-01

    Full Text Available The semiconductor nanocrystal quantum dots (QDs have excellent photo-physical properties, and the QDs-based probes have achieved encouraging developments in cellular and in vivo molecular imaging. More and more researches showed that QDs-based technology may become a promising approach in cancer research. In this review, we focus on recent application of QDs in cancer diagnosis and treatment, including early detection of primary tumor such as ovarian cancer, breast cancer, prostate cancer and pancreatic cancer, as well as regional lymph nodes and distant metastases. With the development of QDs synthesis and modification, the effect of QDs on tumor metastasis investigation will become more and more important in the future.

  5. Gene therapy a promising treatment for breast cancer: current scenario in pakistan

    International Nuclear Information System (INIS)

    Breast cancer is one of the most common cancers among women around the world. It accounts for 22.9% of all the cancers and 18% of all female cancers in the world. One million new cases of breast cancer are diagnosed every year. Pakistan has more alarming situation with 90,000 new cases and ending up into 40,000 deaths annually. The risk factor for a female to develop breast cancer as compared with male is 100 : 1. The traditional way of treatment is by surgery, chemotherapy or radiotherapy. Advanced breast cancer is very difficult to treat with any of the traditional treatment options. A new treatment option in the form of gene therapy can be a promising treatment for breast cancer. Gene therapy provides treatment option in the form of targeting mutated gene, expression of cancer markers on the surface of cells, blocking the metastasis and induction of apoptosis, etc. Gene therapy showed very promising results for treatment of various cancers. All this is being trialed, experimented and practiced outside of Pakistan. Therefore, there is an immense need that this kind of work should be started in Pakistan. There are many good research institutes as well as well-reputed hospitals in Pakistan. Presently, there is a need to develop collaboration between research institutes and hospitals, so that the basic work and clinical trials can be done to treat breast cancer patients in the country. This collaboration will prove to be very healthy and will not only strength research institute but also will be very beneficial for cancer patients. (author)

  6. Current opinion on the role of testosterone in the development of prostate cancer: a dynamic model

    OpenAIRE

    Xu, Xiaohui; Chen, Xinguang (Jim); Hu, Hui; Dailey, Amy B.; Taylor, Brandie D.

    2015-01-01

    Background Since the landmark study conducted by Huggins and Hodges in 1941, a failure to distinguish between the role of testosterone in prostate cancer development and progression has led to the prevailing opinion that high levels of testosterone increase the risk of prostate cancer. To date, this claim remains unproven. Presentation of the hypothesis We present a novel dynamic mode of the relationship between testosterone and prostate cancer by hypothesizing that the magnitude of age-relat...

  7. Current evidence of effects of Helicobacter pylori eradication on prevention of gastric cancer

    OpenAIRE

    Choi, Il Ju

    2013-01-01

    Gastric cancer is the second most common cause of cancer death worldwide and is usually detected at a late stage, except in Korea and Japan where early screening is in effect. Results from animal and epidemiological studies suggest that Helicobacter pylori infection, and subsequent gastritis, promote development of gastric cancer in the infected mucosa. Relatively effective treatment regimens are available to treat H. pylori infection, and in general, mass eradication of the organism is not c...

  8. Vitamin B6 and colorectal cancer: Current evidence and future directions

    OpenAIRE

    Zhang, Xue-Hong; Ma, Jing; Smith-Warner, Stephanie A.; Lee, Jung Eun; Giovannucci, Edward

    2013-01-01

    Colorectal cancer remains the third most common cancer in both women and men worldwide. Identifying modifiable dietary factors is crucial in developing primary prevention strategies. Vitamin B6 is involved in more than 100 coenzyme reactions, and may influence colorectal cancer risk in multiple ways including through its role in one-carbon metabolism related DNA synthesis and methylation and by reducing inflammation, cell proliferation, and oxidative stress. Observational studies of dietary o...

  9. Current Usage of Traditional Chinese Medicine in the Management of Breast Cancer: A Practitioner's Perspective.

    Science.gov (United States)

    McPherson, Luke; Cochrane, Suzanne; Zhu, Xiaoshu

    2016-09-01

    Introduction This qualitative study seeks to explore the role within the context of Australian breast cancer oncology treatments that traditional Chinese medicine (TCM) practitioners play in the treatment of breast cancer. Methods Semistructured interviews were used on 2 groups: the first group was TCM practitioners who were recognized experts in breast cancer, and the second group consisted of TCM practitioners who treated breast cancer as part of their practice but were not recognized experts. Data analysis was achieved through grounded theory with open coding. Results The main themes reported on here are the following: the role of TCM in the biomedical management of breast cancer, TCM strategies for the management of breast cancer, and the perceived holistic approach of the TCM practitioner and the importance of a TCM diagnosis in the role of breast cancer care. Discussion The role of TCM in biomedical breast cancer management is a supportive one; however, this role is difficult as there is a lack of understanding of TCM by biomedical practitioners. The viewpoints of practitioners differed on key strategies of TCM: diagnosis, and treatment protocols. Patients sought the holistic approach of TCM practitioners as they felt it addressed all aspects of their health and not just the symptoms relating to breast cancer. Conclusion The lack of an integrated medicine approach in relation to TCM makes it difficult to demonstrate the value of the contribution TCM can make to biomedicine in the field of breast care oncology. Effectiveness studies are needed that can accurately represent TCM in this field. PMID:26420777

  10. Brain imaging in lung cancer patients without symptoms of brain metastases: a national survey of current practice in England

    International Nuclear Information System (INIS)

    Aim: To determine current practice regarding brain imaging for newly diagnosed lung cancer patients without symptoms of brain metastases. Materials and methods: A survey questionnaire was sent by e-mail to all the lung cancer lead clinicians in England currently on the National Cancer Intelligence Network database. The survey asked whether brain imaging was used in new lung cancer patients without symptoms or signs to suggest brain metastases; and if so, which patient subgroups were imaged according to cell type, stage of disease, and intention to treat, and which techniques were used to image these patients. Responses were received between February and May 2014. Results: Fifty-nine of 154 centres replied to the survey (38%). Thirty of the 59 centres (51%) did not image the brain in these patients. Twenty-nine of the 59 (49%) centres imaged the brain in at least certain subgroups. Of those centres that did image the brain 21 (72%) used CT as the first-line imaging technique and six (20%) used MRI. Twenty-five of 59 (42%) centres stated that the 2011 NICE guidelines had led to a change in their practice. Conclusion: There is wide variation in practice regarding brain imaging in this patient group in England, with no brain imaging at all in approximately half of centres and a spectrum of imaging in the other half. When the brain is imaged, CT is the technique most commonly used. The 2011 NICE guidelines have led to some change in practice but not to national uniformity. - Highlights: • Ascertain current practice in brain imaging for staging asymptomatic lung cancer patients. • Survey questionnaire sent to all the lung cancer lead clinicians in England. • Wide variation in practice with regard to brain imaging in this patient group. • No brain imaging at all in approximately half of centres and a spectrum of imaging in the other half • The 2011 NICE guidelines have led to some change in practice but not to national uniformity

  11. Advances in lung cancer surgery

    Directory of Open Access Journals (Sweden)

    Mark W Hennon

    2012-01-01

    Full Text Available The last few years have witnessed an explosion of the use of minimally invasive techniques for the detection, diagnosis, and treatment of all stages of lung cancer. The use of these techniques has improved the risk-benefit ratio of surgery and has made it more acceptable to patients considering lung surgery. They have also facilitated the delivery of multi-modality therapy to patients with advanced lung cancer. This review article summarizes current surgical techniques that represent the "cutting edge" of thoracic surgery for lung cancer.

  12. Stem cell technology in breast cancer: current status and potential applications

    Directory of Open Access Journals (Sweden)

    Chiotaki R

    2016-04-01

    Full Text Available Rena Chiotaki, Hara Polioudaki, Panayiotis A Theodoropoulos Department of Biochemistry, School of Medicine, University of Crete, Heraklion, Greece Abstract: Breast cancer, the leading cause of cancer among females, is supported by the presence of a rare subset of undifferentiated cells within the tumor, identified as breast cancer stem cells (BCSCs. BCSCs underlie the mechanisms of tumor initiation and sustenance and are implicated in the dissemination of the primary tumor to metastatic sites, as they have been found circulating in the blood of breast cancer patients. The discovery of BCSCs has generated a great amount of interest among the scientific community toward their isolation, molecular characterization, and therapeutic targeting. In this review, after summarizing the literature on molecular characterization of BCSCs and methodologies used for their isolation, we will focus on recent data supporting their molecular and functional heterogeneity. Additionally, following a synopsis of the latest approaches for BCSC targeting, we will specifically emphasize on the therapeutic use of naïve or engineered normal stem cells in the treatment of breast cancer and present contradictory findings challenging their safety. Keywords: breast cancer stem cells, cancer stem cell heterogeneity, targeting cancer stem cells, circulating tumor cells, stem cell technology

  13. Current status of gene therapy for breast cancer: progress and challenges

    Directory of Open Access Journals (Sweden)

    McCrudden CM

    2014-11-01

    Full Text Available Cian M McCrudden, Helen O McCarthySchool of Pharmacy, Queen’s University Belfast, Belfast, UKAbstract: Breast cancer is characterized by a series of genetic mutations and is therefore ideally placed for gene therapy intervention. The aim of gene therapy is to deliver a nucleic acid-based drug to either correct or destroy the cells harboring the genetic aberration. More recently, cancer gene therapy has evolved to also encompass delivery of RNA interference technologies, as well as cancer DNA vaccines. However, the bottleneck in creating such nucleic acid pharmaceuticals lies in the delivery. Deliverability of DNA is limited as it is prone to circulating nucleases; therefore, numerous strategies have been employed to aid with biological transport. This review will discuss some of the viral and nonviral approaches to breast cancer gene therapy, and present the findings of clinical trials of these therapies in breast cancer patients. Also detailed are some of the most recent developments in nonviral approaches to targeting in breast cancer gene therapy, including transcriptional control, and the development of recombinant, multifunctional bio-inspired systems. Lastly, DNA vaccines for breast cancer are documented, with comment on requirements for successful pharmaceutical product development.Keywords: breast cancer, gene therapy, nonviral, clinical trial

  14. Stem cell technology in breast cancer: current status and potential applications.

    Science.gov (United States)

    Chiotaki, Rena; Polioudaki, Hara; Theodoropoulos, Panayiotis A

    2016-01-01

    Breast cancer, the leading cause of cancer among females, is supported by the presence of a rare subset of undifferentiated cells within the tumor, identified as breast cancer stem cells (BCSCs). BCSCs underlie the mechanisms of tumor initiation and sustenance and are implicated in the dissemination of the primary tumor to metastatic sites, as they have been found circulating in the blood of breast cancer patients. The discovery of BCSCs has generated a great amount of interest among the scientific community toward their isolation, molecular characterization, and therapeutic targeting. In this review, after summarizing the literature on molecular characterization of BCSCs and methodologies used for their isolation, we will focus on recent data supporting their molecular and functional heterogeneity. Additionally, following a synopsis of the latest approaches for BCSC targeting, we will specifically emphasize on the therapeutic use of naïve or engineered normal stem cells in the treatment of breast cancer and present contradictory findings challenging their safety. PMID:27217783

  15. Role of cancer awareness in prevention of its outbreak: current scenario in Pakistan

    International Nuclear Information System (INIS)

    Cancer is one of the major threats to mankind after heart diseases. In developing countries, malnutrition and parasitic infections are more serious but cancer has a unique significance because roughly one in the five persons on the face of earth expires due to this ailment. It is traditionally thought to be a disease that has a strong bond with industrial revolution, modem world and chemicals exposed life style on the planet. Excluding the other cancers, solely breast cancer contributes 45% of its cases and 55% deaths occur in low and middle income countries like Pakistan who are in the queue of that transition stage of modernism once faced by the nations. In this review, we discuss the epidemiology, causes, challenges, screening and managerial issues along with a bird's eye view of cancer status in Pakistan that might be helpful in devising preventive and treatment strategies in the future. (author)

  16. Biomarkers that currently effect clinical practice in lung cancer: EGFR, ALK, MET, ROS-1 and KRAS

    Directory of Open Access Journals (Sweden)

    GrzegorzJanuszKorpanty

    2014-08-01

    Full Text Available Lung cancer remains the most lethal malignancy in the world. Despite improvements in surgical treatment, systemic therapy and radiotherapy, the 5-year survival rate for all patients diagnosed with lung cancer remains between 15-20%. Newer therapeutic strategies rely on specific molecular alterations, or biomarkers, that provide opportunities for a personalized approach to specific patient populations. Classification of lung cancer is becoming increasingly focused on these biomarkers, which renders the term “non-small cell lung” cancer less clinically useful. Non-small cell lung cancer is now recognized as a complex malignancy and its molecular and genomic diversity allows for patient-centered treatment options. Here we review advances in targeted treatment of lung adenocarcinoma with respect to five clinically relevant biomarkers - EGFR, ALK, MET, ROS-1 and KRAS.

  17. Quantum Dots for Cancer Research: Current Status, Remaining Issues, and Future Perspectives

    International Nuclear Information System (INIS)

    Cancer is a major threat to public health in the 21st century because it is one of the leading causes of death worldwide. The mechanisms of carcinogenesis, cancer invasion, and metastasis remain unclear. Thus, the development of a novel approach for cancer detection is urgent, and real-time monitoring is crucial in revealing its underlying biological mechanisms. With the optical and chemical advantages of quantum dots (QDs), QD-based nanotechnology is helpful in constructing a biomedical imaging platform for cancer behavior study. This review mainly focuses on the application of QD-based nanotechnology in cancer cell imaging and tumor microenvironment studies both in vivo and in vitro, as well as the remaining issues and future perspectives

  18. The current status and issues of the screening for colorectal cancer with CT colonography

    International Nuclear Information System (INIS)

    In recent years, CTC (CT colonography) has been clinically applied in the screaning of colorectal cancers, and is regarded highly for its diagnostic accuracy. This has become possible because of widespread use of multi-slice CT and increased use of analysis software. In addition, CTC, which yields objective and reproducible results, is a high-potential screening method, in that it is a low-invasive test associated with only mild distress, and can be easily normalized. In this center, screening for colorectal cancers with CTC is being conducted, with its accuracy being proved by statisical data: sensitivity (91.4%), specificity (92.4%), positive predictive value (PPV) (69.6%), negative predictive value (NPV) (98.3%), proper diagnosis rate (92.3%), and rate of detecting cancer (0.21%). CTC is considered to have the potential to become a 'new test for colorectal cancers', and can play an important role in screening for such cancers. (author)

  19. The modality effect of ego depletion: Auditory task modality reduces ego depletion.

    Science.gov (United States)

    Li, Qiong; Wang, Zhenhong

    2016-08-01

    An initial act of self-control that impairs subsequent acts of self-control is called ego depletion. The ego depletion phenomenon has been observed consistently. The modality effect refers to the effect of the presentation modality on the processing of stimuli. The modality effect was also robustly found in a large body of research. However, no study to date has examined the modality effects of ego depletion. This issue was addressed in the current study. In Experiment 1, after all participants completed a handgrip task, one group's participants completed a visual attention regulation task and the other group's participants completed an auditory attention regulation task, and then all participants again completed a handgrip task. The ego depletion phenomenon was observed in both the visual and the auditory attention regulation task. Moreover, participants who completed the visual task performed worse on the handgrip task than participants who completed the auditory task, which indicated that there was high ego depletion in the visual task condition. In Experiment 2, participants completed an initial task that either did or did not deplete self-control resources, and then they completed a second visual or auditory attention control task. The results indicated that depleted participants performed better on the auditory attention control task than the visual attention control task. These findings suggest that altering task modality may reduce ego depletion. PMID:27241617

  20. Current status and future perspectives of multimodality treatment for esophageal cancer in Japan

    International Nuclear Information System (INIS)

    History, current state and future perspectives of the treatment of the cancer in the title (EC) are explained. Japan Clinical Oncology Group (JCOG) EC group (JEOG) has conducted various multicenter randomized controlled trials of adjuvant therapy for surgery of EC, involving chemo- (CT) and radio-therapy (RT) since 1978. The meta-analysis of 24 foreign trials has recently revealed the significantly high efficacy for survival rate of preoperative CRT with the hazard ratio (HR) 0.78 vs CT with HR 0.87. In Japan, esophageal squamous cell carcinoma is predominant (90%) whereas in US, adenocarcinoma amounts to 70-80% and surgical procedure is slightly different. This suggests the necessity of confirmation of the results above and JCOG is comparing the foreign standard of preoperative CRT with preoperative CT. JCOG already established the definitive CRT using the concurrent treatment with 60 Gy and CT by their phase II study (JCOG9516). For stage II/III EC, the phase II study (JCOG9906) for the definitive CRT gave results of complete response (CR) 68% (50/74 cases) with 3-y survival 45%, which are essentially agreeable with 2 European trials'. Other JEOG phase II study with the similar CRT to above showed the complete response 88% (63/72 cases) and 5-y survival 75% in EC of the stage I (T1bN0), comparable to surgical outcome, and thus comparison with surgery (209 cases vs CRT 159) was made, of which results are in analysis. Now a large scale comparative phase III trial of preoperative CT and CRT with 41.4 Gy is in progress. (T.T.)

  1. CHARACTER EDUCATION THROUGH ENGLISH MODALITY

    Directory of Open Access Journals (Sweden)

    Subur Wardoyo

    2010-10-01

    Full Text Available The spread of English in Indonesia carries an inherent philosophy with it. This essay will focus on how the view that ‘there is no absolute truth’ is ingrained in the linguistic modality of English. Furthermore it will show how this philosophy of modality may inevitably shape a student’s character since it allows people to create the shared truths they need or to downgrade the truths of others, with all the potential positive or negative consequences. Finally this essay will also show how a visual picture, descriptive text, and dialogue could serve as teaching aids to shape a student’s character through classroom drills in such modality signifiers as modal auxiliaries, frequency adverbs, reporting frames, tenses etc. On the whole this essay relies heavily on Halliday’s Functional Grammar, von Wright’s Deontic Logic, and Hodge and Kress’s Semiotics while the topic of the picture, text and dialogue heavily centers on the mysterious Alhambra Citadel of Granada.   Keywords    :    Modality, degrees of modality, subjective and objective modality, kinds of truth, deontic logic.

  2. Specific features of current intraperitoneal therapy in patients with ovarian cancer

    Directory of Open Access Journals (Sweden)

    A. G. Kedrova

    2016-01-01

    Full Text Available Background. Today there are 3 trends in favor of intraperitoneal (IP chemotherapy: maintenance of its potential 5- and 10-year survival benefit in patients with ovarian cancer (OC; advantages of the IP administration of drugs even after nonoptimal surgery; enhancement of the efficiency of chemotherapy irrespective of the number of IP treatment cycles. There is also an expanded list of possible IP medicines and incorporation of novel targeted drugs into treatment regimens. However, the long-expected data of the most recent randomized trial GOG 0252 have proven deplorable and led to the activation of discussions on the role of IP therapy.Objective: to generalize the experience of 4 oncology departments with IP therapy in patients with disseminated OC and to compare the findings with those obtained by the world’s leading medical centers.Materials and methods. The retrospective analysis included 76 patients with Stage IIIC OC who had received IP chemotherapy in accordance with 3 regimens. For standardization of IP treatment procedures, the investigators assessed the following indicators: age; tumor morphological type; surgical radicality; catheter model and port placement procedure; drug administration route; number of treatment cycles; efficiency of therapy from expert ultrasonographic findings and CA-124, HE4, CA-19.9 marker levels, time to disease progression. The analysis also involved adverse manifestations, methods of their correction and the reasons for early treatment discontinuation were separately reported. The obtained data were processed using standard statistical programs.Results. 55 of the 76 patients could complete more than 4 IP therapy cycles. Among them, only 4 patients were observed to have disease progression at follow-ups lasting over 24 months.Conclusion. Current IP therapy is a safe and convenient drug treatment in patients with OC after optimal cytoreductive surgery. The mastery and standardization of the

  3. On Modal Refinement and Consistency

    DEFF Research Database (Denmark)

    Nyman, Ulrik; Larsen, Kim Guldstrand; Wasowski, Andrzej

    Almost 20 years after the original conception, we revisit several fundamental question about modal transition systems. First, we demonstrate the incompleteness of the standard modal refinement using a counterexample due to Hüttel. Deciding any refinement, complete with respect to the standard...... notions of implementation, is shown to be computationally hard (co-NP hard). Second, we consider four forms of consistency (existence of implementations) for modal specifications. We characterize each operationally, giving algorithms for deciding, and for synthesizing implementations, together with their...

  4. Current X-ray diagnosis of stomach cancer (comparison of X-ray and morphological methods of the investigation)

    International Nuclear Information System (INIS)

    Using the principles of wide comparisons of the data of radiation diagnosis (routine X-ray study, ultrasonography (USG), CT, MRI) with the morphological findings of resected gastric specimens from patients with endophytic gastric cancer (EGC) (n ∼ 85), the authors propose some points in the problem associated with its diagnosis. They believe that taking into account the fact that there is an obvious growth of endophytic parietally growing gastric cancer with the concurrent reduction in its intestinal forms, it is necessary to restore current radiation to its leading place, along with endoscopy, in detecting the cancer. The authors makes positive assessment of USC, CT, MRI in addition to routine X-ray study and endoscopy. The paper makes indications for USG, CT, MRI concrete

  5. Current Challenges in Development of Differentially Expressed and Prognostic Prostate Cancer Biomarkers

    Directory of Open Access Journals (Sweden)

    Steven M. Lucas

    2012-01-01

    Full Text Available Introduction. Predicting the aggressiveness of prostate cancer at biopsy is invaluable in making treatment decisions. In this paper we review the differential expression of genes and microRNAs identified through microarray analysis as potentially useful markers for prostate cancer prognosis and discuss some of the challenges associated with their development. Methods. A review of the literature was conducted through Medline. Articles were identified through searches of the following terms: “prostate cancer AND differential expression”, “prostate cancer prognosis”, and “prostate cancer AND microRNAs”. Results. Though numerous differentially expressed genes and microRNAs were identified as possible prognostic markers, the significance of several of these genes is either debated due to conflicting results or is not validated in other study populations. A few of the articles constructed predictive nomograms using a panel of biomarkers which require further validation. Challenges to the development of useful markers include different methodology, cancer heterogeneity, and sampling error. These can be overcome by categorizing prognostic factors into particular gene pathways or by supplementing biopsy information with blood or urine-based biomarkers. Conclusion. Though biomarkers based on differential expression offer the potential to improve decision making concerning prostate cancer, further validation of their utility and accuracy at the biopsy level is needed.

  6. Thyroid cancer: Natural history, management strategies and outcomes

    International Nuclear Information System (INIS)

    Objectives: To understand the natural history of thyroid cancer and high risk groups; To define the biological behavior of thyroid cancer and relate it to various prognostic factors and risk groups; To divide the management strategies into conservation, radical surgery and radioactive iodine treatment; To define the role of external radiation therapy and the management of complex and advanced thyroid cancer; To analyze the results of management of anaplastic thyroid cancer and make a plea for combined modality treatment; To define the current role of genetic studies in medullary thyroid cancer. At the end of this refresher course, the attendees will be able to understand the natural history, the prognostic factors and risk groups and surgical and combined modality treatment in thyroid cancer

  7. Basics and state-of-the-art of modal testing

    Indian Academy of Sciences (India)

    D J Ewins

    2000-06-01

    In this paper, the current status of the technology of modal testing is reviewed with particular reference to the application of these methodsto the task of ensuring the optimum design of mechanical structures. Existing methods are summarised and new techniques which are currently under development are described. Some of the current limitations and problem areas are also identified.

  8. Current trends of the external radiotherapy in treatment of non small cell lung cancer

    International Nuclear Information System (INIS)

    Non-small cell lung cancer belongs to the most frequent malign cancer on the world. Local and loco-regional methods of therapy are for this form of cancer highly important. Dominant position has radiation therapy, which is treating 60 % of all patients. Author provides an overview about the conventional and non-conventional sources of radiation, mainly about linear accelerator, which is used in therapy of NSCLC. This article offers basic information about conventional radiotherapy; it evaluates the fractional modes and doses used for curative and palliative radiation therapy. (author)

  9. Development and Current Status of National Cancer Center for Chinese Medicine

    Institute of Scientific and Technical Information of China (English)

    LI Jie; LIN Hong-sheng; HOU Wei; ZHANG Pei-tong; HUA Bao-jin

    2011-01-01

    @@ Chinese medicine (CM) is an important feature of cancer treatment in China.Especially in the last 10years, the effect of CM in cancer treatment has been of high concern and has been accepted by experts and patients locally and overseas.The oncology department (OD) of Guang'anmen Hospital (GAMH) of China Academy of Chinese Medical Sciences (CATCM),which will mark its 50th anniversary in 2013, is one of China's most-respected centers devoted exclusively to cancer patient care, research, education, and prevention through CM.It is located at the campus of GAMH,central Beijing.

  10. Profile of bevacizumab in the treatment of platinum-resistant ovarian cancer: current perspectives

    OpenAIRE

    McClung EC; Wenham RM

    2016-01-01

    E Clair McClung, Robert M WenhamDepartment of Gynecologic Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USAAbstract: Patients with platinum-resistant ovarian cancer have progression of disease within 6 months of completing platinum-based chemotherapy. While several chemotherapeutic options exist for the treatment of platinum-resistant ovarian cancer, the overall response to any of these therapies is ~10%, with a median progression-free survival of 3–4 months and a median ...

  11. Using Current Smoking Prevalence to Project Lung Cancer Morbidity and Mortality in Georgia by 2020

    OpenAIRE

    Davis, Victoria N.; Lavender, Antionette; Bayakly, Rana; Ray, Kenneth; Moon, Tamira

    2013-01-01

    Introduction Tobacco use is the leading preventable cause of disease and premature death in the United States. In Georgia, approximately 18% of adults smoke cigarettes, and 87% of men’s lung cancer deaths and 70% of women’s lung cancer deaths are due to smoking. From 2004–2008, the age-adjusted lung cancer incidence rate in Georgia was 112.8 per 100,000 population, and the mortality rate was 88.2 per 100,000 population. Methods The Georgia Behavioral Risk Factor Surveillance System Survey was...

  12. Therapeutic potential of snake venom in cancer therapy:current perspectives

    Institute of Scientific and Technical Information of China (English)

    Vivek Kumar Vyas; Keyur Brahmbhatt; Hardik Bhatt; Utsav Parmar

    2013-01-01

    Many active secretions produced by animals have been employed in the development of new drugs to treat diseases such as hypertension and cancer. Snake venom toxins contributed significantly to the treatment of many medical conditions. There are many published studies describing and elucidating the anti-cancer potential of snake venom. Cancer therapy is one of the main areas for the use of protein peptides and enzymes originating from animals of different species. Some of these proteins or peptides and enzymes from snake venom when isolated and evaluated may bind specifically to cancer cell membranes, affecting the migration and proliferation of these cells. Some of substances found in the snake venom present a great potential as anti-tumor agent. In this review, we presented the main results of recent years of research involving the active compounds of snake venom that have anticancer activity.

  13. Chemoprevention of cancer: current evidence and future prospects [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Vassiliki Benetou

    2015-09-01

    Full Text Available Cancer chemoprevention refers to the use of agents for the inhibition, delay, or reversal of carcinogenesis before invasion. In the present review, agents examined in the context of cancer chemoprevention are classified in four major categories—hormonal, medications, diet-related agents, and vaccines—and the main representatives of each category are presented. Although there are serious constraints in the documentation of effectiveness of chemopreventive agents, mainly stemming from the long latency of the condition they are addressing and the frequent lack of intermediate biomarkers, there is little disagreement about the role of aspirin, whereas a diet rich in vegetables and fruits appears to convey more protection than individual micronutrients. Among categories of cancer chemopreventive agents, hormonal ones and vaccines might hold more promise for the future. Also, the identification of individuals who would benefit most from chemopreventive interventions on the basis of their genetic profiles could open new prospects for cancer chemoprevention.

  14. Addressing Childhood Cancer in Low-Resource Countries: Current Challenges, Strategies, and Recommendations.

    Science.gov (United States)

    Mbah Afungchwi, Glenn; Challinor, Julia

    2016-07-01

    Children and adolescents represent a small, but critically important, number of patients with cancer worldwide (14.1 million newly diagnosed adults versus 160,000 children annually). The life years saved when a child is cured of cancer are about 71 compared to 15 years for an adult in most high-income countries (HICs). In HICs, about 80% of children survive cancer. Unfortunately, in low- and middle-income countries (LMICs), the survival rates are generally 50% or less. In these resource-limited settings, only 15%-37% of children and adolescents have access to cancer treatment, and most are diagnosed with advanced-stage disease, making cure impossible. PMID:27314196

  15. Mouse models in liver cancer research: A review of current literature

    Institute of Scientific and Technical Information of China (English)

    Martijn WH Leenders; Maarten W Nijkamp; Inne HM Borel Rinkes

    2008-01-01

    Primary liver cancer remains one of the most lethal malignancies worldwide. Due to differences in prevalence of etiological factors the incidence of primary liver cancer varies among the world, with a peak in EasL-Asia. As this disease is still lethal in most of the cases, research has to be done to improve our understanding of the disease, offering insights for possible treatment options. For this purpose, animal models are widely used,especially mouse models. In this review, we describe the different types of mouse models used in liver cancer research, with emphasis on genetically engineered mice used in this field. We focus on hepatocellular carcinoma (HCC), as this is by far the most common Lype of primary liver cancer, accounting for 70%-85% of cases.

  16. Stress and breast cancer: a systematic update on the current knowledge

    DEFF Research Database (Denmark)

    Nielsen, Naja Rod; Grønbaek, Morten

    2006-01-01

    A vast body of research has been carried out to examine the relationship between psychological stress and the risk of breast cancer. Previous reviews on this issue have mainly focused on stressful life events and have included both prospective and retrospective studies. The results from these rev......A vast body of research has been carried out to examine the relationship between psychological stress and the risk of breast cancer. Previous reviews on this issue have mainly focused on stressful life events and have included both prospective and retrospective studies. The results from...... these reviews have revealed conflicting data. We evaluate whether stressful life events, work-related stress, or perceived global stress are differentially associated with breast cancer incidence and breast cancer relapse in prospective studies. Systematic and explicit methods were used to identify, select...

  17. Targeting Bone Metabolism in Patients with Advanced Prostate Cancer: Current Options and Controversies

    OpenAIRE

    Tilman Todenhöfer; Arnulf Stenzl; Hofbauer, Lorenz C.; Rachner, Tilman D.

    2015-01-01

    Maintaining bone health remains a clinical challenge in patients with prostate cancer (PC) who are at risk of developing metastatic bone disease and increased bone loss due to hormone ablation therapy. In patients with cancer-treatment induced bone loss (CTIBL), antiresorptive agents have been shown to improve bone mineral density (BMD) and to reduce the risk of fractures. For patients with bone metastases, both zoledronic acid and denosumab delay skeletal related events (SREs) in the castrat...

  18. Imaging and intervention in prostate cancer: Current perspectives and future trends

    OpenAIRE

    Sanjay Sharma

    2014-01-01

    Prostate cancer is the commonest malignancy in men that causes significant morbidity and mortality worldwide. Screening by digital rectal examination (DRE) and serum prostate-specific antigen (PSA) is used despite its limitations. Gray-scale transrectal ultrasound (TRUS), used to guide multiple random prostatic biopsies, misses up to 20% cancers and frequently underestimates the grade of malignancy. Increasing the number of biopsy cores marginally increases the yield. Evolving techniques of r...

  19. Current status of gene therapy for breast cancer: progress and challenges

    OpenAIRE

    McCrudden CM; McCarthy HO

    2014-01-01

    Cian M McCrudden, Helen O McCarthySchool of Pharmacy, Queen’s University Belfast, Belfast, UKAbstract: Breast cancer is characterized by a series of genetic mutations and is therefore ideally placed for gene therapy intervention. The aim of gene therapy is to deliver a nucleic acid-based drug to either correct or destroy the cells harboring the genetic aberration. More recently, cancer gene therapy has evolved to also encompass delivery of RNA interference technologies, as well as c...

  20. Cardiotoxicity of cancer therapeutics: current issues in screening, prevention and therapy

    Directory of Open Access Journals (Sweden)

    Richard Joseph Sheppard

    2013-03-01

    Full Text Available In the context of modern cancer chemotherapeutics, cancer survivors are living longer and being exposed to potential comorbidities related to non-cancer side effects of such treatments. With close monitoring of cancer patients receiving potentially cardiotoxic medical therapies, oncologists and cardiologists alike are identifying patients in both clinical and subclinical phases of cardiovascular disease related to such chemotherapies. Specifically, cardiotoxicity at the level of the myocardium and potential for the development of heart failure are becoming a growing concern with increasing survival of cancer patients.Traditional chemotherapeutic agents used commonly in the treatment of breast cancer and hematologic malignancies, such as anthracyclines and HER-2 antagonists, are well known to be associated with cardiovascular sequelae. Patients often present without symptoms and an abnormal cardiac imaging study performed as part of routine evaluation of patients receiving cardiotoxic therapies. Additionally, patients can present with signs and symptoms of cardiovascular disease months to years after receiving the chemotherapies. As the understanding of the physiology underlying the various cancers has grown, therapies have been developed that target specific molecules that represent key aspects of physiologic pathways responsible for cancer growth. Inhibition of these pathways, such as those involving tyrosine kinases, has lead to the potential for cardiotoxicity as well. In view of the potential cardiotoxicity of specific chemotherapies, there is a growing interest in identifying patients who are at risk of cardiotoxicity prior to becoming symptomatic or developing cardiotoxicity that may limit the use of potentially life-saving chemotherapy agents. Serological markers and novel cardiac imaging techniques have become the source of many investigations with the goal of screening patients for pre-clinical cardiotoxicity. Additionally, studies have

  1. CHARACTER EDUCATION THROUGH ENGLISH MODALITY

    OpenAIRE

    Subur Wardoyo

    2010-01-01

    The spread of English in Indonesia carries an inherent philosophy with it. This essay will focus on how the view that ‘there is no absolute truth’ is ingrained in the linguistic modality of English. Furthermore it will show how this philosophy of modality may inevitably shape a student’s character since it allows people to create the shared truths they need or to downgrade the truths of others, with all the potential positive or negative consequences. Finally this essay will...

  2. Breast cancer screening in the working population. Current status and future issues in Tokyo

    International Nuclear Information System (INIS)

    We conducted a comparative study of breast cancer mass screening by the Tokyo Health Service Association for the regional and working population. The mammographic screening rate has been over 90% for all examinees since 2004, and the rate of inspection and palpation has been almost 0% in the regional population, although the rate was still 24% of all screenings among the working population even in 2006. In the working population the average age at which breast cancer screening was done was younger than in the regional population. The proportion of the population under 40 was 38.4% in 2003 and 35.7% in 2006, and in this population the rates of mammography, ultrasonography, and inspection and palpation were almost the same. This suggests a degree of confusion about breast cancer screening among younger women. The breast cancer detection rate was significantly better in the regional than in the working population. However, there was no significant difference in the rate between the two populations in the 40- to 59- year age range. In conclusion, the breast cancer screening system for the regional population has been improved as a result of the official notices of the Ministry of Health, Labour and Welfare. On the other hand, the data for the working population have not been favorable because of age-related factors and the methods used for screening. It will be necessary to refine the screening system for the working population to improve not only screening efficacy but also the breast cancer mortality rate. (author)

  3. 6 Common Cancers - Breast Cancer

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues 6 Common Cancers - Breast Cancer Past Issues / Spring 2007 Table of Contents For ... her down. Photo: AP Photo/Brett Flashnick Breast Cancer Breast cancer is a malignant (cancerous) growth that ...

  4. 6 Common Cancers - Breast Cancer

    Science.gov (United States)

    ... Home Current Issue Past Issues 6 Common Cancers - Breast Cancer Past Issues / Spring 2007 Table of Contents For ... slow her down. Photo: AP Photo/Brett Flashnick Breast Cancer Breast cancer is a malignant (cancerous) growth that ...

  5. 6 Common Cancers - Colorectal Cancer

    Science.gov (United States)

    ... Home Current Issue Past Issues 6 Common Cancers - Colorectal Cancer Past Issues / Spring 2007 Table of Contents For ... of colon cancer. Photo: AP Photo/Ron Edmonds Colorectal Cancer Cancer of the colon (large intestine) or rectum ( ...

  6. Current Status and Development of Traditional Chemotherapy in Non-small Cell Lung Cancer under the Background of Targeted Therapy

    OpenAIRE

    Zhang, Guowei; Wang, Huijuan; Mina ZHANG; Li, Peng; Ma, ZhiYong

    2015-01-01

    In recent years, along with rapid development of targeted therapy in non-small cell lung cancer, traditional chemotherapy get less and less attention. Yet it still can not be ignored in the current that how to locate and use traditional chemotherapy so patients could derive maximum benefit. For this purpose, through the literature review and analysis, we point out there are still many traditional chemotherapy irreplaceable places whatever patients’ driver gene status. And there are some new t...

  7. Can Perioperative Chemotherapy for Advanced Gastric Cancer Be Recommended on the Basis of Current Research? A Critical Analysis

    OpenAIRE

    Bauer, Katrin; Porzsolt, Franz; Henne-Bruns, Doris

    2014-01-01

    Purpose According to current guidelines, perioperative chemotherapy is an integral part of the treatment strategy for advanced gastric cancer. Randomized controlled studies have been conducted in order to determine whether perioperative chemotherapy leads to improved R0 resection rates, fewer recurrences, and prolonged survival. The aim of our project was to critically appraise three major studies to establish whether perioperative chemotherapy for advanced, potentially resectable gastric can...

  8. Current trends in initial management of laryngeal cancer: the declining use of open surgery.

    Science.gov (United States)

    Silver, Carl E; Beitler, Jonathan J; Shaha, Ashok R; Rinaldo, Alessandra; Ferlito, Alfio

    2009-09-01

    The role of open surgery for management of laryngeal cancer has been greatly diminished during the past decade. The development of transoral endoscopic laser microsurgery (TLS), improvements in delivery of radiation therapy (RT) and the advent of multimodality protocols, particularly concomitant chemoradiotherapy (CCRT) have supplanted the previously standard techniques of open partial laryngectomy for early cancer and total laryngectomy followed by adjuvant RT for advanced cancer. A review of the recent literature revealed virtually no new reports of conventional conservation surgery as initial treatment for early stage glottic and supraglottic cancer. TLS and RT, with or without laser surgery or CCRT, have become the standard initial treatments for T1, T2 and selected T3 laryngeal cancer. Photodynamic therapy (PDT) may have an emerging role in the treatment of early laryngeal cancer. Anterior commissure involvement presents particular difficulties in application of TLS, although no definitive conclusions have been reached with regard to optimal treatment of these lesions. Results of TLS are equivalent to those obtained by conventional conservation surgery, with considerably less morbidity, less hospital time and better postoperative function. Oncologic results of TLS and RT are equivalent for glottic cancer, but with better voice results for RT in patients who require more extensive cordectomy. The preferred treatment for early supraglottic cancer, particularly for bulkier or T3 lesions is TLS, with or without postoperative RT. The Veterans Administration Study published in 1991 established the fact that the response to neoadjuvant CT predicts the response of a tumor to RT. Patients with advanced tumors that responded either partially or completely to CT were treated with RT, and total laryngectomy was reserved for non-responders. This resulted in the ability to preserve the larynx in a significant number of patients with locally advanced laryngeal cancer, while

  9. Causality, Modality and Explanation

    OpenAIRE

    White, Graham

    2008-01-01

    We start with Fodor's critique of cognitive science in "The mind doesn't work that way: The scope and limits of computational psychology": he argues that much mental activity cannot be handled by the current methods of cognitive science because it is nonmonotonic and, therefore, is global in nature, is not context-free, and is thus not capable of being formalized by a Turing-like mental architecture. We look at the use of nonmonotonic logic in the artificial intelligence ...

  10. Oleanane triterpenoids in the prevention and therapy of breast cancer: current evidence and future perspectives.

    Science.gov (United States)

    Parikh, Nisha R; Mandal, Animesh; Bhatia, Deepak; Siveen, Kodappully Sivaraman; Sethi, Gautam; Bishayee, Anupam

    2014-12-01

    Breast cancer is one of the most frequently diagnosed cancers and major cause of death in women in the world. Emerging evidence underscores the value of dietary and non-dietary phytochemicals, including triterpenoids, in the prevention and treatment of breast cancer. Oleanolic acid, an oleanane-type pentacyclic triterpenoid, is present in a large number of dietary and medicinal plants. Oleanolic acid and its derivatives exhibit several promising pharmacological activities, including antioxidant, anti-inflammatory, hepatoprotective, cardioprotective, antipruritic, spasmolytic, antiallergic, antimicrobial and antiviral effects. Numerous studies indicate that oleanolic acid and other oleanane triterpenoids modulate multiple intracellular signaling pathways and exert chemopreventive and antitumor activities in various in vitro and in vivo model systems. A series of novel synthetic oleanane triterpenoids have been prepared by chemical modifications of oleanolic acid and some of these compounds are considered to be the most potent anti-inflammatory and anticarcinogenic triterpenoids. Accumulating studies provide extensive evidence that synthetic oleanane derivatives inhibit proliferation and induce apoptosis of various cancer cells in vitro and demonstrate cancer preventive or antitumor efficacy in animal models of blood, breast, colon, connective tissue, liver, lung, pancreas, prostate and skin cancer. This review critically examines the potential role of oleanolic acid, oleanane triterpenoids and related synthetic compounds in the chemoprevention and treatment of mammary neoplasia. Both in vitro and in vivo studies on these agents and related molecular mechanisms are presented. Several challenges and future directions of research to translate already available impressive preclinical knowledge to clinical practice of breast cancer prevention and therapy are also presented. PMID:25395898

  11. Computer-aided detection system performance on current and previous digital mammograms in patients with contralateral metachronous breast cancer

    International Nuclear Information System (INIS)

    Background: The computer-aided detection (CAD) system is widely used for screening mammography. The performance of the CAD system for contralateral breast cancer has not been reported for women with a history of breast cancer. Purpose: To retrospectively evaluate the performance of a CAD system on current and previous mammograms in patients with contralateral metachronous breast cancer. Material and Methods: During a 3-year period, 4945 postoperative patients had follow-up examinations, from whom we selected 55 women with contralateral breast cancers. Among them, 38 had visible malignant signs on the current mammograms. We analyzed the sensitivity and false-positive marks of the system on the current and previous mammograms according to lesion type and breast density. Results: The total visible lesion components on the current mammograms included 27 masses and 14 calcifications in 38 patients. The case-based sensitivity for all lesion types was 63.2% (24/38) with false-positive marks of 0.71 per patient. The lesion-based sensitivity for masses and calcifications was 59.3% (16/27) and 71.4% (10/14), respectively. The lesion-based sensitivity for masses in fatty and dense breasts was 68.8% (11/16) and 45.5% (5/11), respectively. The lesion-based sensitivity for calcifications in fatty and dense breasts was 100.0% (3/3) and 63.6% (7/11), respectively. The total visible lesion components on the previous mammograms included 13 masses and three calcifications in 16 patients, and the sensitivity for all lesion types was 31.3% (5/16) with false-positive marks of 0.81 per patient. On these mammograms, the sensitivity for masses and calcifications was 30.8% (4/13) and 33.3% (1/3), respectively. The sensitivity in fatty and dense breasts was 28.6% (2/7) and 33.3% (3/9), respectively. Conclusion: In the women with a history of breast cancer, the sensitivity of the CAD system in visible contralateral breast cancer was lower than in most previous reports using the same CAD

  12. Tasquinimod in the treatment of castrate-resistant prostate cancercurrent status and future prospects

    Science.gov (United States)

    Mehta, Amit R.; Armstrong, Andrew J.

    2016-01-01

    Treatment options have significantly expanded in recent years for men with metastatic castration-resistant prostate cancer (mCRPC), with the routine use of immunotherapy (sipuleucel-T) and novel hormonal agents such as enzalutamide and abiraterone acetate prior to taxane-based chemotherapy or radium-223 radiotherapy. A number of immune checkpoints limit the immune response of the host to metastatic tumor progression in prostate cancer, one of which is an immunosuppressive and pro-angiogenic cell called the myeloid-derived suppressor cell (MDSC). Tasquinimod is a small molecular oral inhibitor of S100A9, a key cell surface regulator of MDSC function, and has shown anti-angiogenic, antitumor and immune-modulatory properties in preclinical models of prostate cancer and other solid tumors. A large randomized phase II trial of tasquinimod in men with chemotherapy-naïve mCRPC demonstrated a significant prolongation in radiographic and symptomatic progression-free survival compared with placebo, which was also associated with improvements in overall survival. Tasquinimod was studied in a global phase III randomized trial in men with bone mCRPC and, while it significantly improved radiographic progression-free survival, this did not result in an overall survival benefit. However, tasquinimod is under evaluation as well as a combination therapy with other systemic agents in prostate cancer and as a single agent in other solid tumors. This review encompasses the preclinical and clinical development of tasquinimod as a therapy for men with prostate cancer. PMID:26834836

  13. Current Management Strategies in Breast Cancer by Targeting Key Altered Molecular Players.

    Science.gov (United States)

    Ali, Shazia; Mondal, Neelima; Choudhry, Hani; Rasool, Mahmood; Pushparaj, Peter N; Khan, Mohammad A; Mahfooz, Maryam; Sami, Ghufrana A; Jarullah, Jummanah; Ali, Ashraf; Jamal, Mohammad S

    2016-01-01

    Breast cancer is the second largest disease affecting women worldwide. It remains the most frequently reported and leading cause of death among women in both developed and developing countries. Tamoxifen and raloxifene are commonly used selective estrogen receptor modulators for treatment of breast cancer in women with high risk, although resistance occurs by tamoxifen after 5 years of therapy and both drugs cause uterine cancer and thromboembolic events. Aromatase inhibitors (AIs) are one of the optional modes used for breast cancer treatment. The combination of AIs along with tamoxifen can also be beneficial. Various therapeutic agents from different sources are being studied, which further need to be improved for potential outcome. For this, clinical trials based on large number of patients with optimal dose and lesser side effects have to be more in practice. Despite the clinical trials going on, there is need of better molecular models, which can identify high risk population, new agents with better benefit having less side effects, and improved biomarkers for treating breast cancer. PMID:26973813

  14. Current status of predictive biomarkers for neoadjuvant therapy in esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    Norihisa; Uemura; Tadashi; Kondo

    2014-01-01

    Neoadjuvant therapy has been proven to be extremely valuable and is widely used for advanced esophageal cancer. However, a significant proportion of treated patients(60%-70%) does not respond well to neoadjuvant treatments and develop severe adverse effects. Therefore, predictive markers for individualization of multimodality treatments are urgently needed in esophageal cancer. Recently, molecular biomarkers that predict the response to neoadjuvant therapy have been explored in multimodal approaches in esophageal cancer and successful examples of biomarker identification have been reported. In this review, promising candidates for predictive molecular biomarkers developed by using multiple molecular approaches are reviewed. Moreover, treatment strategies based on the status of predicted biomarkers are discussed, while considering the international differences in the clinical background. However, in the absence of adequate treatment options related to the results of the biomarker test, the usefulness of these diagnostic tools is limited and new effective therapies for biomarker-identified nonresponders to cancer treatment should be concurrent with the progress of predictive technologies. Further improvement in the prognosis of esophageal cancer patients can be achieved through the introduction of novel therapeutic approaches in clinical practice.

  15. Geriatric assessment with management in cancer care: Current evidence and potential mechanisms for future research

    Science.gov (United States)

    Magnuson, Allison; Allore, Heather; Cohen, Harvey Jay; Mohile, Supriya G.; Williams, Grant R.; Chapman, Andrew; Extermann, Martine; Olin, Rebecca L.; Targia, Valerie; Mackenzie, Amy; Holmes, Holly M.; Hurria, Arti

    2016-01-01

    Older adults with cancer represent a complex patient population. Geriatric assessment (GA) is recommended to evaluate the medical and supportive care needs of this group. “GA with management” is a term encompassing the resultant medical decisions and interventions implemented in response to vulnerabilities identified on GA. In older, non-cancer patients, GA with management has been shown to improve a variety of outcomes, such as reducing functional decline and health care utilization. However, the role of GA with management in the older adult with cancer is less well established. Rigorous clinical trials of GA with management are necessary to develop an evidence base and support its use in the routine oncology care of older adults. At the recent U-13 conference, “Design and Implementation of Intervention Studies to Improve or Maintain Quality of Survivorship in Older and/or Frail Adults with Cancer,” a session was dedicated to developing research priorities in GA with management. Here we summarize identified knowledge gaps in GA with management studies for older patients with cancer and propose areas for future research. PMID:27197915

  16. Tasquinimod in the treatment of castrate-resistant prostate cancer - current status and future prospects.

    Science.gov (United States)

    Mehta, Amit R; Armstrong, Andrew J

    2016-02-01

    Treatment options have significantly expanded in recent years for men with metastatic castration-resistant prostate cancer (mCRPC), with the routine use of immunotherapy (sipuleucel-T) and novel hormonal agents such as enzalutamide and abiraterone acetate prior to taxane-based chemotherapy or radium-223 radiotherapy. A number of immune checkpoints limit the immune response of the host to metastatic tumor progression in prostate cancer, one of which is an immunosuppressive and pro-angiogenic cell called the myeloid-derived suppressor cell (MDSC). Tasquinimod is a small molecular oral inhibitor of S100A9, a key cell surface regulator of MDSC function, and has shown anti-angiogenic, antitumor and immune-modulatory properties in preclinical models of prostate cancer and other solid tumors. A large randomized phase II trial of tasquinimod in men with chemotherapy-naïve mCRPC demonstrated a significant prolongation in radiographic and symptomatic progression-free survival compared with placebo, which was also associated with improvements in overall survival. Tasquinimod was studied in a global phase III randomized trial in men with bone mCRPC and, while it significantly improved radiographic progression-free survival, this did not result in an overall survival benefit. However, tasquinimod is under evaluation as well as a combination therapy with other systemic agents in prostate cancer and as a single agent in other solid tumors. This review encompasses the preclinical and clinical development of tasquinimod as a therapy for men with prostate cancer. PMID:26834836

  17. Immunotherapy and therapeutic vaccines in prostate cancer: an update on current strategies and clinical implications

    Directory of Open Access Journals (Sweden)

    B Harpreet Singh

    2014-06-01

    Full Text Available In recent years, immunotherapy has emerged as a viable and attractive strategy for the treatment of prostate cancer. While there are multiple ways to target the immune system, therapeutic cancer vaccines and immune checkpoint inhibitors have been most successful in late-stage clinical trials. The landmark Food and Drug Administration approval of sipuleucel-T for asymptomatic or minimally symptomatic metastatic prostate cancer set the stage for ongoing phase III trials with the cancer vaccine PSA-TRICOM and the immune checkpoint inhibitor ipilimumab. A common feature of these immune-based therapies is the appearance of improved overall survival without short-term changes in disease progression. This class effect appears to be due to modulation of tumor growth rate kinetics, in which the activated immune system exerts constant immunologic pressure that slows net tumor growth. Emerging data suggest that the ideal population for clinical trials of cancer vaccines is patients with lower tumor volume and less aggressive disease. Combination strategies that combine immunotherapy with standard therapies have been shown to augment both immune response and clinical benefit.

  18. [Current epidemiological overview of the most frequent cancers in Spain. Implications for nursing care].

    Science.gov (United States)

    Martínez-González, Teresa de Jesús; Prada-Morales, Sara; Díaz-Espinos, María Isabel; Bouza-Nebrera, Irene; Lázaro-Escobar, Verónica; Serrano-Gallardo, Pilar

    2012-01-01

    This article is to describe the epidemiological situation of cancer and prevention strategies, particularly related to the work of nurses (primary prevention and early detection), focusing primarily on lung cancer (LC), breast (BC) and colorectal (CRC). 98,046 cancer deaths occurred in Spain in 2006, which is the leading cause of death in our country. The main action of prevention for the LC is based on smoking cessation, the main risk factor (relative risk (RR) from 10 to 30) beside radon and asbestos exposures. Basically the prevention for the BC is based on early detection, mammography remains the ultimate test because it reduces mortality, and must be done along period between 50 and 70 years old with a two-year interval. CRC mortality is reduced by 16% due to early detection test based on fecal occult blood (TsOH), but it's necessary to insist on changes in lifestyle (diet and exercise) as primary prevention strategies, and in breast cancer too. One of the most effective ways to reduce the impact of cancer today is the prevention, which is carried out mainly by the nurses. PMID:22558714

  19. Immunotherapy and therapeutic vaccines in prostate cancer:an update on current strategies and clinical implications

    Institute of Scientific and Technical Information of China (English)

    B Harpreet Singh; James L Gulley

    2014-01-01

    In recent years, immunotherapy has emerged as a viable and attractive strategy for the treatment of prostate cancer. While there are multiple ways to target the immune system, therapeutic cancer vaccines and immune checkpoint inhibitors have been most successful in late-stage clinical trials. The landmark Food and Drug Administration approval of sipuleucel-T for asymptomatic or minimally symptomatic metastatic prostate cancer set the stage for ongoing phase III trials with the cancer vaccine PSA-TRICOM and the immune checkpoint inhibitor ipilimumab. A common feature of these immune-based therapies is the appearance of improved overall survival without short-term changes in disease progression. This class effect appears to be due to modulation of tumor growth rate kinetics, in which the activated immune system exerts constant immunologic pressure that slows net tumor growth. Emerging data suggest that the ideal population for clinical trials of cancer vaccines is patients with lower tumor volume and less aggressive disease. Combination strategies that combine immunotherapy with standard therapies have been shown to augment both immune response and clinical beneift.

  20. Geriatric assessment with management in cancer care: Current evidence and potential mechanisms for future research.

    Science.gov (United States)

    Magnuson, Allison; Allore, Heather; Cohen, Harvey Jay; Mohile, Supriya G; Williams, Grant R; Chapman, Andrew; Extermann, Martine; Olin, Rebecca L; Targia, Valerie; Mackenzie, Amy; Holmes, Holly M; Hurria, Arti

    2016-07-01

    Older adults with cancer represent a complex patient population. Geriatric assessment (GA) is recommended to evaluate the medical and supportive care needs of this group. "GA with management" is a term encompassing the resultant medical decisions and interventions implemented in response to vulnerabilities identified on GA. In older, non-cancer patients, GA with management has been shown to improve a variety of outcomes, such as reducing functional decline and health care utilization. However, the role of GA with management in the older adult with cancer is less well established. Rigorous clinical trials of GA with management are necessary to develop an evidence base and support its use in the routine oncology care of older adults. At the recent U-13 conference, "Design and Implementation of Intervention Studies to Improve or Maintain Quality of Survivorship in Older and/or Frail Adults with Cancer," a session was dedicated to developing research priorities in GA with management. Here we summarize identified knowledge gaps in GA with management studies for older patients with cancer and propose areas for future research. PMID:27197915